Improved Detection and Characterization of Adrenal Disease with PET-CT

The primary aim of the study was to evaluate the role of [18F]Fluciclovine PET/CT in the characterization of intra-prostatic lesions in high-risk primary PCa patients eligible for radical prostatectomy, in comparison with conventional [11C]Choline PET/CT and validated by prostatectomy pathologic examination. Secondary aims were to determine the performance of PET semi-quantitative parameters (SUVmax; target-to-background ratios [TBRs], using abdominal aorta, bone marrow and liver as backgrounds) for malignant lesion detection (and best cut-off values) and to search predictive factors of malignancy. A six sextants prostate template was created and used by PET readers and pathologists for data comparison and validation. PET visual and semi-quantitative analyses were performed: for instance, patient-based, blinded to histopathology; subsequently lesion-based, un-blinded, according to the pathology reference template. Among 19 patients included (mean age 63 years, 89% high and 11% very-high-risk, mean PSA 9.15 ng/mL), 45 malignant and 31 benign lesions were found and 19 healthy areas were selected (n = 95). For both tracers, the location of the “blinded” prostate SUVmax matched with the lobe of the lesion with the highest pGS in 17/19 cases (89%). There was direct correlation between [18F]Fluciclovine uptake values and pISUP. Overall, lesion-based (n = 95), the performance of PET semiquantitative parameters, with either [18F]Fluciclovine or [11C]Choline, in detecting either malignant/ISUP2-5/ISUP4-5 PCa lesions, was moderate and similar (AUCs ≥ 0.70) but still inadequate (AUCs ≤ 0.81) as a standalone staging procedure. A [18F]Fluciclovine TBR-L3 ≥ 1.5 would depict a clinical significant lesion with a sensitivity and specificity of 85% and 68% respectively; whereas a SUVmax cut-off value of 4 would be able to identify a ISUP 4-5 lesion in all cases (sensitivity 100%), although with low specificity (52%). TBRs (especially with threshold significantly higher than aorta and slightly higher than bone marrow), may be complementary to implement malignancy targeting.

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Characterization of Elastofibroma Dorsi with 18FDG PET/CT: a retrospective study

Revista Española de Medicina Nuclear ◽

10.1016/j.remn.2011.01.006 ◽

2011 ◽

Vol 30 (6) ◽

pp. 342-345 ◽

Cited By ~ 17

Author(s):

Y. Blumenkrantz ◽

G.L. Bruno ◽

C.J. González ◽

M. Namías ◽

A.R. Osorio ◽

...

Keyword(s):

Retrospective Study ◽

Elastofibroma Dorsi ◽

18Fdg Pet ◽

Pet Ct

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Targeted Molecular Imaging in Adrenal Disease—An Emerging Role for Metomidate PET-CT

Diagnostics ◽

10.3390/diagnostics6040042 ◽

2016 ◽

Vol 6 (4) ◽

pp. 42 ◽

Cited By ~ 10

Author(s):

Iosif Mendichovszky ◽

Andrew Powlson ◽

Roido Manavaki ◽

Franklin Aigbirhio ◽

Heok Cheow ◽

...

Keyword(s):

Molecular Imaging ◽

Pet Ct ◽

Adrenal Disease ◽

Targeted Molecular Imaging

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Staging 68 Ga-PSMA PET/CT in 963 consecutive patients with newly diagnosed prostate cancer: incidence and characterization of skeletal involvement

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05655-y ◽

2021 ◽

Author(s):

Mikhail Kesler ◽

Kosta Kerzhner ◽

Ido Druckmann ◽

Jonathan Kuten ◽

Charles Levine ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Incidence ◽

Newly Diagnosed ◽

Prostate Cancer Incidence ◽

Skeletal Involvement ◽

Psma Pet ◽

Pet Ct

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Characterization of a parietal lesion detected by diffusion weighted MRI, NaF18-PET/CT and CT

Journal of Biomedical Graphics and Computing ◽

10.5430/jbgc.v3n4p43 ◽

2013 ◽

Vol 3 (4) ◽

Author(s):

Aung Zaw Win ◽

Carina Mari Aparici

Keyword(s):

Diffusion Weighted Mri ◽

Diffusion Weighted ◽

Pet Ct ◽

Parietal Lesion

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Comparative Performance of 18F-FDG PET/MRI and 18F-FDG PET/CT in Detection and Characterization of Pulmonary Lesions in 121 Oncologic Patients

Journal of Nuclear Medicine ◽

10.2967/jnumed.115.167486 ◽

2016 ◽

Vol 57 (4) ◽

pp. 582-586 ◽

Cited By ~ 34

Author(s):

L. M. Sawicki ◽

J. Grueneisen ◽

C. Buchbender ◽

B. M. Schaarschmidt ◽

B. Gomez ◽

...

Keyword(s):

Fdg Pet ◽

Comparative Performance ◽

Pulmonary Lesions ◽

Pet Ct ◽

Oncologic Patients ◽

18F Fdg ◽

Fdg Pet Ct

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PET/CT imaging in lung cancer: indications and findings

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132015000004479 ◽

2015 ◽

Vol 41 (3) ◽

pp. 264-274 ◽

Cited By ~ 26

Author(s):

Bruno Hochhegger ◽

Giordano Rafael Tronco Alves ◽

Klaus Loureiro Irion ◽

Carlos Cezar Fritscher ◽

Leandro Genehr Fritscher ◽

...

