A Case Report of a Solitary Pelvic Mass Proven to Be a Lymph Nodal Metastasis from Anal Cancer

A solitary pelvic-wall lymph nodal metastasis can be mistaken as a primary malignancy when a primary tumor has not been diagnosed. We report the case of a 72-year-old woman with a solitary left pelvic-wall mass that was finally proven to be a left internal iliac lymph nodal metastasis from anal cancer. No signs of the primary tumor had been initially found by general screening using computed tomography, colonoscopy, pelvic magnetic resonance imaging, and gynecological/urological examination; however, squamous cell carcinoma was detected by surgical biopsy of the left pelvic-wall mass. Additional 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) showed focal accumulations in the left pelvic mass and the anal canal. A biopsy of the induration in the anal canal led to the diagnosis of anal cancer, clinical T2N2M0, and stage IIIB (UICC-TNM 7th ed.), which was indicated for definitive chemoradiotherapy. Two months after completing a definitive chemoradiotherapy for anal cancer, a fixed induration developed under the surgical wound along with the surgical tract of the biopsy site. Physical examination and 18F-FDG-PET/computed tomography led to the clinical diagnosis of unresectable surgical tract recurrence of anal cancer. The patient underwent palliative treatment and died 14 months after the diagnosis of the surgical tract recurrence. In conclusion, anal cancer may present as a solitary pelvic mass without any anal symptoms. To evaluate the solitary pelvic mass, 18F-FDG-PET/computed tomography, along with digital examination, will probably help in establishing an accurate diagnosis. Anal cancer must be considered during the differential diagnosis of a solitary pelvic-wall mass for a correct diagnosis and to avoid unnecessary procedures.

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POSITRON EMISSION TOMOGRAPHY WITH 18F -FDG IN THE DIAGNOSIS OF PROSTHETIC HEART VALVE ENDOCARDITIS

Emergency Cardiology and Cardiovascular Risks ◽

10.51922/2616-633x.2021.5.2.1151 ◽

2021 ◽

Vol 5 (1) ◽

pp. 1151-1160

Author(s):

A.S. Lukashevich ◽

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Fdg Pet ◽

Prosthetic Heart Valve ◽

Emission Tomography ◽

Whole Body ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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.

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The Value of 18 Fluorine-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Breast Cancer Staging

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.5525 ◽

2020 ◽

Vol 8 (A) ◽

pp. 970-975

Author(s):

Ahmed Tawakol ◽

Maha Khalil ◽

Yasser G. Abdelhafez ◽

Mai Hussein ◽

Mohamed Fouad Osman

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Fdg Pet ◽

Cancer Staging ◽

Emission Tomography ◽

Breast Cancer Staging ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

BACKGROUND: Accurate staging is important for management decisions in patients with newly diagnosed breast cancer. AIM: This study was conducted to evaluate the value of 18 fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging in breast cancer staging.. METHODS: A prospective study of 80 patients (1 male and 79 female) mean age 51.13 years with histologically confirmed breast cancer. The staging procedures included history, physical examination, mammography, and CT of neck, chest, abdomen, and pelvis; then, PET/CT was performed in a time interval <30 days. The findings of PET/CT were compared with those of the other conventional methods. RESULTS: The agreement between conventional methods (mammography, breast ultrasound, contrast-enhanced CT of the neck, chest, abdomen, and pelvis) and 18F FDG-PET/CT was 0.6 for assessing the T stage, 0.39 for N stage, and 0.75 for M stage. There was moderate agreement between CT and 18F FDG-PET/CT in the detection of nodal lesions (K=0.6) and pulmonary lesions (K=0.51), while a perfect agreement was noted for detecting osseous (K=0.82) and liver lesions (K=0.81). In total, 50 patients (62.5%) were concordantly staged between the conventional imaging and 18F-FDG PET/CT, while 30 patients (37.5%) showed a different tumor, node, and metastasis stage. The changes were driven by the detection of additional findings (n=26) or exclusion of findings (n=4), mainly at the lymph nodes (LNs) and/or distant sites. Regarding N status, 18F FDG-PET/CT revealed previously unknown regional lymphatic spread in supraclavicular (n=4; 5%), infraclavicular (n=11; 13.7%), and internal mammary (n=12; 15%) lymph node groups. 18F-FDG PET/CT changed M status in a total of four patients (5%); three of them were upstaged by detecting distant metastases, while osseous deposits were excluded in one patient leading to downstaging. CONCLUSION: 18F-FDG-PET/CT is considered a valuable imaging tool in the initial staging of breast cancer, which significantly impacts the overall American Joint Committee on Cancer staging in 37.5% of our study population.

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Nuclear Imaging in Infective Endocarditis

Pharmaceuticals ◽

10.3390/ph15010014 ◽

2021 ◽

Vol 15 (1) ◽

pp. 14

Author(s):

Nidaa Mikail ◽

Fabien Hyafil

Keyword(s):

Computed Tomography ◽

Infective Endocarditis ◽

Fdg Pet ◽

Imaging Techniques ◽

Nuclear Imaging ◽

Emission Tomography ◽

Cardiac Devices ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Infective endocarditis (IE) is a life-threatening disease with stable prevalence despite prophylactic, diagnostic, and therapeutic advances. In parallel to the growing number of cardiac devices implanted, the number of patients developing IE on prosthetic valves and cardiac implanted electronic device (CIED) is increasing at a rapid pace. The diagnosis of IE is particularly challenging, and currently relies on the Duke-Li modified classification, which include clinical, microbiological, and imaging criteria. While echocardiography remains the first line imaging technique, especially in native valve endocarditis, the incremental value of two nuclear imaging techniques, 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG-PET/CT) and white blood cells single photon emission tomography with computed tomography (WBC-SPECT), has emerged for the management of prosthetic valve and CIED IE. In this review, we will summarize the procedures for image acquisition, discuss the role of 18F-FDG-PET/CT and WBC-SPECT imaging in different clinical situations of IE, and review the respective diagnostic performance of these nuclear imaging techniques and their integration into the diagnostic algorithm for patients with a suspicion of IE.

