Radiation dose from 18F-FDG PET/CT procedures: influence of specific CT model and protocols

2018 ◽  
Vol 53 (2) ◽  
pp. 107-113
Author(s):  
B. Adeleye ◽  
N. Chetty
Keyword(s):  
Radiation Dose ◽  
Imaging Modality ◽  
Standard Dose ◽  
Ct Imaging ◽  
Dose Assessment ◽  
Radiological Protection ◽  
Study Protocols ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

The increasing use of the integrated 18F-fluoro-deoxy-glucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging modality in the management of tubercular lesions raises concerns about associated radiation exposure. This work aimed to study the effects of CT model and study protocols on the overall radiation dose from a PET/CT examination. Two PET/CT systems with five representative CT exposure protocols applied for clinical patients in PET/CT imaging following retrospective evaluation were studied. CT doses were calculated using the CT-Expo dosimetry software (version 2.4), while the PET component dose was estimated applying the International Commission on Radiological Protection (ICRP) 106 dose coefficients. The total effective dose ranged from 8.0 to 24.05 mSv for system I and 8.35 to 26.85 mSv for system II, resulting in differences of 4.3 to 15% for the low-dose scan and 4.1 to 11% for standard dose scans. The CT component contribution to the total dose was between 32 and 77% for system I, and 35 and 79% for system II. However, the contributions were not significantly different (p > 0.05) for all protocols. The observed variation in CT contribution represents a requisite pedestal on the need for a nation-wide dose assessment for further optimization of the imaging procedure to maximize benefit to patients.

New Targets for PET Imaging of Myeloma

Hemato ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 727-738
Author(s):  
Mona-Elisabeth Revheim ◽  
Caroline Stokke ◽  
Jakob Nordberg Nørgaard ◽  
Hilde Feiring Phillips ◽  
Alexander Gul Sherwani ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Residual Disease ◽  
Imaging Modality ◽  
Ct Imaging ◽  
New Targets ◽  
Pet Tracer ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Recent advances in the treatment of multiple myeloma (MM) have increased the need for accurate diagnosis and detection of minimal residual disease (MRD), disease characterization and localization, and response evaluation and prognostication. Positron emission tomography (PET)/computed tomography (CT) imaging combines molecular and morphological information and has been shown to be especially valuable in this disease. The most frequently used PET tracer in MM is the glucose analog 18F-fluorodeoxyglucose ([18F]FDG). [18F]FDG PET/CT has a sensitivity for detection of MM between 80% to 100% and is currently the main imaging modality for assessing treatment response and for determining MRD. However, 18F-FDG PET/CT has some limitations, and imaging with alternative tracers that may overcome these constraints should be further explored. This article discusses new targets for PET/CT imaging in the assessment of MM.

Incidence and Economic Impact of Incidental Findings on 18F-FDG PET/CT Imaging

2018 ◽  
Vol 69 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Scott J. Adams ◽  
Rajan Rakheja ◽  
Rhonda Bryce ◽  
Paul S. Babyn
Keyword(s):  
Incidental Findings ◽  
Incidental Finding ◽  
Ct Imaging ◽  
Whole Body ◽  
Ontario Health Insurance Plan ◽  
Positron Emission ◽  
Pet Ct ◽  
Picture Archiving And Communication ◽  
Fdg Pet Ct

Purpose The study sought to determine the incidence of incidental findings on whole-body positron emission tomography with computed tomography (PET/CT) imaging and the average costs of investigations to follow-up or further characterize incidental findings. Methods Imaging reports of 215 patients who underwent whole-body PET/CT imaging were retrospectively reviewed. Our provincial picture archiving and communication system was queried and patient charts were reviewed to identify all investigations performed to follow-up incidental findings within 1 year of the initial PET/CT study. Costs of follow-up imaging studies (professional and technical components) and other diagnostic tests and procedures were determined in Canadian dollars (CAD) and U.S. dollars (USD) using the 2015 Ontario Health Insurance Plan Schedule of Benefits and Fees and 2016 U.S. Medicare Physician Fee Schedule, respectively. Results At least 1 incidental finding was reported in 161 reports (74.9%). The mean number of incidental findings ranged from 0.64 in patients <45 years of age to 2.2 in patients 75 years of age and older. Seventy-five recommendations for additional investigations were made for 64 (30%) patients undergoing PET/CT imaging, and 14 of those were carried out specifically to follow-up incidental findings. Averaged across all 215 patients, the total cost of investigations recommended to follow-up incidental findings was CAD$105.51 (USD$127.56) per PET/CT study if all recommendations were acted on, and CAD$22.77 (USD$29.14) based on investigations actually performed. Conclusions As the incidence of incidental findings increases with age and a larger proportion of elderly patients is expected as population demographics change, it will be increasingly important to consider incidental findings on PET/CT imaging with standardized approaches to follow-up.

