High Negative Predictive Value of FDG-PET/CT in Assessment of Tumor Response Following RT of SCCHN

Abstract BACKGROUND Whole body diffusion weighted imaging (WB-DWI) is commonly used for the detection of multiple myeloma (MM). Comparative data on the efficiency of WB-DWI compared with 18 F positron emission tomography computed tomography ( 18 F-FDG PET/CT) to detect MM are lacking. METHODS This was a retrospective, single-center study of twenty-two patients with MM enrolled from January 2019 to December 2019. All patients underwent WB-DWI and 18 F-FDG PET/CT. Pathological and clinical manifestations as well as radiologic follow-up were used for diagnosis. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value of both methods were compared. The appearance diffusion coefficient (ADC) values of MM lesions and false-positive lesions were estimated. RESULTS A total of 214 MM bone lesions were evaluated. WB-DWI showed a higher overall accuracy than PET/CT (75.7% and 55.6%, respectively; < 0.05). However, for sensitivity, specificity, positive predictive value and negative predictive value, there were no significant differences for WB-DWI vs PET/CT (99.3% and 83.9%, 64.9% and 94.8%, 63.6% and 54.2%, 98.1% and 65.3%, respectively). The ADC value for MM lesions was significantly lower than that for false-positive lesions (p < 0.001). Receiver operating curve (ROC) curve analysis showed that the AUC was 0.846, and when the cut-off value was 0.745×10 -3 mm 2 /s, the sensitivity and specificity were 86.0% and 82.4%, respectively, which distinguished MM lesions from non-MM lesions. CONCLUSION WB-DWI may be a useful tool for the diagnosis of MM bone disease due to to higher overall accuracy and measurements of ADC values compared with PET/CT.

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Negative Predictive Value of NI-RADS Category 2 in the First Posttreatment FDG-PET/CT in Head and Neck Squamous Cell Carcinoma

American Journal of Neuroradiology ◽

10.3174/ajnr.a5767 ◽

2018 ◽

Vol 39 (10) ◽

pp. 1884-1888 ◽

Cited By ~ 12

Author(s):

P. Wangaryattawanich ◽

B.F. Branstetter ◽

M. Hughes ◽

D.A. Clump ◽

D.E. Heron ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Negative Predictive Value ◽

Squamous Cell ◽

Predictive Value ◽

Fdg Pet ◽

Neck Squamous Cell Carcinoma ◽

Pet Ct ◽

Fdg Pet Ct

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Negative predictive value of "split-dose" technique for FDG PET/CT-guided percutaneous ablation

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2013.12.497 ◽

2014 ◽

Vol 25 (3) ◽

pp. S184

Author(s):

E. Violari ◽

J.P. Erinjeri ◽

C.T. Sofocleous ◽

E.N. Petre ◽

R.H. Siegelbaum ◽

...

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Fdg Pet ◽

Percutaneous Ablation ◽

Ct Guided ◽

Split Dose ◽

Pet Ct ◽

Fdg Pet Ct

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The Role of 2-[18F]-FDG PET/CT in Detecting Richter Transformation in Chronic Lymphocytic Leukemia: A Systematic Review

Radiation ◽

10.3390/radiation1010006 ◽

2021 ◽

Vol 1 (1) ◽

pp. 65-76

Author(s):

Domenico Albano ◽

Francesco Bertagna ◽

Francesco Dondi ◽

Salvatore Annunziata ◽

Luca Ceriani ◽

...

Keyword(s):

Systematic Review ◽

Chronic Lymphocytic Leukemia ◽

Negative Predictive Value ◽

Predictive Value ◽

Fdg Pet ◽

Lymphocytic Leukemia ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Richter transformation (RT) is a condition wherein B cell chronic lymphocytic leukemia (CLL) transforms into a more aggressive lymphoma variant. The incidence and the significance of RT detected by 2-[18F]-FDG PET/CT is a clinical challenge and it is not widely investigated in the literature. The aim of this systematic review was to analyze published data about the potential role of 2-[18F]-FDG PET/CT in detecting RT. A comprehensive computer literature search of the PubMed/MEDLINE, Embase and Cochrane library databases was conducted up to December 2020. Thirteen studies (1336 patients with CLL) were selected. The maximum standardized uptake value (SUVmax) was the most common metabolic parameter used to detect RT. An SUVmax of 5 had an average overall sensitivity of 87% (range: 71–96%), an average overall specificity of 49% (range: 4–80%), an average positive predictive value of 41% (range: 16–53%) and an average negative predictive value of 84% (range: 33–97%). Other metabolic variables were only marginally investigated, with promising results. 2-[18F]-FDG PET/CT imaging may play an important role in the detection of RT in CLL, based on the high metabolic activity of the nodal lesions that transformed into aggressive lymphomas. 2-[18F]-FDG PET/CT has high negative predictive value for evaluating RT.

