2-18fluoro-deoxy-D-glucose Positron Emission Tomography Is a Reliable Predictor for Viable Tumor in Postchemotherapy Seminoma: An Update of the Prospective Multicentric SEMPET Trial

2004 ◽  
Vol 22 (6) ◽  
pp. 1034-1039 ◽  
Author(s):  
Maria De Santis ◽  
Alexander Becherer ◽  
Carsten Bokemeyer ◽  
Franz Stoiber ◽  
Karin Oechsle ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Predictive Value ◽  
Fdg Pet ◽  
Clinical Decision Making ◽  
Residual Tumor ◽  
Clinical Decision ◽  
Emission Tomography ◽  
Clinical Value ◽  
Positron Emission ◽  
Residual Lesions

Purpose To define the clinical value of 2-18fluoro-deoxy-D-glucose positron emission tomography (FDG PET) as a predictor for viable residual tumor in postchemotherapy seminoma residuals in a prospective multicentric trial. Patients and Methods FDG PET studies in patients with metastatic pure seminoma who had radiographically defined postchemotherapy residual masses were correlated with either the histology of the resected lesion or the clinical outcome documented by computer tomography (CT), tumor markers, and/or physical examination during follow-up. The size of the residual lesions on CT, either > 3 cm or ≤ 3 cm, was correlated with the presence or absence of viable residual tumor. Results Fifty-six FDG PET scans of 51 patients were assessable. All 19 cases with residual lesions > 3 cm and 35 (95%) of 37 with residual lesions ≤ 3 cm were correctly predicted by FDG PET. The specificity, sensitivity, positive predictive value, and negative predictive value of FDG PET were 100% (95% CI, 92% to 100%), 80% (95% CI, 44% to 95%), 100%, and 96%, respectively, versus 74% (95% CI, 58% to 85%), 70% (95% CI, 34% to 90%), 37%, and 92%, respectively, for CT discrimination of the residual tumor by size (> 3 cm/≤ 3 cm). Conclusion This investigation confirms that FDG PET is the best predictor of viable residual tumor in postchemotherapy seminoma residuals and should be used as a standard tool for clinical decision making in this patient group.

Positron-emission Tomography Imaging in Breast Cancer

2011 ◽  
Vol 07 (02) ◽  
pp. 130
Author(s):  
William B Eubank ◽  
Jean H Lee ◽  
David A Mankoff ◽  
◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Clinical Decision Making ◽  
Positron Emission Tomography Imaging ◽  
Distant Metastases ◽  
Clinical Decision ◽  
Emission Tomography ◽  
Response To Treatment ◽  
Positron Emission

There are four major diagnostic tasks in breast cancer: detection and diagnosis; staging (locoregional and distant metastases); response to treatment (neoadjuvant and metastatic therapy); and characterization of the individual tumor for selection of the most appropriate therapy. The use of fluorodeoxyglucose (FDG) positron-emission tomography (PET) and PET–computed tomography (PET-CT) in all four of these tasks has been investigated. The aim of this article is to discuss the strengths and weaknesses of FDG PET with regard to each of these tasks. The diagnostic areas for which FDG PET appears most suited for clinical decision-making will be highlighted.

scholarly journals Positron Emission Tomography (PET) Imaging of Multiple Myeloma in a Post-Treatment Setting

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 230
Author(s):  
Giulia Ferrarazzo ◽  
Silvia Chiola ◽  
Selene Capitanio ◽  
Maria Isabella Donegani ◽  
Alberto Miceli ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Multiple Myeloma ◽  
Fdg Pet ◽  
Therapy Monitoring ◽  
Emission Tomography ◽  
Clinical Value ◽  
Pet Tracers ◽  
Interpretation Criteria ◽  
Monitoring Therapy ◽  
Positron Emission

2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography/computed tomography (FDG PET/CT) has an established clinical value in the diagnosis and initial staging of multiple myeloma (MM). In the last ten years, a vast body of literature has shown that this tool can also be of high relevance for monitoring therapy responses, making it the recommended imaging approach in this field. Starting from the strengths and weaknesses of radiological imaging in MM, the present review aims to analyze FDG PET/CT’s current clinical value focusing on therapy response assessment and objective interpretation criteria for therapy monitoring. Given the potential occurrence of patients with MM showing non-FDG-avid bone disease, new opportunities can be provided by non-FDG PET tracers. Accordingly, the potential role of non-FDG PET tracers in this setting has also been discussed.

