Impact of F-18 Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography on Oncologic Patient Management: First 2 Years' Experience at a Single Canadian Cancer Center

2010 ◽  
Vol 61 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Daniel F. Worsley ◽  
Don C. Wilson ◽  
John E. Powe ◽  
Francois Benard
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Positron Emission Tomography ◽  
Patient Management ◽  
Treatment Decision ◽  
Emission Tomography ◽  
Cancer Center ◽  
Positron Emission ◽  
Pet Ct ◽  
Oncology Center

Purpose The purpose of this study was to assess the influence of positron emission tomography–computed tomography (PET-CT) results on patient management from a single Canadian oncology center during its first 2 years of operation. Methods A total of 3,779 consecutive patients, 18 years of age and older, who were referred for PET-CT imaging at the British Columbia Cancer Agency between July 1, 2005 and June 30, 2007, were included in this analysis. Results were tabulated from a standard questionnaire, which was given to referring physicians following completion of their patient's PET-CT study. Results From July 1, 2005 to June 30, 2007, 3,779 consecutive fluoro-2-deoxyglucose PET-CT examinations were performed in patients aged 18 years or older. A total of 3,429 referring-physician surveys (90.7%) were returned. The results of the PET-CT study resulted in a change in treatment decision in 49.8% of the studies and resulted in improved decision making in 83.2% of the studies. Conclusion This series demonstrated that the results from PET-CT studies performed at a single Canadian oncology center during the first 2 years of its operation altered patient management in 50% of cases and resulted in improved decision making in the majority of cases.

Clinical Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Upper Tract Urothelial Carcinoma: Impact on Detection of Metastases and Patient Management

2015 ◽  
Vol 96 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Hajime Tanaka ◽  
Soichiro Yoshida ◽  
Yoshinobu Komai ◽  
Yasuyuki Sakai ◽  
Shinji Urakami ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Diagnostic Accuracy ◽  
Urothelial Carcinoma ◽  
Patient Management ◽  
Upper Tract Urothelial Carcinoma ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg

Objective: To determine the diagnostic accuracy of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting metastasis and its impact on patient management with upper tract urothelial carcinoma (UTUC). Patients and Methods: Consecutive patients with UTUC underwent 18F-FDG PET/CT after CT for initial staging (n = 47) and for restaging at recurrence (n = 9). Diagnostic accuracy for detecting metastases with PET/CT and CT was compared statistically. The impact of PET/CT on patient management was assessed by comparing questionnaires that were completed by the attending physicians before and after PET/CT. Results: In the lesion-based analysis, 142 lesions were diagnosed as metastases. The sensitivity of PET/CT was significantly better than that of CT (85 vs. 50%, p = 0.0001). In the patient-based analysis, 22 patients were diagnosed as having metastases. The sensitivity/specificity/accuracy of PET/CT tended to be superior to those of CT, but these values were not significantly different (95, 91, and 93% vs. 82, 85, and 84%; p = 0.25, 0.50, and 0.063, respectively). The clinicians changed their assessments of disease extent and management plans in 18 (32%) and 11 (20%) patients, respectively, based on the PET/CT results. Conclusions: The diagnostic accuracy of PET/CT for detecting metastasis was superior to that of CT. PET/CT provided additional information to the CT-based staging, which had an impact on patient management.

The Potential Value of Hybrid Positron Emission Tomography/Dual-Source Computed Tomography Imaging in Coronary Bypass Surgery

2011 ◽  
Vol 14 (5) ◽  
pp. 283 ◽  
Author(s):  
Andre Plass ◽  
Maximilian Y. Emmert ◽  
Oliver Gaemperli ◽  
Hatem Alkadhi ◽  
Philipp Kaufmann ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Myocardial Perfusion ◽  
Predictive Value ◽  
Bypass Surgery ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct