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The negative predictive value (NPV) of FDG-PET/CT in the Head and Neck Squamous Cell Carcinoma (HNSCC) N0 patient, the first report of the ACRIN 6685 trial.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.6041 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 6041-6041 ◽

Cited By ~ 3

Author(s):

Brendan C. Stack ◽

Fenghai Duan ◽

JoRean Sicks ◽

Justin Romanoff ◽

Adam Opanowski ◽

...

Keyword(s):

Head And Neck ◽

Neck Dissection ◽

Negative Predictive Value ◽

Predictive Value ◽

Fdg Pet ◽

Ct Scans ◽

Elective Neck Dissection ◽

Nonparametric Bootstrap ◽

Pet Ct ◽

Fdg Pet Ct

6041 Background: This study evaluated the negative predictive value for node negativity in HNSCC. Methods: Patients were enrolled from 8/10 until 12/16 from 38 centers in the US and 1 center in China. This was a prospective, non-randomized trial. The study was designed to recruit 292 patients; however, 287 were enrolled by study closure. Inclusion criteria were newly diagnosed cT2-T4 SCC patients from the head and neck with one side cN0 who were willing to undergo an elective neck dissection. CN0 was determined by a negative neck CT or MR scan. Exclusions included non-SCC, non-surgical candidates, skin, nasopharynx or sinus primaries. PET/CT imaging reading performed centrally and pathology were analyzed at the neck level (left or right). To estimate confidence intervals, we used a nonparametric bootstrap to account for the correlation of data between sides of neck of the same patient. Correlative data and other image analyses will be reported separately. Results: PET/CT scans and pathology were available for 211 (table) N0 sides of neck for review at last interim analysis. NPV estimate with 95% CI for bilateral necks: 0.896 (0.831, 0.950) and specific to the N0 sides: 0.922 (0.862, 0.973). Conclusions: FDG PET/CT has high NPV for node negativity in HNSCC. This may obviate the need for elective neck dissection in N0 HNSCC patients. This trial was open about three times longer than planned, and a major obstacle to accrual was the generalized assumption among the oncology community that PET/CT had a high NPV. Therefore, patients sent to study centers for further diagnosis and treatment often had their PET/CT scans performed on non-ACRIN certified equipment. This required investigators to forgo offering the trial or the PET/CT was repeated. Our results may suggest application for pre-operative PET/CT nodal imaging of other primaries/lymphatic basins staged cN0. Funding from the National Cancer Institute through the grants U01 CA079778, U01 CA080098, CA180820, CA180794. Clinical trial information: NCT00983697. [Table: see text]

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FDG-PET in Hodgkin lymphoma

Nuklearmedizin ◽

10.3413/nukmed-0216 ◽

2008 ◽

Vol 47 (06) ◽

pp. 235-238 ◽

Cited By ~ 12

Author(s):

M. Dietlein ◽

C. Mauz-Körholz ◽

A. Engert ◽

P. Borchmann ◽

O. Sabri ◽

...

Keyword(s):

Hodgkin Lymphoma ◽

Negative Predictive Value ◽

Predictive Value ◽

Fdg Pet ◽

Study Groups ◽

Therapy Control ◽

German Study ◽

High Negative Predictive Value ◽

Consolidation Radiotherapy

SummaryThe high negative predictive value of FDG-PET in therapy control of Hodgkin lymphoma is proven by the data acquired up to now. Thus, the analysis of the HD15 trial has shown that consolidation radiotherapy might be omitted in PET negative patients after effective chemotherapy. Further response adapted therapy guided by PET seems to be a promising approach in reducing the toxicity for patients undergoing chemotherapy. The criteria used for the PET interpretation have been standardized by the German study groups for Hodgkin lymphoma patients and will be reevaluated in the current studies.

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Advantages of 18F-FDG PET/CT Imaging over Modified Duke Criteria and Clinical Presumption in Patients with Challenging Suspicion of Infective Endocarditis

Diagnostics ◽

10.3390/diagnostics11040720 ◽

2021 ◽

Vol 11 (4) ◽

pp. 720

Author(s):

Valentin Pretet ◽

Cyrille Blondet ◽

Yvon Ruch ◽

Matias Martinez ◽

Soraya El Ghannudi ◽

...

