Splenic uptake on FDG PET/CT correlates with Kikuchi-Fujimoto disease severity

AbstractKikuchi-Fujimoto disease (KFD) is usually self-limiting, but prolonged systemic symptoms often result in frequent hospital visits, long admission durations, or missed workdays. We investigated the role of fluorine-18 fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing KFD severity. We reviewed the records of 31 adult patients with pathologically confirmed KFD who underwent 18F-FDG PET/CT between November 2007 and April 2018 at a tertiary-care referral hospital. Disease severity was assessed using criteria based on clinical manifestations of advanced KFD. Systemic activated lymph nodes and severity of splenic activation were determined using semi-quantitative and volumetric PET/CT parameters. The median of the mean splenic standardized uptake value (SUVmean) was higher in patients with severe KFD than those with mild KFD (2.38 ± 1.18 vs. 1.79 ± 0.99, p = 0.058). Patients with severe KFD had more systemically activated volume and glycolytic activity than those with mild KFD (total lesion glycolysis: 473.5 ± 504.4 vs. 201.6 ± 363.5, p = 0.024). Multivariate logistic regression showed that myalgia (odds ratio [OR] 0.035; 95% confidence interval [CI] 0.001–0.792; p = 0.035), total lymph node SUVmax (cutoff 9.27; OR 24.734; 95% CI 1.323–462.407; p = 0.032), and spleen SUVmean (cutoff 1.79; OR 37.770; 95% CI 1.769–806.583; p = 0.020) were significantly associated with severe KFD. 18F-FDG PET/CT could be useful in assessing KFD severity.

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Increased uptake of fluorine-18 fluoro-2-deoxy-D-glucose (F18-FDG) in the spleen: A novel marker for severe Kikuchi-Fujimoto disease

10.21203/rs.3.rs-32657/v1 ◽

2020 ◽

Author(s):

Hye Seong ◽

Yong Hyu Jeong ◽

Lee Woon ji ◽

Jun Hyoung Kim ◽

Jung Ho Kim ◽

...

Keyword(s):

Disease Severity ◽

Fdg Pet ◽

Clinical Course ◽

Tertiary Care ◽

Clinical Manifestations ◽

Standardized Uptake Value ◽

Clinical Findings ◽

Unknown Etiology ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Background: Kikuchi-Fujimoto disease (KFD), known as histiocytic necrotizing lymphadenitis, is an Asian-endemic disease of unknown etiology. Although KFD is usually self-limiting and benign, patients with prolonged systemic symptoms often have frequent hospital visits, long admission durations, and missed workdays. Immune-modulating drugs are used to shorten the clinical course in severe KFD. However, as there are no established severity markers, administration of these drugs is often arbitrary or delayed. We aimed to investigate the role of fluorine-18 fluoro-2-deoxy-D-glucose (F18-FDG) positron emission tomography/computed tomography (F18-FDG PET/CT) in KFD and to evaluate its performance as a disease severity marker. We retrospectively reviewed medical records of 31 adult patients with pathologically confirmed KFD who underwent F18-FDG PET/CT between November 2007 and April 2018 at a tertiary care referral hospital. Disease severity was assessed using the criteria based on clinical manifestations of advanced KFD. The number of systemic activated lymph nodes and severity of splenic activation were determined using semi-quantitative and volumetric PET/CT parameters. Results: The median value of the mean splenic standardized uptake value (SUV mean ) was higher in the 23 patients with severe KFD (1.79±0.99 vs. 2.38±1.18, p =0.058). Patients with severe KFD presented with more systemically activated volume and glycolytic activity than those with mild KFD (total lesion glycolysis: 473.5±504.4 vs 201.6±363.5, p =0.024). Multivariate logistic regression showed that myalgia (odds ratio [OR], 0.035; 95% confidence interval [CI], 0.001-0.792; p =0.035), total lymph node SUV max (cutoff, 9.27) (OR, 24.734; 95% CI, 1.323-462.407; p =0.032), and spleen SUV mean (cutoff, 1.79) (OR, 37.770; 95% CI, 1.769-806.583; p =0.020) were significantly associated with severe KFD. Conclusions: We suggest that 18 F-FDG PET/CT can be a useful tool for clinical workup in the predicting clinical course of KFD as a complement to laboratory and clinical findings to establish the severity.

