scholarly journals Aktuelle Empfehlungen zur Diagnostik der Riesenzellarteriitis

2019 ◽  
Vol 144 (09) ◽  
pp. 587-594
Author(s):  
Thorsten Bley ◽  
Michael Zänker ◽  
Claudia Dechant ◽  
Nils Venhoff
Keyword(s):  
Temporal Artery ◽  
Duplex Sonography ◽  
Temporal Artery Biopsy ◽  
Positron Emission ◽  
Pet Ct ◽  
Inflammatory Processes ◽  
Magnetic Resonance Imaging Mri ◽  
Fdg Pet Ct ◽  
Color Coded Duplex Sonography ◽  
Inflammation Parameters

AbstractIn Giant Cell Arteritis (GCA), a timely diagnosis is required to avoid severe complications such as blindness or structural vascular damage. The heterogeneous symptoms are mainly due to local and systemic inflammatory processes. Diagnostics are based on increased inflammation parameters in the laboratory, imaging, in which color-coded duplex sonography (FKDS), high-resolution magnetic resonance imaging (MRI), computer tomography (CT) or CT angiography (CTA) and 18F fluorodeoxyglucose-positron emission tomography with CT (FDG-PET-CT) have become established, as well as histopathological findings in temporal artery biopsy.

scholarly journals Primary Hepatic Choriocarcinoma in a Male Patient: A Case Report and Literature Review

2021 ◽  
Author(s):  
Ke Zhao ◽  
Ke Rao ◽  
Xin Chen ◽  
Si Chen ◽  
Haifeng Xu
Keyword(s):  
Male Patient ◽  
Malignant Tumor ◽  
Poor Prognosis ◽  
Clinical Manifestations ◽  
Deep Understanding ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Fdg Pet Ct

Abstract BackgroundChoriocarcinoma is a rare malignant tumor and rarely occurs outside the gonads. Primary hepatic choriocarcinoma is more infrequent, with hidden clinical manifestations, rapid progress, and extremely poor prognosis. Only more than 10 cases were publicly reported in the world. Therefore, there is still a lack of deep understanding of the diagnosis and treatment of the disease.Case presentationWe report a case of primary hepatic choriocarcinoma in a man diagnosed by pathology. A 65-year-old male patient presented with fever and anorexia, nothing but mild jaundice of the skin and sclera was found on physical examination. Abdominal enhanced magnetic resonance imaging (MRI) showed a huge mass in the right hepatic lobe. Fludeoxyglucose-positron emission tomography-computed tomography (FDG-PET/CT) scan showed increased uptake in the liver and sigmoid colon and no uptake in the testes. The patient underwent the right hepatectomy, and postoperative pathology showed that the tumor was primary hepatic choriocarcinoma. Then he received one course of adjuvant chemotherapy. Then he developed severe myelosuppression and was transferred to the intensive care unit for further treatment. He eventually died of severe liver failure about 100 days after surgery. Primary hepatic choriocarcinoma is extremely rare, and its diagnosis is challenging.ConclusionsPrimary hepatic choriocarcinoma is a rare and highly malignant tumor with a poor prognosis. We believe that this differential diagnosis should be considered in liver tumor patients. The effective treatment for this disease is still to be explored.

scholarly journals Bilateral Vertebral Artery Vasculitis—A Rare Manifestation of Giant Cell Arteritis and a Difficult Diagnosis Made Possible by 2-[18F]FDG PET/CT

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 879
Author(s):  
Natasja Justesen ◽  
Michael Hansen ◽  
Mads Jensen ◽  
Oliver Klefter ◽  
Jane Brittain ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Fdg Pet ◽  
Temporal Artery ◽  
High Dose ◽  
Temporal Artery Biopsy ◽  
Glucocorticoid Treatment ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

: Giant cell arteritis (GCA) is the most common form of large vessel vasculitis. GCA is a medical and ophthalmological emergency, and rapid diagnosis and treatment with high-dose corticosteroids is critical in order to reduce the risk of stroke and sudden irreversible loss of vision. GCA can be difficult to diagnose due to insidious and unspecific symptoms—especially if typical superficial extracranial arteries are not affected. In these cases, verification of clinical diagnosis using temporal artery biopsy is not possible. This example illustrates the diagnostic value of hybrid imaging with 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT), and the limitations of the temporal artery biopsy in bilateral vertebral GCA, causing transient ischemic attack in the visual cortex. In addition it indicates that inflammation in the artery wall can be visualized on 2-[18F]FDG PET/CT despite long term and ongoing high dose glucocorticoid treatment.

scholarly journals Imaging Metabolically Active Fat: A Literature Review and Mechanistic Insights