Keyword(s):

Infective Endocarditis ◽

Predictive Value ◽

Fdg Pet ◽

Clinical Suspicion ◽

Duke Criteria ◽

High Clinical Suspicion ◽

Pet Ct ◽

18F Fdg ◽

Sensitivity Specificity ◽

Fdg Pet Ct

According to European Society of Cardiology guidelines (ESC2015) for infective endocarditis (IE) management, modified Duke criteria (mDC) are implemented with a degree of clinical suspicion degree, leading to grades such as “possible” or “rejected” IE despite a persisting high level of clinical suspicion. Herein, we evaluate the 18F-FDG PET/CT diagnostic and therapeutic impact in IE suspicion, with emphasis on possible/rejected IE with a high clinical suspicion. Excluding cases of definite IE diagnosis, 53 patients who underwent 18F-FDG PET/CT for IE suspicion were selected and afterwards classified according to both mDC (possible IE/Duke 1, rejected IE/Duke 0) and clinical suspicion degree (high and low IE suspicion). The final status regarding IE diagnosis (gold standard) was based on the multidisciplinary decision of the Endocarditis Team, including the ‘imaging specialist’. PET/CT images of the cardiac area were qualitatively interpreted and the intensity of each focus of extra-physiologic 18F-FDG uptake was evaluated by a maximum standardized uptake value (SUVmax) measurement. Extra-cardiac 18F-FDG PET/CT pathological findings were considered to be a possible embolic event, a possible source of IE, or even a concomitant infection. Based on the Endocarditis Team consensus, final diagnosis of IE was retained in 19 (36%) patients and excluded in 34 (64%). With a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and global accuracy of 79%, 100%, 100%, 89%, and 92%, respectively, PET/CT performed significantly better than mDC (p = 0.003), clinical suspicion degree (p = 0.001), and a combination of both (p = 0.001) for IE diagnosis. In 41 patients with possible/rejected IE but high clinical suspicion, sensitivity, specificity, PPV, NPV, and global accuracies were 78%, 100%, 100%, 85%, and 90%, respectively. Moreover, PET/CT contributed to patient management in 24 out of 53 (45%) cases. 18F-FDG PET/CT represents a valuable diagnostic tool that could be proposed for challenging IE cases with significant differences between mDC and clinical suspicion degree. 18F-FDG PET/CT allows a binary diagnosis (definite or rejected IE) by removing uncertain diagnostic situations, thus improving patient therapeutic management.

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FDG PET/CT to detect bone marrow involvement in the initial staging of patients with aggressive non-Hodgkin lymphoma: results from the prospective, multicenter PETAL and OPTIMAL>60 trials

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05348-6 ◽

2021 ◽

Author(s):

Dominic Kaddu-Mulindwa ◽

Bettina Altmann ◽

Gerhard Held ◽

Stephanie Angel ◽

Stephan Stilgenbauer ◽

...

Keyword(s):

Bone Marrow ◽

B Cell ◽

Hodgkin Lymphoma ◽

Predictive Value ◽

Fdg Pet ◽

Bone Marrow Involvement ◽

Non Hodgkin Lymphoma ◽

Pet Ct ◽

Fdg Pet Ct ◽

Initial Staging

Abstract Purpose Fluorine-18 fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG PET/CT) is the standard for staging aggressive non-Hodgkin lymphoma (NHL). Limited data from prospective studies is available to determine whether initial staging by FDG PET/CT provides treatment-relevant information of bone marrow (BM) involvement (BMI) and thus could spare BM biopsy (BMB). Methods Patients from PETAL (NCT00554164) and OPTIMAL>60 (NCT01478542) with aggressive B-cell NHL initially staged by FDG PET/CT and BMB were included in this pooled analysis. The reference standard to confirm BMI included a positive BMB and/or FDG PET/CT confirmed by targeted biopsy, complementary imaging (CT or magnetic resonance imaging), or concurrent disappearance of focal FDG-avid BM lesions with other lymphoma manifestations during immunochemotherapy. Results Among 930 patients, BMI was detected by BMB in 85 (prevalence 9%) and by FDG PET/CT in 185 (20%) cases, for a total of 221 cases (24%). All 185 PET-positive cases were true positive, and 709 of 745 PET-negative cases were true negative. For BMB and FDG PET/CT, sensitivity was 38% (95% confidence interval [CI]: 32–45%) and 84% (CI: 78–88%), specificity 100% (CI: 99–100%) and 100% (CI: 99–100%), positive predictive value 100% (CI: 96–100%) and 100% (CI: 98–100%), and negative predictive value 84% (CI: 81–86%) and 95% (CI: 93–97%), respectively. In all of the 36 PET-negative cases with confirmed BMI patients had other adverse factors according to IPI that precluded a change of standard treatment. Thus, the BMB would not have influenced the patient management. Conclusion In patients with aggressive B-cell NHL, routine BMB provides no critical staging information compared to FDG PET/CT and could therefore be omitted. Trial registration NCT00554164 and NCT01478542

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