scholarly journals A 7-year warranty period for chest pain patients with a non-ischaemic [15O]H2O positron emission tomography: a follow-up of 273 individuals

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
RA Jukema ◽  
PA Diemen Van ◽  
RS Driessen ◽  
J Stuijfzand ◽  
PG Raijmakers ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Positron Emission Tomography ◽  
Event Rate ◽  
Favourable Outcome ◽  
Pet Scan ◽  
Emission Tomography ◽  
Warranty Period ◽  
Positron Emission ◽  
All Cause Mortality

Abstract Funding Acknowledgements Type of funding sources: None. Background   A normal perfusion scan is associated with a favourable outcome. The aim of the present study is to determine the warranty period of normal hyperemic myocardial blood flow (MBF) derived with quantitative [15O]H2O positron emission tomography (PET) in symptomatic individuals with cardiovascular risk factors.  Methods A total of 539 patients referred for baseline adenosine [15O]H2O PET MBF imaging because of suspected coronary artery disease (CAD) were investigated. A PET scan was considered normal if the hyperemic MBF  was > 2.3 ml/min/g.  The warranty period was predefined as < 2% annual event rate. The primary endpoint was a composite of late revascularizations, myocardial infarction and all-cause mortality.   Results In a total of 273 patients (mean age 57.2 ± 9.1; 34.4% male) with a normal PET scan, 19 events occurred during a median follow-up of 6.8 years (interquartile range 4.9-7.7).  Events included 10 late revascularizations, 2 myocardial infarctions and 7 deaths. The annual event rate exceeded 2% in the 8th year of follow-up, resulting in a warranty period of 7 years  (see Figure 1).  Conclusion In patients referred for suspected CAD a normal hyperemic perfusion derived by [15O]H2O PET confers a 7-year warranty period against late revascularization, myocardial infarction and all-cause mortality.

Abstract 1775: Prognostic Value of Exercise and Dobutamine Positron Emission Tomography

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Owayed Al Shammeri ◽  
Rob Beanlands ◽  
Terrence Ruddy ◽  
Robert deKemp ◽  
Benjamin Chow
Keyword(s):  
Positron Emission Tomography ◽  
Cardiac Death ◽  
Prognostic Value ◽  
Treadmill Exercise ◽  
Event Rate ◽  
Dobutamine Stress ◽  
Emission Tomography ◽  
Cardiac Events ◽  
Positron Emission

Introduction Positron emission tomography (PET) is commonly performed using vasodilator stress, but exercise and dobutamine stress is available to patients with contraindications to vasodilators. Vasodilator PET appears to have prognostic value, however the prognostic value of PET using stressors which induce myocardial ischemia have not been well evaluated. Hypothesis To evaluate the prognostic value of myocardial demand ischemia induced by treadmill exercise and dobutamine PET. Methods 124 patients (mean age = 61.29 ± 10.73 years; 87 men) had treadmill exercise or dobutamine Rb-82 or N-13 ammonia PET. Images were assessed qualitatively using a 17-segment model and a semi-quantitative visual score (five-point scale) to calculate the summed stress score (SSS). Images were categorized as normal (SSS<4), abnormal (SSS ≥ 4) or inconclusive (SSS< 4 and suboptimal treadmill exercise or dobutamine stress). Follow-up was performed to ascertain outcomes (cardiac death, nonfatal MI and/or late revascularization. Results Of the 124 patients, 46 (37.1%) had a normal PET, 15 (12.1%) had an inconclusive study, and 63 (50.1%) had an abnormal PET (mean follow up 2.8 ± 1.4 years). There were no deaths or non-fatal MI but 1 late revascularization (annual event rate = 1.7%) in the group with a normal PET. Abnormal PET MPI group had 15 cardiac events (1 cardiac death, 4 nonfatal MI, and 10 late revascularization) with an annual event rate of 13.0% (p = 0.002). Conclusions Though small, this study suggests that myocardial PET perfusion defects resulting from demand ischemia induced by treadmill exercise and dobutamine stress may have prognostic value.

