scholarly journals The role of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography in the differential diagnosis of pericardial disease

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Cheol Won Hyeon ◽  
Hyun Kyung Yi ◽  
Eun Kyoung Kim ◽  
Sung-Ji Park ◽  
Sang-Chol Lee ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Fdg Pet ◽  
Diagnostic Yield ◽  
Emission Tomography ◽  
Pericardial Disease ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractThis study aimed to assess the role of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) in the differential diagnosis of pericardial disease. The diagnosis is often troublesome because pericardial fluid analysis or biopsy does not always provide answers. 18FDG-PET/CT can visualize both inflammation and malignancy and offers a whole-body assessment. Patients who visited the Pericardial Disease Clinic of Samsung Medical Center with an 18FDG-PET/CT order code were extracted. Exclusion criteria were as follows: (1) the purpose of the differential diagnosis was not pericardial disease; (2) the patient had a known advanced-stage malignancy; (3) the patient already have confirmative diagnosis using a serology, pericardial effusion analysis or biopsy. The analysis included 107 patients. The most common final diagnosis was idiopathic (n = 46, 43.0%), followed by tuberculosis (n = 30, 28.0%) and neoplastic (n = 11, 10.3%). A maximum standardized uptake value (SUVmax) ≥ 5 typically indicates tuberculosis or neoplastic pericarditis except in just one case of autoimmune pericarditis); especially all of the SUVmax scores ≥ 10 had tuberculosis. The diagnostic yield of pericardial biopsy was very low (10.2%). Interestingly, all of the pericardium with an SUVmax < 4.4 had nondiagnostic results. In contrast, targeted biopsies based on 18FDG uptake demonstrated a higher diagnostic yield (38.7%) than pericardium. The sensitivity of 18FDG-PET/CT was 63.6%. The specificity was 71.9%. The positive predictive value was 20.6%. The negative predictive value 94.5%, and the accuracy was 71.0% for excluding malignancy based upon the FDG uptake patterns. It is possible to explore the differential diagnosis in some patients with difficult pericardiocentesis or pericardial biopsy in a noninvasive manner using on the SUVmax or uptake patterns. In addition, the biopsy strategy depending on 18FDG uptake is helpful to achieve biopsy more safely and with a higher yield. 18FDG-PET may enhance the diagnostic efficacy in patients with pericardial disease.

Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Interpretation Criteria for Assessment of Antibiotic Treatment Response in Pyogenic Spine Infection

2015 ◽  
Vol 66 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Silvia A. Riccio ◽  
Angel K.M. Chu ◽  
Harvey R. Rabin ◽  
Reinhard Kloiber
Keyword(s):  
Soft Tissue ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Active Infection ◽  
Spine Infection ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Purpose The objective of the study was to determine if fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can assess the response of patients with pyogenic spine infection to antibiotic treatment in a clinically useful time frame. Methods Twenty-eight patients with suspected pyogenic spine infection had baseline 18F-FDG PET/CT. Patients with proven or probable infection were divided into good and poor responders to antibiotic therapy based on clinical criteria. These patients had a follow-up 18F-FDG PET/CT 6-8 weeks later. Results Six of 28 patients were deemed negative for infection based on 18F-FDG PET/CT. Two patients were excluded because of discrepancies in interpretation. Of the 20 patients deemed positive for infection, 13 had a pathogen isolated and all showed 18F-FDG uptake in bone and/or soft tissue at baseline. Patients with a poor clinical response to treatment had persistent 18F-FDG uptake in bone and/or soft tissue on follow-up. Patients with good clinical response had uptake confined to the margins of the destroyed disc. None of these patients had recurrent infection, even if antibiotics had already been discontinued at the time of the follow-up scan. Conclusions 18F-FDG uptake confined to the margins of a destroyed disc after antibiotic therapy of pyogenic spine infection must not be considered indicative of persistent infection and likely represents mechanically induced inflammation. 18F-FDG uptake in bone or soft tissue does indicate active infection. Quantification of activity could not reliably differentiate patients with active infection from those without active infection and those who had had a successful response to therapy. The pattern of activity is critical to accurate interpretation.

scholarly journals Physiological Appearance of Hybrid FDG–Positron Emission Tomography/Computed Tomography Imaging Following Uncomplicated Endovascular Aneurysm Sealing Using the Nellix Endoprosthesis

