23. Colon and rectal cancer: A prospective study of recurrence using whole-body F-18 FDG PET, CT scan and immuno-SPECT

Abstract Introduction [18F]-FDG-PET/CT positive metastatic lesions in radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) have a poor prognosis and lenvatinib represents the best therapy. We investigated the role of [ 18F]-FDG-PET/CT in the evaluation of metabolic response and prediction of the outcome of RAI-R DTC patients treated with lenvatinib. Materials and Methods Thirty-three progressive metastatic RAI-R DTC patients treated with lenvatinib were investigated at baseline and during follow-up with biochemical (Tg/TgAb), morphological (whole-body CT scan) and metabolic evaluation ([ 18F]-FDG-PET/CT). Results Nineteen of thirty-three (57.6%) patients showed the greatest metabolic response at the first [ 18F]-FDG-PET/CT scan, performed after 4 weeks of lenvatinib, while 5/33 (15.1%) patients had this response later. Moreover, 66.7% of patients had both a metabolic response at the first [ 18F]-FDG-PET/CT scan and a morphological response at the first CT scan. We observed a correlation between the metabolic response at [ 18F]-FDG-PET/CT scan performed after 4 weeks of treatment and the biochemical response at the same time in 60.6% of patients. The median overall survival (OS) was significantly longer in patients with either a metabolic response at last [ 18F]-FDG-PET/CT (40.00 vs 8.98 months) or a morphological response at last CT scan (37.22 vs 9.53 months) than in those without response. Moreover, the OS was longer in patients with a metabolic response at [ 18F]-FDG-PET/CT performed after 4 weeks of treatment (36.53 vs 11.28 months). Conclusions Our data show that [ 18F]-FDG-PET/CT can early predict the response to lenvatinib and correlates with the OS of RAI-R DTC patients treated with this drug.

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21. Nuclear medicine in the evaluation of ovarian cancer: Prospective study of ovarian carcinoma recurrences using F-18 FDG PET, CT scan and immunoscintigraphy

Nuclear Medicine Communications ◽

10.1097/00006231-199910000-00032 ◽

1999 ◽

Vol 20 (10) ◽

pp. 942

Author(s):

R. P. Baum

Keyword(s):

Ovarian Cancer ◽

Nuclear Medicine ◽

Prospective Study ◽

Ovarian Carcinoma ◽

Ct Scan ◽

Fdg Pet ◽

Pet Ct ◽

Fdg Pet Ct ◽

Pet Ct Scan

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A Prospective Study Comparing Whole-Body FDG PET/CT to Combined Planar Bone Scan With 67Ga SPECT/CT in the Diagnosis of Spondylodiskitis

Clinical Nuclear Medicine ◽

10.1097/rlu.0b013e318262ae6c ◽

2012 ◽

Vol 37 (9) ◽

pp. 827-832 ◽

Cited By ~ 27

Author(s):

David Fuster ◽

Oriol Solà ◽

Alex Soriano ◽

Anna Monegal ◽

Xavier Setoain ◽

...

Keyword(s):

Prospective Study ◽

Fdg Pet ◽

Bone Scan ◽

Whole Body ◽

Pet Ct ◽

A Prospective Study ◽

Fdg Pet Ct

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The Role of 18F-FDG-PET/CT Scan in the Management of Multiple Myeloma

Asian Pacific Journal of Cancer Care ◽

10.31557/apjcc.2020.5.2.119-123 ◽

2020 ◽

Vol 5 (2) ◽

pp. 119-123

Author(s):

Shirin Haghighat

Keyword(s):

