The Role of Whole- Body Diffusion Imaging with Background Signal Suppression (DWBS) in comparison with PET/CT in assessment of lymphoma patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Randa Hossein Abdallah ◽  
Samer Malak Botros ◽  
Amal Ibrahim Ahmed Othman ◽  
Mohamed Mahmoud Ibrahim Aboshanab
Keyword(s):  
Fdg Pet ◽  
Whole Body ◽  
Malignant Lymphomas ◽  
Pet Ct ◽  
Accuracy Measures ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct ◽  
Post Therapy ◽  
Initial Staging ◽  
Higher Sensitivity

Abstract Background Malignant lymphomas [Hodgkin lymphomas (HL) and non-Hodgkin lymphoma (NHL)] rank third in incidence, of all childhood cancers, Moreover, in adolescents (aged 15-19 years) the malignant lymphomas are the leading cause of cancer. Furthermore, as with many other cancers, the likelihood of an individual being diagnosed with lymphoma increases markedly with age, with the median age at diagnosis being 67 years. Aim of the Work To compare between F-18-FDG PET-CT and whole-body diffusion-weighted imaging MR protocol (DWIBS) for initial staging and post chemotherapy evaluation in patients with pathologically proven lymphoma (Hodgkin and Non-Hodgkin). Patients and Methods The study is conducted on 32 patients with pathologically proven lymphoma to perform 18-F-FDG PET/CT either for pre-treatment initial staging or for evaluation of response to chemotherapy. A total of 22 had HD (69%) and 10 had NHL (31%). Staging PET/CT and WB-MRI/DWIBS were done at time of diagnosis in 19 of the 32 patients (59.4%), where immediate post-therapy PET/CT and WB-MRI-DWIBS were performed 13 patients (40.6%). Accuracy measures were calculated for PET CT and DWIBS. Results Accuracy measures confirm the higher sensitivity and specificity of PET-CT over DWIBS. Results for F-18 FDG PET/CT were clearly superior with statistically higher sensitivity, specificity, accuracy, PPV & NPV (96.3%, 99.16%, 98.43%, 97.5% and 98.75%) compared to (83.95%, 97.91%, 94.38%, 93.15% and 94.74%) for DWIBS results respectively. Conclusion F-18-FDG PET-CT remains a cornerstone in the evaluation of malignant lymphoma patients; it has significant higher sensitivity, specificity and overall accuracy compared to WB-MRI/DWIBS in HL and NHL patients, either in initial staging or in post therapy evaluation. WB-MRI/DWIBS in HL and NHL patients, either in initial staging or in post therapy evaluation. WB-MRI/DWIBS despite of its relatively longer acquisition time may provide a complementary tool for FDG PET CT.

scholarly journals Comparison of the Diagnostic Value of MRI and Whole Body 18F-FDG PET/CT in Diagnosis of Spondylodiscitis

2020 ◽  
Vol 9 (5) ◽  
pp. 1581
Author(s):  
Corinna Altini ◽  
Valentina Lavelli ◽  
Artor Niccoli-Asabella ◽  
Angela Sardaro ◽  
Alessia Branca ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Diagnostic Value ◽  
Whole Body ◽  
Spine Infection ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct ◽  
Ct And Mri

Spondylodiscitis is a spine infection for which a diagnosis by a magnetic resonance imaging (MRI) is considered the most appropriate imaging technique. The aim of this study was to compare the role of an 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and an MRI in this field. For 56 patients with suspected spondylodiscitis for whom MRI and 18F-FDG PET/CT were performed, we retrospectively analyzed the results. Cohen’s κ was applied to evaluate the agreement between the two techniques in all patients and in subgroups with a different number of spinal districts analyzed by the MRI. Sensitivity, specificity, and accuracy were also evaluated. The agreements of the 18F-FDG PET/CT and MRI in the evaluation of the entire population, whole-spine MRI, and two-districts MRI were moderate (κ = 0.456, κ = 0.432, and κ = 0.429, respectively). In patients for whom one-district MRI was performed, 18F-FDG PET/CT and MRI were both positive and completely concordant (κ = 1). We also separately evaluated patients with suspected spondylodiscitis caused by Mycobacterium tuberculosis for whom the MRI and 18F-FDG PET/CT were always concordant excepting in 2 of the 18 (11%) patients. Sensitivity, specificity, and accuracy of the MRI and 18F-FDG PET/CT were 100%, 60%, 97%, and 92%, 100%, and 94%, respectively. Our results confirmed the 18F-FDG PET/CT diagnostic value in the diagnosis of spondylodiscitis is comparable to that of MRI for the entire spine evaluation. This could be considered a complementary technique or a valid alternative to MRI.

Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard

2014 ◽  
Vol 24 (5) ◽  
pp. 1153-1165 ◽  
Author(s):  
Annemieke S. Littooij ◽  
Thomas C. Kwee ◽  
Ignasi Barber ◽  
Claudio Granata ◽  
Malou A. Vermoolen ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Whole Body ◽  
Reference Standard ◽  
Whole Body Mri ◽  
Prospective Comparison ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Initial Staging

scholarly journals 18F-FDG-PET/CT for Evaluation of treatment response in high grade lymphoma

2017 ◽  
Vol 1 (1) ◽  
pp. 42-52
Author(s):  
Yadav Ajay Kumar ◽  
Kumar Rakesh ◽  
Malhotra Arun ◽  
Sharma Atul
Keyword(s):  
Treatment Response ◽  
Fdg Pet ◽  
High Grade ◽  
Predictive Values ◽  
Pet Ct ◽  
18F Fdg ◽  
Ct Data ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct ◽  
Post Therapy

18F-FDG PET is highly sensitive and specific for evaluation of the treatment response of high-grade lymphomas. The molecular information provided by 18F-FDG-PET identifies the functional content of anatomic finding and helps to categorize their nature as malignant or benign. On the other hand, the CT data obtained in the same setting provides anatomical localization of the 18F-FDG-PET data while also improving the FDG-PET image quality as it is utilized for attenuation correction. Previously, most of the studies were done on this topic by using 18F-FDG-PET alone. Present study was planning to assess the role of 18F-FDG-PET/CT in evaluation of treatment response in patient of HD and NHL. Results showed that 43 patients out of 52 showed no pathologic FDG uptakes, whereas 9 showed persistent uptakes. Among the 43 patients who had negative PET scans, only three relapsed, whereas among the 9 patients who had persistent abnormal 18F-FDG uptakes on post therapy PET/CT scans, two recovered. The sensitivity, specificity, positive and negative predictive values and accuracy of post therapy PET/CT scan was 70%, 95%, 78%, 93%, and 90% respectively.

scholarly journals Agreement Between 18F-FDG PET/CT and Whole-Body Magnetic Resonance Compared With Skeletal Survey for Initial Staging and Response at End-of-Treatment Evaluation of Patients With Multiple Myeloma

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nieves Gómez León ◽  
Beatriz Aguado Moreno ◽  
María Herreros Pérez ◽  
Luisa F. León Ramírez ◽  
Adrián Alegre ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Magnetic Resonance ◽  
Fdg Pet ◽  
Treatment Evaluation ◽  
Whole Body ◽  
End Of Treatment ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Initial Staging

Diagnostic Capabilities of MRI Versus 18F FDG PET-CT in Postoperative Patients with Thyroglobulin Positive, 131I-negative Local Recurrent or Metastatic Thyroid Cancer

2019 ◽  
Vol 15 (10) ◽  
pp. 956-964
Author(s):  
Cesur Samanci ◽  
Yilmaz Onal ◽  
Sait Sager ◽  
Sertac Asa ◽  
Fethi Emre Ustabasioglu ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Study Design ◽  
Predictive Value ◽  
Fdg Pet ◽  
Elevated Serum ◽  
Whole Body ◽  
Pet Ct ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