Positron Emission Tomography Scans in the Evaluation of Postchemotherapy Residual Masses in Patients With Seminoma

1999 ◽  
Vol 17 (11) ◽  
pp. 3457-3460 ◽  
Author(s):  
Kristen N. Ganjoo ◽  
Rebecca J. Chan ◽  
Matt Sharma ◽  
Lawrence H. Einhorn
Keyword(s):  
Positron Emission Tomography ◽  
Residual Disease ◽  
Pet Scan ◽  
Emission Tomography ◽  
Positron Emission ◽  
Group A ◽  
Residual Masses ◽  
Group B ◽  
Pet Scans

PURPOSE: To assess the ability of positron emission tomography (PET) scans in differentiating between necrosis and viable seminoma in postchemotherapy (PC) residual disease. PATIENTS AND METHODS: We conducted a prospective study of 29 patients with seminoma at Indiana University. All patients had PC residual disease. Computed tomography and PET scans were performed for 19 patients after primary chemotherapy (group A) and for 10 patients after salvage chemotherapy (group B). RESULTS: In group A, the PC masses were ≥ 3 cm in 14 patients, less than 3 cm in three patients, and not quantified in two patients. All of the patients in group A had negative PET scan results and have had stable or decreasing residual mass size (median follow-up duration, 11.5 months; range, 6 to 26 months). In group B, the PC masses were ≥ 3 cm in four patients, less than 3 cm in five patients, and not quantified in one patient. One patient had a positive PET scan result for a posterior mediastinal mass. Pathologic diagnosis of the PET-positive mass showed only necrotic tissue. The same patient had a negative PET scan of the retroperitoneal mass but relapsed in that area. Overall, of patients in group B, five have stable or decreasing mass (median follow-up duration, 8 months; range, 7 to 22 months), and five had relapsed disease. CONCLUSION: PET scans have no apparent benefit in PC evaluation of residual masses in bulky seminoma.

scholarly journals Defining the prognostic value of [15O]H2O positron emission tomography derived myocardial ischemic burden

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P.A Van Diemen ◽  
J.T Wijmenga ◽  
R.S Driessen ◽  
M.J Bom ◽  
S.P Schumacher ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Single Photon ◽  
Event Rate ◽  
Photon Emission ◽  
Emission Tomography ◽  
Emission Computed Tomography ◽  
Quantitative Pet ◽  
Flow Reserve ◽  
Positron Emission

Abstract Background A myocardial ischemic burden (IB) of 10% is used to denote high-risk patients with coronary artery disease (CAD). This threshold has primarily been assessed by single-photon emission computed tomography. Differences in the pharmacokinetics of the utilized traces, higher resolution of positron emission tomography (PET), and lastly differences in assessment of IB might lead to a higher prognostic threshold for quantitative PET. Purpose To determine a [15O]H2O PET derived IB to identify low (annualized event rate (AER) &lt;1.0%) and high (AER ≥3%) risk CAD patients. Methods 623 patients who underwent [15O]H2O PET because of suspected CAD and in whom follow-up was obtained were included. The IB was defined as the percentage of myocardium with a hyperemic blood flow (hMBF) ≤2.3 ml/min/g and by a coronary flow reserve (CFR) of ≤2.5. The endpoint was a composite of death and non-fatal myocardial infarction (MI). Time-dependent ROC curves were constructed for the prediction of the endpoint within the first 5-years, based on these curves thresholds were selected for which specificity was maximized and sensitivity was at least 80%. Patients were classified as having a high IB if their respective IBs were above the prognostic thresholds and as having a low IB if not. Results During a median follow-up of 6.7 years, 34 (6%) patients died and 28 (4%) experienced a MI resulting in 62 (10%) endpoints. An IB of 24% and 28% for hMBF and CFR, respectively, was found to be the optimal threshold to define prognosis. Patients with a high hMBF or high CFR IB had worse outcome compared to patients with a low IB (log-rank p&lt;0.001 for both), with AERs of 0.6% vs. 2.8%, and 0.6% vs. 2.4% (p&lt;0.001 for both), respectively. Patients with a concordantly high hMBF and CFR derived IB had the worst outcome (AER: 3.1%), whereas patients with a concordantly low or discordant IB result had a similarly low event rate of 0.5% and 0.9% (p=0.953), respectively (log-rank p=0.445). A concordantly high hMBF and CFR IB was an independent predictor of adverse outcome beyond clinical characteristics (adjusted hazard ratio: 3.52, p&lt;0.001). Conclusion An IB of 24% and 28% for hMBF and CFR was found to be the optimal prognostic threshold. Both measurements can be used to determine patients outcome. However combining hMBF and CFR IB results leads to a further refinement of risk-stratification allowing for the identification of low (concordant low or discordant IB result) and high (concordant high IB result) risk CAD patients. Funding Acknowledgement Type of funding source: None

scholarly journals [18F]fluoro-2-deoxy-d-glucose ([18F]FDG) positron emission tomography imaging of thymic carcinoid tumor presenting with recurrent Cushing’s syndrome

