scholarly journals Gallbladder cancer detected by elevated serum KL-6 levels during the follow-up of interstitial pneumonia: a case report

2021 ◽  
Author(s):  
Yoshikuni Yonenaga ◽  
Manabu Kurosawa ◽  
Shunichi Higashide
Keyword(s):  
Gallbladder Cancer ◽  
Cancer Cells ◽  
Interstitial Pneumonia ◽  
Malignant Tumors ◽  
Elevated Serum ◽  
Serum Levels ◽  
Whole Body ◽  
Positron Emission ◽  
Enhanced Computed Tomography

AbstractSerum Krebs von den Lungen-6 (KL-6) is clinically used for the diagnosis of interstitial pneumonia (IP) as well as the evaluation of its disease activity. A female patient was diagnosed with idiopathic IP when she was 62 years old. Four years later, serum levels of KL-6 had been elevated gradually from 2400–3821 U/ml, and she was found to have gallbladder cancer detected by contrast-enhanced computed tomography (CT) and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT. She thus underwent a radical extended cholecystectomy. After the operation, serum levels of KL-6 showed a steep decline to 590 U/ml. Immunohistological examination revealed that KL-6 presented in gallbladder cancer cells. Taken together, serum KL-6 was shown to be produced by gallbladder cancer cells. Here, we present the first patient in whom increased serum KL-6 levels led to the diagnosis of gallbladder cancer during follow-up of IP. When serum levels of KL-6 are elevated during the follow-up care of IP despite no worsening of IP, an examination of the whole body should be performed to find possibly existing malignant tumors.

Incidence and Economic Impact of Incidental Findings on 18F-FDG PET/CT Imaging

2018 ◽  
Vol 69 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Scott J. Adams ◽  
Rajan Rakheja ◽  
Rhonda Bryce ◽  
Paul S. Babyn
Keyword(s):  
Incidental Findings ◽  
Incidental Finding ◽  
Ct Imaging ◽  
Whole Body ◽  
Ontario Health Insurance Plan ◽  
Positron Emission ◽  
Pet Ct ◽  
Picture Archiving And Communication ◽  
Fdg Pet Ct

Purpose The study sought to determine the incidence of incidental findings on whole-body positron emission tomography with computed tomography (PET/CT) imaging and the average costs of investigations to follow-up or further characterize incidental findings. Methods Imaging reports of 215 patients who underwent whole-body PET/CT imaging were retrospectively reviewed. Our provincial picture archiving and communication system was queried and patient charts were reviewed to identify all investigations performed to follow-up incidental findings within 1 year of the initial PET/CT study. Costs of follow-up imaging studies (professional and technical components) and other diagnostic tests and procedures were determined in Canadian dollars (CAD) and U.S. dollars (USD) using the 2015 Ontario Health Insurance Plan Schedule of Benefits and Fees and 2016 U.S. Medicare Physician Fee Schedule, respectively. Results At least 1 incidental finding was reported in 161 reports (74.9%). The mean number of incidental findings ranged from 0.64 in patients <45 years of age to 2.2 in patients 75 years of age and older. Seventy-five recommendations for additional investigations were made for 64 (30%) patients undergoing PET/CT imaging, and 14 of those were carried out specifically to follow-up incidental findings. Averaged across all 215 patients, the total cost of investigations recommended to follow-up incidental findings was CAD$105.51 (USD$127.56) per PET/CT study if all recommendations were acted on, and CAD$22.77 (USD$29.14) based on investigations actually performed. Conclusions As the incidence of incidental findings increases with age and a larger proportion of elderly patients is expected as population demographics change, it will be increasingly important to consider incidental findings on PET/CT imaging with standardized approaches to follow-up.

scholarly journals Early detection of relapse by whole-body positron emission tomography in the follow-up of patients with Hodgkin’s disease

2003 ◽  
Vol 14 (1) ◽  
pp. 123-130 ◽  
Author(s):  
G. Jerusalem ◽  
Y. Beguin ◽  
M.F. Fassotte ◽  
T. Belhocine ◽  
R. Hustinx ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Early Detection ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Emission Tomography ◽  
Whole Body ◽  
Positron Emission

scholarly journals Whole body positron emission tomography in follow-up of high risk melanoma

2007 ◽  
Vol 46 (5) ◽  
pp. 685-690 ◽  
Author(s):  
Ilkka O. Koskivuo ◽  
Marko P. Seppänen ◽  
Erkki A. Suominen ◽  
Heikki R. I. Minn
Keyword(s):  
Positron Emission Tomography ◽  
High Risk ◽  
Emission Tomography ◽  
Whole Body ◽  
High Risk Melanoma ◽  
Positron Emission ◽  
Risk Melanoma

scholarly journals Molecular Imaging in Breast Cancer: From Whole-Body PET/CT to Dedicated Breast PET

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
B. B. Koolen ◽  
W. V. Vogel ◽  
M. J. T. F. D. Vrancken Peeters ◽  
C. E. Loo ◽  
E. J. Th. Rutgers ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Malignant Tumors ◽  
Volume Effect ◽  
Whole Body ◽  
Response Monitoring ◽  
Breast Cancer Patients ◽  
Dedicated Breast Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Elevated Glucose

Positron emission tomography (PET), with or without integrated computed tomography (CT), using 18F-fluorodeoxyglucose (FDG) is based on the principle of elevated glucose metabolism in malignant tumors, and its use in breast cancer patients is frequently being investigated. It has been shown useful for classification, staging, and response monitoring, both in primary and recurrent disease. However, because of the partial volume effect and limited resolution of most whole-body PET scanners, sensitivity for the visualization of small tumors is generally low. To improve the detection and quantification of primary breast tumors with FDG PET, several dedicated breast PET devices have been developed. In this nonsystematic review, we shortly summarize the value of whole-body PET/CT in breast cancer and provide an overview of currently available dedicated breast PETs.

