Usefulness of Functional Image Analysis Using Positron Emission Tomography for the Discrimination between Hypoplastic Myelodysplastic Syndromes and Aplastic Anemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4916-4916
Author(s):  
Masaaki Takatoku ◽  
Toshihiko Sato ◽  
Kaoru Hatano ◽  
Ken Omine ◽  
Masaki Mori ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Bone Marrow ◽  
Aplastic Anemia ◽  
Bone Marrow Biopsy ◽  
Myelodysplastic Syndromes ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Time Point

Abstract Myelodysplastic syndromes (MDS) and aplastic anemia (AA) are classified bone marrow failure syndromes. Their clinical and pathological features partly overlap. It is sometimes difficult to distinguish hypoplastic MDS from AA by using current common diagnostic methods such as bone marrow biopsy and chromosome analysis. Although magnetic resonance image (MRI) is useful for diagnosis of MDS with hypercellular bone marrow, it is difficult to discriminate between hypoplastic MDS and AA using this method because the high intensity patterns on T1-enhanced images are similar in these disorders. Quantitative imaging with fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has been recognized as a useful examination for discrimination between benign and malignant regions in various conditions. Since the decrease in FDG uptake at the late phase is much slower in a malignant region than in a benign region, dual time point imaging provides more accurate information than does conventional single time point scanning. In this study, we investigated the usefulness of dual time protocol FDG-PET in differential diagnosis of hypoplastic MDS and AA. Seventeen patients (7 with typical MDS (RA), 4 with hypoplastic MDS, 6 with AA) and 30 healthy adults agreed to participate in this study. Bone marrow biopsy, FDG-PET, MRI and CT were carried out. Spine, femur and iliac lesions were detected by their increased FDG uptake at 60 and 120 min after injection of 0.12 mCi/kg of FDG. The mean lesional standardized uptake values (SUVmean) at 60 and 120 min after injection of FDG were determined. While the median SUVmean of normal lumbar regions at 60 min was 1.123 ± 0.219, that of MDS cases was 2.06 (range, 1.62–2.32). At 120 min, the median SUVmean of normal cases was 1.180 ± 0.119, whereas that of MDS cases was 2.44 (range, 2.08–2.98). It is noteworthy that the SUVmean of four hypoplastic MDS cases was also high (ranges: 1.96–2.23 at 60 min and 1.97–2.52 at 120 min), suggesting that bone marrow in hypoplastic MDS has a hyper-metabolic state of glucose like other malignant disorders. We also observed a patchy hot area, which may be a visualization of ineffective hematopoiesis, throughout the spine image of hypoplastic MDS. In contrast, the SUVmeans at both time points of four AA cases were not different from those in normal control cases. These results suggest that functional imaging analysis using an FDG-PET dual time protocol enables discrimination between hypoplastic MDS and AA, in which MR images similar intensities.

Usefulness of FDG-PET (Positron Emission Tomography) in the Discrimination between Hypoplastic Myelodysplastic Syndromes and Aplastic Anemia.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4738-4738
Author(s):  
Masaaki Takatoku ◽  
Takahiro Nagashima ◽  
Toshihiko Sato ◽  
Tadashi Nagai ◽  
Norio Komatsu ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Bone Marrow ◽  
Aplastic Anemia ◽  
Myelodysplastic Syndromes ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Fdg Uptake ◽  
Positron Emission ◽  
18F Fdg ◽  
Time Point