<p><b>Background:</b> We evaluated how comprehensive assessment of coronary artery lesions and their hemodynamic relevance by means of hybrid positron emission tomography (PET) and computed tomography (CT) imaging would affect decision-making in coronary artery bypass surgery (CABG), compared with using invasive coronary angiography (ICA) alone.</p><p><b>Methods:</b> After undergoing ICA, 27 patients (21 men and 6 women; mean SD age, 66 � 10 years) planned for cardiac surgery were scheduled for myocardial perfusion stress/rest evaluation with [13N]ammonia PET and CT coronary angiography. Only ICA was available to the surgeon. Postoperatively, the performed CABG was compared with the hypothetical strategy based on hybrid PET/CT findings (regional coronary flow reserve [CFR], myocardial perfusion defects). Procedures included CABG (n = 18) alone, CABG combined with valve replacement (n = 6), and CABG combined with isolated valve replacement (n = 3). A total of 56 bypass grafts (28 venous and 28 arterial) and 66 distal anastomoses were placed.</p><p><b>Results:</b> CT evaluation showed 93% concordance (66/71) with ICA regarding significant stenoses, with sensitivity, specificity, positive predictive value, and negative predictive value of 93.1%, 98.7%, 94.4%, and 98.4%, respectively. In the PET scan, 16 patients had 1 ischemic region, and 12 patients had 1 scar region, including 5 patients who presented with mixed conditions (scar and ischemia). One patient had a completely normal myocardium. Compared with the performed surgery, PET/CT fusion evaluation showed that of the performed anastomoses, 48% had documented ischemia (with a CFR <2 in 86%), 38% were nonischemic (although a CFR value <2 was found in 78%), and 14% had scar tissue (fixed perfusion defect).</p><p><b>Conclusions:</b> Although <50% of bypasses were placed to areas with myocardial ischemia, the CFR was low in the majority of nonischemic regions, a finding that may have important prognostic relevance. PET/CT fusion imaging could potentially influence planning for CABG and provide incremental prognostic information.</p>

scholarly journals 18F-Fluciclovine Positron Emission Tomography in Prostate Cancer: A Systematic Review and Diagnostic Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 304
Author(s):  
Giuseppina Biscontini ◽  
Cinzia Romagnolo ◽  
Chiara Cottignoli ◽  
Andrea Palucci ◽  
Fabio Massimo Fringuelli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Meta Analysis ◽  
False Negative ◽  
Final Analysis ◽  
Emission Tomography ◽  
True Negative ◽  
Positron Emission ◽  
Pet Ct

Background: to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical therapy, biochemical recurrence, and advanced setting. Methods: A systematic web search through Embase and Medline was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies performed from 2011 to 2020 were evaluated. The terms used were “PET” or “positron emission tomography” or “positron emission tomography/computed tomography” or “PET/CT” or “positron emission tomography-computed tomography” or “PET-CT” and “Fluciclovine” or “FACBC” and “prostatic neoplasms” or “prostate cancer” or “prostate carcinoma”. Only studies reporting about true positive (TP), true negative (TN), false positive (FP) and false negative (FN) findings of 18F-fluciclovine PET were considered eligible. Results: Fifteen out of 283 studies, and 697 patients, were included in the final analysis. The pooled sensitivity for 18F-Fluciclovine PET/CT for diagnosis of primary PCa was 0.83 (95% CI: 0.80–0.86), the specificity of 0.77 (95% CI: 0.74–0.80). The pooled sensitivity for preoperative LN staging was 0.57 (95% CI: 0.39–0.73) and specificity of 0.99 (95% CI: 0.94–1.00). The pooled sensitivity for the overall detection of recurrence in relapsed patients was 0.68 (95% CI: 0.63–0.73), and specificity of 0.68 (95% CI: 0.60–0.75). Conclusion: This meta-analysis showed promising results in term of sensitivity and specificity for 18F-Fluciclovine PET/CT to stage the primary lesion and in the assessment of nodal metastases, and for the detection of PCa locations in the recurrent setting. However, the limited number of studies and the broad heterogeneity in the selected cohorts and in different investigation protocols are limitation affecting the strength of these results.