Background: The detection of recurrence or metastasis might be challenging in patients, who underwent total thyroidectomy and radioactive iodine therapy for Differentiated Thyroid Carcinoma (DTC), with increased serum Thyroglobulin (Tg) levels and negative 131I whole body scan (131I-WBS) results. Aims: The purpose of this study was to compare the ability of Magnetic Resonance Imaging (MRI) and 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F FDG PET-CT) to detect recurrence or cervical and upper mediastinal metastases in postoperative DTC patients who had negative 131I-WBS despite elevated serum Tg levels. Study Design: This study has a retrospective study design. Methods: We evaluated cervical and upper mediastinal MRI and 18F FDG PET-CT of 32 postoperative patients with DTC (26 patients with papillary thyroid carcinoma and 6 patients with follicular thyroid carcinoma). Results: We evaluated 44 lesions in 32 patients. For all lesions, the Positive Predictive Value, (PPV) Negative Predictive Value (NPV), sensitivity, specificity, and accuracy of MRI were 81.4%, 76.4%, 84.6%, 72.2%, and 79.5% respectively. The PPV, NPV, sensitivity, specificity, and accuracy of 18F FDG PET-CT were 100.0%, 85.7%, 88.4%, 100.0%, and 93.1%, respectively. Conclusion: Although we could not replace 18F FDG PET-CT, MRI might be used as an adjunct to 18F FDG PET-CT for the evaluation of recurrent or cervical and upper mediastinal metastatic thyroid cancers; however, MRI is inadequate for the detection of metastases in small lymph nodes.

Whole-Body Diffusion-Weighted MRI Compared to 18 FFDG PET/CT in Initial Staging and Therapy Response Assessment of Hodgkin Lymphoma in Pediatric Patients

2020 ◽  
Vol 71 (2) ◽  
pp. 217-225 ◽  
Author(s):  
Gali Shapira-Zaltsberg ◽  
Nagwa Wilson ◽  
Esther Trejo Perez ◽  
Lesleigh Abbott ◽  
Stephen Dinning ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Pediatric Patients ◽  
Whole Body ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Initial Staging

Purpose: The aim of our study was to compare whole-body diffusion-weighted MRI (WB-DWI-MRI) to fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the assessment of initial staging and treatment response in pediatric patients with Hodgkin lymphoma. Materials and Methods: This prospective study comprised 11 children with Hodgkin lymphoma. Whole-body DWI-MRI and FDG-PET/CT were obtained at baseline and after 2 cycles of chemotherapy. Two radiologists measured the apparent diffusion coefficient (ADC) values of the sites of involvement agreed upon in consensus and 1 nuclear medicine physician assessed the PET/CT. Reliability of radiologists’ ratings was assessed by intraclass correlation coefficients (ICC2,1). The sensitivity and positive predictive value (PPV) of DW-MRI relative to PET/CT were calculated for nodal and extranodal sites. The patients were staged according to both modalities. Association of treatment responses was assessed through the Pearson correlation between the ADC ratios and the change standardized uptake value (SUV) between baseline and follow-up. Results: There was good agreement between the raters for nodal and extranodal ADC measurements. The sensitivity and PPV of DW-MRI relative to PET/CT of nodal disease was 0.651 and 1.0, respectively, at baseline, and 0.697 and 0.885 at follow-up. The sensitivity and PPV of extranodal disease were 0.545 and 0.6 at baseline, and 0.167 and 0.333 at follow-up. Diffusion-weighted MRI determined correct tumor stage in 8 of 11 examinations. There was poor correlation between the ADC ratios and the absolute change in SUV between baseline and follow-up (0.348). Conclusion: Our experience showed that WB-DWI-MRI is inferior to PET/CT for initial staging and assessment of treatment response of Hodgkin lymphoma in pediatric patients.

scholarly journals Role of Multimodal Imaging in Patients With Suspected Infections After the Bentall Procedure

2021 ◽  
Vol 8 ◽  
Author(s):  
Martina Sollini ◽  
Francesco Bartoli ◽  
Roberto Boni ◽  
Roberta Zanca ◽  
Andrea Colli ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Fdg Pet ◽  
Multimodal Imaging ◽  
Suspected Infection ◽  
Bentall Procedure ◽  
Duke Criteria ◽  
Pet Ct ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct ◽  
Higher Sensitivity

