Clinical impact of positron emission tomography or positron emission tomography/computed tomography in the posttherapy surveillance of endometrial carcinoma: evaluation of 88 patients

2008 ◽  
Vol 18 (6) ◽  
pp. 1332-1338 ◽  
Author(s):  
J.-Y. Park ◽  
E. N. Kim ◽  
D.-Y. Kim ◽  
J.-H. Kim ◽  
Y.-M. Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Clinical Impact ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Sensitivity Specificity

The objective of this study was to evaluate the validity and clinical impact of positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) using 18-fluoro-2-deoxy-D-glucose in the posttherapy surveillance of patients with endometrial carcinoma. Eighty-eight patients previously treated for histopathologically diagnosed endometrial adenocarcinoma underwent 99 PET or PET/CT scans at follow-up visits at Asan Medical Center, Seoul, Korea, between 2001 and 2007. The standard of reference for tumor recurrence consisted of histopathologic confirmation or follow-up information at least 6 months after PET or PET/CT. Of the 88 patients, 24 underwent PET (n= 11) and/or PET/CT (n= 14) scans due to suspected disease recurrence. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of PET and/or PET/CT in detecting recurrence in these patients were 100%, 83.3%, 96%, 95%, and 100%, respectively. Especially, PET/CT revealed true-positive findings in three patients with elevated tumor markers but negative CT findings. The remaining 64 patients underwent PET (n= 8) and/or PET/CT (n= 66) as part of routine posttherapy surveillance; these patients were asymptomatic, with no evidence of disease. The sensitivity, specificity, accuracy, PPV, and NPV of PET and/or PET/CT in detecting recurrence in these patients were all 100%. Clinical decisions on treatment were changed in 14 (21.9%) patients by introducing PET or PET/CT into their conventional posttherapy surveillance program. PET and/or PET/CT were highly effective in discriminating true recurrence in patients with suspected recurrence, highly sensitive in detecting recurrence in asymptomatic patients, and had impacts on clinical decisions in a considerable portion of patients.

The Potential Value of Hybrid Positron Emission Tomography/Dual-Source Computed Tomography Imaging in Coronary Bypass Surgery

2011 ◽  
Vol 14 (5) ◽  
pp. 283 ◽  
Author(s):  
Andre Plass ◽  
Maximilian Y. Emmert ◽  
Oliver Gaemperli ◽  
Hatem Alkadhi ◽  
Philipp Kaufmann ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Myocardial Perfusion ◽  
Predictive Value ◽  
Bypass Surgery ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct

<p><b>Background:</b> We evaluated how comprehensive assessment of coronary artery lesions and their hemodynamic relevance by means of hybrid positron emission tomography (PET) and computed tomography (CT) imaging would affect decision-making in coronary artery bypass surgery (CABG), compared with using invasive coronary angiography (ICA) alone.</p><p><b>Methods:</b> After undergoing ICA, 27 patients (21 men and 6 women; mean SD age, 66 � 10 years) planned for cardiac surgery were scheduled for myocardial perfusion stress/rest evaluation with [13N]ammonia PET and CT coronary angiography. Only ICA was available to the surgeon. Postoperatively, the performed CABG was compared with the hypothetical strategy based on hybrid PET/CT findings (regional coronary flow reserve [CFR], myocardial perfusion defects). Procedures included CABG (n = 18) alone, CABG combined with valve replacement (n = 6), and CABG combined with isolated valve replacement (n = 3). A total of 56 bypass grafts (28 venous and 28 arterial) and 66 distal anastomoses were placed.</p><p><b>Results:</b> CT evaluation showed 93% concordance (66/71) with ICA regarding significant stenoses, with sensitivity, specificity, positive predictive value, and negative predictive value of 93.1%, 98.7%, 94.4%, and 98.4%, respectively. In the PET scan, 16 patients had 1 ischemic region, and 12 patients had 1 scar region, including 5 patients who presented with mixed conditions (scar and ischemia). One patient had a completely normal myocardium. Compared with the performed surgery, PET/CT fusion evaluation showed that of the performed anastomoses, 48% had documented ischemia (with a CFR <2 in 86%), 38% were nonischemic (although a CFR value <2 was found in 78%), and 14% had scar tissue (fixed perfusion defect).</p><p><b>Conclusions:</b> Although <50% of bypasses were placed to areas with myocardial ischemia, the CFR was low in the majority of nonischemic regions, a finding that may have important prognostic relevance. PET/CT fusion imaging could potentially influence planning for CABG and provide incremental prognostic information.</p>

scholarly journals IMAGING IN ENDOCRINOLOGY: 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up

