Skeletal muscle metabolism on whole-body positron emission tomography during pitching

Abstract Background Electromyography (EMG) has been used for evaluating skeletal muscle activity during pitching. However, it is difficult to observe the influence of movement on skeletal muscle activity in deep-lying regions of the trunk and extremities using EMG. An alternative method that may be used is the measurement of glucose metabolism of skeletal muscle using positron emission tomography-computed tomography (PET-CT). This technique is a reliable measure of muscle metabolism, demonstrating a high correlation with the intensity of muscle activity. This study aimed to evaluate whole-body skeletal muscle metabolism during pitching using PET-CT. Methods Ten uninjured, skilled, adult pitchers, who were active at college or professional level, threw 40 baseballs at maximal effort before an intravenous injection of 37 MBq of 18F-fluorodeoxyglucose (FDG). Subsequently, additional 40 balls were pitched. PET-CT images were obtained 50 min after FDG injection, and regions of interest were defined within 72 muscles. The standardized uptake value (SUV) of FDG by muscle tissue per unit volume was calculated, and the mean SUV of the pitchers was compared with that of a healthy adult control group who did not exercise before the measurements. Statistical analysis was performed using a t-test, and P < 0.05 was considered statistically significant. Results Whole-body PET images showed a significant increase in glucose metabolism in the muscle groups of the fingers and toes in both the throwing and non-throwing sides. Additionally, asymmetric increases in glucose metabolism were observed in the muscles of the thigh. Conclusions This is the first study to evaluate whole-body muscle metabolism during pitching using PET-CT. Our findings would be useful in determining the training required for pitchers, and can be further applied to other sporting activities that involve throwing.

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Evaluation of individual skeletal muscle activity by glucose uptake during pedaling exercise at different workloads using positron emission tomography

Journal of Applied Physiology ◽

10.1152/japplphysiol.90821.2008 ◽

2009 ◽

Vol 107 (2) ◽

pp. 599-604 ◽

Cited By ~ 18

Author(s):

Yuichi Gondoh ◽

Manabu Tashiro ◽

Masatoshi Itoh ◽

Mohammad M. Masud ◽

Hiroomi Sensui ◽

...

Keyword(s):

Skeletal Muscle ◽

Positron Emission Tomography ◽

Glucose Uptake ◽

Muscle Activity ◽

Rectus Femoris ◽

Emission Tomography ◽

Whole Body ◽

Control Subjects ◽

Positron Emission ◽

Iliacus Muscle

Skeletal muscle glucose uptake closely reflects muscle activity at exercise intensity levels <55% of maximal oxygen consumption (V̇o2max). Our purpose was to evaluate individual skeletal muscle activity from glucose uptake in humans during pedaling exercise at different workloads by using [18F]fluorodeoxyglucose (FDG) and positron emission tomography (PET). Twenty healthy male subjects were divided into two groups (7 exercise subjects and 13 control subjects). Exercise subjects were studied during 35 min of pedaling exercise at 40 and 55% V̇o2max exercise intensities. FDG was injected 10 min after the start of exercise or after 20 min of rest. PET scanning of the whole body was conducted after completion of the exercise or rest period. In exercise subjects, mean FDG uptake [standardized uptake ratio (SUR)] of the iliacus muscle and muscles of the anterior part of the thigh was significantly greater than uptake in muscles of control subjects. At 55% V̇o2max exercise, SURs of the iliacus muscle and thigh muscles, except for the rectus femoris, increased significantly compared with SURs at 40% V̇o2max exercise. Our results are the first to clarify that the iliacus muscle, as well as the muscles of the anterior thigh, is the prime muscle used during pedaling exercise. In addition, the iliacus muscle and all muscles in the thigh, except for the rectus femoris, contribute when the workload of the pedaling exercise increases from 40 to 55% V̇o2max.