2019 ◽  
Vol 20 (21) ◽  
pp. 5509
Author(s):  
Joseph Frankl ◽  
Amber Sherwood ◽  
Deborah J. Clegg ◽  
Philipp E. Scherer ◽  
Orhan K. Öz
Keyword(s):  
Adipose Tissue ◽  
Brown Adipose Tissue ◽  
Cancer Surveillance ◽  
Mitochondrial Uncoupling ◽  
Positron Emission ◽  
Brown Adipose ◽  
Pet Ct ◽  
Brown Adipose Tissue Activity ◽  
Magnetic Resonance Imaging Mri ◽  
Fdg Pet Ct

Currently, obesity is one of the leading causes death in the world. Shortly before 2000, researchers began describing metabolically active adipose tissue on cancer-surveillance 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in adult humans. This tissue generates heat through mitochondrial uncoupling and functions similar to classical brown and beige adipose tissue in mice. Despite extensive research, human brown/beige fat’s role in resistance to obesity in humans has not yet been fully delineated. FDG uptake is the de facto gold standard imaging technique when studying brown adipose tissue, although it has not been rigorously compared to other techniques. We, therefore, present a concise review of established and emerging methods to image brown adipose tissue activity in humans. Reviewed modalities include anatomic imaging with CT and magnetic resonance imaging (MRI); molecular imaging with FDG, fatty acids, and acetate; and emerging techniques. FDG-PET/CT is the most commonly used modality because of its widespread use in cancer imaging, but there are mechanistic reasons to believe other radiotracers may be more sensitive and accurate at detecting brown adipose tissue activity. Radiation-free modalities may help the longitudinal study of brown adipose tissue activity in the future.

scholarly journals Inflammation, Atherosclerosis, and Coronary Artery Disease: PET/CT for the Evaluation of Atherosclerosis and Inflammation

2014 ◽  
Vol 8s3 ◽  
pp. CMC.S17063 ◽  
Author(s):  
Nadia Alie ◽  
Mootaz Eldib ◽  
Zahi A. Fayad ◽  
Venkatesh Mani
Keyword(s):  
Arterial Walls ◽  
Major Cardiovascular Events ◽  
Positron Emission ◽  
Increased Risk ◽  
Pet Ct ◽  
Potential Benefits ◽  
Artery Disease ◽  
Magnetic Resonance Imaging Mri ◽  
Fdg Pet Ct ◽  
Preclinical And Clinical Studies

Atherosclerosis is a prevalent cardiovascular disease marked by inflammation and the formation of plaque within arterial walls. As the disease progresses, there is an increased risk of major cardiovascular events. Owing to the nature of atherosclerosis, it is imperative to develop methods to further understand the physiological implications and progression of the disease. The combination of positron emission tomography (PET)/computed tomography (CT) has proven to be promising for the evaluation of atherosclerotic plaques and inflammation within the vessel walls. The utilization of the radiopharmaceutical tracer, 18F-fluorodeoxyglucose (18F-FDG), with PET/CT is invaluable in understanding the pathophysiological state involved in atherosclerosis. In this review, we will discuss the use of 18F-FDG-PET/CT imaging for the evaluation of atherosclerosis and inflammation both in preclinical and clinical studies. The potential of more specific novel tracers will be discussed. Finally, we will touch on the potential benefits of using the newly introduced combined PET/magnetic resonance imaging (MRI) for non-invasive imaging of atherosclerosis.

scholarly journals Motor Speech Apraxia in a 70-Year-Old Man with Left Dorsolateral Frontal Arachnoid Cyst: A [18F]FDG PET-CT Study

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Nicolaas I. Bohnen ◽  
Jacob Haugen ◽  
Karen Kluin ◽  
Vikas Kotagal
Keyword(s):  
Arachnoid Cyst ◽  
Brain Structures ◽  
Motor Speech ◽  
Left Frontal Lobe ◽  
Neurodegenerative Process ◽  
Positron Emission ◽  
Pet Ct ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Fdg Pet Ct

Motor speech apraxia is a speech disorder of impaired syllable sequencing which, when seen with advancing age, is suggestive of a neurodegenerative process affecting cortical structures in the left frontal lobe. Arachnoid cysts can be associated with neurologic symptoms due to compression of underlying brain structures though indications for surgical intervention are unclear. We present the case of a 70-year-old man who presented with a two-year history of speech changes along with decreased initiation and talkativeness, shorter utterances, and dysnomia. [18F]Fluorodeoxyglucose (FDG) Positron Emission and Computed Tomography (PET-CT) and magnetic resonance imaging (MRI) showed very focal left frontal cortical hypometabolism immediately adjacent to an arachnoid cyst but no specific evidence of a neurodegenerative process.

