Imaging in the Diagnosis of Nonspecific Pyogenic Spondylodiskitis

2020 ◽  
Author(s):  
Christoph Eckhard Heyde ◽  
Ulrich Josef Albert Spiegl ◽  
Anna Voelker ◽  
Nicolas von der Hoeh ◽  
Jeanette Henkelmann
Keyword(s):  
Fdg Pet ◽  
Early Stage ◽  
High Morbidity ◽  
Gadolinium Enhancement ◽  
Simultaneous Acquisition ◽  
Positron Emission ◽  
Modic Type ◽  
Magnetic Resonance Imaging Mri ◽  
Anatomical Information

AbstractThe prevalence of nonspecific pyogenic spondylodiskitis, associated with both a high morbidity and a high mortality, has increased in the last few decades. The diagnosis is often delayed because of the nonspecific clinical manifestation at the early stage. The reliability of radiographs is limited, particularly in early stage after the onset of infection. Computed tomography (CT) can reliably assess the bony condition with the possibility of spatial visualization. Contrast enhancement supports the detection of affected soft tissue. Magnetic resonance imaging (MRI) continues to be the gold standard in the diagnosis of spondylodiskitis. Sophisticated investigation protocols supported by gadolinium enhancement secure the diagnosis. MRI has a high resolution without radiation exposure. Different nuclear investigation techniques extend the diagnostic options. Reports of 18F-fluorodeoxyglucose-positron emission tomography (18-FDG-PET) are particularly promising to confirm the diagnosis. The drawback of the reduced image quality with respect to detailed anatomical information can be overcome by a combined simultaneous acquisition of CT or MRI. With respect to one of the greatest challenges, the differentiation between degenerative changes (Modic type 1) and infection at an early stage using differentiated MRI protocols and FDG-PET is promising. This overview presents a concise state-of-the-art look at radiologic investigations in case of suspected nonspecific pyogenic spondylodiskitis with the focus on a pragmatic approach.

scholarly journals A Review on the Value of Imaging in Differentiating between Large Vessel Vasculitis and Atherosclerosis

2021 ◽  
Vol 11 (3) ◽  
pp. 236
Author(s):  
Pieter H. Nienhuis ◽  
Gijs D. van Praagh ◽  
Andor W. J. M. Glaudemans ◽  
Elisabeth Brouwer ◽  
Riemer H. J. A. Slart
Keyword(s):  
Fdg Pet ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Current Evidence ◽  
Future Directions ◽  
Inflammatory Conditions ◽  
Positron Emission ◽  
Magnetic Resonance Imaging Mri ◽  
Review Reports ◽  
Ct Studies

Imaging is becoming increasingly important for the diagnosis of large vessel vasculitis (LVV). Atherosclerosis may be difficult to distinguish from LVV on imaging as both are inflammatory conditions of the arterial wall. Differentiating atherosclerosis from LVV is important to enable optimal diagnosis, risk assessment, and tailored treatment at a patient level. This paper reviews the current evidence of ultrasound (US), 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET), computed tomography (CT), and magnetic resonance imaging (MRI) to distinguish LVV from atherosclerosis. In this review, we identified a total of eight studies comparing LVV patients to atherosclerosis patients using imaging—four US studies, two FDG-PET studies, and two CT studies. The included studies mostly applied different methodologies and outcome parameters to investigate vessel wall inflammation. This review reports the currently available evidence and provides recommendations on further methodological standardization methods and future directions for research.

scholarly journals Clinical and Pathological Evidence of Anti-GD2 Immunotherapy Induced Differentiation in Relapsed/Refractory High-Risk Neuroblastoma

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1264
Author(s):  
Jaume Mora ◽  
Alicia Castañeda ◽  
Maria Cecilia Colombo ◽  
Maite Gorostegui ◽  
Fernando Gomez ◽  
...  
Keyword(s):  
High Risk ◽  
Fdg Pet ◽  
Current Therapy ◽  
Bone Lesions ◽  
Functional Magnetic Resonance ◽  
Positron Emission ◽  
Apparent Diffusion ◽  
Neuroblastic Tumors ◽  
Direct Cell ◽  
Magnetic Resonance Imaging Mri