2020 ◽  
Vol 27 (3) ◽  
pp. 509-515
Author(s):  
Erik Groot Jebbink ◽  
Leo H. van Den Ham ◽  
Beau B. J. van Woudenberg ◽  
Riemer H. J. A. Slart ◽  
Clark J. Zeebregts ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Graft Infection ◽  
Emission Tomography ◽  
Visual Examination ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Purpose: To investigate the physiological uptake of hybrid fluorine-18-fluorodeoxyglucose (FDG)–positron emission tomography/computed tomography (PET/CT) before and after an uncomplicated endovascular aneurysm sealing (EVAS) procedure as a possible tool to diagnose EVAS graft infection and differentiate from postimplantation syndrome. Materials and Methods: Eight consecutive male patients (median age 78 years) scheduled for elective EVAS were included in the prospective study ( ClinicalTrials.gov identifier NCT02349100). FDG-PET/CT scans were performed in all patients before the procedure and 6 weeks after EVAS. The abdominal aorta was analyzed in 4 regions: suprarenal, infrarenal neck, aneurysm sac, and iliac. The following parameters were obtained for each region: standard uptake value (SUV), tissue to background ratio (TBR), and visual examination of FDG uptake to ascertain its distribution. Demographic data were obtained from medical files and scored based on reporting standards. Results: Visual examination showed no difference between pre- and postprocedure FDG uptake, which was homogenous. In the suprarenal region no significant pre- and postprocedure differences were observed for the SUV and TBR parameters. The infrarenal neck region showed a significant decrease in the SUV and no significant decrease in the TBR. The aneurysm sac and iliac regions both showed a significant decrease in SUV and TBR between the pre- and postprocedure scans. Conclusion: Physiological FDG uptake after EVAS was stable or decreased with regard to the preprocedure measurements. Future research is needed to assess the applicability and cutoff values of FDG-PET/CT scanning to detect endograft infection after EVAS.

scholarly journals Molecular imaging and immunotherapy

2020 ◽  
Vol 35 (1_suppl) ◽  
pp. 37-41
Author(s):  
Laura Evangelista
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Clinical Practice ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

The utility of positron emission tomography (PET) for the evaluation of response to immunotherapy has been considered a hot topic, particularly in the last 2 to 3 years. Different experiences have been collected in clinical practice, with 18F-Fluorodeoxyglucose (FDG) PET/computed tomography (CT), particularly in patients affected by lymphoma, malignant melanoma, and lung cancer. It has been tested in different settings of disease, from the prediction to the prognosis relative to the response to immunotherapy. In the present mini-review, some evidence is reported about the role of FDG PET/CT in patient candidates to or treated with immunotherapy.

Fusion of Metabolic Function and Morphology: Sequential [18F]Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Studies Yield New Insights Into the Natural History of Bone Metastases in Breast Cancer

2007 ◽  
Vol 25 (23) ◽  
pp. 3440-3447 ◽  
Author(s):  
Yong Du ◽  
Ian Cullum ◽  
Tim M. Illidge ◽  
Peter J. Ell
Keyword(s):  
Bone Metastases ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Mixed Pattern ◽  
Fdg Pet Ct ◽  
Morphology Changes

Purpose By monitoring bone metastases with sequential [18F]fluorodeoxyglucose positron-emission tomography/computed tomography ([18F]FDG-PET/CT) imaging, this study investigates the clinical relevance of [18F]FDG uptake features of bone metastases with various radiographic appearances. Patients and Methods Bone metastases were found in 67 of 408 consecutive patients with known/suspected recurrent breast cancer on [18F]FDG-PET/CT, characterized by CT morphology changes and/or bony [18F]FDG uptake. Twenty-five of the patients had sequential [18F]FDG-PET/CT examinations (86 studies) over an average follow-up period of 23 months. The temporal changes in [18F]FDG uptake and corresponding CT morphology features of 146 bone lesions identified in these 25 patients were followed up and correlated with therapeutic outcome retrospectively. Results The 146 lesions were classified as osteolytic (77), osteoblastic (41), mixed-pattern (11), or no change/negative (17) on CT. The majority of the osteolytic (72; 93.5%) and mixed-pattern lesions (nine; 81.8%), but fewer of the osteoblastic lesions (25; 61%), showed increased [18F]FDG uptake. After treatment, 58 osteolytic lesions (80.5%) became [18F]FDG negative and osteoblastic on CT and only 14 relatively large lesions (19.5%) remained [18F]FDG avid. Of the 25 [18F]FDG-avid osteoblastic lesions, 13 (52%) became [18F]FDG negative, but 12 (48%) remained [18F]FDG avid and increased in size on CT. Five of the mixed-pattern lesions remained [18F]FDG avid after treatment. All 17 CT-negative lesions became [18F]FDG negative; however, nine of them became osteoblastic. None of the initially [18F]FDG-negative lesions showed [18F]FDG avidity during follow-up. Conclusion [18F]FDG uptake reflects the immediate tumor activity of bone metastases, whereas the radiographic morphology changes vary greatly with time among patients.