Abstract Usefulness of FDG-PET (positron emission tomography) in the discrimination between hypoplastic myelodysplastic syndromes and aplastic anemia Masaaki Takatoku, MD PhD1, Takahiro Nagashima, MD*1, Toshihiko Sato, MD*2, Tadashi Nagai, MD PhD1, Norio Komatsu, MD PhD1, Keiya Ozawa, MD PhD1 1Division of Hematology, Department of Medicine, Jichi Medical School, Minamikawachi, Tochigi, Japan; 2Utsunomiya Central Clinic, Utsunomiya, Tochigi, Japan It is sometimes difficult to distinguish hypoplastic myelodysplastic syndromes (MDS) from aplastic anemia (AA) using current diagnostic methods, such as bone marrow pathology and chromosome analysis. Although magnetic resonance imaging (MRI) is useful for diagnosis of MDS with hypercellular marrow, it is not easy to discriminate between hypoplastic MDS and AA using this method, because the high intensity pattern on T1 enhanced image is similar in these disorders. Recently, quantitative imaging with fluorine-18 fluorodeoxyglucose (FDG) PET has been recognized as a useful method for the discrimination between benign and malignant regions in various conditions. Because the decrease in the FDG-uptake at the late phase is much slower in malignant region than in benign region, dual time point imaging provides more accurate information than single time point scanning. In this study, we investigated the usefulness of dual time protocol FDG-PET in the differential diagnosis of hypoplastic MDS and AA. Six patients [2 with AA, 4 with MDS (including one hypoplastic MDS)] and 30 healthy adults agreed to participate in this study. Bone marrow biopsy, FDG- PET, MRI, and computed tomography (CT) were carried out, and a PET functional image was integrated into a CT anatomical image. The spine, femur and sternum lesions were detected by their increased 18F-FDG uptake at 60 and 120 min after injection of 0.12 mCi/kg of 18F-FDG. The maximum and mean lesional standardized uptake values (SUVmax and SUVmean) after 60 and 120 min were determined. The median SUVmax and SUVmean values of normal lumbar regions at 60 min were 1.94 ± 0.16 and 1.77 ± 0.11, respectively. In the MDS cases, those values at 60 min were 2.39 (range 2.12–2.72) and 2.06 (range 1.91–2.23), respectively. At 120 min, the median SUVmax and SUVmean values of normal cases were 1.33 ± 0.21 and 1.20 ± 0.16, respectively, whereas those of MDS cases were 2.42 (range 2.08–2.78) and 2.14 (range 1.50–2.26), respectively. Thus, the SUVmax and SUVmean values in MDS cases remained at high levels at 120 min in contrast to the decreased levels in normal cases. It is noteworthy that the SUVmax and SUVmean values of a hypoplastic MDS case were also high (2.21 and 2.01 at 60 min, 2.16 and 1.97 at 120 min), suggesting that bone marrow in MDS has a hyper metabolic state of glucose like other malignant disorders. We also observed patchy hot areas, which may be a visualization of ineffective hematopoiesis, throughout the spine image of hypoplastic MDS. In contrast, the SUVmax and SUVmean values of AA cases were 1.82 and 1.66 at 60 min and 1.31 and 1.19 at 120 min (case 1), 1.69 and 1.61 at 60 min and 1.30 and 1.13 at 120 min (case 2), indicating that there is no difference in the SUVmax and SUVmean values at the both time points between AA and normal cases. These results raised the possibility that the discrimination between hypoplastic MDS and AA, in which MRI shows a common observation, can be made using FDG-PET.

scholarly journals 11C-acetate positron emission tomography is more precise than 18F-fluorodeoxyglucose positron emission tomography in evaluating tumor burden and predicting disease risk of multiple myeloma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Miao Chen ◽  
Wenjia Zhu ◽  
Jianhua Du ◽  
Chen Yang ◽  
Bing Han ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Disease Progression ◽  
Fdg Pet ◽  
Tumor Burden ◽  
Emission Tomography ◽  
Focal Lesions ◽  
Bone Marrow Uptake ◽  
Positron Emission

AbstractThe optimal method of tumor burden evaluation in newly diagnosed multiple myeloma (NDMM) is yet to be determined. This study aimed to compare the value of 11C-acetate positron-emission tomography (PET)/computed tomography (CT) (AC-PET and 18F-fluorodeoxyglucose PET/CT (FDG-PET) in the assessment of tumor burden in NDMM. This study evaluated 64 NDMM patients between February 2015 and July 2018. AC-PET and FDG-PET were used to assess myeloma lesions. The clinical data, imaging results, and their correlations were analyzed. Diffuse bone marrow uptake in AC-PET was significantly correlated with biomarkers for tumor burden, including serum hemoglobin (P = 0.020), M protein (P = 0.054), the percentage of bone marrow plasma cells (P < 0.001), and the Durie–Salmon stage of the disease (P = 0.007). The maximum standard uptake value (SUVmax) of focal lesions and high diffuse bone marrow uptake in AC-PET showed stronger correlations with high-risk disease (P = 0.017, P = 0.013) than those in FDG-PET. Moreover, the presence of diffuse bone marrow uptake, more than ten focal lesions, and an SUVmax of focal lesions of > 6.0 in AC-PET, but not in FDG-PET, predicted a higher probability of disease progression and shorter progression-free survival (P < 0.05). AC-PET outperformed FDG-PET in tumor burden evaluation and disease progression prediction in NDMM.