scholarly journals Prospective Risk-Adjusted [18F]Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography Assessment of Radiation Response in Head and Neck Cancer

2009 ◽  
Vol 27 (15) ◽  
pp. 2509-2515 ◽  
Author(s):  
Benjamin J. Moeller ◽  
Vishal Rana ◽  
Blake A. Cannon ◽  
Michelle D. Williams ◽  
Erich M. Sturgis ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Fdg Pet ◽  
Response Assessment ◽  
Ct Imaging ◽  
Radiation Response ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Purpose [18F]Fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) imaging may improve assessment of radiation response in patients with head and neck cancer, but it is not yet known for which patients this is most useful. We conducted a prospective trial to identify patient populations likely to benefit from the addition of functional imaging to the assessment of radiotherapy response. Patients and Methods Ninety-eight patients with locally advanced cancer of the oropharynx, larynx, or hypopharynx were prospectively enrolled and treated with primary radiotherapy, with or without chemotherapy. Patients underwent FDG-PET/CT and contrast-enhanced CT imaging 8 weeks after completion of treatment. Functional and anatomic imaging response was correlated with clinical and pathologic response. Imaging accuracy was then compared between imaging modalities. Results Although postradiation maximum standard uptake values were significantly higher in nonresponders compared with responders, the positive and negative predictive values of FDG-PET/CT scanning were similar to those for CT alone in the unselected study population. Subset analyses revealed that FDG-PET/CT outperformed CT alone in response assessment for patients at high risk for treatment failure (those with human papillomavirus [HPV] –negative disease, nonoropharyngeal primaries, or history of tobacco use). No benefit to FDG-PET/CT was seen for low-risk patients lacking these features. Conclusion These data do not support the broad application of FDG-PET/CT for radiation response assessment in unselected head and neck cancer patients. However, FDG-PET/CT may be the imaging modality of choice for patients with highest risk disease, particularly those with HPV-negative tumors. Optimal timing of FDG-PET/CT imaging after radiotherapy merits further investigation.

SAT0542 UTILITY OF QUANTITATIVE ANALYSIS OF 18FDG-PET/CT in IgG4-RELATED DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1228.1-1228
Author(s):  
S. Tsuji ◽  
N. Iwamoto ◽  
H. Yoshiro ◽  
K. Fujikawa ◽  
K. Takashi ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Fdg Pet ◽  
Ct Imaging ◽  
Organ Involvement ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Biopsy Site ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Background:In IgG4-related diseases (IgG4-RD), usefulness of18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging for detecting the organ involvement of IgG4-RD have been shown and,18FDG PET/CT was more accurate and appeared to be more sensitive as compared to other imaging technics1,2. However, until now, the studies regarding about quantitative analysis of PET/CT imaging in IgG4-RD were few. To avoid unnecessary biopsy and select suitable lesion for biopsy on multi-organ involvement disease such as IgG4-RD, the information which lesion is suspected as disease-involvement lesion in a non-invasive test is important.Objectives:The purpose of this work is to evaluate the usefulness of18FDG-PE/CT imaging in management of IgG4-RD using quantitative analysis of PET/CT imaging.Methods:21 patients with IgG4-RD, in whom PET/CT was undertaken at the time of diagnosis between December 2009 and July 2018, were enrolled. We retrospectively investigated the association between histological findings in which biopsy was performed for diagnosis of IgG4-RD and findings of PET/CT.18FDG uptake was assessed in site of major organ involvement of IgG4-RD which could be differentiated from the normal uptake of background tissue with18FDG-PET/CT. For quantitative analysis, we measured the highest standardized uptake value (SUV) of the pixels within the region of interest (ROI) (SUVmax) and the average SUV within ROI (SUVmean). We also measured SUVmeanof liver as reference tissue. Then, we calculated ratio between SUVmeanof ROI and SUVmean/liver.Results:The age at diagnosis was 64.5 ± 11.9 years, serum IgG4 was 743.8 ± 584.1 mg/dl, and biopsy was performed at 24 sites (Submandibular gland 10, prostate gland 4, pancreas 2, thyroid gland 1, lung 1, retroperitoneum 1, kidney 1). Histological findings were consistent with IgG4RD (positive) at 19 sites.Although SUVmaxat the biopsy site was not correlated with the biopsy results, SUVmeanat the biopsy site were significantly higher in the biopsy-positive group (figure 1). As similar, SUVmean/liver SUVmeanwere also higher in the biopsy-positive group (2.17 vs 1.52, respectively P<0.05). To establish cut-off value of SUVmeanto consider biopsy, A receiver operating characteristics (ROC) curve was constructed. ROC curve analysis indicated SUVmean=4.074 as cut-off value which discriminate IgG4-RD related lesion.Conclusion:Our present study suggested that quantitative analysis of18FDG-PET/CT imaging is useful for selecting the biopsy site in IgG4-related disease.Figure 1.XXXXXReferences:[1]Ebbo M, Grados A, Guedj E, et al. Usefulness of 2-[18F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography for staging and evaluation of treatment response in IgG4-related disease: a retrospective multicenter study. Arthritis Care Res (Hoboken) 2014; 66(1): 86-96.[2]Zhang J, Chen H, Ma Y, et al. Characterizing IgG4-related disease with (1)(8)F-FDG PET/CT: a prospective cohort study. Eur J Nucl Med Mol Imaging 2014; 41(8): 1624-34.Disclosure of Interests:None declared

