scholarly journals Whole body positron emission tomography/computed tomography (PET/CT) tumour staging with integrated PET/CT colonography: technical feasibility and first experiences in patients with colorectal cancer

Gut ◽  
2006 ◽  
Vol 55 (1) ◽  
pp. 68-73 ◽  
Author(s):  
P Veit
2021 ◽  
Vol 5 (1) ◽  
pp. 1151-1160
Author(s):  
A.S. Lukashevich ◽  

Purpose. The purpose of the article is to evaluate the diagnostic significance of positron emission tomography / computed tomography with 18F -fluorodeoxyglucose (18F -FDG PET/CT) for the diagnosis of prosthetic endocarditis. Methods of research. The study included 82 patients with suspected prosthetic endocarditis in accordance with the criteria proposed by Duke University [1-5]. The patients received hospital treatment at the State Institution RSPC "Cardiology" from January 2016 to March 2021. The study was of a prospective, non-randomized, single-center cohort design. The duration of the monitor period was 12 months from the moment of patients’ inclusion in the study. Whole-body positron emission tomography / computed tomography (PET/CT) examinations were performed in 82 patients. 27 patients were selected for surgical treatment. Conservative treatment group included 16 patients. 27 patients were selected into the observation group, they were suspected to have prosthetic heart valve infection in the primary referral and underwent PET/CT scanning, according to which the diagnosis of prosthetic endocarditis was excluded. The event under the study did not develop in this group during the year of observation. Results and conclusion. The history of infective endocarditis was not statistically significant and did not increase the risk of developing prosthetic endocarditis in the sample presented. The Duke criteria are less reliable in establishing the diagnosis of prosthetic endocarditis. The median number of days from the date of the first prosthesis implantation to the onset of prosthetic endocarditis was about 4 years. This study revealed that the development of the infectious process in the area of the prosthesis was noted in a more distant postoperative period compared to literature data. Histological confirmation of infection was noted in 100% (27 patients) of cases in reoperated patients. The presence of a more formidable complication such as valve ring abscess located mainly in the projection of the aortic valve ring was quite common in both groups. Presepsin and Interleukin-6 have a statistically significant (U = 394,50 p = 0,01 and U = 94,50 p = 0.004) value in the prognosis of prosthetic endocarditis. Considering the data obtained from ROC analysis, it can be said that the cut-off point at which it is possible to diagnose prosthetic endocarditis based on PETCT is 2.85. The presented methods for the interpretation of whole-body FDG-PET/CT images of patients with suspected infectious complications after cardiac surgery, as well as with the presence of prosthetic endocarditis, show high sensitivity and specificity.


Dose-Response ◽  
2020 ◽  
Vol 18 (3) ◽  
pp. 155932582093828
Author(s):  
Weiguo Li ◽  
Lianying Fang ◽  
Jieqing Li

Objective: The aim of this study was to measure occupational exposure doses of technologists who dispense and inject radiopharmaceuticals in 7 positron emission tomography/computed tomography (PET/CT) departments. This was done with the goal to help improving protective designs in PET departments and/or establishing national protection standards. Method: Common LiF thermoluminescence dosimeters (TLDs) were placed on the chest and necklace of the technologists to monitor whole-body and thyroid doses, respectively. Ring TLDs were also worn on both index fingers to measure individual hand doses. All TLDs were assembled and measured once every 3 months for a total of 12 months. Additionally, we measured and compared the dose of TLDs attached to both the inside and the outside of the technologist’s lead coat. Results: Technologists received relatively high exposures, which accounted for 64% to 94% of the collective dose in their respective departments. Their thyroid doses ranged from 1.2 to 1.7 mSv/a; some technologists’ hand doses exceeded 500 mSv/a. Use of a lead coat reduced the average dose by 8%. Conclusion: Technologists working in PET/CT departments were the main population exposed to radiation. This work underscores the need for enhanced protective measures for these workers to better reduce their exposure, particularly for their hands.


2005 ◽  
Vol 23 (28) ◽  
pp. 6846-6853 ◽  
Author(s):  
Didier Lardinois ◽  
Walter Weder ◽  
Marina Roudas ◽  
Gustav K. von Schulthess ◽  
Michaela Tutic ◽  
...  

Purpose The aim of this prospective study was to assess the incidence and the nature of solitary extrapulmonary [18F] fluorodeoxyglucose (FDG) accumulations in patients with non–small-cell lung cancer (NSCLC) staged with integrated positron emission tomography and computed tomography (PET/CT) and to evaluate the impact on management. Patients and Methods A total of 350 patients with NSCLC underwent whole-body PET/CT imaging. All solitary extrapulmonary FDG accumulations were evaluated by histopathology, further imaging, or clinical follow-up. Results PET/CT imaging revealed extrapulmonary lesions in 110 patients. In 72 patients (21%), solitary lesions were present. A diagnosis was obtained in 69 of these patients, including 37 (54%) with solitary metastases and 32 (46%) with lesions unrelated to the lung primary. Histopathologic examinations of these 32 lesions revealed a second clinically unsuspected malignancy or a recurrence of a previous diagnosed carcinoma in six patients (19%) and a benign tumor or inflammatory lesion in 26 patients (81%). The six malignancies consisted of carcinoma of the breast in two patients, and carcinoma of the orbit, esophagus, prostate, and non-Hodgkin's lymphoma in one patient each. Benign tumors and inflammatory lesions included eight colon adenomas, four Warthin's tumors, one granuloma of the lower jaw, one adenoma of the thyroid gland, one compensatory muscle activity due to vocal chord palsy, two occurrences of arthritis, three occurrences of reflux esophagitis, two occurrences of pancreatitis, two occurrences of diverticulitis, one hemorrhoidal inflammation, and one rib fracture. Conclusion Solitary extrapulmonary FDG accumulations in patients with newly diagnosed lung cancer should be analyzed critically for correct staging and optimal therapy, given that up to half of the lesions may represent unrelated malignancies or benign disease.