scholarly journals IMAGING IN ENDOCRINOLOGY: 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up

2015 ◽  
Vol 173 (3) ◽  
pp. R115-R130 ◽  
Author(s):  
Massimo Salvatori ◽  
Bernadette Biondi ◽  
Vittoria Rufini
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Whole Body ◽  
Clinical Indications ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

In recent years, 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) has emerged as an important tool for the postoperative management of patients with differentiated thyroid cancer (DTC) and it is widely used in selected clinical situations. The most valuable role that FDG-PET/CT plays in clinical practice is that it can be used to obtain prognostic information in patients with increasing thyroglobulin (Tg) levels and negative 131I whole-body scan post-thyroidectomy and radioiodine (RAI) ablation. FDG-PET/CT may also have a potential role in the initial staging and follow-up of high-risk patients with aggressive histological subtypes, in the identification of patients who are at the highest risk of disease-specific mortality, in the management of patients with RAI-refractory disease, in clinical trials of novel targeted therapies in patients with advanced metastatic disease, and in the evaluation of thyroid nodules with indeterminate fine-needle aspiration for cytology. However, several controversies remain to be resolved, namely: the cutoff value of Tg in the selection of DTC patients for FDG-PET/CT, whether FDG-PET/CT scanning should be performed under thyrotropin stimulation or suppression, and the clinical significance of thyroid FDG-PET/CT incidentalomas. The aim of the present article is to provide an overview of the data about the molecular basis for, clinical indications of, and controversies related to the use of FDG-PET/CT in patients with DTC.

Positron Emission Tomography for Staging of Pediatric Sarcoma Patients: Results of a Prospective Multicenter Trial

2007 ◽  
Vol 25 (34) ◽  
pp. 5435-5441 ◽  
Author(s):  
Thomas Völker ◽  
Timm Denecke ◽  
Ingo Steffen ◽  
Daniel Misch ◽  
Stefan Schönberger ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Tumor Board ◽  
Whole Body ◽  
Therapy Planning ◽  
Positron Emission ◽  
Pediatric Sarcoma ◽  
The Impact

Purpose The objective of this study was to evaluate the impact of positron emission tomography (PET) using fluorine-18–fluorodeoxyglucose (FDG) for initial staging and therapy planning in pediatric sarcoma patients. Patients and Methods In this prospective multicenter study, 46 pediatric patients (females, n = 22; males, n = 24; age range, 1 to 18 years) with histologically proven sarcoma (Ewing sarcoma family tumors, n = 23; osteosarcoma, n = 11; rhabdomyosarcoma, n = 12) were examined with conventional imaging modalities (CIMs), including ultrasound, computed tomography (CT), magnetic resonance imaging, and bone scintigraphy according to the standardized algorithms of the international therapy optimization trials, and whole-body FDG-PET. A lesion- and patient-based analysis of PET alone and CIMs alone and a side-by-side (SBS) analysis of FDG-PET and CIMs were performed. The standard of reference consisted of all imaging material, follow-up data (mean follow-up time, 24 ± 12 months), and histopathology and was determined by an interdisciplinary tumor board. Results FDG-PET and CIMs were equally effective in the detection of primary tumors (accuracy, 100%). PET was superior to CIMs concerning the correct detection of lymph node involvement (sensitivity, 95% v 25%, respectively) and bone manifestations (sensitivity, 90% v 57%, respectively), whereas CT was more reliable than FDG-PET in depicting lung metastases (sensitivity, 100% v 25%, respectively). The patient-based analysis revealed the best results for SBS, with 91% correct therapy decisions. This was significantly superior to CIMs (59%; P < .001). Conclusion In staging pediatric sarcoma, subsidiary FDG-PET scanning depicts important additional information and has a relevant impact on therapy planning when analyzed side-by-side with CIMs.

scholarly journals Combined method for differential diagnosis of pancreatic cystic neoplasm

2019 ◽  
Vol 17 (6) ◽  
pp. 27-34
Author(s):  
A. P. Koshel ◽  
E. S. Drozdov ◽  
T. N. Dibina ◽  
S. S. Klokov ◽  
E. B. Mironova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Malignant Tumors ◽  
Statistical Significance ◽  
Serum Levels ◽  
Cystic Neoplasm ◽  
Combined Method ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Sensitivity Specificity ◽  
Diagnostic Criterion

Objective. The frequency of detection of cystic neoplasm of the pancreas (CNP) has recently increased. Some of these neoplasms are benign, while others are malignant. Differential diagnosis between benign and malignant CNP remains challenging.Aim: to develop a combined method for differential diagnosis of CNP and to evaluate the role of the neutrophil to leukocyte ratio (NLR) as a diagnostic criterion of malignant CNP.Material and Methods. A retrospective analysis of the treatment of 82 patients with CNP, who underwent surgery between 2008 and 2018, was carried out. Benign lesions were detected in 62 patients and malignant tumors were diagnosed in 20 patients. The NLR and the serum levels of CA 19-9 as well as the presence of intracystic lesions were assessed as predictors of malignant CNP.Results. The presence of intracystic lesions detected by contrast-enhanced computed tomography and the elevated levels of serum CA 19-9 (>39 U/mL) and NLI (>1.876) were proven to be independent predictors of malignant CNP with statistical significance. The combination of all three criteria indicated malignant cystic neoplasm. The sensitivity, specificity and overall accuracy of the combined method were 71.4 %, 95.6 % and 86.5%, respectively.Conclusions. The combined method for differential diagnosis of malignant CNP is easy to use and has high accuracy. There is a direct correlation between NLI and malignant CNP.

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