Background: Neuroblastic tumors (NBTs) originate from a block in the process of differentiation. Histologically, NBTs are classified in neuroblastoma (NB), ganglioneuroblastoma (GNB), and ganglioneuroma (GN). Current therapy for high-risk (HR) NB includes chemotherapy, surgery, radiotherapy, and anti-GD2 monoclonal antibodies (mAbs). Anti-GD2 mAbs induce immunological cytoxicity but also direct cell death. Methods: We report on patients treated with naxitamab for chemorefractory NB showing lesions with long periods of stable disease. Target lesions with persisting 123I-Metaiodobenzylguanidine (MIBG) uptake after 4 cycles of immunotherapy were further evaluated by functional Magnetic Resonance Imaging (MRI) and/or Fluorodeoxyglucose (FDG)-positron emission tomography (PET). MIBG avid lesions that became non-restrictive on MRI (apparent diffusion coefficient (ADC) > 1) and/or FDG-PET negative (SUV < 2) were biopsied. Results: Twenty-seven relapse/refractory (R/R) HR-NB patients were enrolled on protocol Ymabs 201. Two (7.5%) of the 27 showed persistent bone lesions on MIBG, ADC high, and/or FDG-PET negative. Forty-four R/R HR-NB patients received chemo-immunotherapy. Twelve (27%) of the 44 developed persistent MIBG+ but FDG-PET- and/or high ADC lesions. Twelve (86%) of the 14 cases identified were successfully biopsied producing 16 evaluable samples. Histology showed ganglioneuroma maturing subtype in 6 (37.5%); ganglioneuroma mature subtype with no neuroblastic component in 4 (25%); differentiating NB with no Schwannian stroma in 5 (31%); and undifferentiated NB without Schwannian stroma in one (6%). Overall, 10 (62.5%) of the 16 specimens were histopathologically fully mature NBTs. Conclusions: Our results disclose an undescribed mechanism of action for naxitamab and highlight the limitations of conventional imaging in the evaluation of anti-GD2 immunotherapy clinical efficacy for HR-NB.

scholarly journals Cervical Cancer: Associations between Metabolic Parameters and Whole Lesion Histogram Analysis Derived from Simultaneous 18F-FDG-PET/MRI

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Hans-Jonas Meyer ◽  
Sandra Purz ◽  
Osama Sabri ◽  
Alexey Surov
Keyword(s):  
Cervical Cancer ◽  
Fdg Pet ◽  
Metabolic Tumor Volume ◽  
Total Lesion Glycolysis ◽  
Histogram Analysis ◽  
Whole Body ◽  
Standardized Uptake Values ◽  
Positron Emission ◽  
18F Fdg ◽  
Magnetic Resonance Imaging Mri

Multimodal imaging has been increasingly used in oncology, especially in cervical cancer. By using a simultaneous positron emission (PET) and magnetic resonance imaging (MRI, PET/MRI) approach, PET and MRI can be obtained at the same time which minimizes motion artefacts and allows an exact imaging fusion, which is especially important in anatomically complex regions like the pelvis. The associations between functional parameters from MRI and 18F-FDG-PET reflecting different tumor aspects are complex with inconclusive results in cervical cancer. The present study correlates histogram analysis and 18F-FDG-PET parameters derived from simultaneous FDG-PET/MRI in cervical cancer. Overall, 18 female patients (age range: 32–79 years) with histopathologically confirmed squamous cell cervical carcinoma were retrospectively enrolled. All 18 patients underwent a whole-body simultaneous 18F-FDG-PET/MRI, including diffusion-weighted imaging (DWI) using b-values 0 and 1000 s/mm2. Apparent diffusion coefficient (ADC) histogram parameters included several percentiles, mean, min, max, mode, median, skewness, kurtosis, and entropy. Furthermore, mean and maximum standardized uptake values (SUVmean and SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were estimated. No statistically significant correlations were observed between SUVmax or SUVmean and ADC histogram parameters. TLG correlated inversely with p25 (r=−0.486,P=0.041), p75 (r=−0.490,P=0.039), p90 (r=−0.513,P=0.029), ADC median (r=−0.497,P=0.036), and ADC mode (r=−0.546,P=0.019). MTV also showed significant correlations with several ADC parameters: mean (r=−0.546,P=0.019), p10 (r=−0.473,P=0.047), p25 (r=−0.569,P=0.014), p75 (r=−0.576,P=0.012), p90 (r=−0.585,P=0.011), ADC median (r=−0.577,P=0.012), and ADC mode (r=−0.597,P=0.009). ADC histogram analysis and volume-based metabolic 18F-FDG-PET parameters are related to each other in cervical cancer.