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18F-FDG-PET/CT in radiation therapy-induced parotid gland inflammation

European Journal of Hybrid Imaging ◽

10.1186/s41824-020-00091-x ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Alaa Mouminah ◽

Austin J. Borja ◽

Emily C. Hancin ◽

Yu Cheng Chang ◽

Thomas J. Werner ◽

...

Keyword(s):

Parotid Gland ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Post Treatment ◽

Parotid Glands ◽

Positron Emission ◽

Pet Ct ◽

Average Maximum ◽

Pre Treatment ◽

Fdg Pet Ct

Abstract Background 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used in the clinical management of oncologic and inflammatory pathologies. It may have utility in detecting radiotherapy (RT)-induced damage of oral tissues. Thus, the aim of the present study was to use FDG-PET/CT to evaluate parotid gland inflammation following RT in patients with head and neck cancer (HNC). Methods This retrospective study included patients with HNC treated with photon, proton, or combined photon/proton RT, in addition to chemotherapy. All patients received FDG-PET/CT imaging pre-treatment and 3 months post-treatment. The average mean standardized uptake value (Avg SUVmean) and the average maximum standardized uptake value (Avg SUVmax) of the left and right parotid glands were determined by global assessment of FDG activity using OsiriX MD software. A two-tailed paired t test was used to compare Avg SUVmean and Avg SUVmax pre- and post-RT. Results Forty-seven HNC patients were included in the study. Parotid gland Avg SUVmean was significantly higher at 3 months post-treatment than pre-treatment (p < 0.05) in patients treated with photon RT, but no significant differences were found between pre- and post-treatment Avg SUVmean in patients treated with proton RT or combined photon/proton RT. Conclusion Our results suggest that photon RT may cause radiation-induced inflammation of the parotid gland, and that proton RT, which distributes less off-target radiation, is a safer treatment alternative.

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Relationship between tumor mutational burden and maximum standardized uptake value in 2-[18F]FDG PET (positron emission tomography) scan in cancer patients

EJNMMI Research ◽

10.1186/s13550-020-00732-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Amin Haghighat Jahromi ◽

Donald A. Barkauskas ◽

Matthew Zabel ◽

Aaron M. Goodman ◽

Garret Frampton ◽

...

Keyword(s):

Fdg Pet ◽

Standardized Uptake Value ◽

Emission Tomography ◽

Maximum Standardized Uptake Value ◽

Tissue Biopsy ◽

Mutational Burden ◽

Positron Emission ◽

Pet Ct ◽

Tumor Mutational Burden ◽

Fdg Pet Ct

Abstract Purpose Deriving links between imaging and genomic markers is an evolving field. 2-[18F]FDG PET/CT (18F-fluorodeoxyglucose positron emission tomography–computed tomography) is commonly used for cancer imaging, with maximum standardized uptake value (SUVmax) as the main quantitative parameter. Tumor mutational burden (TMB), the quantitative variable obtained using next-generation sequencing on a tissue biopsy sample, is a putative immunotherapy response predictor. We report the relationship between TMB and SUVmax, linking these two important parameters. Methods In this pilot study, we analyzed 1923 patients with diverse cancers and available TMB values. Overall, 273 patients met our eligibility criteria in that they had no systemic treatment prior to imaging/biopsy, and also had 2-[18F]FDG PET/CT within 6 months prior to the tissue biopsy, to ensure acceptable temporal correlation between imaging and genomic evaluation. Results We found a linear correlation between TMB and SUVmax (p < 0.001). In the multivariate analysis, only TMB independently correlated with SUVmax, whereas age, gender, and tumor organ did not. Conclusion Our observations link SUVmax in readily available, routinely used, and noninvasive 2-[18F]FDG PET/CT imaging to the TMB, which requires a tissue biopsy and time to process. Since higher TMB has been implicated as a prognostic biomarker for better outcomes after immunotherapy, further investigation will be needed to determine if SUVmax can stratify patient response to immunotherapy.

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Pulmonary Findings of [18F]FDG PET/CT Images on Asymptomatic COVID-19 Patients

Pathogens ◽

10.3390/pathogens10070839 ◽

2021 ◽

Vol 10 (7) ◽

pp. 839

Author(s):

Tzu-Chuan Ho ◽

Chin-Chuan Chang ◽

Hung-Pin Chan ◽

Ying-Fong Huang ◽

Yi-Ming Arthur Chen ◽

...