scholarly journals The Role of Fluorine-18-fluorodeoxyglucose Positron Emission Tomography in Assessing the Response to Neoadjuvant Treatment in Patients with Osteosarcoma

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Carmelo Caldarella ◽  
Marco Salsano ◽  
Maria Antonietta Isgrò ◽  
Giorgio Treglia
Keyword(s):  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Neoadjuvant Treatment ◽  
Emission Tomography ◽  
Whole Body ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Fluorine 18 Fluorodeoxyglucose

Aim. The objective of this study is to systematically review the role of positron emission tomography (PET) and PET/computed tomography (PET/CT) with fluorine-18-fluorodeoxyglucose (FDG) in assessing the response to neoadjuvant treatment in patients with osteosarcoma (OS). Methods. A comprehensive literature search of published studies through March 2012 in PubMed/MEDLINE, Embase, and Scopus databases regarding whole-body FDG-PET and FDG-PET/CT in patients with OS was performed. Results. Twenty-two studies have investigated the role of FDG-PET and FDG-PET/CT in the evaluation of response to neoadjuvant treatment with either chemotherapy or radiation therapy in patients with OS. The main findings of these studies are presented. Conclusion. FDG-PET or PET/CT seems to be sensitive and reliable diagnostic tools in the assessment of metabolic response to treatment in patients with OS, after baseline PET evaluation has been performed in advance. However, false positive findings due to inflammation in sites of tumoral response should be considered.

The role of positron emission tomography in the selection of patients for salvage hysterectomy following chemoradiotherapy for locally advanced cervical cancer

2019 ◽  
Vol 29 (2) ◽  
pp. 266-271
Author(s):  
Chrishanthi Rajasooriyar ◽  
Ming-Yin Lin ◽  
Rashi Kalra ◽  
Andrew Lim ◽  
Kailash Narayan
Keyword(s):  
Cervical Cancer ◽  
Fdg Pet ◽  
Ct Scanning ◽  
Post Treatment ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Selection For ◽  
Fdg Pet Ct

BackgroundPatients selection for salvage hysterectomy following chemoradiotherapy of cervical cancer is vital to avoid significant morbidity. The purpose of this study was to describe the role of post-treatment F18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography scanning (FDG-PET/CT) in patient selection for salvage hysterectomy.MethodsThis was a retrospective analysis of 49 patients with cervical cancer treated between January 1996 and December 2012 who were candidates for salvage hysterectomy.ResultsThree groups were defined based on institutional treatment guidelines, as experience in using post-treatment FDG-PET/CT to guide management evolved. Group 1 consisted of 15 patients who underwent planned hysterectomy based on clinical, cytological, or histological suspicion. Of these, only three (20%) patients had residual disease on histology. Group 2 consisted of 13 patients who had post-treatment FDG-PET/CT 3–6 months after the completion of chemoradiotherapy due either to suspicion of recurrence on examination or patients thought to be at high risk of recurrence at the primary site. Of these, eight patients had hysterectomy and four patients showed positive histology for residual tumor. Group 3 had 21 patients who showed isolated FDG uptake at the primary site on first FDG-PET/CT scanning at 6 months. A subsequent FDG-PET/CT scan after 3 months showed disease progression in seven and complete metabolic response in 14, and surgery was avoided in all patients.ConclusionFDG-PET/CT scanning at 6 months after radiotherapy is a good tool for assessing treatment response in patients with cervical cancer. In patients with persistent uptake on 6 months post-treatment FDG-PET/CT, repeat imaging at a 3-month interval helps in selecting patients for salvage hysterectomy.

scholarly journals Role of 2-[18F]FDG as a Radiopharmaceutical for PET/CT in Patients with COVID-19: A Systematic Review