scholarly journals Questioning the Value of Fluorodeoxyglucose Positron Emission Tomography for Residual Lesions After Chemotherapy for Metastatic Seminoma: Results of an International Global Germ Cell Cancer Group Registry

2018 ◽  
Vol 36 (34) ◽  
pp. 3381-3387 ◽  
Author(s):  
Richard Cathomas ◽  
Dirk Klingbiel ◽  
Brandon Bernard ◽  
Anja Lorch ◽  
Xavier Garcia del Muro ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Cell Cancer ◽  
Emission Tomography ◽  
Resected Specimen ◽  
Cancer Group ◽  
Positron Emission ◽  
Median Diameter ◽  
Chemotherapy Patients ◽  
Residual Lesions

Purpose Residual lesions after chemotherapy are frequent in metastatic seminoma. Watchful waiting is recommended for lesions < 3 cm as well as for fluorodeoxyglucose (FDG) positron emission tomography (PET)–negative lesions ≥ 3 cm. Information on the optimal management of PET-positive residual lesions ≥ 3 cm is lacking. Patients and Methods We retrospectively identified 90 patients with metastatic seminoma with PET-positive residual lesions after chemotherapy. Patients with elevated α-fetoprotein or nonseminomatous histology were excluded. We analyzed the post-PET management and its impact on relapse and survival and calculated the positive predictive value (PPV) for PET. Results Median follow-up time was 29 months (interquartile range [IQR], 10 to 62 months). Median diameter of the largest residual mass was 4.9 cm (range, 1.1 to 14 cm), with masses located in the retroperitoneum (77%), pelvis (16%), mediastinum (17%), and/or lung (3%). Median time from the last day of chemotherapy to PET was 6.9 weeks (IQR, 4.4 to 9.9 weeks). Post-PET management included repeated imaging in 51 patients (57%), resection in 26 patients (29%), biopsy in nine patients (10%) and radiotherapy in four patients (4%). Histology of the resected specimen was necrosis in 21 patients (81%) and vital seminoma in five patients (19%). No biopsy revealed vital seminoma. Relapse or progression occurred in 15 patients (17%) after a median of 3.7 months (IQR, 2.5 to 4.9 months) and was found in 11 (22%) of 51 patients on repeated imaging, in two (8%) of 26 patients after resection, and in two (22%) of nine patients after biopsy. All but one patient who experienced relapse were successfully treated with salvage therapy. The PPV for FDG-PET was 23%. Conclusion FDG-PET has a low PPV for vital tumor in residual lesions after chemotherapy in patients with metastatic seminoma. This cautions against clinical decisions based on PET positivity alone.

Thoracic positron emission tomography using18F-fluorodeoxyglucose for the evaluation of residual mediastinal Hodgkin disease

Blood ◽  
2001 ◽  
Vol 98 (10) ◽  
pp. 2930-2934 ◽  
Author(s):  
Martin R. Weihrauch ◽  
Daniel Re ◽  
Klemens Scheidhauer ◽  
Sascha Ansén ◽  
Markus Dietlein ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Predictive Value ◽  
Fdg Pet ◽  
Mediastinal Mass ◽  
Hodgkin Disease ◽  
Emission Tomography ◽  
Metabolic Imaging ◽  
Positron Emission ◽  
Mediastinal Disease