Multiple Myeloma ◽

Ct Scan ◽

Fdg Pet ◽

Bone Involvement ◽

Whole Body ◽

Newly Diagnosed ◽

Pet Ct ◽

Fdg Pet Ct ◽

Pet Ct Scan

Bone lesion is a myeloma-defining event which is reported in 80% of multiple myeloma patients. Imaging of bone is essential in the evaluation of pattern and extent of bone involvement. Recently, whole body X ray (WBXR) has been replaced by more accurate imaging such as whole bode MRI and FDG-PET/CT scan. This review article provides the advantages and role of PET/CT scan in the diagnosis and management of multiple myeloma patients. Generally, PET/CT in diagnosis of bone involvement of newly diagnosed myeloma patients is more sensitive than WBXR. The prognostic value of PET/CT in newly diagnosed patients has been described as well. Different studies have demonstrated that several PET parameters such as the number of focal lesions (FL), SUVmax and extramedullary disease(EMD) may affect the outcome of multiple myeloma patients. Interstingely, the main role of PET/CT in myeloma patients is treatment response monitoring and to some extent assessment of MRD. PET/CT appears to be superior than MRI in evaluation of response due to its ability in differentiating active lesion from negative one.

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O08 Neurosarcoidosis mimicking CNS lymphoma

Rheumatology Advances in Practice ◽

10.1093/rap/rkaa053.007 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Tarunya Arun

Keyword(s):

Case Report ◽

Ct Scan ◽

Fdg Pet ◽

Facial Pain ◽

Brain Mri ◽

Whole Body ◽

Pet Ct ◽

History Of ◽

Fdg Pet Ct ◽

Pet Ct Scan

Abstract Case report - Introduction Sarcoidosis is a multisystem disease which involves formation of inflammatory lesions known as granulomas. Central nervous system’s involvement is rare. Clinical neurologic complications occur in approximately 5% of patients. Diagnostic criteria for neurosarcoidosis in the absence of central nervous system (CNS) histology are not firmly established. A clinically compatible picture, exclusion of other neurological diseases, and histological confirmation of disease elsewhere are generally required. We present a case report of neurosarcoidosis presenting as a lymphoma mimic. Case report - Case description A 45-year-old right-handed white male with past medical history of obstructive sleep apnoea, presented to the acute neurology clinic with several weeks’ history of cognitive decline and severe L facial pain. He had lost 2 stone in weight and there was loss of appetite over 2 months. Neurology examination (including cranial nerves) was unremarkable except for a mini mental state score of 25/30, where he lost points on the attention and recall tasks. CT head revealed a mass in the L cavernous sinus. Brain MRI with contrast revealed an enhancing lesion in the left. suspicious of lymphoma. Additional work up included whole body FDG-PET/CT scan, lumbar puncture. Lumbar puncture showed normal CSF. Serum ACE was normal and a paraneoplastic panel. Whole body PET/CT scan showed FDG avid areas in the bilateral neck, axillary regions, chest and pelvis and inguinal regions, highly consistent with lymphoma. Bone marrow biopsy was negative for lymphoma. Further EBUS biopsy before start of prednisolone revealed multiple non caseating granulomas, diagnostic of sarcoidosis. The patient was treated with oral prednisolone, followed by anti-tumour necrosis factor-a infliximab infusion. A repeat brain MRI with contrast done at five months after initiation of steroids, methotrexate and infliximab showed complete resolution of the intracranial lesion. Neurological and neuropsychological evaluation three months after diagnosis demonstrated resolution of facial pain and cognitive decline. Case report - Discussion There exists several mimics of neurosarcoidosis. Both clinically and radiographically, neurosarcoidosis can be difficult to diagnose. MRI and PET scan in neurosarcoidosis can often mimic malignancy. Early symptomatic treatment is advised for neurosarcoidosis, thus there is a clear need for more prompt diagnosis to allow commencement of the appropriate therapy. There is no known cure for neurosarcoidosis. Immunosuppression is the primary means of controlling the disease, and corticosteroids are the cornerstone of therapy. Treatment options are limited; however, there is more evidence suggesting that steroids and immunomodulatory agents such as infliximab may improve clinical outcomes, which may be due to the anti-TNF-α effect on reducing oxidative stress. Case report - Key learning points Our patient had a clinical presentation suspicious of lymphoma, however he did not have lymphoma and had a good response to corticosteroids and infliximab. Often, FDG PET/CT scan can be misleading and may appear to be neoplastic rather than inflammatory. ACE levels in both CSF and serum are not always positive. Biopsy in these cases is necessary to establish correct diagnosis. Prompt treatment can lead to significant reduction in mortality and morbidity

