Fluorodeoxyglucose-Positive Warthin Tumor in a Neck Node Mimicking Metastasis in Primary Intraosseous Left Posterior Mandibular Cancer Staging With Positron Emission Tomography/Computed Tomography

Purpose Under Medicare's Coverage with Evidence Development policy, positron emission tomography (PET)/computed tomography (CT) and PET became covered services for previously noncovered cancer indications if prospective registry data were collected. The National Oncologic PET Registry (NOPR) was developed to meet these coverage requirements and to assess how PET affects care decisions. Methods The NOPR collected questionnaire data from referring physicians on intended patient management before and after PET. After 1 year, the cohort included data from 22,975 studies (83.7% PET/CT) from 1,178 centers. The numbers of scans performed for diagnosis of suspected cancer (or unknown primary cancer), initial cancer staging, restaging, and suspected cancer recurrence were approximately equal. Prostatic, pancreatic and ovarian cancers represented approximately 30% of cases. Results If PET data were not available, the most common pre-PET plan would have been other imaging. In these patients, the post-PET strategies changed to watching in 37% and treatment in 48%. In patients with planned biopsy before PET, biopsy was avoided in approximately 70%. If the pre-PET strategy was treatment, the post-PET strategy involved a major change in type in 8.7% and goal in 5.6%. When intended management was classified as either treatment or nontreatment, the post-PET plan was three-fold more likely to lead to treatment than nontreatment (28.3% v 8.2%; odds ratio = 3.4; 95% CI, 3.2 to 3.6). Overall, physicians changed their intended management in 36.5% (95% CI, 35.9 to 37.2) of cases after PET. Conclusion This large, prospective, nationally representative registry of elderly cancer patients found that physicians often change their intended management on the basis of PET scan results across the full spectrum of its potential uses.

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Positron emission tomography/computed tomography for optimized colon cancer staging and follow-up.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.408 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 408-408

Author(s):

Bodil E. Engelmann ◽

Annika Loft ◽

Andreas Kjær ◽

Hans J. Nielsen ◽

Anne Kiil Berthelsen ◽

...

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Colon Cancer ◽

Cancer Staging ◽

Emission Tomography ◽

Positron Emission ◽

Pet Ct ◽

Primary Colon Cancer ◽

Primary Colon

408 Background: Optimal management of colon cancer requires detailed assessment of extent of disease. Diagnostic accuracy of 18F-fluorodeoxyglucose (FDG) positron emission tomography/ computed tomography (PET/CT) in primary colon cancer staging and for detection of recurrence was investigated. Methods: PET/CT for preoperative staging was performed on 66 prospectively included patients with primary colon cancer. Diagnostic accuracy for PET/CT and CT alone was analysed. Forty-two stage I-III colon cancer patients had PET/CT follow-up examinations every six months for two years. Serological levels of Tissue Inhibitor of Metalloproteinases (TIMP-1), Carcinoembryonic Antigen (CEA), and liberated domain I of urokinase Plasminogen Activator Receptor [uPAR(I)] and FDG-uptake related tumour gene expression were analysed. Results: Accuracy for T-, N- and M-staging by PET/CT were 82 % [95% Confidence Interval (CI) 70; 91], 66 % [CI 51; 78] and 89 % [CI 79; 96]; for CT 77 % [CI 64; 87], 60 % [CI 46; 73] and 69 % [CI 57; 80]. Cumulative relapse incidences for stage I – III colon cancer at 6, 12, 18 and 24 months were 7.1 % [CI 0; 14.9]; 14.3 % [CI 3.7; 24.9]; 19.0 % [CI 7.1; 30.9] and 21.4 % [CI 9.0; 33.8]. PET/CT diagnosed all relapses detected during the first two postoperative years. High preoperative TIMP-1 levels were associated with significant hazards towards both risk of recurrence and shorter overall survival. FDG-uptake in colon cancer showed significant correlation to hexokinase 2, the hypoxia marker carboanhydrase IX and the proliferation marker ki67. Conclusions: This study indicates PET/CT to be a valuable tool for staging and follow-up in colon cancer. TIMP-1 provided prognostic information potentially useful in selection of patients for intensive follow-up.

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New approaches to gastric cancer staging: Beyond endoscopic ultrasound, computed tomography and positron emission tomography

World Journal of Gastroenterology ◽

10.3748/wjg.v20.i38.13783 ◽

2014 ◽

Vol 20 (38) ◽

pp. 13783 ◽

Cited By ~ 17

Author(s):

Hyuk Yoon

Keyword(s):

Gastric Cancer ◽

Computed Tomography ◽

Positron Emission Tomography ◽

Endoscopic Ultrasound ◽

Cancer Staging ◽

Emission Tomography ◽

New Approaches ◽

Positron Emission ◽

Ultrasound Computed Tomography

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Whole Body Positron Emission Tomography/Computed Tomography Staging of Metastatic Choroidal Melanoma

Yearbook of Ophthalmology ◽

10.1016/s0084-392x(08)70177-1 ◽

2007 ◽

Vol 2007 ◽

pp. 223-224

Author(s):

C.L. Shields

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Choroidal Melanoma ◽

Emission Tomography ◽

Whole Body ◽

Positron Emission

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Positron Emission Tomography (PET) and Single-Photon Emission Computed Tomography (SPECT) of Brain Tumors

Neurologic Clinics ◽

10.1016/s0733-8619(18)30285-8 ◽

1991 ◽

Vol 9 (2) ◽

pp. 287-305 ◽

Cited By ~ 5

Author(s):

Jack M. Rozental

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Single Photon ◽

Photon Emission ◽

Emission Tomography ◽

Emission Computed Tomography ◽

Single Photon Emission ◽

Positron Emission ◽

Single Photon Emission Computed ◽

Photon Emission Computed Tomography

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

The Heart Surgery Forum ◽

10.1532/hsf98.20111045 ◽

2011 ◽

Vol 14 (5) ◽

pp. 283 ◽

Cited By ~ 2

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

Background: 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.Methods: 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.Results: 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).Conclusions: 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.

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