2015 ◽  
Vol 173 (3) ◽  
pp. R115-R130 ◽  
Author(s):  
Massimo Salvatori ◽  
Bernadette Biondi ◽  
Vittoria Rufini
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Whole Body ◽  
Clinical Indications ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

In recent years, 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) has emerged as an important tool for the postoperative management of patients with differentiated thyroid cancer (DTC) and it is widely used in selected clinical situations. The most valuable role that FDG-PET/CT plays in clinical practice is that it can be used to obtain prognostic information in patients with increasing thyroglobulin (Tg) levels and negative 131I whole-body scan post-thyroidectomy and radioiodine (RAI) ablation. FDG-PET/CT may also have a potential role in the initial staging and follow-up of high-risk patients with aggressive histological subtypes, in the identification of patients who are at the highest risk of disease-specific mortality, in the management of patients with RAI-refractory disease, in clinical trials of novel targeted therapies in patients with advanced metastatic disease, and in the evaluation of thyroid nodules with indeterminate fine-needle aspiration for cytology. However, several controversies remain to be resolved, namely: the cutoff value of Tg in the selection of DTC patients for FDG-PET/CT, whether FDG-PET/CT scanning should be performed under thyrotropin stimulation or suppression, and the clinical significance of thyroid FDG-PET/CT incidentalomas. The aim of the present article is to provide an overview of the data about the molecular basis for, clinical indications of, and controversies related to the use of FDG-PET/CT in patients with DTC.

scholarly journals Prognostic Value of Volume-Based Positron Emission Tomography/Computed Tomography in Nasopharyngeal Carcinoma Patients after Comprehensive Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yueli Tian ◽  
Khamis Hassan Bakari ◽  
Shanshan Liao ◽  
Xiaotian Xia ◽  
Xun Sun ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Overall Survival ◽  
Nasopharyngeal Carcinoma ◽  
Prognostic Value ◽  
Emission Tomography ◽  
Whole Body ◽  
Positron Emission ◽  
Pet Ct

Objective. We assessed the prognostic value of standardized uptake value (SUV) and volume-based methods including whole-body metabolic tumor volume (WBMTV) and whole-body total lesion glycolysis (WBTLG) using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) of patients with nasopharyngeal carcinoma (NPC) after therapy. Methods. A total of 221 posttherapy NPC cases were enrolled, all of whom had undergone PET/CT scanning and follow-up in this retrospective study. The diagnostic results of PET/CT were analyzed and compared with histopathological diagnosis or clinical follow-up. Receiver operator characteristic curves, the Kaplan-Meier method, and the log-rank test were used to assess the optimal cutoff values for WBMTV and WBTLG to identify independent predictors of survival. Results. The detection rates of the threshold SUV were 2.5, 20%, and 40%, and SUV background methods were 65.6% (378/576), 80.2% (462/576), 71.5% (412/576), and 90.4% (521/576), respectively (P<0.005). Patients with a WBMTV < 8.10 and/or a WBTLG < 35.58 had significantly better 5-year overall survival than those above the cutoffs (90.7% versus 51.2%, P<0.001; 91.7% versus 50.4%, P<0.001), respectively. Multivariate Cox regression modeling showed both WBTLG (RR, 1.002; P=0.004) and age (RR, 1.046; P=0.006) could be used to predict overall survival. WBTLG (RR, 1.003; P<0.001) may have predictive relevance in estimating disease-free survival. Conclusions. SUV volume-based threshold background methodology had a significantly higher detection rate for metastatic lesions. WBTLG could be used as an independent prognostic indicator for posttherapy NPC.

scholarly journals Accuracy of [18Fluorine]-Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography-Computed Tomography Response Assessment Following (Chemo)radiotherapy for Locally Advanced Laryngeal/Hypopharyngeal Carcinoma