The utility of 68Ga-DOTATATE PET/CT in localizing primary/metastatic pheochromocytoma and paraganglioma in children and adolescents – a single-center experience

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sanjeet Kumar Jaiswal ◽  
Vijaya Sarathi ◽  
Gaurav Malhotra ◽  
Priya Hira ◽  
Ravikumar Shah ◽  
...  
Keyword(s):  
Functional Imaging ◽  
Fdg Pet ◽  
Disease Surveillance ◽  
Imaging Modality ◽  
Von Hippel Lindau ◽  
Single Center Experience ◽  
Contrast Enhanced Ct ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractObjectivesPediatric pheochromocytoma and paraganglioma (PPGL) are rare tumors with limited data on the diagnostic performance of 68Ga-DOTA(0)-Tyr(3)-octreotate positron emission tomography–computed tomography (68Ga-DOTATATE PET/CT). We have described our experience of 68Ga-DOTATATE PET/CT in overall and von Hippel Lindau (VHL)-associated pediatric PPGL and compared its sensitivity with that of 131I-meta-iodobenzyl-guanidine (131I-MIBG), 18F-fluorodeoxyglucose PET/CT (18F-FDG PET/CT), and contrast-enhanced CT (CECT).MethodsRetrospective evaluation of consecutive PPGL patients (age: ≤20 years), who had undergone at least one functional imaging [131I-MIBG, 18F-FDG PET/CT, and/or 68Ga-DOTATATE PET/CT], was done. Composite of anatomical and all the performed functional imaging scans, image comparator (IC), was considered as the gold standard for sensitivity analysis.ResultsIn a cohort of 32 patients (16 males, age at diagnosis: 16.4 ± 2.68 years), lesion-wise sensitivity of 68Ga-DOTATATE PET/CT (95%) was higher than that of both 18F-FDG-PET/CT (80%, p=0.027) and 131I-MIBG (65%, p=0.0004) for overall lesions, than that of 18F-FDG-PET/CT (100 vs. 67%, p=0.017) for primary PPG, and than that of 131I-MIBG (93 vs. 42%, p=0.0001) for metastases. In the VHL (n=14), subgroup, 68Ga-DOTATATE PET/CT had higher lesion-wise sensitivity (100%) compared to 18F-FDG PET/CT (74%, p=0.045) and 131I-MIBG (64%, p=0.0145).ConclusionsIn our pediatric PPGL cohort, overall lesion-wise sensitivity of 68Ga-DOTATATE PET/CT was higher than that of 18F–FDG PET/CT and 131I-MIBG scintigraphy. Hence, we recommend 68Ga-DOTATATE PET/CT as the preferred modality in pediatric PPGL. 68Ga-DOTATATE PET/CT may evolve as a preferred imaging modality for disease surveillance in VHL.

scholarly journals 18F-Fluorodeoxyglucose positron emission tomography-computed tomography imaging in HIV-infected patients with lymphadenopathy, with or without fever and/or splenomegaly

2017 ◽  
Vol 29 (7) ◽  
pp. 691-694
Author(s):  
L Jain ◽  
S Mackenzie ◽  
JB Bomanji ◽  
R Shortman ◽  
M Noursadeghi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Ct Imaging ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Fluorodeoxyglucose Positron Emission

We audited whether 18F-Fluorodeoxyglucose positron emission tomography-computed tomography (18FDG PET-CT) imaging could discriminate between different diagnoses in HIV-infected patients presenting with lymphadenopathy, with or without fever and/or splenomegaly. Maximum standardised uptake (SUVmax) values were similar in lymphoma and mycobacterial and fungal infections and were lower but similar in those with human herpesvirus (HHV) 8-associated disease and HIV-associated reactive lymphadenopathy. Nodal 18FDG avidity, with SUVmax ≥10, excluded diagnoses of HHV 8-associated disease and miscellaneous conditions, and HIV-associated reactive lymphadenopathy was additionally excluded in those who had undetectable plasma HIV viral loads. This audit suggests 18FDG PET-CT imaging did not permit discrimination between specific diagnoses but has utility in identifying lymph nodes with increased avidity that could be targeted for biopsy and in ruling out significant pathology.