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Preoperative 18F-FDG-PET/CT vs Contrast-Enhanced CT to Identify Regional Nodal Metastasis among Patients with Head and Neck Squamous Cell Carcinoma

Otolaryngology ◽

10.1177/0194599817703927 ◽

2017 ◽

Vol 157 (3) ◽

pp. 439-447 ◽

Cited By ~ 2

Author(s):

Joshua K. Cho ◽

Thomas J. Ow ◽

Andrew Y. Lee ◽

Richard V. Smith ◽

Nicolas F. Schlecht ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Fdg Pet ◽

Nodal Metastasis ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Regional Nodal Metastasis

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Prognostic value of metabolic response measured by 18F-FDG-PET in oesophageal cancer patients treated with definitive chemoradiotherapy

Nuclear Medicine Communications ◽

10.1097/mnm.0000000000000594 ◽

2016 ◽

Vol 37 (12) ◽

pp. 1282-1289 ◽

Cited By ~ 4

Author(s):

Cem Onal ◽

Nese Torun ◽

Ozan C. Guler ◽

Berna A. Yildirim

Keyword(s):

Cancer Patients ◽

Oesophageal Cancer ◽

Fdg Pet ◽

Prognostic Value ◽

Metabolic Response ◽

Definitive Chemoradiotherapy ◽

18F Fdg

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Clinical Impact of 18F-FDG PET/CT in the Diagnostic Workup of Pancreatic Ductal Adenocarcinoma: A Systematic Review

Diagnostics ◽

10.3390/diagnostics10121042 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1042

Author(s):

Annachiara Arnone ◽

Riccardo Laudicella ◽

Federico Caobelli ◽

Priscilla Guglielmo ◽

Marianna Spallino ◽

...

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Pancreatic Ductal Adenocarcinoma ◽

Fdg Pet ◽

Emission Tomography ◽

Ductal Adenocarcinoma ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

In this review, the performance of fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the diagnostic workup of pancreatic ductal adenocarcinoma (PDAC) is evaluated. A comprehensive literature search up to September 2020 was performed, selecting studies with the presence of: sample size ≥10 patients and index test (i.e., “FDG” or “18F-FDG” AND “pancreatic adenocarcinoma” or “pancreas cancer” AND “PET” or “positron emission tomography”). The methodological quality was evaluated using the revised quality assessment of diagnostic accuracy studies (QUADAS-2) tool and presented according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Basic data (authors, year of publication, country and study design), patients’ characteristics (number of enrolled subjects and age), disease phase, type of treatment and grading were retrieved. Forty-six articles met the adopted research criteria. The articles were divided according to the considered clinical context. Namely, besides conventional anatomical imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), molecular imaging with FDG PET/CT is an important tool in PDAC, for all disease stages. Further prospective studies will be necessary to confirm the cost-effectiveness of such imaging techniques by testing its real potential improvement in the clinical management of PDAC.

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18F FDG PET-CT Imaging in Tuberculosis

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v19i2.36011 ◽

2018 ◽

Vol 19 (2) ◽

pp. 135

Author(s):

Shamim MF Begum ◽

Md Abdus Shakur Khan

Keyword(s):

Computed Tomography ◽

Fdg Pet ◽

Ct Imaging ◽

Medical Emergency ◽

Imaging Features ◽

Conventional Imaging ◽

Imaging Tool ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

<p>Tuberculosis (TB) is the second highest infective cause of death worldwide and the global impact of TB is very important. Among all the TB burden WHO regions, 40% TB cases accounts in the South East Asian region. It has become a medical emergency not only in developing countries but also in some high-income countries. The rising incidence of multidrug resistance (MDR) TB and HIV co-infection has increased the morbidity and mortality of TB despite the availability of cheap and effective treatment. The diagnosis of active TB is almost similar over the world. Conventional radiography and Computed Tomography (CT) imaging play a crucial role in the diagnosis of TB. But these conventional imaging are often nonspecific and unable to provide a definitive diagnosis in cases of atypical and heterogeneous presentation. The signs of TB may mimic other diseases in conventional imaging. The introduction of new imaging tool Fluorine18 Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (18F FDG PET-CT) opens the door to evaluate its potentiality application in TB. The role of this new imaging tool in TB imaging has been well documented. 18F FDG PET-CT may assist in early diagnosis, facilitate differentiation between malignancies and TB, identification of extrapulmonary TB, staging of TB, and in assessment of treatment response. Therefore, familiarity with the spectrum of imaging features and understanding the use of 18F FDG PET-CT in diagnosis and management of TB is important, especially for referring clinicians and the reporting nuclear medicine specialists in TB burden country like Bangladesh. This article reviews the main applications, pattern of imaging spectrum with limitations of 18F FDG PET-CT in TB.</p><p>Bangladesh J. Nuclear Med. 19(2): 135-140, July 2016</p>

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