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Impact of 18F-FDG PET/CT on Clinical Management of Suspected Radio-Iodine Refractory Differentiated Thyroid Cancer (RAI-R-DTC)

Diagnostics ◽

10.3390/diagnostics11081430 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1430

Author(s):

Elisa Lodi Rizzini ◽

Andrea Repaci ◽

Elena Tabacchi ◽

Lucia Zanoni ◽

Valentina Vicennati ◽

...

Keyword(s):

Thyroid Cancer ◽

Ct Scan ◽

Fdg Pet ◽

Therapeutic Approach ◽

Differentiated Thyroid Cancer ◽

Whole Body ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Pet Ct Scan

Background: As reported in the literature, [18F]-fluorodeoxyglucose positron emission tomography/computed tomography ([18F]-FDG PET/CT) provides useful qualitative and semi-quantitative data for the prognosis of advanced differentiated thyroid cancer. Instead, there is a lack of data about the real clinical impact of 18F-FDG PET/CT on the choice of the more effective therapeutic approach for advanced differentiated thyroid cancer (DTC) that starts to lose iodine avidity. The primary aim of this retrospective study was to assess how 18F-FDG PET/CT can guide the choice of the best therapeutic approach to RAI-refractory DTC (RAI-R-DTC) in patients with a doubtful iodine uptake/negative 18F-FDG PET/CT I whole-body scan after several radioactive iodine therapies (RAIT). The secondary aim was to assess the prognostic role of clinical and semi-quantitative metabolic 18F-FDG PET/CT parameters in comparison to published data. Materials and methods: A monocentric retrospective observational study was performed, reviewing the medical records of 53 patients recruited from a database of 208 patients treated at our Institution between 2011 and 2019, with advanced DTC that underwent FDG PET/CT scan for a suspected RAI-R-DTC. Selected patients had to perform a 18F-FDG PET/CT scan after the second RAIT based on a doubtful iodine uptake/negative 131 I whole-body scan and/or persistent elevated thyroglobulin levels. Metabolic response was defined according to positron emission tomography response criteria in solid tumors (PERCIST) guidelines. Standardized uptake value (SUV)max, SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated. The association between metabolic features, clinical parameters and progression free survival (PFS) was assessed applying Kruskal–Wallis, chi-square-Pearson correlation tests, and Cox regression analyses when appropriate. Results: Among our sample of 53 patients (mean age 52.0 ± 19.9 years; 31 women and 22 men), 27 (51.0%) presented a positive 18F-FDG PET/CT scan: 16 (59.0%) underwent watchful waiting, 4 (15.0%) received external-beam radiation therapy (EBRT), 4 (15.0%) underwent surgery, 2 (7.4%) received another course of RAI therapy, and 1 underwent surgery + EBRT. PERCIST response was evaluated in 14/27 patients. Median follow-up was 5.8 ± 3.9 years and median PFS was 38.0 ± 21.8 months. At the last follow-up assessment, 14/53 (26.4%) demonstrated disease progression, 13/53 (24.5) persistence of structural disease, 25/53 (47%) persistence of biochemical disease, and 15/53 (28%) had an excellent response. A significant association was found between therapeutic approach, metabolic response, and final disease response evaluation, as well as a linear correlation between MTV and TLG with thyroglobulin level. Conclusions: Our Institutional experience confirmed the role of 18F-FDG PET/CT as a useful guide in the clinical management of RAI-R-DTC and obviated further unnecessary RAIT.

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