Clinical molecular imaging in intestinal graft-versus-host disease: mapping of disease activity, prediction, and monitoring of treatment efficiency by positron emission tomography

Blood ◽  
2008 ◽  
Vol 111 (5) ◽  
pp. 2909-2918 ◽  
Author(s):  
Matthias Stelljes ◽  
Sven Hermann ◽  
Jörn Albring ◽  
Gabriele Köhler ◽  
Markus Löffler ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Graft Versus Host Disease ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Hematopoietic Stem ◽  
Host Disease ◽  
Graft Versus Host ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Intestinal Gvhd

Gastrointestinal graft-versus-host disease (GVHD) is a common and potentially life-threatening complication after allogeneic hematopoietic stem-cell transplantation (HSCT). Noninvasive tests for assessment of GVHD activity are desirable but lacking. In the present study, we were able to visualize intestinal GVHD-associated inflammation in an allogeneic murine transplantation model by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in vivo. A predominant localization of intestinal GVHD to the colon was verified by histology and fluorescence reflectance imaging of enhanced green fluorescent protein (EGFP)–expressing donor cells. Colonic infiltration by EGFP+ donor lymphocytes matched increased FDG uptake in PET examinations. These preclinical data were prospectively translated into 30 patients with suspected intestinal GVHD beyond 20 days after transplantation. A total of 14 of 17 patients with a diagnostic histology showed significant FDG uptake of the gut, again predominantly in the colon. No increased FDG uptake was detected in 13 patients without histologic evidence of intestinal GVHD. Our findings indicate that FDG-PET is a sensitive and specific noninvasive imaging technique to assess intestinal GVHD, map its localization, and predict and monitor treatment responsiveness. Novel targeted tracers for PET may provide new insights into the pathophysiology of GVHD and bear the potential to further improve GVHD diagnosis.

Routine Bone Marrow Biopsy Has Little or No Therapeutic Consequence for Positron Emission Tomography/Computed Tomography–Staged Treatment-Naive Patients With Hodgkin Lymphoma

2012 ◽  
Vol 30 (36) ◽  
pp. 4508-4514 ◽  
Author(s):  
Tarec Christoffer El-Galaly ◽  
Francesco d'Amore ◽  
Karen Juul Mylam ◽  
Peter de Nully Brown ◽  
Martin Bøgsted ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Risk Assessment ◽  
Positron Emission Tomography ◽  
Bone Marrow ◽  
Hodgkin Lymphoma ◽  
Bone Marrow Biopsy ◽  
Emission Tomography ◽  
Newly Diagnosed ◽  
Positron Emission ◽  
Pet Ct

Purpose To investigate whether bone marrow biopsy (BMB) adds useful information to [18F]fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) staging in patients with Hodgkin lymphoma (HL). Patients and Methods Newly diagnosed patients with HL undergoing a pretherapeutic staging that encompasses both PET/CT and BMB were included in this retrospective study. The pattern of skeletal FDG uptake was categorized as uni-, bi-, or multifocal (≥ three lesions). Clinical stage, risk assessment, and treatment plan were determined with and without the contribution of BMB results according to the Ann Arbor classification and the guidelines from the German Hodgkin Study Group. Results A total of 454 patients with HL were included of whom 82 (18%) had focal skeletal PET/CT lesions and 27 (6%) had positive BMB. No patients with positive BMB were assessed as having stage I to II disease by PET/CT staging. BMB upstaged five patients, assessed as being stage III before BMB; none of the 454 patients would have been allocated to another treatment on the basis of BMB results. Focal skeletal PET/CT lesions identified positive and negative BMBs with a sensitivity and specificity of 85% and 86%, respectively. The positive and negative predictive values of focal skeletal PET/CT lesions for BMB results were 28% and 99%, respectively. Conclusion A consistent finding of this study was the absence of positive BMBs in PET/CT-assessed stage I to II disease. The omission of staging BMB would not have changed the risk assessment or treatment strategy in this cohort of 454 newly diagnosed patients with HL.

Detection of Inflammatory Lesions by F-18 Fluorodeoxyglucose Positron Emission Tomography in Patients with Polymyositis and Dermatomyositis

2012 ◽  
Vol 39 (8) ◽  
pp. 1659-1665 ◽  
Author(s):  
TAKAYOSHI OWADA ◽  
REIKA MAEZAWA ◽  
KAZUHIRO KURASAWA ◽  
HARUTSUGU OKADA ◽  
SATOKO ARAI ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Inflammatory Myopathy ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Muscle Diseases ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Fluorodeoxyglucose Positron Emission

Objective.To evaluate the usefulness of F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) imaging in the management of patients with inflammatory myopathy. We examined whether FDG-PET scanning detects myositis or extramuscular lesions in patients with polymyositis (PM) and dermatomyositis (DM).Methods.FDG-PET imaging was performed in 24 patients with active inflammatory myopathy (PM, 11; DM, 13). The images were read by radiologists in a blinded manner. FDG uptake into muscles was judged positive when the intensity of muscles was higher than or equal to that of the liver. As controls, FDG imaging findings of patients with a lung mass and without muscle diseases were used. To investigate associations between FDG-PET findings and clinical/laboratory findings, the patients’ medical records were reviewed retrospectively.Results.Increased FDG uptake in muscles was found in 8 of 24 (33%) patients. In 67 of 69 (97%) controls without muscle diseases, no muscle FDG uptake was detected. The sensitivity of FDG-PET to detect myositis was lower than that of electromyogram (EMG), magnetic resonance imaging, and muscle biopsy. There were no significant differences in clinical manifestations between patients with and without increased FDG uptake in muscles, although patients with FDG muscle uptake had a tendency to have extended myositis with endomysial cell infiltration. FDG-PET detected neoplasms in patients with associated malignancy. FDG uptake in lungs was found in 7 of 18 patients with interstitial lung disease.Conclusion.FDG-PET imaging has limited usefulness for the evaluation of myositis in patients with PM/DM because of its low sensitivity, although it might be useful for detection of malignancy in these patients.

