scholarly journals Computed Tomography Assessment of Cerebral Perfusion Using a Distributed Parameter Tracer Kinetics Model: Validation with H2(15)O Positron Emission Tomography Measurements and Initial Clinical Experience in Patients with Acute Stroke

2007 ◽  
Vol 28 (2) ◽  
pp. 402-411 ◽  
Author(s):  
Sotirios Bisdas ◽  
Frank Donnerstag ◽  
Georg Berding ◽  
Thomas J Vogl ◽  
Choon Hua Thng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Acute Stroke ◽  
Pet Imaging ◽  
Perfusion Ct ◽  
Emission Tomography ◽  
Minor Stroke ◽  
Distributed Parameter ◽  
Positron Emission

We describe a distributed parameter (DP) model for tracer kinetic analysis in brain and validate the derived perfusion values with positron emission tomography (PET) scans. The proposed model is applied on actual clinical cases of hemispheric stroke. Nine patients with experienced transient ischaemic attack or minor stroke and a stenosis of the internal carotid artery were referred for computed tomography (CT) and PET imaging. The applicability of the DP model in clinical practice was tested in seven patients with acute stroke who received a baseline perfusion CT study and a noncontrast follow-up CT study after 2.4 ± 1.8 days. The mean blood flow ( F) value for all patients with carotid stenosis in the pooled data (54 regions of interest (ROIs)) was 37.9 ± 11.2 mL/min per 100 g in perfusion CT and 35.6 ± 9.8 mL/min per 100 g in perfusion PET imaging [ r = 0.77 ( P = 0.00)]. Regression analysis of the pooled ROIs for every patient revealed significant correlation between F values in seven patients [ r = 0.50 to 0.79 ( r2-values ranged from 0.45 to 0.79), (0.01 ≤ P ≤ 0.05)]. Parametric maps that corresponded to all physiologic parameters were generated for every perfusion CT in the patients with acute stroke using the DP model. The ischaemic area was better delineated in F, intravascular blood volume and lag time ( tlag) maps. The correlation coefficient comparing the visually outlined regions of abnormality between the tlag parametric map and the follow-up CT scans was 0.81 ( P = 0.003). In conclusion, DP physiological model using more realistic pharmacokinetics is feasible in dynamic contrast-enhanced CT of the brain in patients with acute and chronic cerebrovascular disease.

scholarly journals Positron emission tomography/computed tomography for optimized colon cancer staging and follow up

2013 ◽  
Vol 49 (2) ◽  
pp. 191-201 ◽  
Author(s):  
Bodil Elisabeth Engelmann ◽  
Annika Loft ◽  
Andreas Kjær ◽  
Hans Jørgen Nielsen ◽  
Anne Kiil Berthelsen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Colon Cancer ◽  
Cancer Staging ◽  
Emission Tomography ◽  
Positron Emission

scholarly journals IMAGING IN ENDOCRINOLOGY: 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up

2015 ◽  
Vol 173 (3) ◽  
pp. R115-R130 ◽  
Author(s):  
Massimo Salvatori ◽  
Bernadette Biondi ◽  
Vittoria Rufini
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Whole Body ◽  
Clinical Indications ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

In recent years, 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) has emerged as an important tool for the postoperative management of patients with differentiated thyroid cancer (DTC) and it is widely used in selected clinical situations. The most valuable role that FDG-PET/CT plays in clinical practice is that it can be used to obtain prognostic information in patients with increasing thyroglobulin (Tg) levels and negative 131I whole-body scan post-thyroidectomy and radioiodine (RAI) ablation. FDG-PET/CT may also have a potential role in the initial staging and follow-up of high-risk patients with aggressive histological subtypes, in the identification of patients who are at the highest risk of disease-specific mortality, in the management of patients with RAI-refractory disease, in clinical trials of novel targeted therapies in patients with advanced metastatic disease, and in the evaluation of thyroid nodules with indeterminate fine-needle aspiration for cytology. However, several controversies remain to be resolved, namely: the cutoff value of Tg in the selection of DTC patients for FDG-PET/CT, whether FDG-PET/CT scanning should be performed under thyrotropin stimulation or suppression, and the clinical significance of thyroid FDG-PET/CT incidentalomas. The aim of the present article is to provide an overview of the data about the molecular basis for, clinical indications of, and controversies related to the use of FDG-PET/CT in patients with DTC.

Surveillance Procedures for Patients for Cervical Carcinoma: A Review of the Literature

2009 ◽  
Vol 19 (3) ◽  
pp. 306-313 ◽  
Author(s):  
Vanna Zanagnolo ◽  
Lucas Alfonso Minig ◽  
Angelo Gadducci ◽  
Tiziano Maggino ◽  
E. Sartori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Cancer ◽  
Positron Emission Tomography ◽  
Clinical Outcome ◽  
Cervical Carcinoma ◽  
Disease Free Survival ◽  
Emission Tomography ◽  
Recurrent Cervical Cancer ◽  
Positron Emission

Cervical cancer is still one of the most common malignancies in women. Treatment for cervical cancer is very successful, especially in early stage. However, some patients will experience recurrence. Primary purpose of follow-up programs is early detection of recurrence disease that should be more likely to be amenable to treatment, thereby improving the clinical outcome. Although, in the literature, most studies have shown that the surveillance programs did not improve the clinical outcome of patients with diagnosis of recurrence, this clinical practice is regarded as traditional management. The use of Papanicolaou tests to detect recurrent cervical cancer is not sufficiently justified. The assessment of tumor markers such as squamous cell carcinoma antigen could be useful. Imaging techniques are important for the detection and assessment of recurrent disease. The role of chest radiographs to detect asymptomatic recurrence in patients treated for cervical carcinoma remains controversial. Detection of a new abnormal mass or the changes in the size of a known lesion caused by cancer growth and the determination of the extent of recurrence with computed tomography and magnetic resonance imaging may provide clinical assistance in selection of optimal therapy. The fluoro-2-deoxy-glucose-positron emission tomography for surveillance only shows 80% of specificity and accuracy with negative predictive value of 100%. Integrated fluoro-2-deoxy-glucose-positron emission tomography/computed tomography provides precise anatomic localization of suspicious areas and therefore a better diagnostic interpretation with a possible impact on disease-free survival as well. In conclusion, our review confirms the need of prospective studies to compare the effectiveness of different follow-up regimens measuring as outcome overall survival and quality of life parameters.

Sign in / Sign up

Export Citation Format

Share Document