Purpose: This study aimed to assess the diagnostic performances of multimodal imaging [i.e., white blood cell single-photon emission computed tomography/CT (99mTc-HMPAO-WBC SPECT/CT) and 18-fluoride-fluorodeoxyglucose positron emission tomography/CT ([18F]FDG PET/CT)] in patients with suspected infection after the Bentall procedure, proposing new specific diagnostic criteria for the diagnosis.Methods: Between January 2009 and December 2019, we selected within a cardiovascular infections registry, 76 surgically treated patients (27 women and 49 men, median 66 years, and range 29–83 years). All the patients underwent molecular imaging for a suspected infection after the replacement of the aortic valve and ascending aorta according to the Bentall procedure. We analyzed 98 scans including 49 99mTc-WBC and 49 [18F]FDG PET/CT. A total of 22 patients with very early/early suspected infection (<3 months after surgery) were imaged with both the techniques. Positive imaging was classified according to the anatomical site of increased uptake: to the aortic valve (AV), to both the AV and AV tube graft (AVTG) or to the TG, to surrounding tissue, and/or to extracardiac sites (embolic events or other sites of concomitant infection). Standard clinical workup included in all the patients having echocardiography/CT, blood culture, and the Duke criteria. Pretest probability and positive/negative likelihood ratio were calculated. Sensitivity and specificity of 99mTc labeled hexamethylpropylene amine oxime-WBC SPECT/CT (99mTc-HMPAO-WBC SPECT/CT) and [18F]FDG PET/CT imaging were calculated by using microbiology (n = 35) or clinical follow-up (n = 41) as final diagnosis. 99mTc-HMPAO-WBC scintigraphy and [18F]FDG PET/CT findings were compared with 95% CIs by using the McNemar test to those of echocardiography/CT, blood culture, and the Duke criteria.Results: Sensitivity, specificity, and accuracy of 99mTc-HMPAO-WBC were 86, 92, and 88%, respectively, with a slightly higher sensitivity for tube graft infection (TGI) as compared to isolated AV and combined AVTG. Overall, sensitivity, specificity, and accuracy of [18F]FDG PET/CT were 97, 73, and 90%, respectively. In 22 patients with suspected very early and early postsurgical infections, the two imaging modalities were concordant in 17 cases [10 true positive (TP) and 7 true negative (TN)]. [18F]FDG PET/CT presented a higher sensitivity than 99mTc-HMPAO-WBC scan. 99mTc-HMPAO-WBC scan correctly classified as negative three false-positive (FP) PET/CT findings.Conclusion: Our findings supported the use of 99mTc-HMPAO-WBC SPECT/CT and [18F]FDG PET/CT in patients with suspicion infection after the Bentall procedure early in the course of the disease onset to confirm the diagnosis and provide a comprehensive assessment of disease burden through the proposed criteria.

scholarly journals Multi-task weak supervision enables anatomically-resolved abnormality detection in whole-body FDG-PET/CT

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Sabri Eyuboglu ◽  
Geoffrey Angus ◽  
Bhavik N. Patel ◽  
Anuj Pareek ◽  
Guido Davidzon ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Location Estimation ◽  
Supervised Machine Learning ◽  
Whole Body ◽  
Free Text ◽  
Abnormality Detection ◽  
Weak Supervision ◽  
Radiology Reports ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractComputational decision support systems could provide clinical value in whole-body FDG-PET/CT workflows. However, limited availability of labeled data combined with the large size of PET/CT imaging exams make it challenging to apply existing supervised machine learning systems. Leveraging recent advancements in natural language processing, we describe a weak supervision framework that extracts imperfect, yet highly granular, regional abnormality labels from free-text radiology reports. Our framework automatically labels each region in a custom ontology of anatomical regions, providing a structured profile of the pathologies in each imaging exam. Using these generated labels, we then train an attention-based, multi-task CNN architecture to detect and estimate the location of abnormalities in whole-body scans. We demonstrate empirically that our multi-task representation is critical for strong performance on rare abnormalities with limited training data. The representation also contributes to more accurate mortality prediction from imaging data, suggesting the potential utility of our framework beyond abnormality detection and location estimation.

scholarly journals Advantages of 18F-FDG PET/CT Imaging over Modified Duke Criteria and Clinical Presumption in Patients with Challenging Suspicion of Infective Endocarditis

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 720
Author(s):  
Valentin Pretet ◽  
Cyrille Blondet ◽  
Yvon Ruch ◽  
Matias Martinez ◽  
Soraya El Ghannudi ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Predictive Value ◽  
Fdg Pet ◽  
Clinical Suspicion ◽  
Duke Criteria ◽  
High Clinical Suspicion ◽  
Pet Ct ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

