Comparison of diagnostic accuracy of 18F-FDG PET, 123I-IMT- and 99mTc-MIBI SPECT

2006 ◽  
Vol 45 (01) ◽  
pp. 49-56 ◽  
Author(s):  
N. Özdemir-Sahin ◽  
P. Hipp ◽  
W. Mier ◽  
M. Eisenhut ◽  
J. Debus ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Fdg Pet ◽  
Tumour Progression ◽  
Roc Curves ◽  
Low Grade ◽  
Who Grade ◽  
Pet Tracer ◽  
Patient Groups ◽  
99Mtc Mibi ◽  
Mibi Spect

Summary Aim was to evaluates the diagnostic accuracy of the SPECTtracers 3-123I-α-methyl-L-tyrosine (IMT) and 99mTc(I)- hexakis(2-methoxyisobutylisonitrile) (MIBI) as well as the PET-tracer 2-18F-2-deoxyglucose (FDG) for detecting tumour progression in irradiated low grade astrocytomas (LGA). Patients, methods: We examined 91 patients (56 males; 35 females; 44.7 ± 11.5 years), initially suffering from histologically proven LGAs (mean WHO grade II) and treated by stereotactic radiotherapy (59.0 ± 4.6 Gy). On average 21.9 ± 11.2 months after radiotherapy, patients presented new Gd-DTPA enhancing lesions on MRI, which did not allow a differentiation between progressive tumour (PT) and non-PT (nPT) at this point of time. PET scans (n=82) were acquired 45 min after injection of 208 ± 32 MBq FDG. SPECT scans started 10 min after injection of 269 ± 73 MBq IMT (n=68) and 15 min after injection of 706 ± 63 MBq MIBI (n=34). Lesions were classified as PT and nPT based on prospective follow-up (clinically, MRI) for 17.2 ± 9.9 months after PET/SPECT. Lesion-to-normal ratios (L/N) were calculated using contra lateraly mirrored reference regions for the SPECT examinations and reference regions in the contra lateral grey (GM) and white matter (WM) for FDG PET. Ratios were evaluated by Receiver Operating Characteristic (ROC) analysis. Results: In the patient groups nPT and PT, L/N ratios for FDG (GS) were 0.6 ± 0.3 vs. 1.2 ± 0.5 (p = 0.003), for FDG (WS) 1.2 ± 0.4 vs. 2.6 ± 0.4 (p <0.001), for IMT 1.1 ± 0.1 vs. 1.8 ± 0.4 (p <0.001) and for MIBI 1.6 ± 0.7 vs. 2.6 ± 2.2 (p = 0.554). Areas under the non-parametric ROC-curves were: 0.738 ± 0.059 for FDG (GS), 0.790 ± 0.057 for FDG (WS), 0.937 ± 0.037 for IMT and 0.564 ± 0.105 for MIBI. Conclusion: MIBI-SPECT examinations resulted in a low accuracy and especially in a poor sensitivity even at modest specificity values. A satisfying diagnostic accuracy was reached with FDG PET. Using WM as reference region for FDG PET, a slightly higher AUC as compared to GM was calculated. IMT yielded the best ROC characteristics and the highest diagnostic accuracy for differentiating between PT and nPT in irradiated LGA.

18Fluor-FDG-SPECT zum Nachweis von hibernierendem Myokard: eine Zwischenbilanz FDG-SPECT and Hibernation: An Interim Review

1997 ◽  
Vol 36 (04) ◽  
pp. 125-130
Author(s):  
A. Schaefer ◽  
L. Trampert ◽  
E. Oberhausen ◽  
C.-M. Kirsch ◽  
R. Berberich ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Intraindividueller Vergleich ◽  
99Mtc Mibi ◽  
Mibi Spect

Zusammenfassung Ziel der vorliegenden Arbeit war ein intraindividueller Vergleich von FDG-PET und FDG-SPECT in der myokardialen Vitalitätsdiagnostik. Material und Methodik: Bei 30 Patienten mit KHK wurden vor Revas-kularisation beide Verfahren durchgeführt. Die Beurteilung der myokardialen Perfusion erfolgte mittels 99mTc-MIBI SPECT. Die Resultate wurden von zwei erfahrenen Auswertern unter Verwendung einer 25-Segment-Einteilung des Myokards verglichen. Ergebnisse: Die segmentale Übereinstimmung zwischen PET und SPECT betrug 94,1 %. Die PET wies einen höheren Anteil hibernierendes Myokard aus (8,9% vs. 5,7%) und weniger Narbensegmente (11,5% vs. 16,0%). Die Indikation zur Revaskularisation wurde in 22 Fällen identisch beurteilt. Bei den übrigen 8 Untersuchungen sprach sechsmal die PET und zweimal die SPECT für eine Intervention. Schlußfolgerung: Einer hohen segmentalen Übereinstimmung stehen also erhebliche Unterschiede in der letztendlich entscheidenden klinischen Beurteilung der Untersuchungsergebnisse entgegen.