Keyword(s):

Systematic Review ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Fdg Uptake ◽

Asymptomatic Patients ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Maximal Standardized Uptake Value ◽

Fdg Pet Ct

During the coronavirus disease 2019 (COVID-19) pandemic, several case studies demonstrated that many asymptomatic patients with COVID-19 underwent fluorine-18 fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) examination for various indications. However, there is a lack of literature to characterize the pattern of [18F]FDG PET/CT imaging on asymptomatic COVID-19 patients. Therefore, a systematic review to analyze the pulmonary findings of [18F]FDG PET/CT on asymptomatic COVID-19 patients was conducted. This systematic review was performed under the guidelines of PRISMA. PubMed, Medline, and Web of Science were used to search for articles for this review. Articles with the key words: “asymptomatic”, “COVID-19”, “[18F]FDG PET/CT”, and “nuclear medicine” were searched for from 1 January 2020 to 20 May 2021. Thirty asymptomatic patients with COVID-19 were included in the eighteen articles. These patients had a mean age of 62.25 ± 14.85 years (male: 67.71 ± 12.00; female: 56.79 ± 15.81). [18F]FDG-avid lung lesions were found in 93.33% (28/30) of total patients. The major lesion was [18F]FDG-avid multiple ground-glass opacities (GGOs) in the peripheral or subpleural region in bilateral lungs, followed by the consolidation. The intensity of [18F]FDG uptake in multiple GGOs was 5.605 ± 2.914 (range from 2 to 12) for maximal standardized uptake value (SUVmax). [18F]FDG-avid thoracic lymph nodes (LN) were observed in 40% (12/40) of the patients. They mostly appeared in both mediastinal and hilar regions with an SUVmax of 5.8 ± 2.93 (range from 2.5 to 9.6). The [18F]FDG uptake was observed in multiple GGOs, as well as in the mediastinal and hilar LNs. These are common patterns in PET/CT of asymptomatic patients with COVID-19.

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Use of 68Ga-PSMA-11 and 18F-FDG PET-CT Dual-Tracer to Differentiate Between Lymph Node Metastases and Ganglia

Frontiers in Oncology ◽

10.3389/fonc.2021.646110 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yiping Shi ◽

Lian Xu ◽

Yinjie Zhu ◽

Yining Wang ◽

Ruohua Chen ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastases ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Fdg Uptake ◽

Positron Emission ◽

Pet Ct ◽

Node Metastases ◽

Ct Data ◽

Fdg Pet Ct

PurposeDifferentiating lymph node metastases (LNM) from peripheral ganglia by physiological prostate-specific membrane antigen (PSMA) uptake is challenging. Two tracers (68Ga-PSMA-11 and 18F-fluorodeoxyglucose [FDG]) metabolic uptake patterns were evaluated by positron emission tomography-computed tomography (PET-CT), searching for differences that could tell ganglia from LNM.MethodsDual 68Ga-PSMA-11 and 18F-FDG PET-CT data of 138 prostate cancer patients acquired from June 2018 to December 2019 were retrospectively evaluated. Ganglia and LNM with PSMA-11 uptake above local background were analyzed by the location and PSMA-11-PET and FDG-PET maximum standardized uptake value (SUVmax).ResultsPSMA-11-positive ganglia (n = 381) and LNM (n = 83) were identified in 138 and 58 patients, respectively. The LNM SUVmax of PSMA-11-PET (16.4 ± 14.8 vs 2.3 ± 0.7, P < 0.001) and FDG-PET (3.3 ± 3.2 vs 1.5 ± 0.5, P < 0.001) were higher than in ganglia. The probabilities of being an LNM in the low-potential (PSMA-11-PET SUVmax of <4.1 and FDG-PET SUVmax of <2.05), moderate-potential (PSMA-11-PET SUVmax of >4.1 and FDG-PET SUVmax of <2.05, or PSMA-11-PET SUVmax of <4.1 and FDG-PET SUVmax of >2.05), and high-potential (PSMA-11-PET SUVmax of >4.1 and FDG-PET SUVmax of >2.05) groups were 0.9% (3/334), 44.6% (37/83), and 91.5% (43/47), respectively (P < 0.001). The cervical and coeliac ganglia had higher PSMA-11 and FDG uptake than the sacral ganglia (P < 0.001 for all). LNM PSMA-11 and FDG uptake was similar in these three locations.ConclusionThe FDG-PET and PSMA-11-PET SUVmax, especially when combined, could well differentiate LNM from ganglia. The tracers uptake differed between cervical/coeliac and sacral ganglia, so the lesion location should be considered during image assessment.