2017 ◽  
Vol 11 ◽  
pp. 117955491771300 ◽  
Author(s):  
Finbar Slevin ◽  
Ekin Ermiş ◽  
Sriram Vaidyanathan ◽  
Mehmet Sen ◽  
Andrew F Scarsbrook ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Squamous Cell Carcinoma ◽  
Predictive Value ◽  
Fdg Pet ◽  
Response Assessment ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Introduction: The accuracy of response assessment positron emission tomography (PET)-computed tomography (CT) following radiotherapy with or without chemotherapy for laryngeal/hypopharyngeal squamous cell carcinoma is uncertain. Methods: In all, 35 patients with laryngeal or hypopharyngeal squamous cell carcinoma who were treated between 2009 and 2014 with (chemo)radiotherapy were identified. The accuracy of response assessment PET-CT was made by correlation with clinical follow-up and pathological findings. Results: Of the 35 patients, 20 (57%) had an overall complete metabolic response. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for response assessment [18Fluorine]-fluoro-2-deoxy-d-glucose (FDG) PET-CT for primary and nodal sites, respectively, were 100%, 73%, 46%, and 100% and 83%, 95%, 83%, and 95%. Conclusions: Response assessment FDG PET-CT following (chemo)radiotherapy for laryngeal and hypopharyngeal carcinomas has a high NPV for both primary site and lymph nodes and can be used to guide treatment decisions. The PPV of residual FDG uptake at the primary tumour site is limited and requires examination and biopsy confirmation.

scholarly journals Impact and prognostic value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan in the evaluation of residual head and neck cancer: Single-center experience from Pakistan

2017 ◽  
Vol 06 (02) ◽  
pp. 081-083
Author(s):  
Saima Riaz ◽  
Humayun Bashir ◽  
Hassan Iqbal ◽  
Arif Jamshed ◽  
Ahmad Murtaza ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Head And Neck ◽  
Predictive Value ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Ct Scans ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: Overview of clinical impact of positron emission tomography-computed tomography (PET-CT) scans in patients with head and neck carcinomas at our center. Methods: Retrospective review of posttreatment 18F-fluorodeoxyglucose (18F-FDG) PET-CT scans in patients with head and neck carcinomas with risk of residual disease. Clinical outcome served as the reference standard. Results: This study included 93 patients (65.6% males, mean age: 48.8 years ± 17.2 standard deviation) with squamous cell carcinoma as most frequent histopathology (91.4%). PET-CT scans were performed on average 6 months posttreatment. Diagnostic accuracy, positive predictive value, and negative predictive value of PET-CT for disease were found to be 88%, 88%, and 92%, respectively. A median follow-up of 24 months was available for 91 patients. Kaplan–Meier curves showed significantly higher disease-free survival with negative PET-CT as compared to positive PET-CT (P = 0.01) and maximum standardized uptake values of <5.0 (P = 0.01). Conclusion: FDG PET-CT has diagnostic and prognostic implications in treated patient of head and neck cancers.

scholarly journals Positron emission tomography/computed tomography for optimized colon cancer staging and follow-up.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 408-408
Author(s):  
Bodil E. Engelmann ◽  
Annika Loft ◽  
Andreas Kjær ◽  
Hans J. Nielsen ◽  
Anne Kiil Berthelsen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Colon Cancer ◽  
Cancer Staging ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Primary Colon Cancer ◽  
Primary Colon