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Whole-body Muscle Activity During Baseball Pitching Exercise

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118s00145 ◽

2018 ◽

Vol 6 (7_suppl4) ◽

pp. 2325967118S0014

Author(s):

Yasushi Takata ◽

Junsuke Nakase ◽

Kengo Shimozaki ◽

Hiroyuki Tsuchiya

Keyword(s):

Skeletal Muscle ◽

Glucose Metabolism ◽

Muscle Activity ◽

Trunk Muscles ◽

Whole Body ◽

Positron Emission ◽

Pet Ct ◽

Full Power ◽

Muscle Groups ◽

Tensor Fasciae Latae

Objectives: Electromyography (EMG) has been used for evaluating skeletal muscle activity during pitching. However, when using EMG, it is difficult to observe the influence of a movement on skeletal muscle activity in deep lying regions of the trunk and extremities. Therefore, at present, only partial investigations into the upper limbs and throwing side have been performed in pitchers. Furthermore, since electrodes and lead wires may interfere with normal motion, it is difficult to conduct experiments that truly replicate a real-world pitching environment. Some studies have utilized 18F-fluorodeoxyglucose- positron emission tomography (FDG-PET) to display cumulative muscle activity during exercise. Glucose metabolism measured by FDG-PET demonstrates a high correlation with intensity of muscle activity and its reliability as an index for measuring muscle activity has been confirmed. This study aimed to evaluate whole body skeletal muscle activity during a pitching exercise by using positron emission tomography-computed tomography (PET-CT). Methods: The study was performed on 10 uninjured, skilled adult pitchers, who were active at a college or professional level (mean ± standard deviation [SD] age, 21.5±3.7 years; height, 175.9±3.4 cm; weight, 74.7±5.2 kg; body mass index, 24.2±1.8). Each participant threw 40 balls at full power for 20 min before 37 MBq of FDG was injected intravenously. Additional 40 balls were then pitched at full power for another 20 min, followed by 25 min of rest in a sitting position. PET-CT images were obtained 50 min after FDG injection. Regions of interest were defined within 72 muscles. The standardized uptake value (SUV) of FDG by muscle tissue per unit volume was calculated, and the mean SUV of the pitchers was compared with that of a healthy adult control group (mean ± standard deviation [SD] age, 28.8±3.5 years; height, 170.4±4.6 cm; weight, 69.6±9.9 kg; body mass index, 23.88±3.0) who restricted exercise and only performed activities of daily living before measuring FDG accumulation. Statistical analysis was performed using a Mann-Whitney test, with a level of significance as p <0.05. Results: Whole-body PET images of the pitchers (Figure 1) show significant increase in glucose metabolism in the muscle groups in the fingers and toes. In addition, the hamstrings on the throwing side and the iliacus, tensor fasciae latae, sartorius on the non-throwing side showed increases in glucose metabolism (Table1). There was however no increase in glucose metabolism either in the rotator cuff or in the trunk muscles. Conclusion: In the present study, we discovered the accumulation of FDG in the relatively small skeletal muscles of the fingers and toes during pitching, and we believe that training these muscles may improve pitching performance. Some muscles of the femoral region showed unilateral accumulation of FDG. We believe this reflects the asymmetric movements performed during pitching. Interestingly, there was little accumulation of FDG in the rotator cuff and trunk muscles, suggesting the possibility that these muscles contribute less to the throwing movement. In conclusion, the whole-body skeletal muscle activity during pitching was investigated using PET-CT and a significant increase in glucose metabolism was observed in muscle groups in the fingers and toes, the hamstrings on the throwing side, and the iliacus, tensor fasciae latae, sartorius on the non-throwing side. [Table: see text]

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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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Evaluation of Skeletal Muscle Activity During Foot Training Exercises Using Positron Emission Tomography

10.21203/rs.3.rs-958459/v1 ◽

2021 ◽

Author(s):

Tomoyuki Kanayama ◽

Junsuke Nakase ◽

Takafumi Mochizuki ◽

Kazuki Asai ◽

Rikuto Yoshimizu ◽

...

Keyword(s):