2020 ◽  
Vol 13 (11) ◽  
pp. 377
Author(s):  
Salvatore Annunziata ◽  
Roberto C. Delgado Bolton ◽  
Christel-Hermann Kamani ◽  
John O. Prior ◽  
Domenico Albano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Evidence Based ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Some recent studies evaluated the role of fluorine-18 fluorodeoxyglucose (2-[18F]FDG) as a radiopharmaceutical for positron emission tomography/computed tomography (PET/CT) imaging in patients with Coronavirus Disease (COVID-19). This article aims to perform a systematic review in this setting. A comprehensive computer literature search in PubMed/MEDLINE and Cochrane library databases regarding the role of 2-[18F]FDG PET/CT in patients with COVID-19 was carried out. This combination of key words was used: (A) “PET” OR “positron emission tomography” AND (B) “COVID” OR “SARS”. Only pertinent original articles were selected; case reports and very small case series were excluded. We have selected 11 original studies of 2-[18F]FDG PET/CT in patients with COVID-19. Evidence-based data showed first preliminary applications of this diagnostic tool in this clinical setting, with particular regard to the incidental detection of interstitial pneumonia suspected for COVID-19. To date, according to evidence-based data, 2-[18F]FDG PET/CT cannot substitute or integrate high-resolution CT to diagnose suspicious COVID-19 or for disease monitoring, but it can only be useful to incidentally detect suspicious COVID-19 lesions in patients performing this imaging method for standard oncological and non-oncological indications. Published data about the possible role of 2-[18F]FDG PET/CT in patients with COVID-19 are increasing, but larger studies are warranted.

scholarly journals A Giant Duodenal Leiomyoma Showing Increased Uptake on 18F-Fluorodeoxyglucose Positron Emission Tomography

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Keisuke Nonoyama ◽  
Hidehiko Kitagami ◽  
Akira Yasuda ◽  
Shiro Fujihata ◽  
Minoru Yamamoto ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Differential Diagnosis ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
The Third ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Fluorodeoxyglucose Positron Emission

Background. Although 18F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) is now widely used in their differential diagnosis, it is sometimes difficult to distinguish between benign and malignant diseases. Case Presentation. A 44-year-old woman was found to have abnormalities on health screening. Magnetic resonance imaging for detailed examination showed an intra-abdominal tumor measuring 12 cm in the major axis near the cranial end of the uterus. Upper gastrointestinal tract endoscopy showed a tumor with an ulcer in the third part of the duodenum, involving half the circumference. Heterogeneous uptake was observed within the tumor on FDG-PET/CT. Based on these findings, the patient underwent surgery for suspected primary malignant lymphoma of the duodenum or gastrointestinal stromal tumor. Laparotomy revealed a 12 cm tumor in the third part of the duodenum. Partial duodenectomy and end-to-end duodenojejunostomy were performed. Pathological findings showed a solid tumor growing from the muscle layer of the duodenum to outside the serous membrane; based on immunostaining, it was diagnosed as a leiomyoma. Conclusions. Duodenal leiomyomas are originally benign; to date, there have been no reports of uptake in duodenal leiomyomas on FDG-PET/CT; therefore, our case is rare. Leiomyomas should be considered in the differential diagnosis of duodenal neoplastic diseases.

scholarly journals OP0190 USEFULNESS OF 18F-FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY IN DIAGNOSING POLYMYALGIA RHEUMATICA AND LARGE-VESSEL VASCULITIS: A CASE-CONTROL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 114.2-115
Author(s):  
A. Desvages ◽  
F. Hives ◽  
X. Deprez ◽  
A. Pierache ◽  
R. M. Flipo ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Polymyalgia Rheumatica ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Control Groups ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
And Control

