2019 Roger A. Mann Award Winner: Imaging of Bone Perfusion and Metabolism in Subjects Undergoing Total Ankle Arthroplasty Using 18F-Positron Emission Tomography

Category: Ankle Arthritis Introduction/Purpose: Total ankle replacement (TAR) continues to exhibit a relatively high incidence of complications and need for revision surgery, particularly when compared to knee and hip arthroplasty. One common mode of failure in TAR is talar component subsidence. This may be caused by disruption in the talar blood supply related to the surgical technique. Positron emission tomography (PET) imaging with [18F]-Fluoride has demonstrated utility in evaluating bone perfusion, and PET-CT in particular is useful in the setting of total joint replacement. In this study we aim to quantify changes in talar perfusion before and after TAR with the INBONE II system (Wright Medical Technology, Inc., Memphis, TN) using [18F]-Fluoride PET-CT. It is our hypothesis that perfusion to the talus would decrease after TAR. Methods: Eight subjects (5M/3F) aged 70.4 ± 7.5 years [Range 61-83] were enrolled for 18F-PET/CT imaging prior to and 3 months following TAR. 5–10 mCi of 18F-Fluoride was administered and dynamic acquisition in list mode for 45 minutes was performed on the operative and non-operative ankles simultaneously on a Siemens mCT Biograph scanner. Static acquisition of the whole body was also performed one hour after injection. Regions of interest (ROI’s) were placed on the postoperative CT images in the body of the talus beneath the INBONE II talar component. These regions were manually delineated on the preoperative CT scans, and were drawn to replicate the ROIs placed on the postoperative studies. ROI’s were overlaid on the fused static 18F-PET images and standard uptake values (SUVs) calculated for these regions as well as the whole foot. Changes in SUVs were analyzed using a paired t-tests with a significance level of 0.05. Results: We found no significant difference in bone perfusion in the talus after TAR in our cohort of patients. 18F uptake in the ROI underneath the talar component compared to that measured at baseline prior to surgery was 3.36 +/- 1.44 SUV postoperatively vs. 2.65 ± 1.24 SUV preoperatively, (p=0.33). Similar results were seen in the whole foot: 2.99 +/- 1.22 SUV postoperatively vs. 2.47 ± 0.75 SUV preoperatively (p=0.16). Figure 1 displays preoperative and postoperative uptake in the bone in the area corresponding to the base of the talar component. Although we did not find a significant difference in our initial study, the observed increase in perfusion to the talus after TAR may reach significance with a larger cohort of patients. Conclusion: 18F-PET demonstrates the ability to quantify changes in bone perfusion and metabolism following TAR. Our results suggest that the vascular blood supply to the talus is not disrupted after TAR. Additional pharmacokinetic analysis of the dynamic activity curves will also allow for estimates of bone blood flow and osteoblastic turnover via compartmental modeling. These results may be used to confirm the presence of adequate bone blood flow and vascularity in the body of the talus following total ankle replacement.

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Coupling of porcine bone blood flow and metabolism in high-turnover bone disease measured by [15O]H2O and [18F]fluoride ion positron emission tomography

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-002-0797-2 ◽

2002 ◽

Vol 29 (7) ◽

pp. 907-914 ◽

Cited By ~ 19

Author(s):

Morand Piert ◽

Hans-Jürgen Machulla ◽

Michael Jahn ◽

Anke Stahlschmidt ◽

Georg A. Becker ◽

...

Keyword(s):

Positron Emission Tomography ◽

Blood Flow ◽

Bone Disease ◽

Emission Tomography ◽

Fluoride Ion ◽

Bone Blood Flow ◽

High Turnover ◽

Positron Emission ◽

18F Fluoride

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Imaging of Bone Perfusion and Metabolism in Subjects Undergoing Total Ankle Arthroplasty Using 18F-Fluoride Positron Emission Tomography

Foot & Ankle International ◽

10.1177/1071100719882717 ◽

2019 ◽

Vol 40 (12) ◽

pp. 1351-1357

Author(s):

Jonathan P. Dyke ◽

Jonathan H. Garfinkel ◽

Lauren Volpert ◽

Austin Sanders ◽

Meghan Newcomer ◽

...

