Comparison of chest x-ray, thoracic computed tomography and 18F-FDG PET/CT for staging of sarcoidosis

Author(s):  
Zehra Yasar ◽  
Erdogan Cetinkaya ◽  
Elif Tanriverdio ◽  
Aysel Kargi ◽  
Sule Gul ◽  
...  
2020 ◽  
Vol 9 (12) ◽  
pp. 3940
Author(s):  
Amir Emamifar ◽  
Søren Hess ◽  
Torkell Ellingsen ◽  
Susan Due Kay ◽  
Jacob Christian Bang ◽  
...  

The aim of the study was to identify the prevalence of newly diagnosed malignancies in patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), with the aid of 18F-FDG PET/CT scan compared to conventional imaging techniques: Chest X-ray (CXR) and abdominal ultrasound (US). Secondarily, to examine the relative diagnostic accuracy of these two imaging modalities for the detection of cancer. Eighty consecutive patients with newly diagnosed PMR, GCA, or concomitant PMR and GCA, were included and followed up for 40 weeks. All patients underwent an 18F-FDG PET/CT scan, CXR, and abdominal US at diagnosis. Imaging findings were dichotomously categorized into malignant or benign. Among 80 patients, three patients were diagnosed with seronegative rheumatoid arthritis and were excluded from the analysis. Of the remaining 77, 64 (83.1%) patients were diagnosed with pure PMR, 3 (3.9%) with pure GCA, and 10 (13.0%) with concomitant PMR and GCA. Five types of cancer that were more prevalent than the one-year prevalence of 1.2% among the background population were found in four (5.2%; 95%CI: 1.4–12.8%) patients. CXR/abdominal US could detect the solid cancer in one patient, whereas 18F-FDG PET/CT could identify all four solid cancers. Furthermore, four (5.2%; 95%CI: 1.4–12.8%) cases of monoclonal gammopathy of undetermined significance (MGUS) were found. An increase in C reactive protein (CRP) implicated an increased risk for cancer of 2.4% (OR: 1.024, 95%CI: 1.001–1.047; p = 0.041). 18F-FDG PET/CT can reveal occult cancers at an early stage with a high negative predictive value, and it is specifically beneficial in PMR/GCA patients with nonspecific symptoms.


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.


2020 ◽  
Vol 8 (A) ◽  
pp. 970-975
Author(s):  
Ahmed Tawakol ◽  
Maha Khalil ◽  
Yasser G. Abdelhafez ◽  
Mai Hussein ◽  
Mohamed Fouad Osman

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.


2021 ◽  
Vol 15 (1) ◽  
pp. 14
Author(s):  
Nidaa Mikail ◽  
Fabien Hyafil

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.


Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1042
Author(s):  
Annachiara Arnone ◽  
Riccardo Laudicella ◽  
Federico Caobelli ◽  
Priscilla Guglielmo ◽  
Marianna Spallino ◽  
...  

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.


2018 ◽  
Vol 19 (2) ◽  
pp. 135
Author(s):  
Shamim MF Begum ◽  
Md Abdus Shakur Khan

<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>


2018 ◽  
Vol 36 (3) ◽  
pp. 223
Author(s):  
Keeratikarn Boonyawan ◽  
Sasipilai Naivikul ◽  
Putipun Puataweepong ◽  
Wichana Chamroonrat ◽  
Thiti Swangsilpa ◽  
...  

Objective: The correlation between 18F-fluorodexyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and four-dimensional computed tomography (4DCT) based-tumor volumes is unclear. This prospective study was conducted to determine the optimal threshold of PET/CT for gross tumor volume (GTV) delineation using 4DCT as the standard reference for locally advanced lung cancer patients.Material and Methods: Ten patients with histologically proven primary lung cancer who underwent radiotherapy fromJune 2017 to March 2018 in Ramathibodi Hospital were enrolled in the study. The 4DCT simulation and 18F-FDG PET/CT simulation were performed on the same position and same date. Eight standard uptake value (SUV) thresholds of SUV 1.5.0-2.0 and 15.0-35.0% of maximum SUV were selected for contouring in order to be compared with 4DCT based tumor volumes. The comparison methods used were the mean percentage volume change, dice similarity coefficient (DSC), and 3D-centroid shift of the targets between 18F-FDG PET/CT-based gross tumor volume (GTVPET) and internal gross tumor volume (IGTV) from 4DCT.Results: The largest and smallest volume of primary tumors were 422.6 cm3 and 5.9 cm3. GTVPET contoured using SUV 1.5 (GTVPET1.5) approximated closely to IGTV in all the parameters, including volume change, DSC, and 3D-centroid shift. The best median percentage volume change, median DSC, and median centroid shift between IGTV and GTVPET1.5 were 5.55, 0.745 and 0.37, respectively.Conclusion: GTVPET contoured by 18F-FDG PET at SUV1.5 corresponded most closely to the IGTV in all parameters. Further study with a larger sample size and clinical outcome analysis is needed.


Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1289
Author(s):  
Mio Mori ◽  
Kazunori Kubota ◽  
Tomoyuki Fujioka ◽  
Leona Katsuta ◽  
Yuka Yashima ◽  
...  

We used virtual navigator real-time ultrasound (US) fusion imaging with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to identify a lesion that could not be detected on the US alone in a preoperative breast cancer patient. Of the patient’s two lesions of breast cancer, the calcified lesion could not be identified by US alone. By fusing US with 18F-FDG PET/CT, which had been performed in advance, the location of the lesion could be estimated and marked, which benefited planning an appropriate surgery. The fusion of US and 18F-FDG PET/CT was a simple and noninvasive method for identifying the lesions detected by 18F-FDG PET/CT.


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