Revisional Analysis of Electroencephalography and Magnetoencephalography Based on Comprehensive Epilepsy Conference

2020 ◽  
pp. 191-197
Author(s):  
Nobukazu Nakasato ◽  
Akitake Kanno ◽  
Makoto Ishida ◽  
Shin-ichiro Osawa ◽  
Masaki Iwasaki ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Principal Component ◽  
Clinical Decision ◽  
Case Conference ◽  
Positron Emission ◽  
Source Models ◽  
Magnetic Resonance Imaging Mri ◽  
Spike Analysis ◽  
No Gold Standard ◽  
Analysis Models

This chapter highlights the importance of the revised analysis of electroencephalography (EEG) and magnetoencephalography (MEG) spike source estimation based on comprehensive case conference discussion. It discusses two typical cases of localization-related epilepsy: case 1 as a simple situation and case 2 as a complicated situation. No “gold standard” for epileptic spike analysis in EEG or MEG has been established, so several methods must be adopted to achieve the most reasonable interpretation. However, such intense and revisional analyses may be too time-consuming in clinical settings and result in arbitrary conclusions. Therefore, the authors currently use a simple method first, that is, a single dipole model for the peak or preceding upward slope of unaveraged single spikes. In the following case conference, EEG and MEG data are reviewed with seizure semiology, anatomical magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). If all the findings almost agree, the clinical decision can be easily made. If not, revisional analysis of EEG/MEG is recommended using averaged spikes and principal component analysis models as well as distributed source models. In addition to EEG/MEG, the authors often order revisional analysis and additional MRI and FDG-PET studies after the conference. Even further history taking will be recommended if necessary.

scholarly journals Advanced Imaging and Receipt of Guideline Concordant Care in Women with Early Stage Breast Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Elizabeth Trice Loggers ◽  
Diana S. M. Buist ◽  
Laura S. Gold ◽  
Steven Zeliadt ◽  
Rachel Hunter Merrill ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Breast Mri ◽  
Advanced Imaging ◽  
Positron Emission ◽  
Younger Age ◽  
Pet Ct ◽  
Estrogen Receptor Positive ◽  
Magnetic Resonance Imaging Mri

Objective.It is unknown whether advanced imaging (AI) is associated with higher quality breast cancer (BC) care.Materials and Methods.Claims and Surveillance Epidemiology and End Results data were linked for women diagnosed with incident stage I-III BC between 2002 and 2008 in western Washington State. We examined receipt of preoperative breast magnetic resonance imaging (MRI) or AI (defined as computed tomography [CT]/positron emission tomography [PET]/PET/CT) versus mammogram and/or ultrasound (M-US) alone and receipt of guideline concordant care (GCC) using multivariable logistic regression.Results.Of 5247 women, 67% received M-US, 23% MRI, 8% CT, and 3% PET/PET-CT. In 2002, 5% received MRI and 5% AI compared to 45% and 12%, respectively, in 2008. 79% received GCC, but GCC declined over time and was associated with younger age, urban residence, less comorbidity, shorter time from diagnosis to surgery, and earlier year of diagnosis. Breast MRI was associated with GCC for lumpectomy plus radiation therapy (RT) (OR 1.55, 95% CI 1.08–2.26, andp=0.02) and AI was associated with GCC for adjuvant chemotherapy for estrogen-receptor positive (ER+) BC (OR 1.74, 95% CI 1.17–2.59, andp=0.01).Conclusion.GCC was associated with prior receipt of breast MRI and AI for lumpectomy plus RT and adjuvant chemotherapy for ER+ BC, respectively.