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Utility of flouro-deoxy-glucose positron emission tomography/computed tomography in the diagnostic and staging evaluation of patients with primary CNS lymphoma

CNS Oncology ◽

10.2217/cns-2019-0016 ◽

2019 ◽

Vol 8 (4) ◽

pp. CNS46 ◽

Cited By ~ 3

Author(s):

Meetakshi Gupta ◽

Tejpal Gupta ◽

Nilendu Purandare ◽

Venkatesh Rangarajan ◽

Ameya Puranik ◽

...

Keyword(s):

Fdg Pet ◽

Standardized Uptake Value ◽

Emission Tomography ◽

Whole Body ◽

Cns Lymphoma ◽

Maximum Standardized Uptake Value ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Aim: To prospectively assess the clinical utility of pretreatment flouro-deoxy-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with primary central nervous system (CNS) lymphoma (PCNSL). Materials & methods: Patients with suspected/proven PCNSL underwent baseline whole-body 18F-FDG-PET/CT. Maximum standardized uptake value and tumor/normal tissue ratios were compared between CNS lymphoma and other histological diagnoses. Results: The mean maximum standardized uptake value (27.5 vs 18.2; p = 0.001) and mean tumor/normal tissue ratio (2.34 vs 1.53; p < 0.001) of CNS lymphoma was significantly higher than other histologic diagnoses. Five of 50 (10%) patients with biopsy-proven CNS lymphomas had pathologically increased FDG-uptake at extraneuraxial sites uncovering systemic lymphoma. Conclusion: Pretreatment whole-body 18F-FDG-PET/CT provides valuable complementary information in the diagnostic and staging evaluation of patients with PCNSL to guide therapeutic decision-making.

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In Which Patients with Sarcoidosis Is FDG PET/CT Indicated?

Journal of Clinical Medicine ◽

10.3390/jcm9030890 ◽

2020 ◽

Vol 9 (3) ◽

pp. 890 ◽

Cited By ~ 5

Author(s):

Ruth G.M. Keijsers ◽

Jan C. Grutters

Keyword(s):

Fdg Pet ◽

Cardiac Sarcoidosis ◽

Clinical Manifestations ◽

Emission Tomography ◽

Diagnostic Process ◽

Inflammatory Lesions ◽

Positron Emission ◽

Pet Ct ◽

Conventional Tests ◽

Fdg Pet Ct

Sarcoidosis is a granulomatous disease of which the etiology remains unknown. The diverse clinical manifestations may challenge clinicians, particularly when conventional markers are inconclusive. From various studies, it has become clear that fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT aids in sarcoidosis care. In this article, an update on FDG PET/CT in sarcoidosis is provided. The use of FDG PET/CT in the diagnostic process of sarcoidosis is explained, especially in determining treatable inflammatory lesions in symptomatic patients with indecisive conventional tests. Furthermore, FDG PET/CT for evaluating the potential benefit of additional inflammatory treatment is described and its use in cardiac sarcoidosis is highlighted.

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Relationship between tumor mutational burden and maximum standardized uptake value in 2-[18F]FDG PET (positron emission tomography) scan in cancer patients

10.21203/rs.3.rs-68828/v2 ◽

2020 ◽

Author(s):

Amin Haghighat Jahromi ◽

Donald A Barkauskas ◽

Matthew Zabel ◽

Aaron M. Goodman ◽

Garret Frampton ◽

...

Keyword(s):