Skeletal Muscle ◽

Positron Emission Tomography ◽

Muscle Activity ◽

Skeletal Muscles ◽

Standardized Uptake Value ◽

Emission Tomography ◽

Abductor Hallucis ◽

Continuous Training ◽

Positron Emission ◽

The Difference

Abstract The foot exercises “rock-paper-scissors” and “towel gathering” are widely used in patients with lower limb disorders; however, there are no detailed reports on muscle activity during such training. We quantitatively evaluated the difference in skeletal muscle activity between the two exercises using positron emission tomography. Eight university student athletes were included. Four participants each were assigned to the foot rock-paper-scissors and towel gathering groups. Participants in each group underwent continuous training for 15 min. They received an intravenous injection of 18F-fluorodeoxyglucose and retrained for 15 min, following which they rested for 45 min. Regions of interest were defined in 25 muscles. The standardized uptake value (SUV) in the trained limb was compared with that in the non-trained control limb. SUVs increased in four skeletal muscles (tibialis anterior, peroneus brevis, extensor hallucis brevis, and abductor hallucis) in the rock-paper-scissors group, and in four muscles (flexor digitorum longus, extensor hallucis brevis, extensor digitorum brevis, and quadratus plantae) in the towel gathering group. Thus, foot rock-paper-scissors and towel gathering affected skeletal muscles related to the medial longitudinal arch and toe grip strength, respectively. Given that the two exercises target different skeletal muscles, they should be taught and implemented according to their respective purposes.

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Imaging Enterobacterales infections in patients using pathogen-specific positron emission tomography

Science Translational Medicine ◽

10.1126/scitranslmed.abe9805 ◽

2021 ◽

Vol 13 (589) ◽

pp. eabe9805

Author(s):

Alvaro A. Ordonez ◽

Luz M. Wintaco ◽

Filipa Mota ◽

Andres F. Restrepo ◽

Camilo A. Ruiz-Bedoya ◽

...

Keyword(s):

Positron Emission Tomography ◽

Solid Phase ◽

Multidrug Resistant ◽

Sterile Inflammation ◽

Emission Tomography ◽

Whole Body ◽

Hamster Model ◽

Positron Emission ◽

Pet Ct

Enterobacterales represent the largest group of bacterial pathogens in humans and are responsible for severe, deep-seated infections, often resulting in sepsis or death. They are also a prominent cause of multidrug-resistant (MDR) infections, and some species are recognized as biothreat pathogens. Tools for noninvasive, whole-body analysis that can localize a pathogen with specificity are needed, but no such technology currently exists. We previously demonstrated that positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-d-sorbitol (18F-FDS) can selectively detect Enterobacterales infections in murine models. Here, we demonstrate that uptake of 18F-FDS by bacteria occurs via a metabolically conserved sorbitol-specific pathway with rapid in vitro 18F-FDS uptake noted in clinical strains, including MDR isolates. Whole-body 18F-FDS PET/computerized tomography (CT) in 26 prospectively enrolled patients with either microbiologically confirmed Enterobacterales infection or other pathologies demonstrated that 18F-FDS PET/CT was safe, could rapidly detect and localize Enterobacterales infections due to drug-susceptible or MDR strains, and differentiated them from sterile inflammation or cancerous lesions. Repeat imaging in the same patients monitored antibiotic efficacy with decreases in PET signal correlating with clinical improvement. To facilitate the use of 18F-FDS, we developed a self-contained, solid-phase cartridge to rapidly (<10 min) formulate ready-to-use 18F-FDS from commercially available 2-deoxy-2-[18F]fluoro-d-glucose (18F-FDG) at room temperature. In a hamster model, 18F-FDS PET/CT also differentiated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia from secondary Klebsiella pneumoniae pneumonia—a leading cause of complications in hospitalized patients with COVID-19. These data support 18F-FDS as an innovative and readily available, pathogen-specific PET technology with clinical applications.

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Whole body muscle activity during weightlifting exercise evaluated by positron emission tomography

10.21203/rs.3.rs-612816/v1 ◽

2021 ◽

Author(s):

Rikuto Yoshimizu ◽

Junsuke Nakase ◽

Takafumi Mochizuki ◽

Yasushi Takata ◽

Kengo Shimozaki ◽

...

Keyword(s):