scholarly journals Differentiation between non-small cell lung cancer and radiation pneumonitis after carbon-ion radiotherapy by 18F-FDG PET/CT texture analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Makito Suga ◽  
Ryuichi Nishii ◽  
Kenta Miwa ◽  
Yuto Kamitaka ◽  
Kana Yamazaki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Diagnostic Accuracy ◽  
Fdg Pet ◽  
Radiation Pneumonitis ◽  
Roc Curves ◽  
Small Cell ◽  
Small Cell Lung ◽  
Texture Parameters ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractThe differentiation of non-small cell lung cancer (NSCLC) and radiation pneumonitis (RP) is critically essential for selecting optimal clinical therapeutic strategies to manage post carbon-ion radiotherapy (CIRT) in patients with NSCLC. The aim of this study was to assess the ability of 18F-FDG PET/CT metabolic parameters and its textural image features to differentiate NSCLC from RP after CIRT to develop a differential diagnosis of malignancy and benign lesion. We retrospectively analyzed 18F-FDG PET/CT image data from 32 patients with histopathologically proven NSCLC who were scheduled to undergo CIRT and 31 patients diagnosed with RP after CIRT. The SUV parameters, metabolic tumor volume (MTV), total lesion glycolysis (TLG) as well as fifty-six texture parameters derived from seven matrices were determined using PETSTAT image-analysis software. Data were statistically compared between NSCLC and RP using Wilcoxon rank-sum tests. Diagnostic accuracy was assessed using receiver operating characteristics (ROC) curves. Several texture parameters significantly differed between NSCLC and RP (p < 0.05). The parameters that were high in areas under the ROC curves (AUC) were as follows: SUVmax, 0.64; GLRLM run percentage, 0.83 and NGTDM coarseness, 0.82. Diagnostic accuracy was improved using GLRLM run percentage or NGTDM coarseness compared with SUVmax (p < 0.01). The texture parameters of 18F-FDG uptake yielded excellent outcomes for differentiating NSCLC from radiation pneumonitis after CIRT, which outperformed SUV-based evaluation. In particular, GLRLM run percentage and NGTDM coarseness of 18F-FDG PET/CT images would be appropriate parameters that can offer high diagnostic accuracy.

scholarly journals Intraoperative squash cytology and histopathological correlation of primary temporal lobe lesions: a 6 year study at tertiary care centre of Kashmir, India

2018 ◽  
Vol 6 (6) ◽  
pp. 2148
Author(s):  
Mohd Iqbal Lone ◽  
Tazeen Jeelani ◽  
Gazanfar Rashid ◽  
Nusrat Bashir ◽  
Dekyong Angmo
Keyword(s):  
Diagnostic Accuracy ◽  
Temporal Lobe ◽  
Pleomorphic Xanthoastrocytoma ◽  
Cns Tumors ◽  
Careful Examination ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
Who Grade ◽  
Female Ratio ◽  
Temporal Lobe Lesions

Background: Central nervous system (CNS) tumors constitute about 1-2% of all the tumors. They are the 6th most common tumors in adults and 2nd most common among childhood tumors. Gliomas are the most common CNS neoplasms. In addition to gliomas temporal lobe has predilection for some peculiar tumor subtypes having good prognosis, including pleomorphic xanthoastrocytoma (PXA), low grade astrocytic tumors and dysembryoplastic neuroepithelial tumor (DNET) in children.Methods: Study was conducted in the department of pathology Sher-e-Kashmir institute of medical sciences (SKIMS) Soura, Srinagar Kashmir India. This was six-year study.Results: Temporal lobe tumors were commonly seen in 3rd to 4th decade of life accounting for 37.9% of the cases followed by 4th to 5th decade (27.5%). The mean age of presentation being 40±10 yrs. Males outnumbered females with a male: female ratio of 1.7:1. Intraoperative squash smears were mostly reported as High grade gliomas (WHO Grade III-IV) accounting to a total of 42 cases (36.2%). On histopathology frequent temporal lobe tumor seen was Glioblastoma multiforme (GBM) 17.4%, followed by pleomorphic xanthoastrocytoma and oligodendroglioma accounting for 14.6% of cases each. On comparing the diagnostic accuracy of intraoperative squash smears to that of Histopathological diagnosis an overall accuracy of 86.2% was observed.Conclusions: Intra operative squash technique in CNS tumors is universally accepted method. In temporal lobe lesions, on adequate sampling and careful examination, squash cytology has fairly good diagnostic accuracy rate of 86.2% when compared to histopathology.