2005 ◽  
Vol 152 (4) ◽  
pp. 521-525 ◽  
Author(s):  
Athina Markou ◽  
Patrick Manning ◽  
Banu Kaya ◽  
Sam N Datta ◽  
Jamshed B Bomanji ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
High Resolution ◽  
Carcinoid Tumor ◽  
Fdg Pet ◽  
Pet Scan ◽  
Emission Tomography ◽  
Thymic Carcinoid ◽  
Acth Secretion ◽  
Positron Emission ◽  
Thymic Carcinoid Tumor

We report a case of a young woman with Cushing’s syndrome (CS), in whom although endocrine investigations and negative pituitary imaging were suggestive of ectopic ACTH secretion, the results of inferior petrosal sinus (IPS) sampling after coricotropin-releasing hormone (CRH) stimulation were suggestive of pituitary ACTH hypersecretion. 111In-labelled octreotide and high-resolution computer tomography (CT) revealed a lesion possibly responsible for the ACTH source in the thymus. Thymectomy confirmed concomitant ectopic CRH and probable ACTH production by a thymic neuroendocrine carcinoma. After an 8-year remission period the patient developed a clinical and biochemical relapse. A high-resolution computed tomography (CT) scan of the thorax showed a 2-cm nodule in the thymic bed, which was positive on a [18F]fluoro-2-deoxy-d-glucose ([18F]FDG) positron emission tomography (PET) scan. However, a repeated thymectomy did not result in remission. A repeat [18F]FDG PET study showed persistent disease in the thymic bed and also uptake in the adrenals. The patient underwent bilateral adrenalectomy, which resulted in clinical remission. A further [18F]FDG PET scan 8 months later showed no progression of the thymic tumor and confirmed complete excision of the adrenals. This is a rare case of concomitant CRH and ACTH secretion from a thymic carcinoid tumor; the case illustrates the usefulness of functional imaging with [18F]FDG PET in the diagnosis, management and follow-up of neuroendocrine tumors.

scholarly journals Association of weight change with cerebrospinal fluid biomarkers and amyloid positron emission tomography in preclinical Alzheimer’s disease

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Oriol Grau-Rivera ◽  
◽  
Irene Navalpotro-Gomez ◽  
Gonzalo Sánchez-Benavides ◽  
Marc Suárez-Calvet ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Weight Loss ◽  
Cerebrospinal Fluid ◽  
Weight Change ◽  
Emission Tomography ◽  
Link Type ◽  
Preclinical Ad ◽  
Positron Emission ◽  
T Tau

Abstract Background Recognizing clinical manifestations heralding the development of Alzheimer’s disease (AD)-related cognitive impairment could improve the identification of individuals at higher risk of AD who may benefit from potential prevention strategies targeting preclinical population. We aim to characterize the association of body weight change with cognitive changes and AD biomarkers in cognitively unimpaired middle-aged adults. Methods This prospective cohort study included data from cognitively unimpaired adults from the ALFA study (n = 2743), a research platform focused on preclinical AD. Cognitive and anthropometric data were collected at baseline between April 2013 and November 2014. Between October 2016 and February 2020, 450 participants were visited in the context of the nested ALFA+ study and underwent cerebrospinal fluid (CSF) extraction and acquisition of positron emission tomography images with [18F]flutemetamol (FTM-PET). From these, 408 (90.1%) were included in the present study. We used data from two visits (average interval 4.1 years) to compute rates of change in weight and cognitive performance. We tested associations between these variables and between weight change and categorical and continuous measures of CSF and neuroimaging AD biomarkers obtained at follow-up. We classified participants with CSF data according to the AT (amyloid, tau) system and assessed between-group differences in weight change. Results Weight loss predicted a higher likelihood of positive FTM-PET visual read (OR 1.27, 95% CI 1.00–1.61, p = 0.049), abnormal CSF p-tau levels (OR 1.50, 95% CI 1.19–1.89, p = 0.001), and an A+T+ profile (OR 1.64, 95% CI 1.25–2.20, p = 0.001) and was greater among participants with an A+T+ profile (p < 0.01) at follow-up. Weight change was positively associated with CSF Aβ42/40 ratio (β = 0.099, p = 0.032) and negatively associated with CSF p-tau (β = − 0.141, p = 0.005), t-tau (β = − 0.147 p = 0.004) and neurogranin levels (β = − 0.158, p = 0.002). In stratified analyses, weight loss was significantly associated with higher t-tau, p-tau, neurofilament light, and neurogranin, as well as faster cognitive decline in A+ participants only. Conclusions Weight loss predicts AD CSF and PET biomarker results and may occur downstream to amyloid-β accumulation in preclinical AD, paralleling cognitive decline. Accordingly, it should be considered as an indicator of increased risk of AD-related cognitive impairment. Trial registration NCT01835717, NCT02485730, NCT02685969.

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