Fdg Pet ◽

Standardized Uptake Value ◽

Emission Tomography ◽

Maximum Standardized Uptake Value ◽

Tissue Biopsy ◽

Mutational Burden ◽

Positron Emission ◽

Pet Ct ◽

Tumor Mutational Burden ◽

Fdg Pet Ct

Abstract Purpose: Deriving links between imaging and genomic markers is an evolving field. 2-[18F]FDG PET/CT (18F-fluorodeoxyglucose Positron Emission Tomography- Computed Tomography) is commonly used for cancer imaging, with maximum standardized uptake value (SUVmax) as the main quantitative parameter. Tumor mutational burden (TMB), the quantitative variable obtained using next-generation sequencing on a tissue biopsy sample, is a putative immunotherapy response predictor. We report the relationship between TMB and SUVmax, linking these two important parameters.Methods: In this pilot study, we analyzed 1923 patients with diverse cancers and available TMB values. Overall, 273 patients met our eligibility criteria in that they had no systemic treatment prior to imaging/biopsy, and also had 2-[18F]FDG PET/CT within six months prior to the tissue biopsy, to ensure acceptable temporal correlation between imaging and genomic evaluation.Results: We found a linear correlation between TMB and SUVmax (p<0.001). In the multivariate analysis, only TMB independently correlated with SUVmax whereas age, gender and tumor organ did not.Conclusion: Our observations link SUVmax in readily available, routinely used, and non-invasive 2-[18F]FDG PET/CT imaging to the TMB, which requires a tissue biopsy and time to process. Since higher TMB has been implicated as a prognostic biomarker for better outcomes after immunotherapy, further investigation will be needed to determine if SUVmax can stratify patient response to immunotherapy.

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Initial and Delayed Metabolic Activity of Palatine Tonsils Measured with the PET/CT-Dedicated Parameters

Diagnostics ◽

10.3390/diagnostics10100836 ◽

2020 ◽

Vol 10 (10) ◽

pp. 836

Author(s):

Agata Pietrzak ◽

Andrzej Marszalek ◽

Malgorzata Paterska ◽

Pawel Golusinski ◽

Julitta Narozna ◽

...

Keyword(s):

Fdg Pet ◽

Standardized Uptake Value ◽

Ct Scanning ◽

Chronic Tonsillitis ◽

Palatine Tonsils ◽

Specificity And Sensitivity ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct ◽

Time Point

One of the most critical elements in the palatine tonsils (PT) patients’ management is to distinguish chronic tonsillitis and malignant tumor. The single-time-point (STP) 2-deoxy-2-[18 F]fluoro-D-glucose positron emission tomography/computed tomography (18 F-FDG PET/CT) examination offers the most significant sensitivity and specificity in the head and neck (H&N) region evaluation among commonly used methods of imaging. However, introducing dual-time-point (DTP) scanning might improve the specificity and sensitivity of the technique, limited by the 18 F-FDG non-tumor-specific patterns, especially when comparing different metabolic parameters. The study aims to compare several surrogates of the maximal standardized uptake value (SUVmax), obtained in 36 subjects, divided into confirmed by pathologic study PT cancer and tonsillitis in patients who underwent DTP 18 F-FDG PET/CT scanning. In this study, we observed the increased sensitivity and the specificity of the DTP 18 F-FDG PET/CT when compared with the standard PET/CT protocol. It could be concluded that DTP 18 F-FDG PET/CT improves the PT cancer and chronic tonsillitis differential diagnosis.

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The role of functional imaging; DWI, ADC and 18F-FDG PET/CT in the evaluation of HCC treatment response after transarterial chemoembolization

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00595-x ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Ahmed S. Abdelrahman ◽

Amgad S. Abdel-Rahman ◽

Noha M. Taha

Keyword(s):

Functional Imaging ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Diagnostic Value ◽

Liver Imaging ◽

Positron Emission ◽

Pet Ct ◽

Sensitivity Specificity ◽

Fdg Pet Ct

Abstract Background The transcatheter arterial chemoembolization (TACE) is one of the treatment lines for patients with hepatocellular carcinoma (HCC), this study was conducted to assess the role of functional imaging including the DWI, ADC and 18F-2-fluoro-2-deoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) for detection of residual HCC after TACE as compared to the structural liver imaging reporting and data system (LI-RADS). Results The optimal cut off value of standardized uptake value ratio (SUVmax/liver SUVmean ratio) for detection of residual viable HCC after TACE was 1.09 with 88.9%, 87.5% and 88.6% sensitivity, specificity, and accuracy respectively, a lower diagnostic value was noted in the qualitative visual FDG PET/CT assessment with sensitivity, specificity, and accuracy of 81.5%, 75% and 80% respectively. The sensitivity, specificity, and accuracy of DWI for identification of post-TACE viable HCC were 77.8%, 75%, and 77.1% respectively. The optimal cut off value of ADC for the diagnosis of variable HCC was 1.32 × 10−3 mm2/s with sensitivity, specificity, and accuracy of 81.5%, 75%, and 80% respectively. Conclusions DWI, ADC and FDG PET/CT are effective functional imaging modalities for the evaluation of viable residual HCC post-TACE with comparable findings for the dynamic cross-section imaging.

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