Keyword(s):

Lung Cancer ◽

Pulmonary Nodules ◽

Cancer Staging ◽

Ct Imaging ◽

Inappropriate Treatment ◽

Pet Ct ◽

Disease Staging ◽

Anatomical Information ◽

Work Up

The use of PET/CT imaging in the work-up and management of patients with lung cancer has greatly increased in recent decades. The ability to combine functional and anatomical information has equipped PET/CT to look into various aspects of lung cancer, allowing more precise disease staging and providing useful data during the characterization of indeterminate pulmonary nodules. In addition, the accuracy of PET/CT has been shown to be greater than is that of conventional modalities in some scenarios, making PET/CT a valuable noninvasive method for the investigation of lung cancer. However, the interpretation of PET/CT findings presents numerous pitfalls and potential confounders. Therefore, it is imperative for pulmonologists and radiologists to familiarize themselves with the most relevant indications for and limitations of PET/CT, seeking to protect their patients from unnecessary radiation exposure and inappropriate treatment. This review article aimed to summarize the basic principles, indications, cancer staging considerations, and future applications related to the use of PET/CT in lung cancer.

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Adrenal incidentaloma

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.0529 ◽

2011 ◽

pp. 781-788

Author(s):

Massimo Terzolo

Keyword(s):

Clinical Practice ◽

Medical Practice ◽

Adrenal Mass ◽

Adrenal Incidentaloma ◽

Specific Diagnosis ◽

Incidental Discovery ◽

Definition Of ◽

Adrenal Disease ◽

Ct And Mri

Adrenal incidentaloma is an adrenal mass that is discovered serendipitously with a radiological examination performed for indications unrelated to adrenal disease (1). The incidental discovery of an adrenal mass has become an increasingly common problem, because of the widespread use of ultrasonography, CT, and MRI in clinical practice (2, 3). These techniques have greatly improved their power of resolution over recent years, thereby increasing the possibility of detection of tiny adrenal lumps. Several factors hinder a clear characterization of the phenomenon ‘adrenal incidentaloma’, which may be considered as a byproduct of technology applied to medical practice. Adrenal incidentaloma is not a single pathological entity and the likelihood of any specific diagnosis depends both on the circumstances of discovery and the applied definition of incidentaloma. Unfortunately, published reports are inconsistent in applying inclusion and exclusion criteria for these various factors, making the results difficult to interpret. A further issue is the lack of specific clinical features of the patients carrying an adrenal incidentaloma.

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Imaging biomarkers for malignant peripheral nerve sheath tumors in neurofibromatosis type 1

Neurology ◽

10.1212/wnl.0000000000008092 ◽

2019 ◽

Vol 93 (11) ◽

pp. e1076-e1084 ◽

Cited By ~ 7

Author(s):

Shivani Ahlawat ◽

Jaishri O. Blakeley ◽

Fausto J. Rodriguez ◽

Laura M. Fayad

Keyword(s):

Fdg Pet ◽

Neurofibromatosis Type ◽

Nerve Sheath Tumors ◽

Peripheral Nerve Sheath Tumors ◽

Pet Ct ◽

Adc Values ◽

Adc Mapping ◽

Fdg Pet Ct

ObjectiveTo determine the utility of quantitative metrics obtained from fMRI using diffusion-weighted imaging (DWI)/apparent diffusion coefficient (ADC) mapping compared with metabolic (18F-fluorodeoxyglucose [FDG]-PET/CT) imaging in patients with neurofibromatosis type 1 (NF1) for the characterization of peripheral nerve sheath tumors (PNSTs) as benign or malignant.MethodsThis Institutional Review Board–approved, Health Insurance Portability and Accountability Act–compliant study retrospectively reviewed imaging of 55 PNSTs in 21 patients with NF1. Imaging included anatomic (unenhanced T1, fluid-sensitive, contrast-enhanced T1-weighted), functional DWI (b = 50, 400, 800 s/mm2) and ADC mapping, magnetic resonance sequences, and FDG-PET/CT imaging. Anatomic (size), functional (minimum ADC values), and metabolic (maximum standardized uptake values [SUVmax]) imaging characteristics were recorded. ADC values were correlated with SUVmax. With histologic correlation for all malignant PNSTs (MPNSTs) or clinical or imaging stability (>12 months) for benign lesions used as reference standards, diagnostic accuracy was calculated.ResultsOf 55 PNSTs, there were 19 (35%) malignant and 36 (65%) benign PNSTs. Benign PNSTs were overall smaller than MPNSTs (largest diameter 4.3 ± 1.3 vs 8.2 ± 3.3 cm, respectively, p = 0.014). Benign PNSTs had higher ADCmin (×10−3 mm2/s) than MPNSTs (1.6 ± 0.4 vs 0.6 ± 0.2, respectively, p < 0.0001) and lower SUVmax than MPNSTs (3.2 ± 1.8 vs 8 ± 3.9, p < 0.0001, respectively). ADCmin correlated inversely with SUVmax (correlation coefficient r = −0.0.58, p < 0.0001). Maintaining a sensitivity of 100% with threshold values of ADCmin ≤1 or SUVmax >3.2, DWI yielded a specificity of 94% while FDG-PET/CT offered a specificity of 83%.ConclusionsBoth quantitative metabolic imaging and functional imaging offer high sensitivity for the characterization of PNSTs in NF1; however, DWI/ADC mapping offers increased specificity and may be a more useful modality.Classification of evidenceThis study provides Class II evidence that for patients with NF1, MRI using DWI/ADC mapping accurately distinguishes malignant and benign PNSTs.

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