Keyword(s):

Positron Emission Tomography ◽

The Body ◽

Total Ankle Arthroplasty ◽

Emission Tomography ◽

Bone Blood Flow ◽

Level Of Evidence ◽

Ankle Arthroplasty ◽

Positron Emission ◽

Pet Ct ◽

Before And After

Background: Total ankle arthroplasty (TAA) continues to exhibit a relatively high incidence of complications and need for revision surgery compared to knee and hip arthroplasty. One common mode of failure in TAA is talar component subsidence. This may be caused by disruption in the talar blood supply related to the operative technique. The purpose of this study was to quantify changes in talar bone perfusion and turnover before and after TAA with the INBONE II system using 18F-fluoride positron emission tomography / computed tomography (PET/CT). Methods: Nine subjects (5 M/4 F) aged 68.9 ± 8.2 years were enrolled for 18F-fluoride PET/CT imaging before and 3 months after TAA. Regions of interest (ROI) were placed on the postoperative CT images in the body of the talus beneath the talar component and overlaid on the fused static PET images. Standard uptake values (SUVs) along with dynamic K1 (bone blood flow) and ki (bone metabolism or osteoblastic turnover) were calculated. Results: The SUV underneath the talar component compared to that measured at baseline before surgery was 1.93 ± 0.29 preoperatively vs 2.47 ± 0.37 postoperatively ( P > .05). K1 was 0.84 ± 0.16 mL/min/mL preoperatively vs 1.51 ± 0.23 mL/min/mL postoperatively ( P = .026). ki was constant at 0.09 ± 0.03 mL/min/mL preoperatively vs 0.12 ± 0.03 mL/min/mL postoperatively ( P > .05). Conclusion: Our study was the first to link 18F-fluoride PET/CT with pre-post evaluation of total ankle replacements. The study quantified perfusion within the talus beneath the TAA implant supporting the hypothesis that perfusion of the talus remained intact after surgery. Level of Evidence: Level II, prospective cohort study with development of diagnostic criteria.

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Positron Emission Tomography in Parkinson’s Disease

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100041512 ◽

1992 ◽

Vol 19 (S1) ◽

pp. 138-141 ◽

Cited By ~ 3

Author(s):

Barry J. Snow

Keyword(s):

Parkinson’S Disease ◽

Positron Emission Tomography ◽

Parkinson's Disease ◽

Blood Flow ◽

D2 Receptor ◽

The Body ◽

Emission Tomography ◽

Motor Tasks ◽

Positron Emission ◽

Ligand Interactions

ABSTRACT:Positron emission tomography (PET) allows the study of physiological and neurochemical processes which would otherwise be inaccessible, using radioactive labels on biological compounds to follow their fate in the body. By analysing changes of concentration with time we can measure blood flow, neuronal metabolism and receptor ligand interactions. In Parkinson’s disease (PD), PET has been used to examine the dopaminergic deficit and its relationship to motor performance. It has also been shown to detect asymptomatic dopaminergic lesions that have implications for the etiology of PD. In untreated PD there is increased density of D2 binding sites, while in chronically treated PD with motor fluctuations, D2 receptor density is reduced. [18F]-fluorodeoxyglucose studies of demented PD patients show a pattern of cortical metabolism similar to Alzheimer’s disease. Activation studies, which measure changes in blood flow during the performance of motor tasks, show reduced activation of medial frontal areas in PD.

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Pancreatic serous cystoadenoma (CSA) showing increased tracer uptake at 68-GaDOTA-peptide Positron Emission Tomography (68Ga-DOTA-peptide PET-CT): a case report

BMC Surgery ◽

10.1186/s12893-020-01004-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Gennaro Nappo ◽

Niccola Funel ◽

Simone Giudici ◽

Paola Spaggiari ◽

Giovanni Capretti ◽

...

Keyword(s):

Positron Emission Tomography ◽

Somatostatin Receptors ◽

The Body ◽

Emission Tomography ◽

Neuroendocrine Neoplasm ◽

Unexpected Finding ◽

Pancreatic Lesion ◽

Positron Emission ◽

Pet Ct ◽

Pancreatic Neuroendocrine Neoplasm

Abstract Background Serous cysto-adenoma (SCA) is a rare benign neoplasm of the pancreas. SCA can mimic other pancreatic lesions, such as neuroendocrine tumours. 68Gallium-DOTA-peptide Positron Emission Tomography (PET) is able to image in vivo the over-expression of the somatostatin receptors, playing an important role for the identification of neuroendocrine neoplasms. Case presentation We reported a case of 63-year-old man, with a solid lesion of 7 cm of diameter of the body–tail of the pancreas. Two fine-needle-aspirations (FNA) were inconclusive. A 68Ga-DOTA-peptide PET-CT revealed a pathological uptake of the pancreatic lesion. The diagnosis of a pancreatic neuroendocrine neoplasm was established and a laparoscopic distal splenopancreatectomy and cholecystectomy was performed. Final histopathological report revealed the presence of a micro-cystic SCA. Conclusions The current case firstly reports a pancreatic SCA showing increased radiopharmaceutical uptake at 68Ga-DOTA-peptide PET-CT images. This unexpected finding should be taken into account during the diagnostic algorithm of a pancreatic lesion, in order to minimize the risk of misdiagnosis and overtreatment of SCA.