AB0597 FDG PET-CT versus Temporal Artery Biopsy in Patients Presenting with Gca/Pmr: A Retrospective Cross-Sectional Study

2014 ◽  
Vol 73 (Suppl 2) ◽  
pp. 1003.1-1003
Author(s):  
S.A. Just ◽  
R.A. Gildberg-Mortensen ◽  
R.A. Andreasen ◽  
N. Lomborg ◽  
M.B. Morillon ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Temporal Artery ◽  
Cross Sectional Study ◽  
Temporal Artery Biopsy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pet Ct ◽  
Fdg Pet Ct

Positron Emission Tomography/Computerized Tomography in Newly Diagnosed Patients with Giant Cell Arteritis Who Are Taking Glucocorticoids

2017 ◽  
Vol 44 (12) ◽  
pp. 1859-1866 ◽  
Author(s):  
Alison H. Clifford ◽  
Elana M. Murphy ◽  
Steven C. Burrell ◽  
Mathew P. Bligh ◽  
Ryan F. MacDougall ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Computerized Tomography ◽  
Temporal Artery ◽  
Emission Tomography ◽  
Temporal Artery Biopsy ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct

Objective.Large vessel uptake on positron emission tomography/computerized tomography (PET/CT) supports the diagnosis of giant cell arteritis (GCA). Its value, however, in patients without arteritis on temporal artery biopsy and in those receiving glucocorticoids remains unknown. We compared PET/CT results in GCA patients with positive (TAB+) and negative temporal artery biopsies (TAB−), and controls.Methods.Patients with new clinically diagnosed GCA starting treatment with glucocorticoids underwent temporal artery biopsy and PET/CT. Using a visual semiquantitative approach, 18F-fluorodeoxyglucose (FDG) uptake was scored in 8 vascular territories and summed overall to give a total score in patients and matched controls.Results.Twenty-eight patients with GCA and 28 controls were enrolled. Eighteen patients with GCA were TAB+. Mean PET/CT scores after an average of 11.9 days of prednisone were higher in patients with GCA compared to controls, for both total uptake (10.34 ± 2.72 vs 7.73 ± 2.56; p = 0.001), and in 6 of 8 specific vascular territories. PET/CT scores were similar between TAB+ and TAB− patients with GCA. The optimal cutoff for distinguishing GCA cases from controls was a total PET/CT score of ≥ 9, with an area under the receiver-operating characteristic curve of 0.75, sensitivity 71.4%, and specificity 64.3%. Among patients with GCA, these measures correlated with greater total PET/CT scores: systemic symptoms (p = 0.015), lower hemoglobin (p = 0.009), and higher platelet count (p = 0.008).Conclusion.Vascular FDG uptake scores were increased in most patients with GCA despite exposure to prednisone; however, the sensitivity and specificity of PET/CT in this setting were lower than those previously reported.

[18F]FDG positron emission tomography and ultrasound in the diagnosis of giant cell arteritis: congruent or complementary imaging methods?

Rheumatology ◽  
2019 ◽  
Vol 59 (4) ◽  
pp. 772-778 ◽  
Author(s):  
Stephan Imfeld ◽  
Markus Aschwanden ◽  
Christof Rottenburger ◽  
Elke Schegk ◽  
Christoph T Berger ◽  
...  
Keyword(s):  
False Positive ◽  
Vessel Wall ◽  
Axillary Artery ◽  
Diagnostic Yield ◽  
Imaging Modality ◽  
Temporal Artery ◽  
Positron Emission ◽  
Pet Ct ◽  
Diagnostic Work ◽  
Fdg Pet Ct

Abstract Objectives [18F]Fluorodeoxyglucose (FDG)-PET/CT and US are both well established for diagnosing GCA. The present study investigates their accuracy and whether they provide overlapping or complementary information in a cohort of patients presenting with suspicion of GCA. Methods We selected consecutive patients from our cohort of suspected GCA cases that underwent both extended vascular US and PET/CT for diagnostic work-up between December 2006 and August 2012. Results A total of 102 patients were included. Diagnosis of GCA was confirmed in 68 patients and excluded in 34 patients (controls). Vasculitic changes in US were most often found in the temporal artery with 32 positive findings on each side, followed by the popliteal artery (10 right, 9 left) and the subclavian/axillary artery (7 right, 8 left). By contrast, PET/CT showed vasculitis most frequently in the vertebral (23 right, 33 left) and common carotid arteries (32 right, 24 left), followed by the subclavian arteries (16 right, 18 left), and the thoracic (17) and abdominal aorta (23). In 37/68 GCA patients PET/CT and US both revealed vasculitic findings, 11/68 had positive findings in US only and 14/68 in PET/CT only. Specificity of US was higher (one false-positive vs five false-positive in PET/CT). On a single segment level, only 20 of 136 positive segments were positive in both imaging modalities. Conclusion PET/CT measuring vessel wall metabolism and US vessel wall morphology showed a comparable diagnostic accuracy for GCA. However PET/CT and US were often discrepant within single vascular regions. Thus PET/CT and US should be considered as complementary methods, with a second imaging modality increasing the diagnostic yield by 16–20%.

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