408 Background: Optimal management of colon cancer requires detailed assessment of extent of disease. Diagnostic accuracy of 18F-fluorodeoxyglucose (FDG) positron emission tomography/ computed tomography (PET/CT) in primary colon cancer staging and for detection of recurrence was investigated. Methods: PET/CT for preoperative staging was performed on 66 prospectively included patients with primary colon cancer. Diagnostic accuracy for PET/CT and CT alone was analysed. Forty-two stage I-III colon cancer patients had PET/CT follow-up examinations every six months for two years. Serological levels of Tissue Inhibitor of Metalloproteinases (TIMP-1), Carcinoembryonic Antigen (CEA), and liberated domain I of urokinase Plasminogen Activator Receptor [uPAR(I)] and FDG-uptake related tumour gene expression were analysed. Results: Accuracy for T-, N- and M-staging by PET/CT were 82 % [95% Confidence Interval (CI) 70; 91], 66 % [CI 51; 78] and 89 % [CI 79; 96]; for CT 77 % [CI 64; 87], 60 % [CI 46; 73] and 69 % [CI 57; 80]. Cumulative relapse incidences for stage I – III colon cancer at 6, 12, 18 and 24 months were 7.1 % [CI 0; 14.9]; 14.3 % [CI 3.7; 24.9]; 19.0 % [CI 7.1; 30.9] and 21.4 % [CI 9.0; 33.8]. PET/CT diagnosed all relapses detected during the first two postoperative years. High preoperative TIMP-1 levels were associated with significant hazards towards both risk of recurrence and shorter overall survival. FDG-uptake in colon cancer showed significant correlation to hexokinase 2, the hypoxia marker carboanhydrase IX and the proliferation marker ki67. Conclusions: This study indicates PET/CT to be a valuable tool for staging and follow-up in colon cancer. TIMP-1 provided prognostic information potentially useful in selection of patients for intensive follow-up.

scholarly journals Lugano classification: response evaluation criteria for positron emission tomography/computed tomography in lymphoma follow-up

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Samar R. Ragheb ◽  
Amir L. Louka ◽  
Sherine M. Sharara
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background The purpose of this study is to assess the role of 18 fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET-CT) in the follow-up of patients with lymphoma after finishing therapy. Results This study included 42 lymphomas (25 non-Hodgkin’s lymphoma and 17 Hodgkin’s lymphoma); patients ranging in age from 18 to 70 years were examined by 18FDG PET-CT after therapy and analyzed retrospectively. Confirmatory biopsy was mandatory in cases of suspected disease recurrence and follow-up in cases of complete metabolic response. Positron emission tomography/computed tomography in assessment of lymphoma treatment response reveals significant statistical significance (P < 0.05). It shows 100% sensitivity, 92.8% specificity, and 95.2% accuracy in the prediction of response. Conclusion Positron emission tomography/computed tomography plays an important role in detection of response to treatment of lymphoma after finishing therapy.

The role of fusion positron emission tomography/computed tomography (PET/CT) scan in patients with resectable pancreatic neoplasms.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 322-322 ◽  
Author(s):  
Saqib Razzaque ◽  
Noman Ashraf ◽  
Jill M. Weber ◽  
Jose Mario Pimiento ◽  
Mokenge Peter Malafa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Predictive Value ◽  
Pancreatic Neoplasms ◽  
Preoperative Staging ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Pet Ct Scan

322 Background: The role of fusion positron emission tomography/computed tomography scans (PET/CT) in staging of patients with pancreatic neoplasms (PN) is poorly defined. Currently PET/CT is not recommended as part of staging workup in patients with potentially resectable PN. Methods: Using a comprehensive cancer PET registry we identified 107 patients with PN who were potentially resectable based on the initial preoperative staging CT scans and endoscopic ultrasound (EUS), from January 2006 - December 2010. Subsequently all these patients had PET/CT performed prior to surgery. Patients with borderline resectable or locally advanced disease were excluded from the analysis. Statistical analyses were performed included sensitivity, specificity, positive predictive value, and negative predictive value. Statistical analyses were performed with STATA IC (Stata Statistical Software, Release 10.0; Strata Corp., College Station, TX). Results: PET/CT altered management and prevented futile surgery in 6.5 % patients by identifying metastases not detected by other modalities. One patient was found to have metastasis to the supraclavicular lymph node, five had occult hepatic lesions and another had peri-esophageal lymph nodes. All sites were biopsied and metastases confirmed by pathology. The sensitivity and specificity of PET/CT scan in detecting metastatic disease in this patient population was 42.1% and 83.3% respectively. Our study indicated a positive predictive value of PET/CT to be 40% and negative predictive value 84.5%, with a false positive rate of 16.6%. Conclusions: PET/CT was instrumental in preventing futile laprotomy in 6.5 % patients. Larger studies utilizing PET/CT in the initial preoperative staging workup are warranted.

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