Einsatz der FDG-PET bei der Diagnostik des zentralnervösen Lupus erythematodes und Vergleich mit CT und MRI

1989 ◽  
Vol 28 (05) ◽  
pp. 187-192 ◽  
Author(s):  
Gabriele Stoppe ◽  
K. Wildhagen ◽  
G. J. Meyer ◽  
O. Schober
Keyword(s):  
Lupus Erythematosus ◽  
Fdg Pet ◽  
Central Nervous System Involvement ◽  
Special Problem ◽  
Emission Tomography ◽  
Cranial Computed Tomography ◽  
Resonance Imaging ◽  
Positron Emission ◽  
Neuropsychiatric Sle ◽  
Magnetic Resonance Imaging Mri

Central nervous system involvement has been found in 30-75% of all cases of systemic lupus erythematosus (SLE). Up to now, clinical diagnosis is difficult and there are no markers for disease activity. We have compared cranial computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) using fluorodesoxyglucose (FDG) in two cases. FDG-PET is shown to be the most sensitive method demonstrating even reversible deficits and a better correlation with other neurological findings. MRI seems to be more sensitive than CT. A survey of the literature concerning imaging methods in neuropsychiatric SLE is given. The special problem of neuronal desactivation by antineuronal activity is discussed.

scholarly journals The Additional Value of 18F-FDG PET and MRI in Patients with Glioma: A Review of the Literature from 2015 to 2020

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 357
Author(s):  
Natale Quartuccio ◽  
Riccardo Laudicella ◽  
Antonio Vento ◽  
Salvatore Pignata ◽  
Maria Vittoria Mattoli ◽  
...  
Keyword(s):  
Functional Data ◽  
Fdg Pet ◽  
Diagnostic Value ◽  
Complementary Information ◽  
Positron Emission ◽  
Combined Use ◽  
18F Fdg ◽  
Magnetic Resonance Imaging Mri ◽  
Additional Value ◽  
Fluorine 18 Fluorodeoxyglucose

Aim: Beyond brain computed tomography (CT) scan, Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) hold paramount importance in neuro-oncology. The aim of this narrative review is to discuss the literature from 2015 to 2020, showing advantages or complementary information of fluorine-18 fluorodeoxyglucose (18F-FDG) PET imaging to the anatomical and functional data offered by MRI in patients with glioma. Methods: A comprehensive Pubmed/MEDLINE literature search was performed to retrieve original studies, with a minimum of 10 glioma patients, published from 2015 until the end of April 2020, on the use of 18F-FDG PET in conjunction with MRI. Results: Twenty-two articles were selected. Combined use of the two modalities improves the accuracy in predicting prognosis, planning treatments, and evaluating recurrence. Conclusion: According to the recent literature, 18F-FDG PET provides different and complementary information to MRI and may enhance performance in the whole management of gliomas. Therefore, integrated PET/MRI may be particularly useful in gliomas, since it could provide accurate morphological and metabolic information in one-shoot examination and improve the diagnostic value compared to each of procedures.

Low Value of [18F]-Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography in Primary Staging of Early-Stage Cervical Cancer Before Radical Hysterectomy

2006 ◽  
Vol 24 (1) ◽  
pp. 123-128 ◽  
Author(s):  
Hung-Hsueh Chou ◽  
Ting-Chang Chang ◽  
Tzu-Chen Yen ◽  
Koon-Kwan Ng ◽  
Swei Hsueh ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positron Emission Tomography ◽  
Radical Hysterectomy ◽  
Fdg Pet ◽  
Early Stage ◽  
Emission Tomography ◽  
Dual Phase ◽  
Primary Staging ◽  
Positron Emission ◽  
Early Stage Cervical Cancer