According to European Society of Cardiology guidelines (ESC2015) for infective endocarditis (IE) management, modified Duke criteria (mDC) are implemented with a degree of clinical suspicion degree, leading to grades such as “possible” or “rejected” IE despite a persisting high level of clinical suspicion. Herein, we evaluate the 18F-FDG PET/CT diagnostic and therapeutic impact in IE suspicion, with emphasis on possible/rejected IE with a high clinical suspicion. Excluding cases of definite IE diagnosis, 53 patients who underwent 18F-FDG PET/CT for IE suspicion were selected and afterwards classified according to both mDC (possible IE/Duke 1, rejected IE/Duke 0) and clinical suspicion degree (high and low IE suspicion). The final status regarding IE diagnosis (gold standard) was based on the multidisciplinary decision of the Endocarditis Team, including the ‘imaging specialist’. PET/CT images of the cardiac area were qualitatively interpreted and the intensity of each focus of extra-physiologic 18F-FDG uptake was evaluated by a maximum standardized uptake value (SUVmax) measurement. Extra-cardiac 18F-FDG PET/CT pathological findings were considered to be a possible embolic event, a possible source of IE, or even a concomitant infection. Based on the Endocarditis Team consensus, final diagnosis of IE was retained in 19 (36%) patients and excluded in 34 (64%). With a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and global accuracy of 79%, 100%, 100%, 89%, and 92%, respectively, PET/CT performed significantly better than mDC (p = 0.003), clinical suspicion degree (p = 0.001), and a combination of both (p = 0.001) for IE diagnosis. In 41 patients with possible/rejected IE but high clinical suspicion, sensitivity, specificity, PPV, NPV, and global accuracies were 78%, 100%, 100%, 85%, and 90%, respectively. Moreover, PET/CT contributed to patient management in 24 out of 53 (45%) cases. 18F-FDG PET/CT represents a valuable diagnostic tool that could be proposed for challenging IE cases with significant differences between mDC and clinical suspicion degree. 18F-FDG PET/CT allows a binary diagnosis (definite or rejected IE) by removing uncertain diagnostic situations, thus improving patient therapeutic management.

scholarly journals FDG PET/CT to detect bone marrow involvement in the initial staging of patients with aggressive non-Hodgkin lymphoma: results from the prospective, multicenter PETAL and OPTIMAL>60 trials

2021 ◽  
Author(s):  
Dominic Kaddu-Mulindwa ◽  
Bettina Altmann ◽  
Gerhard Held ◽  
Stephanie Angel ◽  
Stephan Stilgenbauer ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Predictive Value ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
Non Hodgkin Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Initial Staging

Abstract Purpose Fluorine-18 fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG PET/CT) is the standard for staging aggressive non-Hodgkin lymphoma (NHL). Limited data from prospective studies is available to determine whether initial staging by FDG PET/CT provides treatment-relevant information of bone marrow (BM) involvement (BMI) and thus could spare BM biopsy (BMB). Methods Patients from PETAL (NCT00554164) and OPTIMAL>60 (NCT01478542) with aggressive B-cell NHL initially staged by FDG PET/CT and BMB were included in this pooled analysis. The reference standard to confirm BMI included a positive BMB and/or FDG PET/CT confirmed by targeted biopsy, complementary imaging (CT or magnetic resonance imaging), or concurrent disappearance of focal FDG-avid BM lesions with other lymphoma manifestations during immunochemotherapy. Results Among 930 patients, BMI was detected by BMB in 85 (prevalence 9%) and by FDG PET/CT in 185 (20%) cases, for a total of 221 cases (24%). All 185 PET-positive cases were true positive, and 709 of 745 PET-negative cases were true negative. For BMB and FDG PET/CT, sensitivity was 38% (95% confidence interval [CI]: 32–45%) and 84% (CI: 78–88%), specificity 100% (CI: 99–100%) and 100% (CI: 99–100%), positive predictive value 100% (CI: 96–100%) and 100% (CI: 98–100%), and negative predictive value 84% (CI: 81–86%) and 95% (CI: 93–97%), respectively. In all of the 36 PET-negative cases with confirmed BMI patients had other adverse factors according to IPI that precluded a change of standard treatment. Thus, the BMB would not have influenced the patient management. Conclusion In patients with aggressive B-cell NHL, routine BMB provides no critical staging information compared to FDG PET/CT and could therefore be omitted. Trial registration NCT00554164 and NCT01478542

Sign in / Sign up

Export Citation Format

Share Document