Abstract Residual mediastinal masses are frequently observed in patients with Hodgkin disease (HD) after completed therapy, and the discrimination between active tumor tissue and fibrotic residues remains a clinical challenge. We studied the diagnostic value of metabolic imaging by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in detecting active mediastinal disease and predicting relapse. Twenty-eight HD patients with a residual mediastinal mass of at least 2 cm after initial therapy or after salvage chemotherapy were prospectively assigned to 29 examinations with FDG PET and were evaluated as 29 “subjects.” Patients were monitored for at least 1 year after examination and observed for signs of relapse. Median follow-up was 28 months (range, 16 to 68 months). A PET-negative mediastinal tumor was observed in 19 subjects, of whom 16 stayed in remission and 3 relapsed. Progression or relapse occurred in 6 of 10 subjects with a positive PET, whereas 4 subjects remained in remission. The negative predictive value (negative PET result and remission) at 1 year was 95%, and the positive predictive value (positive PET result and relapse) was 60%. The disease-free survival for PET-negative and PET-positive patients at 1 year was 95% and 40%, respectively. The difference was statistically significant. A negative FDG PET indicates that an HD patient with a residual mediastinal mass is unlikely to relapse before 1 year, if ever. On the other hand, a positive PET result indicates a significantly higher risk of relapse and demands further diagnostic procedures and a closer follow-up.

scholarly journals [18F]-2-Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography Localizes Residual Thyroid Cancer in Patients with Negative Diagnostic 131I Whole Body Scans and Elevated Serum Thyroglobulin Levels

1999 ◽  
Vol 84 (7) ◽  
pp. 2291-2302 ◽  
Author(s):  
Weiping Wang ◽  
Homer Macapinlac ◽  
Steven M. Larson ◽  
Samuel D. J. Yeh ◽  
Timothy Akhurst ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Thyroid Cancer ◽  
Predictive Value ◽  
Fdg Pet ◽  
Residual Disease ◽  
False Negative ◽  
Emission Tomography ◽  
Whole Body ◽  
Positron Emission ◽  
Metastatic Thyroid Cancer

Progressive dedifferentiation of thyroid cancer cells leads to a loss of iodine-concentrating ability, with resultant false negative, whole body radioactive iodine scans in approximately 20% of all differentiated metastatic thyroid cancer lesions. We tested the hypothesis that all metastatic thyroid cancer lesions that did not concentrate iodine, but did produce thyroglobulin (Tg), could be localized by [18F]2-fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography (PET). We performed FDG-PET on 37 patients with differentiated thyroid cancer after surgery and radioiodine ablation who had negative diagnostic 131I whole body scans during routine follow-up. Serum Tg, Tg autoantibodies, neck ultrasounds, and other clinically indicated imaging procedures were performed to detect residual disease. In those with elevated Tg levels, FDG-PET localized occult disease in 71%, was false positive in one, and was false negative in five patients. The majority of false negative FDG-PET occurred in patients with minimal cervical adenopathy. Surgical resections, biopsies, 131I therapy, and differentiation therapy were performed based on the PET results. The FDG-PET result changed the clinical management in 19 of the 37 patients. In patients with elevated Tg levels, FDG-PET had a positive predictive value of 92%. In patients with low Tg levels, FDG-PET had a negative predictive value of 93%. No FDG-PET scans were positive in stage I patients; however, they were always positive in stage IV patients with elevated Tg levels. An elevated TSH level (i.e. hypothyroidism) did not increase the ability to detect lesions. FDG-PET is able to localize residual thyroid cancer lesions in patients who have negative diagnostic 131I whole body scans and elevated Tg levels, although it was not sensitive enough to detect minimal residual disease in cervical nodes.

scholarly journals Accuracy of [18Fluorine]-Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography-Computed Tomography Response Assessment Following (Chemo)radiotherapy for Locally Advanced Laryngeal/Hypopharyngeal Carcinoma

2017 ◽  
Vol 11 ◽  
pp. 117955491771300 ◽  
Author(s):  
Finbar Slevin ◽  
Ekin Ermiş ◽  
Sriram Vaidyanathan ◽  
Mehmet Sen ◽  
Andrew F Scarsbrook ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Squamous Cell Carcinoma ◽  
Predictive Value ◽  
Fdg Pet ◽  
Response Assessment ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Introduction: The accuracy of response assessment positron emission tomography (PET)-computed tomography (CT) following radiotherapy with or without chemotherapy for laryngeal/hypopharyngeal squamous cell carcinoma is uncertain. Methods: In all, 35 patients with laryngeal or hypopharyngeal squamous cell carcinoma who were treated between 2009 and 2014 with (chemo)radiotherapy were identified. The accuracy of response assessment PET-CT was made by correlation with clinical follow-up and pathological findings. Results: Of the 35 patients, 20 (57%) had an overall complete metabolic response. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for response assessment [18Fluorine]-fluoro-2-deoxy-d-glucose (FDG) PET-CT for primary and nodal sites, respectively, were 100%, 73%, 46%, and 100% and 83%, 95%, 83%, and 95%. Conclusions: Response assessment FDG PET-CT following (chemo)radiotherapy for laryngeal and hypopharyngeal carcinomas has a high NPV for both primary site and lymph nodes and can be used to guide treatment decisions. The PPV of residual FDG uptake at the primary tumour site is limited and requires examination and biopsy confirmation.