Background:Polymyalgia rheumatica (PMR) is a relatively common disease among the elderly. None of the most common imaging techniques provides diagnostic certainty of PMR. 18F-fluoro-dexoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) may be a useful candidate as it can be used to visualize articular and periarticular FDG uptake at different locations, as well as associated large-vessel vasculitis (LVV), but its usefulness needs to be evaluated in the absence of large-scale case-control studies.Objectives:The purpose of this study was to determine the usefulness of FDG-PET/CT in diagnosing PMR and LVV.Methods:We analysed FDG-PET/CT scans performed between January 2015 and December 2019 on patients diagnosed with PMR. For comparisons, patients with PMR were matched 1:1 to controls according to age and sex. FDG-PET/CT scans had been performed on controls over the same period for diagnosis of cancer-associated stroke. FDG uptake was scored visually using a semi-quantitative analysis (score 0-3) for 17 articular or periarticular sites, as described by Sondag et al. [1], and for 13 vascular sites, as described by Slart et al. [2]. The case and control groups were compared using generalized linear mixed models (binomial distribution, logit function) for binary outcomes, and linear mixed models for continuous outcomes, with matched sets as a random effect. The optimal threshold for the number of sites with significant hyperfixation (score ≥ 2) was determined by maximizing the Youden index.Results:81 patients with a diagnosis of PMR and 81 controls were included (mean (SD) age 70.7 (9.8) years; 44.4% women). We found significant differences between the PMR and control groups at all articular or periarticular sites for: 1) FDG uptake score (p<0.0001); 2) number of patients per site with significant FDG uptake (score ≥ 2) (p<0.0001); 3) global FDG articular uptake scores (score 0-51) (31 [IQR, 21 to 37] versus 6 [IQR, 3 to 10], p<0.001); and 4) number of sites with significant FDG uptake (score ≥ 2) (score 0-17) (11 [IQR, 7 to 13] versus 1 [IQR, 0 to 2], p<0.001). Using ROC curve analysis (Figure 1), we found that the presence of 6 or more sites with significant FDG uptake (≥ 2) was associated with the diagnosis of PMR with a sensitivity of 84% and a specificity of 96% (AUC 0.96 [95% CI 0.93-0.99]). No significant differences in global FDG vascular uptake scores (score 0-39) or in number of patients with at least 1 significant uptake vascular site (score ≥ 2) were found between the PMR and control groups (1 [IQR, 0 to 4] versus 4 [0 to 6], p=0.06 and 8 (11.3%) versus 10 (14.1%), p=0.62 respectively).Figure 1.ROC curve analyzing performance of FDG-PET/CT for the diagnosis of PMR according to the number of sites with significant FDG uptake (≥ 2)Conclusion:Our results demonstrate that the FDG uptake score and the number of sites with significant FDG uptake could be relevant criteria for the diagnosis of PMR. However, unlike other authors, we found no evidence suggesting that FDG-PET/CT may be useful in diagnosing silent underlying LVV in patients with isolated PMR.References:[1]Sondag M, Guillot X, Verhoeven F, Blagosklonov O, Prati C, Boulahdour H, et al. Utility of 18F-fluoro-dexoxyglucose positron emission tomography for the diagnosis of polymyalgia rheumatica: a controlled study. Rheumatology (Oxford). 2016;55(8):1452-7.[2]Slart RHJA, Writing group, Reviewer group, Members of EANM Cardiovascular, Members of EANM Infection & Inflammation, Members of Committees, SNMMI Cardiovascular, Members of Council, PET Interest Group, et al. FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET Interest Group (PIG), and endorsed by the ASNC. Eur J Nucl Med Mol Imaging. 2018;45(7):1250-69.Disclosure of Interests:None declared

scholarly journals Role of integrated F-18 fluoro-deoxy-glucose positron emission tomography and computed tomography in evaluation of lung cancer

2012 ◽  
Vol 20 (3-4) ◽  
pp. 107-111
Author(s):  
Dragana Sobic-Saranovic
Keyword(s):  
Lung Cancer ◽  
Fdg Pet ◽  
Small Cell ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Lung cancer is one of the leading causes of death in the world. It is generally divided in two groups: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Positron emission tomography (PET)/CT using the glucose analogue labeled with 18-fluor (F-18): fluoro-deoxy-glucose (F-18-FDG), is unique integrated imaging modality that offers simultaneous anatomic and metabolic information valuable in the diagnosis, staging and follow-up of both types of lung cancer and in particular in NSCLC. FDG accumulation in tissue is proportional to the amount of glucose utilization. Increased consumption of glucose is a characteristic of almost all types of lung cancer except in bronchoalveolar carcinoma and well differentiated neuroendocrine tumors. The objective of this brief review is to highlight the clinical role of F-18-FDG PET/CT in detection, staging, re-staging, and assessment of therapy response and follow up in lung cancer. The performance of F-18-FDG PET/CT in specific clinical situations is of special interest: in the differentiation of indeterminate lung lesions, the staging of NSCLC for lymph node and extra thoracic metastases, for therapy planning, the detection of recurrent lung cancer and the use in SCLC. In conclusion, F-18-FDG PET/CT helps in characterization of suspicious lesions, provides more precise staging of NSCLC than other imaging techniques, allows better patients? selection for new modalities of treatment, helps in restaging after induction therapy, allows better delineation for radiotherapy planning and helps in follow up evaluation by differentiating residual or recurrent tumor from post treatment scar.

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