Purpose The role of positron emission tomography (PET) with [18F]-fluoro-2-deoxy-d-glucose (FDG) in early-stage cervical cancer is unclear. We aimed to investigate the clinical benefit of FDG-PET in primary staging before radical hysterectomy and pelvic lymphadenectomy (RH-PLND). Patients and Methods Patients with untreated stage IA2 to IIA adenocarcinoma (AD) or adenosquamous carcinoma (ASC) or nonbulky (≤ 4 cm) squamous cell carcinoma cervical cancer with magnetic resonance imaging (MRI) –defined negative nodal metastasis were enrolled onto a prospective study with a two-stage design. All patients had a preoperative dual-phase FDG-PET, technetium-99m–sulfur colloid lymphoscintigraphy, and intraoperative sentinel lymph node (LN) detection at RH-PLND. The gold standard of LN metastasis is histologic. A sample size of 120 patients was calculated to fit study aims (diagnostic efficacy of PET and sentinel LN sampling). An interim analysis was performed when 60 patients were accrued, which led to the current report. Results There were 36 SCCs, 20 ADs, and four ASCs. Of the 60 patients, 10 (16.7%) had pelvic LN metastases, and one (1.7%) had para-aortic LN (PALN) metastasis histologically. FDG-PET detected the single PALN metastasis (one of one patient) but detected only one (10%) of the 10 pelvic LN metastases. The PET false-negative pelvic LN micrometastases measured a median of 4.0 × 3.0 mm (range, 0.5 × 0.5 to 7 × 6 mm). The second stage of this trial will be continued without PET. Conclusion This study shows that dual-phase FDG-PET has little value in primary, nonbulky, stage IA2 to IIA and MRI-defined, LN-negative cervical cancer.

scholarly journals Specification and Selection of Regions of Interest (ROIs) in a Computerized Brain Atlas

1991 ◽  
Vol 11 (1_suppl) ◽  
pp. A64-A68 ◽  
Author(s):  
C. Bohm ◽  
T. Greitz ◽  
R. Seitz ◽  
L. Eriksson
Keyword(s):  
Quantitative Evaluation ◽  
Brain Atlas ◽  
Localization Accuracy ◽  
Transmission Computed Tomography ◽  
Positron Emission ◽  
Anatomical Localization ◽  
Magnetic Resonance Imaging Mri ◽  
Evaluation Of Data ◽  
Anatomical Information ◽  
Selection Of

The computerized individually adjustable brain atlas (CBA) has been further developed. The atlas was primarily designed for anatomical localization and quantitative evaluation of data in positron emission tomography (PET), but may also be employed for other neuroimaging modalities, such as transmission computed tomography (CT) and magnetic resonance imaging (MRI). The atlas is based on anatomical information obtained from digitized cryosectioned brains. Using spatially standardized and then averaged MRI images, we demonstrate the high localization accuracy and precision of the brain atlas. This is a prerequisite for obtaining accuracy when using the atlas in the localization and the quantitative evaluation of PET data. The specification and the selection of region of interests (ROIs) by the CBA are presented and discussed.

scholarly journals 18F-FDG PET in the Diagnosis and Treatment of Primary Central Nervous System Lymphoma

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Nobuyuki Kawai ◽  
Keisuke Miyake ◽  
Yuka Yamamoto ◽  
Yoshihiro Nishiyama ◽  
Takashi Tamiya
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Tumors ◽  
Fdg Pet ◽  
Early Stage ◽  
Central Nervous System Lymphoma ◽  
Diagnosis And Treatment ◽  
Fdg Uptake ◽  
Malignant Brain Tumors ◽  
Positron Emission

This paper summarizes the usefulness and limitation of positron emission tomography (PET) with18F-fluorodeoxyglucose (18F-FDG) in the diagnosis and treatment of primary central nervous system lymphoma (PCNSL). The18F-FDG uptake in typical PCNSL is about 2.5 times higher than that in the normal gray matter, and the tumor can usually be identified visually. The18F-FDG uptake pattern and value provide useful information for differentiating PCNSL from other enhancing malignant brain tumors especially glioblastoma (GB). The18F-FDG uptake in typical PCNSL is usually homogenous, and the uptake value is significantly higher than that in GB. However,18F-FDG PET often fails to show the presence of tumor in the brain as18F-FDG uptake is faint in atypical PCNSL such as disseminated or nonenhancing lesions.18F-FDG PET is also useful for evaluating the treatment response at a very early stage after the initial treatment. Pretreatment and posttreatment18F-FDG uptake values may have a prognostic value in patients with PCNSL. In conclusion,18F-FDG PET is very useful in the diagnosis of typical PCNSL and can differentiate PCNSL from other malignant brain tumors. However, the usefulness of18F-FDG PET is limited in the diagnosis of atypical PCNSL.

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