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Comparison between The Diagnostic Performance of Positron Emission Tomography and Diffusion-Weighted MRI in Detecting Recurrence of Head and Neck Squamous Cell Carcinoma during Post Treatment Follow-up

QJM ◽

10.1093/qjmed/hcaa047.010 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M A Talaat ◽

E K Hakim ◽

M S Taha ◽

T M Rabie ◽

A M Askoura ◽

...

Keyword(s):

Positron Emission Tomography ◽

Squamous Cell Carcinoma ◽

Meta Analysis ◽

Emission Tomography ◽

Diffusion Weighted Mri ◽

Positron Emission ◽

Pet Ct ◽

Significant Difference ◽

Pet Ct Scan

Abstract Background Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. (16) Despite aggressive combined-modality treatment regimens, there remains a high percentage (15-50%) of locoregional recurrences.(7) This problem make the clinician to rely on the functional imaging modalities such as Diffusion weighted MRI and Positron Emission Tomography to detect recurrence. Objective To perform a meta-analytical study on the comparison between the diagnostic role of DW/MRI and PET/CT scan in detecting recurrence of HNSCC during post-treatment follow-up. Methods This meta-analysis was conducted from 1/1/ 1998 to 31/3/2018 . Literature search on PubMed and Google scholar was done to identify randomised controlled trials and comparative studies either prospective or retrospective. MedCalc ver. 18.2 (MedCalc, Ostend, Belgium) was used for data analysis. Results Of the eight articles included, The meta-analysis was based on a total of 199 patients. All of them used DW/MRI and 186 of them used PET/CT. Comparative study between the two groups regarding sensitivity, specificity and accuracy revealed; highly significant difference in sensitivity in favor of PET/CT (p < 0.009), significant increase in specificity in favor of DW/MRI (p = 0.048) and no significant difference in accuracy between the two group. Conclusion PET/CT scan was found to be more sensitive than DW/MRI while DW/MRI was found to be more specific than PET/CT. Yet both have the same degree of accuracy.

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Evaluation of image quality at the detector’s edge of dedicated breast positron emission tomography: Can small breast cancer near the chest wall be detected ?

10.21203/rs.3.rs-21524/v1 ◽

2020 ◽

Author(s):

Yoko Satoh ◽

Utaroh Motosugi ◽

Masamichi Imai ◽

Yoshie Omiya ◽

Hiroshi Onishi

Keyword(s):

Breast Cancer ◽

Positron Emission Tomography ◽

Image Quality ◽

Chest Wall ◽

Phantom Study ◽

Emission Tomography ◽

Clinical Images ◽

Positron Emission ◽

Pet Ct ◽

Significant Difference

Abstract Purpose : We assessed image quality of dedicated breast positron emission tomography (dbPET) at the detector's edge by phantom and clinical studies.Methods: A breast phantom with four spheres (16, 10, 7.5, and 5 mm in diameter) was filled with 18 F-fluorodeoxyglucose solution of sphere-to-background ratio was 8:1. It was positioned such that the spheres were five different positions from the top edge to the centre of the detector and scanned for 5 min in each position. Reconstructed images were visually evaluated, and % background variability ( %N 5mm ), % contrast ( %Q H ,5mm ), contrast-to-noise ratio ( Q H ,5mm / N 5mm ), and coefficient of variation of the background ( CV background ) were calculated. Next, tumour-to-background ratios (TBRs) between breast cancer near the chest wall (close to the detector’s edge; peripheral group) and at other locations (non-peripheral group) were compared. The TBR of each lesion was also compared between dbPET and PET/computed tomography (CT).Results: As closer to the detector’s edge, the %N 5mm and CV background increased and %Q H ,5mm and Q H ,5mm / N 5mm decreased in the phantom study. The disadvantages of this placement were visually confirmed. With regard to clinical images, TBR of dbPET was significantly higher than that of PET/CT in both the peripheral (12.1±6.2 vs. 6.5±3.4, p =0.0001) and non-peripheral (13.1±7.1 vs. 7.7±7.4, p =0.0004) groups. There was no significant difference in TBR of dbPET between the peripheral and non-peripheral groups (12.1±6.2 vs. 13.1±7.1, p= 0.6367).Conclusion : In the phantom study, the image quality decreased closer to the detector’s edge than at a depth of 1/8. In clinical studies, however, the lesion detectability of dbPET was the same even if the lesion was close to the detector’s edge or not, and it was higher than that in PET/CT. dbPET has a great potential for detecting breast lesions near the chest wall even in young women with small breasts.