scholarly journals Non-FDG PET/CT in Diagnostic Oncology: a pictorial review

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Francesco Giammarile ◽  
Paolo Castellucci ◽  
Rudi Dierckx ◽  
Enrique Estrada Lobato ◽  
Mohsen Farsad ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Fdg Pet ◽  
Imaging Modality ◽  
Common Variants ◽  
Inflammatory Conditions ◽  
Pictorial Review ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Radiopharmaceuticals

AbstractPositron emission tomography/computed tomography (PET/CT) is currently one of the main imaging modalities for cancer patients worldwide. Fluorodeoxyglucose (FDG) PET/CT has earned its global recognition in the modern management of cancer patients and is rapidly becoming an important imaging modality for patients with cardiac, neurological, and infectious/inflammatory conditions.Despite its proven benefits, FDG has limitations in the assessment of several relevant tumours such as prostate cancer. Therefore, there has been a pressing need for the development and clinical application of different PET radiopharmaceuticals that could image these tumours more precisely. Accordingly, several non-FDG PET radiopharmaceuticals have been introduced into the clinical arena for management of cancer. This trend will undoubtedly continue to spread internationally. The use of PET/CT with different PET radiopharmaceuticals specific to tumour type and biological process being assessed is part of the personalised precision medicine approach.The objective of this publication is to provide a case-based method of understanding normal biodistribution, variants, and pitfalls, including several examples of different imaging appearances for the main oncological indications for each of the new non-FDG PET radiopharmaceuticals. This should facilitate the interpretation and recognition of common variants and pitfalls to ensure that, in clinical practice, the official report is accurate and helpful.Some of these radiopharmaceuticals are already commercially available in many countries (e.g. 68Ga-DOTATATE and DOTATOC), others are in the process of becoming available (e.g. 68Ga-PSMA), and some are still being researched. However, this list is subject to change as some radiopharmaceuticals are increasingly utilised, while others gradually decrease in use.

The Role of FDG-PET/CT Imaging in Head and Neck Malignant Conditions: Impact on Diagnostic Accuracy and Patient Care

2007 ◽  
Vol 137 (1) ◽  
pp. 130-137 ◽  
Author(s):  
Arie Gordin ◽  
Avishay Golz ◽  
Zohar Keidar ◽  
Marcello Daitzchman ◽  
Rachel Bar-Shalom ◽  
...  
Keyword(s):  
Head And Neck ◽  
Clinical Management ◽  
Imaging Modality ◽  
Head And Neck Carcinoma ◽  
Diagnostic Procedures ◽  
Positron Emission ◽  
Neck Carcinoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact

BACKGROUND: To assess the value of positron emission tomography/computed tomography (PET/CT) with 18 F-Fluorodeoxyglucose (FDG) in patients with head and neck carcinoma as compared with PET and conventional imaging alone, and to assess the impact of PET/CT on further clinical management. STUDY DESIGN: Prospective nonrandomized study. SETTING: Ninety patients with head and neck tumors had 107 PET/CT examinations. RESULTS: The study analysis showed that PET/CT had a sensitivity of 89%, specificity 95%, PPV 94%, NPV 90%, and accuracy of 92%. PET/CT altered management in 51 patients (56%). PET/CT eliminated the need for previously planned diagnostic procedures in 24 patients, induced a change in the planned therapeutic approach in 21 patients and guided biopsy in 6 patients. CONCLUSIONS: PET/CT is an imaging modality with high diagnostic performance in the assessment of head and neck cancer, and induced a change in further clinical management in more than half of the study population.

scholarly journals PET-FDG: Impetus

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1030 ◽  
Author(s):  
Cristina Nanni
Keyword(s):  
Multiple Myeloma ◽  
Fdg Pet ◽  
Complex Disease ◽  
Imaging Modality ◽  
Response To Therapy ◽  
Emission Tomography ◽  
Therapy Assessment ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

The International Myeloma Working Group (IMWG)recommends FDG PET/CT (Fluoro-Deoxy-glucose Positron Emission Tomography/Computed Tomography) as the gold standard imaging modality for initial evaluation and response to therapy assessment in multiple myeloma. In fact, FDG PET/CT, provides multiple useful indexes to risk-stratify patients and has significant prognostic value. However, multiple myeloma remains a complex disease to interpret on imaging. The Italian myeloma criteria for PET use (IMPeTUs) were proposed to standardize FDG PET/CT reading in multiple myeloma. In this communication an overview on IMPeTUs is provided as well as some examples of application.

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