scholarly journals Impact and prognostic value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan in the evaluation of residual head and neck cancer: Single-center experience from Pakistan

2017 ◽  
Vol 06 (02) ◽  
pp. 081-083
Author(s):  
Saima Riaz ◽  
Humayun Bashir ◽  
Hassan Iqbal ◽  
Arif Jamshed ◽  
Ahmad Murtaza ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Head And Neck ◽  
Predictive Value ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Ct Scans ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: Overview of clinical impact of positron emission tomography-computed tomography (PET-CT) scans in patients with head and neck carcinomas at our center. Methods: Retrospective review of posttreatment 18F-fluorodeoxyglucose (18F-FDG) PET-CT scans in patients with head and neck carcinomas with risk of residual disease. Clinical outcome served as the reference standard. Results: This study included 93 patients (65.6% males, mean age: 48.8 years ± 17.2 standard deviation) with squamous cell carcinoma as most frequent histopathology (91.4%). PET-CT scans were performed on average 6 months posttreatment. Diagnostic accuracy, positive predictive value, and negative predictive value of PET-CT for disease were found to be 88%, 88%, and 92%, respectively. A median follow-up of 24 months was available for 91 patients. Kaplan–Meier curves showed significantly higher disease-free survival with negative PET-CT as compared to positive PET-CT (P = 0.01) and maximum standardized uptake values of <5.0 (P = 0.01). Conclusion: FDG PET-CT has diagnostic and prognostic implications in treated patient of head and neck cancers.

Thoracic positron emission tomography using18F-fluorodeoxyglucose for the evaluation of residual mediastinal Hodgkin disease

Blood ◽  
2001 ◽  
Vol 98 (10) ◽  
pp. 2930-2934 ◽  
Author(s):  
Martin R. Weihrauch ◽  
Daniel Re ◽  
Klemens Scheidhauer ◽  
Sascha Ansén ◽  
Markus Dietlein ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Predictive Value ◽  
Fdg Pet ◽  
Mediastinal Mass ◽  
Hodgkin Disease ◽  
Emission Tomography ◽  
Metabolic Imaging ◽  
Positron Emission ◽  
Mediastinal Disease

Residual mediastinal masses are frequently observed in patients with Hodgkin disease (HD) after completed therapy, and the discrimination between active tumor tissue and fibrotic residues remains a clinical challenge. We studied the diagnostic value of metabolic imaging by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in detecting active mediastinal disease and predicting relapse. Twenty-eight HD patients with a residual mediastinal mass of at least 2 cm after initial therapy or after salvage chemotherapy were prospectively assigned to 29 examinations with FDG PET and were evaluated as 29 “subjects.” Patients were monitored for at least 1 year after examination and observed for signs of relapse. Median follow-up was 28 months (range, 16 to 68 months). A PET-negative mediastinal tumor was observed in 19 subjects, of whom 16 stayed in remission and 3 relapsed. Progression or relapse occurred in 6 of 10 subjects with a positive PET, whereas 4 subjects remained in remission. The negative predictive value (negative PET result and remission) at 1 year was 95%, and the positive predictive value (positive PET result and relapse) was 60%. The disease-free survival for PET-negative and PET-positive patients at 1 year was 95% and 40%, respectively. The difference was statistically significant. A negative FDG PET indicates that an HD patient with a residual mediastinal mass is unlikely to relapse before 1 year, if ever. On the other hand, a positive PET result indicates a significantly higher risk of relapse and demands further diagnostic procedures and a closer follow-up.

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