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Evaluation of image quality at the detector’s edge of dedicated breast positron emission tomography

10.21203/rs.3.rs-21524/v2 ◽

2020 ◽

Author(s):

Yoko Satoh ◽

Utaroh Motosugi ◽

Masamichi Imai ◽

Yoshie Omiya ◽

Hiroshi Onishi

Keyword(s):

Positron Emission Tomography ◽

Image Quality ◽

Chest Wall ◽

Clinical Studies ◽

Phantom Study ◽

Emission Tomography ◽

Clinical Images ◽

Positron Emission ◽

Pet Ct ◽

Significant Difference

Abstract Background: We assessed image quality of dedicated breast positron emission tomography (dbPET) at the detector's edge by phantom and clinical studies.Methods: A breast phantom with four spheres (16, 10, 7.5, and 5 mm diameter) was filled with 18F-fluorodeoxyglucose solution (sphere-to-background ratio, 8:1). The spheres occupied five different positions from the top edge to the centre of the detector and were scanned for 5 min in each position. Reconstructed images were visually evaluated, and % background variability (%N5mm), % contrast (%QH,5mm), and contrast-to-noise ratio (QH,5mm/N5mm) for the 5 mm sphere; and coefficient of variation of the background (CVbackground) were calculated. Subsequently, clinical cases were analysed. Tumour-to-background ratios (TBRs) between breast cancer near the chest wall (close to the detector’s edge; peripheral group) and at other locations (non-peripheral group) were compared. The TBR of each lesion was compared between dbPET and PET/computed tomography (CT).Results: Closer to the detector’s edge, the %N5mm and CVbackground increased and %QH,5mm and QH,5mm/N5mm decreased in the phantom study. The disadvantages of this placement were visually confirmed. Regarding clinical images, TBR of dbPET was significantly higher than that of PET/CT in both the peripheral (12.1±6.2 vs. 6.5±3.4, p=0.0001) and non-peripheral (13.1±7.1 vs. 7.7±7.4, p=0.0004) groups. There was no significant difference in TBR of dbPET between the peripheral and non-peripheral groups (12.1±6.2 vs. 13.1±7.1, p=0.6367).Conclusion: The phantom study revealed poorer image quality closer to the detector edge at a depth of 1/8 of the axial field of view (FOV) than at other more central parts. In clinical studies, however, lesion detectability of dbPET was the same regardless of the lesion position, and it was higher than that in PET/CT. dbPET has a great potential for detecting breast lesions near the chest wall if they are within the FOV, even in young women with small breasts.

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Brain Positron Emission Tomography-Computed Tomography Gender Differences in Tinnitus Patients

Journal of the American Academy of Audiology ◽

10.3766/jaaa.15067 ◽

2016 ◽

Vol 27 (09) ◽

pp. 714-719 ◽

Cited By ~ 1

Author(s):

Nathan Shlamkovich ◽

Haim Gavriel ◽

Ephraim Eviatar ◽

Mordechay Lorberboym ◽

Eliad Aviram

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Fdg Pet ◽

Emission Tomography ◽

Positron Emission ◽

Pet Ct ◽

Significant Difference ◽

Therapeutic Protocols ◽

And Gender ◽

Fdg Pet Ct

Background: Increased metabolism in the left auditory cortex has been reported in tinnitus patients. However, gender difference has not been addressed. Purpose: To assess the differences in Positron emission tomography–computed tomography (PET-CT) results between the genders in tinnitus patients. Research Design: Retrospective cohort. Study Sample: Included were patients referred to our clinic between January 2011 and August 2013 who complained of tinnitus and underwent fluorodeoxyglucose (FDG)-PET to assess brain metabolism. Data Analysis: Univariate and multivariate nominal logistic regressions were used to evaluate the association between upper temporal gyrus (UTG; right and left) and gender. Results: Included were 140 patients (87 males) with an average age of 52.5 yr (median = 53.1). Bilateral tinnitus was found in 85 patients (60.7%), left sided in 30 (21.4%), and right sided in 21(15%). Increased uptake in the UTG was found in 60% of the patients on either side. Males had a statistically significant increased uptake in the UTG in those with unilateral tinnitus and in the entire population. Conclusions: We present the largest study reported so far on tinnitus patients who have undergone FDG-PET-CT. We found a statistically significant difference between the genders in FDG uptake by the UTG. Further investigations should be undertaken to reveal the etiologies for these differences and to assess different therapeutic protocols according to gender.

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