scholarly journals The Utility of Metabolic Parameters on Baseline F-18 FDG PET/CT in Predicting Treatment Response and Survival in Paediatric and Adolescent Hodgkin Lymphoma

2021 ◽  
Vol 10 (24) ◽  
pp. 5979
Author(s):  
Janet Denise Reed ◽  
Andries Masenge ◽  
Ane Buchner ◽  
Fareed Omar ◽  
David Reynders ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Bone Marrow ◽  
Treatment Response ◽  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Metabolic Parameters ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Lymphoma is the third most common paediatric cancer. Early detection of high-risk patients is necessary to anticipate those who require intensive therapy and follow-up. Current literature shows that residual tumor avidity on PET (Positron Emission Tomography) following chemotherapy corresponds with decreased survival. However, the value of metabolic parameters has not been adequately investigated. In this retrospective study, we aimed to evaluate the prognostic value of metabolic and other parameters in paediatric and adolescent Hodgkin lymphoma. We recorded tMTV (total Metabolic Tumor Volume), TLG (Total Lesion Glycolysis), and SUVmax (maximum Standard Uptake Value) on baseline PET, as well the presence of bone marrow or visceral involvement. HIV (human immunodeficiency virus) status and baseline biochemistry from clinical records were noted. All patients received stage-specific standard of care therapy. Response assessment on end-of-treatment PET was evaluated according to the Deauville criteria. We found that bone marrow involvement (p = 0.028), effusion (p < 0.001), and treatment response (p < 0.001) on baseline PET, as well as HIV status (p = 0.036) and baseline haemoglobin (p = 0.039), were significantly related to progression-free survival (PFS), whereas only effusion (p = 0.017) and treatment response (p = 0.050) were predictive of overall survival (OS). Only baseline tMTV predicted treatment response (p = 0.017). This confirms the value of F-18 FDG PET/CT (Fluoro-deoxy-glucose Positron Emission Tomography/Computed Tomography) in prognostication in paediatric and adolescent Hodgkin lymphoma; however, further studies are required to define the significance of metabolic parameters.

scholarly journals Physiological Appearance of Hybrid FDG–Positron Emission Tomography/Computed Tomography Imaging Following Uncomplicated Endovascular Aneurysm Sealing Using the Nellix Endoprosthesis

2020 ◽  
Vol 27 (3) ◽  
pp. 509-515
Author(s):  
Erik Groot Jebbink ◽  
Leo H. van Den Ham ◽  
Beau B. J. van Woudenberg ◽  
Riemer H. J. A. Slart ◽  
Clark J. Zeebregts ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Graft Infection ◽  
Emission Tomography ◽  
Visual Examination ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Purpose: To investigate the physiological uptake of hybrid fluorine-18-fluorodeoxyglucose (FDG)–positron emission tomography/computed tomography (PET/CT) before and after an uncomplicated endovascular aneurysm sealing (EVAS) procedure as a possible tool to diagnose EVAS graft infection and differentiate from postimplantation syndrome. Materials and Methods: Eight consecutive male patients (median age 78 years) scheduled for elective EVAS were included in the prospective study ( ClinicalTrials.gov identifier NCT02349100). FDG-PET/CT scans were performed in all patients before the procedure and 6 weeks after EVAS. The abdominal aorta was analyzed in 4 regions: suprarenal, infrarenal neck, aneurysm sac, and iliac. The following parameters were obtained for each region: standard uptake value (SUV), tissue to background ratio (TBR), and visual examination of FDG uptake to ascertain its distribution. Demographic data were obtained from medical files and scored based on reporting standards. Results: Visual examination showed no difference between pre- and postprocedure FDG uptake, which was homogenous. In the suprarenal region no significant pre- and postprocedure differences were observed for the SUV and TBR parameters. The infrarenal neck region showed a significant decrease in the SUV and no significant decrease in the TBR. The aneurysm sac and iliac regions both showed a significant decrease in SUV and TBR between the pre- and postprocedure scans. Conclusion: Physiological FDG uptake after EVAS was stable or decreased with regard to the preprocedure measurements. Future research is needed to assess the applicability and cutoff values of FDG-PET/CT scanning to detect endograft infection after EVAS.

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