Positron Emission Tomography ◽

Muscle Activity ◽

Erector Spinae ◽

Triceps Surae ◽

Emission Tomography ◽

Whole Body ◽

Computed Tomography Images ◽

Positron Emission ◽

The Right ◽

Fdg Accumulation

Abstract BackgroundThis study investigated the whole-body skeletal muscle activity pattern of hang power clean (HPC), a major weight training exercise, using positron emission tomography (PET).MethodTwelve college weightlifting athletes performed three sets of HPC 20 times with a barbell set to 40 kg both before and after an intravenous injection of 37 MBq 18F-fluorodeoxyglucose (FDG). PET-computed tomography images were obtained 50 min after FDG injection. Regions of interest were defined within 71 muscles. The standardized uptake value was calculated to examine the FDG uptake of muscle tissue per unit volume, and FDG accumulation was compared to the control group. The Mann–Whitney U-test was used to evaluate the differences in the mean SUV between groups. The difference between SUVs of the right and left muscles was evaluated by a paired t-test. A P-value < 0.05 was considered statistically significant.ResultsFDG accumulation within the vastus lateralis, vastus intermedius, and vastus medialis was higher than that of the rectus femoris. FDG accumulation within the triceps surae muscle was significantly higher only in the soleus. In the trunk and hip muscles, FDG accumulation of only the erector spinae was significantly increased. In all skeletal muscles, there was no difference between SUVs of the right and left muscles.ConclusionsThe monoarticular muscles in the lower limbs were active in HPC. In contrast, deep muscles in the trunk and hip were not active during HPC. HPC is not suitable for core training and needs to be supplemented with other training.

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Exposure Doses to Technologists Working in 7 PET/CT Departments

Dose-Response ◽

10.1177/1559325820938288 ◽

2020 ◽

Vol 18 (3) ◽

pp. 155932582093828

Author(s):

Weiguo Li ◽

Lianying Fang ◽

Jieqing Li

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Occupational Exposure ◽

Emission Tomography ◽

Whole Body ◽

Average Dose ◽

Protective Measures ◽

Positron Emission ◽

Pet Ct ◽

Main Population

Objective: The aim of this study was to measure occupational exposure doses of technologists who dispense and inject radiopharmaceuticals in 7 positron emission tomography/computed tomography (PET/CT) departments. This was done with the goal to help improving protective designs in PET departments and/or establishing national protection standards. Method: Common LiF thermoluminescence dosimeters (TLDs) were placed on the chest and necklace of the technologists to monitor whole-body and thyroid doses, respectively. Ring TLDs were also worn on both index fingers to measure individual hand doses. All TLDs were assembled and measured once every 3 months for a total of 12 months. Additionally, we measured and compared the dose of TLDs attached to both the inside and the outside of the technologist’s lead coat. Results: Technologists received relatively high exposures, which accounted for 64% to 94% of the collective dose in their respective departments. Their thyroid doses ranged from 1.2 to 1.7 mSv/a; some technologists’ hand doses exceeded 500 mSv/a. Use of a lead coat reduced the average dose by 8%. Conclusion: Technologists working in PET/CT departments were the main population exposed to radiation. This work underscores the need for enhanced protective measures for these workers to better reduce their exposure, particularly for their hands.

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Texture Analysis in the Diagnosis of Primary Breast Cancer: Comparison of High-Resolution Dedicated Breast Positron Emission Tomography (dbPET) and Whole-Body PET/CT

Frontiers in Medicine ◽

10.3389/fmed.2020.603303 ◽

2020 ◽

Vol 7 ◽

Author(s):

Yoko Satoh ◽

Kenji Hirata ◽

Daiki Tamada ◽

Satoshi Funayama ◽

Hiroshi Onishi

Keyword(s):

Breast Cancer ◽

Positron Emission Tomography ◽

High Resolution ◽

Texture Analysis ◽

Texture Features ◽

Emission Tomography ◽

Whole Body ◽

Tumor Characteristics ◽

Positron Emission ◽

Pet Ct

Objective: This retrospective study aimed to compare the ability to classify tumor characteristics of breast cancer (BC) of positron emission tomography (PET)-derived texture features between dedicated breast PET (dbPET) and whole-body PET/computed tomography (CT).Methods: Forty-four BCs scanned by both high-resolution ring-shaped dbPET and whole-body PET/CT were analyzed. The primary BC was extracted with a standardized uptake value (SUV) threshold segmentation method. On both dbPET and PET/CT images, 38 texture features were computed; their ability to classify tumor characteristics such as tumor (T)-category, lymph node (N)-category, molecular subtype, and Ki67 levels was compared. The texture features were evaluated using univariate and multivariate analyses following principal component analysis (PCA). AUC values were used to evaluate the diagnostic power of the computed texture features to classify BC characteristics.Results: Some texture features of dbPET and PET/CT were different between Tis-1 and T2-4 and between Luminal A and other groups, respectively. No association with texture features was found in the N-category or Ki67 level. In contrast, receiver-operating characteristic analysis using texture features' principal components showed that the AUC for classification of any BC characteristics were equally good for both dbPET and whole-body PET/CT.Conclusions: PET-based texture analysis of dbPET and whole-body PET/CT may have equally good classification power for BC.