scholarly journals Additive value of positron emission tomography/computed tomography scan for detection of aortic tube graft infection: a case report

2020 ◽  
Author(s):  
Farnoosh Larti ◽  
Mohammad Amin Khadembashiri ◽  
Mehrshad Abbasi ◽  
Alborz Sherafati
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Graft Infection ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
History Of ◽  
Pet Ct Scan

Abstract Background Diagnosis of aortic graft infection is challenging, and delayed diagnosis is associated with poor prognosis. Positron emission tomography/computed tomography (PET/CT) has improved diagnostic accuracy. Case summary A patient with a history of congenital heart disease was admitted due to fever. He had a history of four cardiac surgeries, including the Bentall procedure for endocarditis. Blood cultures were negative. A semi-mobile mass was detected in the distal portion of the aortic tube graft in echocardiography. PET/CT scan was used to confirm tube graft infection and to support proceeding to cardiac surgery. Discussion Using multimodality imaging, including PET/CT scan in combination with echocardiography, can improve diagnostic accuracy for the detection of aortic tube graft infection, infection of prosthetic valves, or intra-cardiac devices, especially in high-risk surgical cases.

POSITRON EMISSION TOMOGRAPHY WITH 18F -FDG IN THE DIAGNOSIS OF PROSTHETIC HEART VALVE ENDOCARDITIS

2021 ◽  
Vol 5 (1) ◽  
pp. 1151-1160
Author(s):  
A.S. Lukashevich ◽  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Prosthetic Heart Valve ◽  
Emission Tomography ◽  
Whole Body ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Purpose. The purpose of the article is to evaluate the diagnostic significance of positron emission tomography / computed tomography with 18F -fluorodeoxyglucose (18F -FDG PET/CT) for the diagnosis of prosthetic endocarditis. Methods of research. The study included 82 patients with suspected prosthetic endocarditis in accordance with the criteria proposed by Duke University [1-5]. The patients received hospital treatment at the State Institution RSPC "Cardiology" from January 2016 to March 2021. The study was of a prospective, non-randomized, single-center cohort design. The duration of the monitor period was 12 months from the moment of patients’ inclusion in the study. Whole-body positron emission tomography / computed tomography (PET/CT) examinations were performed in 82 patients. 27 patients were selected for surgical treatment. Conservative treatment group included 16 patients. 27 patients were selected into the observation group, they were suspected to have prosthetic heart valve infection in the primary referral and underwent PET/CT scanning, according to which the diagnosis of prosthetic endocarditis was excluded. The event under the study did not develop in this group during the year of observation. Results and conclusion. The history of infective endocarditis was not statistically significant and did not increase the risk of developing prosthetic endocarditis in the sample presented. The Duke criteria are less reliable in establishing the diagnosis of prosthetic endocarditis. The median number of days from the date of the first prosthesis implantation to the onset of prosthetic endocarditis was about 4 years. This study revealed that the development of the infectious process in the area of the prosthesis was noted in a more distant postoperative period compared to literature data. Histological confirmation of infection was noted in 100% (27 patients) of cases in reoperated patients. The presence of a more formidable complication such as valve ring abscess located mainly in the projection of the aortic valve ring was quite common in both groups. Presepsin and Interleukin-6 have a statistically significant (U = 394,50 p = 0,01 and U = 94,50 p = 0.004) value in the prognosis of prosthetic endocarditis. Considering the data obtained from ROC analysis, it can be said that the cut-off point at which it is possible to diagnose prosthetic endocarditis based on PETCT is 2.85. The presented methods for the interpretation of whole-body FDG-PET/CT images of patients with suspected infectious complications after cardiac surgery, as well as with the presence of prosthetic endocarditis, show high sensitivity and specificity.

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