scholarly journals Contribution of advanced neuro-imaging (MR diffusion, perfusion and proton spectroscopy) in differentiation between low grade gliomas GII and MR morphologically similar non neoplastic lesions

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Mohamed Saied Abdelgawad ◽  
Mohamed Hamdy Kayed ◽  
Mohamed Ihab Samy Reda ◽  
Eman Abdelzaher ◽  
Ahmed Hafez Farhoud ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Cerebral Blood Volume ◽  
Area Under The Curve ◽  
Threshold Value ◽  
Low Grade ◽  
Dynamic Susceptibility ◽  
Who Grade ◽  
Low Grade Gliomas ◽  
Neoplastic Lesions ◽  
Neuro Imaging

Abstract Background Non-neoplastic brain lesions can be misdiagnosed as low-grade gliomas. Conventional magnetic resonance (MR) imaging may be non-specific. Additional imaging modalities such as spectroscopy (MRS), perfusion and diffusion imaging aid in diagnosis of such lesions. However, contradictory and overlapping results are still present. Hence, our purpose was to evaluate the role of advanced neuro-imaging in differentiation between low-grade gliomas (WHO grade II) and MR morphologically similar non-neoplastic lesions and to prove which modality has the most accurate results in differentiation. Results All patients were classified into two main groups: patients with low-grade glioma (n = 12; mean age, 38.8 ± 16; 8 males) and patients with non-neoplastic lesions (n = 27; mean age, 36.6 ± 15; 19 males) based on the histopathological and clinical–radiological diagnosis. Using ROC curve analysis, a threshold value of 0.93 for rCBV (AUC = 0.875, PPV = 92%, NPV = 71.4%) and a threshold value of 2.5 for Cho/NAA (AUC = 0.829, PPV = 92%, NPV = 71.4%) had 85.2% sensitivity and 83.3% specificity for predicting neoplastic lesions. The area under the curve (AUC) of ROC analysis was good for relative cerebral blood volume (rCBV) and Cho/NAA ratios (> 0.80) and fair for Cho/Cr and NAA/Cr ratios (0.70–0.80). When the rCBV measurements were combined with MRS ratios, significant improvement was observed in the area under the curve (AUC) (0.969) with improved diagnostic accuracy (89.7%) and sensitivity (88.9%). Conclusions Evaluation of rCBV and metabolite ratios at MRS, particularly Cho/NAA ratio, may be helpful in differentiating low-grade gliomas from non-neoplastic lesions. The combination of dynamic susceptibility contrast (DSC) perfusion and MRS can significantly improve the diagnostic accuracy and can help avoiding the need for an invasive biopsy.

scholarly journals Introduction of Novel Semiquantitative Evaluation of 99mTc-MIBI SPECT Before and After Treatment of Glioma

Medicina ◽  
2012 ◽  
Vol 48 (1) ◽  
pp. 3
Author(s):  
Vytenis Deltuva ◽  
Nemira Jurkienė ◽  
Ilona Kulakienė ◽  
Adomas Bunevičius ◽  
Algimantas Matukevičius ◽  
...  
Keyword(s):  
Radiation Treatment ◽  
Tracer Uptake ◽  
Low Grade Glioma ◽  
Low Grade ◽  
High Grade ◽  
Grade Versus ◽  
Semiquantitative Evaluation ◽  
99Mtc Mibi ◽  
Spect Scan ◽  
Mibi Spect