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Etiology of Solitary Extrapulmonary Positron Emission Tomography and Computed Tomography Findings in Patients With Lung Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2005.10.116 ◽

2005 ◽

Vol 23 (28) ◽

pp. 6846-6853 ◽

Cited By ~ 87

Author(s):

Didier Lardinois ◽

Walter Weder ◽

Marina Roudas ◽

Gustav K. von Schulthess ◽

Michaela Tutic ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Positron Emission Tomography ◽

Ct Imaging ◽

Emission Tomography ◽

Whole Body ◽

Benign Tumors ◽

Positron Emission ◽

Pet Ct ◽

The Impact

Purpose The aim of this prospective study was to assess the incidence and the nature of solitary extrapulmonary [18F] fluorodeoxyglucose (FDG) accumulations in patients with non–small-cell lung cancer (NSCLC) staged with integrated positron emission tomography and computed tomography (PET/CT) and to evaluate the impact on management. Patients and Methods A total of 350 patients with NSCLC underwent whole-body PET/CT imaging. All solitary extrapulmonary FDG accumulations were evaluated by histopathology, further imaging, or clinical follow-up. Results PET/CT imaging revealed extrapulmonary lesions in 110 patients. In 72 patients (21%), solitary lesions were present. A diagnosis was obtained in 69 of these patients, including 37 (54%) with solitary metastases and 32 (46%) with lesions unrelated to the lung primary. Histopathologic examinations of these 32 lesions revealed a second clinically unsuspected malignancy or a recurrence of a previous diagnosed carcinoma in six patients (19%) and a benign tumor or inflammatory lesion in 26 patients (81%). The six malignancies consisted of carcinoma of the breast in two patients, and carcinoma of the orbit, esophagus, prostate, and non-Hodgkin's lymphoma in one patient each. Benign tumors and inflammatory lesions included eight colon adenomas, four Warthin's tumors, one granuloma of the lower jaw, one adenoma of the thyroid gland, one compensatory muscle activity due to vocal chord palsy, two occurrences of arthritis, three occurrences of reflux esophagitis, two occurrences of pancreatitis, two occurrences of diverticulitis, one hemorrhoidal inflammation, and one rib fracture. Conclusion Solitary extrapulmonary FDG accumulations in patients with newly diagnosed lung cancer should be analyzed critically for correct staging and optimal therapy, given that up to half of the lesions may represent unrelated malignancies or benign disease.

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Positron Emission Tomography (PET) Radiopharmaceuticals in Multiple Myeloma

Molecules ◽

10.3390/molecules25010134 ◽

2019 ◽

Vol 25 (1) ◽

pp. 134 ◽

Cited By ~ 1

Author(s):

Christos Sachpekidis ◽

Hartmut Goldschmidt ◽

Antonia Dimitrakopoulou-Strauss

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Multiple Myeloma ◽

Bone Marrow ◽

Bone Disease ◽

Emission Tomography ◽

Whole Body ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg

Multiple myeloma (MM) is a plasma cell disorder, characterized by clonal proliferation of malignant plasma cells in the bone marrow. Bone disease is the most frequent feature and an end-organ defining indicator of MM. In this context, imaging plays a pivotal role in the management of the malignancy. For several decades whole-body X-ray survey (WBXR) has been applied for the diagnosis and staging of bone disease in MM. However, the serious drawbacks of WBXR have led to its gradual replacement from novel imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT). PET/CT, with the tracer 18F-fluorodeoxyglucose (18F-FDG), is now considered a powerful diagnostic tool for the detection of medullary and extramedullary disease at the time of diagnosis, a reliable predictor of survival as well as the most robust modality for treatment response evaluation in MM. On the other hand, 18F-FDG carries its own limitations as a radiopharmaceutical, including a rather poor sensitivity for the detection of diffuse bone marrow infiltration, a relatively low specificity, and the lack of widely applied, established criteria for image interpretation. This has led to the development of several alternative PET tracers, some of which with promising results regarding MM detection. The aim of this review article is to outline the major applications of PET/CT with different radiopharmaceuticals in the clinical practice of MM.

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