Molecules ◽  
2019 ◽  
Vol 25 (1) ◽  
pp. 134 ◽  
Author(s):  
Christos Sachpekidis ◽  
Hartmut Goldschmidt ◽  
Antonia Dimitrakopoulou-Strauss

Multiple myeloma (MM) is a plasma cell disorder, characterized by clonal proliferation of malignant plasma cells in the bone marrow. Bone disease is the most frequent feature and an end-organ defining indicator of MM. In this context, imaging plays a pivotal role in the management of the malignancy. For several decades whole-body X-ray survey (WBXR) has been applied for the diagnosis and staging of bone disease in MM. However, the serious drawbacks of WBXR have led to its gradual replacement from novel imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT). PET/CT, with the tracer 18F-fluorodeoxyglucose (18F-FDG), is now considered a powerful diagnostic tool for the detection of medullary and extramedullary disease at the time of diagnosis, a reliable predictor of survival as well as the most robust modality for treatment response evaluation in MM. On the other hand, 18F-FDG carries its own limitations as a radiopharmaceutical, including a rather poor sensitivity for the detection of diffuse bone marrow infiltration, a relatively low specificity, and the lack of widely applied, established criteria for image interpretation. This has led to the development of several alternative PET tracers, some of which with promising results regarding MM detection. The aim of this review article is to outline the major applications of PET/CT with different radiopharmaceuticals in the clinical practice of MM.


2015 ◽  
Vol 173 (3) ◽  
pp. R115-R130 ◽  
Author(s):  
Massimo Salvatori ◽  
Bernadette Biondi ◽  
Vittoria Rufini

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.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yueli Tian ◽  
Khamis Hassan Bakari ◽  
Shanshan Liao ◽  
Xiaotian Xia ◽  
Xun Sun ◽  
...  

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.


2017 ◽  
Vol 24 (3) ◽  
pp. 421-424 ◽  
Author(s):  
Robert Drescher ◽  
Falk Gühne ◽  
Martin Freesmeyer

Purpose: To propose a positron emission tomography (PET)/computed tomography (CT) protocol including early-dynamic and late-phase acquisitions to evaluate graft patency and aneurysm diameter, detect endoleaks, and rule out graft or vessel wall inflammation after endovascular aneurysm repair (EVAR) in one examination without intravenous contrast medium. Technique: Early-dynamic PET/CT of the endovascular prosthesis is performed for 180 seconds immediately after intravenous injection of F-18-fluorodeoxyglucose. Data are reconstructed in variable time frames (time periods after tracer injection) to visualize the arterial anatomy and are displayed as PET angiography or fused with CT images. Images are evaluated in view of vascular abnormalities, graft configuration, and tracer accumulation in the aneurysm sac. Whole-body PET/CT is performed 90 to 120 minutes after tracer injection. Conclusion: This protocol for early-dynamic PET/CT and PET angiography has the potential to evaluate vascular diseases, including the diagnosis of complications after endovascular procedures.


2020 ◽  
pp. 000313482095483
Author(s):  
Pablo E. Serrano ◽  
Chu-Shu Gu ◽  
Carol-Anne Moulton ◽  
Steven Gallinger

Introduction Selected patients with colorectal cancer liver metastases (CRLM) and synchronous extrahepatic disease (EHD) are considered for surgery. Objectives To evaluate the change in surgical management and long-term survival (disease-free survival [DFS] and overall survival [OS]) for patients with CRLM and EHD who undergo positron emission tomography combined with computed tomography (PET-CT) vs no PET-CT. Methods Patients with CRLM were enrolled in a trial evaluating the effect of PET-CT (vs no PET-CT) on surgical management, DFS, and OS. This is a sub-study of the trial, including only patients with synchronous EHD. Cox proportional hazard models were used to calculate risks for recurrence and death. Survival were described by Kaplan-Meier method and compared with log-rank test. Results Of 25 patients with EHD (PET-CT arm: 14/270 (5%) and no PET-CT arm: 11/134 (8%)), PET-CT changed surgical management in 14%, all of which avoided liver resection due to more extensive disease. Complete metastasectomy was achieved in 36% (5/14) and 72% (8/11), respectively. Respectively, PET-CT vs no PET-CT had statistically similar median DFS, 5.6 months (95% confidence interval (CI) 3.6-18) vs 7.6 months (95% CI 2.9-15) and median OS, 42 months (95% CI 25-48) vs 29 months (95% CI 17-41). EHD was associated with worse DFS (hazard ratio HR = 1.89, 95% CI 1.41-2.52) and OS (HR = 2.47, 95% CI 1.6-3.83). Conclusions Preoperative PET-CT for the management of resectable CRLM did not improve long-term outcomes among patients who had synchronous EHD; however, it changed surgical management in a relatively significant proportion of patients.


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