Background and Objective. There is a need for objective semiquantitative indexes for the evaluation of results of single-photon emission tomography (SPECT) in patients with brain glioma. The aim of this study was to validate the total size index (TSI) and total intensity index (TII) based on technetium-99m-methoxyisobutylisonitrile (99mTc-MIBI) SPECT scans to discriminate the patients with high-grade glioma versus low-grade glioma and to evaluate the changes of viable glioma tissue by the means of TSI and TII after surgery and after radiation treatment. Material and Methods. Thirty-two patients (mean age, 55 years [SD, 18]; 20 men) underwent a 99mTc-MIBI-SPECT scan before surgery. Of these patients, 27 underwent a postoperative 99mTc- MIBI-SPECT scan and 7 patients with grade IV glioma underwent a third 99mTc-MIBI-SPECT scan after radiation treatment. TII that corresponds to the area and intensity of tracer uptake and TSI that corresponds to the area of tracer uptake were calculated before surgery, after surgery, and after radiation treatment. Results. The TII and TSI were found to be valid in discriminating the patients with high-grade versus low-grade glioma with optimal cutoff values of 3.0 and 2.5, respectively. Glioma grade correlated with the preoperative TSI score (r=0.76, P<0.001) and preoperative TII score (r=0.64, P<0.001). There was a significant decrease in the TII and TSI after surgery in patients with grade IV glioma. After radiation treatment, there was a significant increase in the TII in patients with grade IV glioma. Conclusions. TSI and TII were found to be reliable in discriminating the patients with high-grade versus low-grade glioma and allowed for the semiquantitative evaluation of change in viable glioma tissue after surgery and after radiation treatment in patients with grade IV glioma.

scholarly journals Diagnostic accuracy for the epileptogenic zone detection in focal epilepsy could be higher in FDG-PET/MRI than in FDG-PET/CT

2020 ◽  
Author(s):  
Kazufumi Kikuchi ◽  
Osamu Togao ◽  
Koji Yamashita ◽  
Daichi Momosaka ◽  
Tomohiro Nakayama ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Fdg Pet ◽  
Focal Epilepsy ◽  
Focal Cortical Dysplasia ◽  
Low Grade ◽  
Cavernous Haemangioma ◽  
Epileptogenic Zone ◽  
Visual Score ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Objectives To examine the utility of FDG-PET/MRI in patients with epilepsy by comparing the diagnostic accuracy of PET/MRI and PET/CT in epileptogenic zone (EZ) detection. Methods This prospective study included 31 patients (17 males, 14 females) who underwent surgical resection for EZ. All patients were first scanned using FDG-PET/CT followed immediately with FDG-PET/MRI. Two series of PET plus standalone MR images were interpreted independently by five board-certified radiologists. A 4-point visual score was used to assess image quality. Sensitivities and visual scores from both PETs and standalone MRI were compared using the McNemar test with Bonferroni correction and Dunn’s multiple comparisons test. Results The EZs were confirmed histopathologically via resection as hippocampal sclerosis (n = 11, 35.5%), gliosis (n = 8, 25.8%), focal cortical dysplasia (n = 6, 19.4%), and brain tumours (n = 6, 19.4%) including cavernous haemangioma (n = 3), dysembryoplastic neuroepithelial tumour (n = 1), ganglioglioma (n = 1), and polymorphous low-grade neuroepithelial tumour of the young (n = 1). The sensitivity of FDG-PET/MRI was significantly higher than that of FDG-PET/CT and standalone MRI (FDG-PET/MRI vs. FDG-PET/CT vs. standalone MRI; 77.4–90.3% vs. 58.1–64.5% vs. 45.2–80.6%, p < 0.0001, respectively). The visual scores derived from FDG-PET/MRI were significantly higher than those of FDG-PET/CT, as well as standalone MRI (2.8 ± 1.2 vs. 2.0 ± 1.1 vs. 2.1 ± 1.2, p < 0.0001, respectively). Compared to FDG-PET/CT, FDG-PET/MRI increased the visual score (51.9%, increased visual scores of 2 and 3). Conclusions The diagnostic accuracy for the EZ detection in focal epilepsy could be higher in FDG-PET/MRI than in FDG-PET/CT. Key Points • Sensitivity of FDG-PET/MRI was significantly higher than that of FDG-PET/CT and standalone MRI (FDG-PET/MRI vs. FDG-PET/CT vs. standalone MRI; 77.4–90.3% vs. 58.1–64.5% vs. 45.2–80.6%, p < 0.0001, respectively). • Visual scores derived from FDG-PET/MRI were significantly higher than those of FDG-PET/CT and standalone MRI (2.8 ± 1.2 vs. 2.0 ± 1.1 vs. 2.1 ± 1.2, p < 0.0001, respectively). • Compared to FDG-PET/CT, FDG-PET/MRI increased the visual score (51.9%, increased visual scores of 2 and 3).

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