Positron emission tomography/computed tomography (PET/CT) for the diagnosis of recurrent cancer (PETREC): A multicenter, prospective cohort study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6049-6049
Author(s):  
John J. You ◽  
Richard I. Inculet ◽  
Sukhbinder K. Dhesy-Thind ◽  
Adrien M. Chan ◽  
Marc Freeman ◽  
...  
Keyword(s):  
Head And Neck ◽  
Clinical Management ◽  
Cancer Recurrence ◽  
Management Plan ◽  
Small Cell ◽  
Small Cell Lung ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact

6049 Background: The clinical utility of PET/CT in patients with suspected cancer recurrence remains unclear. The aim of this multi-center, prospective, comparative effectiveness study is to assess the impact of PET/CT on clinical management of patients with suspected cancer recurrence. Methods: Patients were eligible if cancer recurrence (non-small cell lung, breast, head and neck, ovarian, esophageal, Hodgkin’s or non-Hodgkin’s lymphoma) was clinically suspected, and if conventional imaging (e.g. X-ray, ultrasound, CT, or MRI) was non-diagnostic. As a pre-requisite to PET/CT booking, clinicians were asked at enrolment to indicate their planned management if PET/CT were not available. Patients then underwent 18FDG-PET/CT. Clinicians were then asked to indicate their management plan based on PET/CT findings. Patients were followed up once at 3 months. The primary outcome was change in planned management after PET/CT and was assessed independently and in duplicate by external outcome adjudicators using all available source documents. Results: 101 patients (mean age 64 y, 45% male, median 1.3 y since last treatment) were enrolled from 4 centers in Ontario, Canada between April 2009 and June 2011. Distribution of tumor types was: non-small cell lung (55%), breast (19%), ovarian (10%), esophageal (6%), lymphoma (6%), head and neck (4%). 8 patients did not complete the study (non-adherence to protocol, 2; death, 5; disease progression prior to PET/CT, 1), of whom 2 did not receive PET/CT. PET/CT changed planned management in 52 (53%) patients (Table). At 3 months, planned management was carried out in 46/52 (88%) patients. Conclusions: In patients with suspected cancer recurrence, PET/CT changes planned management from non-treatment to treatment for approximately 1 in every 3 patients (“number needed to scan” = 3) and contributes importantly to clinical management. [Table: see text]

The Role of FDG-PET/CT Imaging in Head and Neck Malignant Conditions: Impact on Diagnostic Accuracy and Patient Care

2007 ◽  
Vol 137 (1) ◽  
pp. 130-137 ◽  
Author(s):  
Arie Gordin ◽  
Avishay Golz ◽  
Zohar Keidar ◽  
Marcello Daitzchman ◽  
Rachel Bar-Shalom ◽  
...  
Keyword(s):  
Head And Neck ◽  
Clinical Management ◽  
Imaging Modality ◽  
Head And Neck Carcinoma ◽  
Diagnostic Procedures ◽  
Positron Emission ◽  
Neck Carcinoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact

BACKGROUND: To assess the value of positron emission tomography/computed tomography (PET/CT) with 18 F-Fluorodeoxyglucose (FDG) in patients with head and neck carcinoma as compared with PET and conventional imaging alone, and to assess the impact of PET/CT on further clinical management. STUDY DESIGN: Prospective nonrandomized study. SETTING: Ninety patients with head and neck tumors had 107 PET/CT examinations. RESULTS: The study analysis showed that PET/CT had a sensitivity of 89%, specificity 95%, PPV 94%, NPV 90%, and accuracy of 92%. PET/CT altered management in 51 patients (56%). PET/CT eliminated the need for previously planned diagnostic procedures in 24 patients, induced a change in the planned therapeutic approach in 21 patients and guided biopsy in 6 patients. CONCLUSIONS: PET/CT is an imaging modality with high diagnostic performance in the assessment of head and neck cancer, and induced a change in further clinical management in more than half of the study population.

scholarly journals Role of integrated F-18 fluoro-deoxy-glucose positron emission tomography and computed tomography in evaluation of lung cancer

2012 ◽  
Vol 20 (3-4) ◽  
pp. 107-111
Author(s):  
Dragana Sobic-Saranovic
Keyword(s):  
Lung Cancer ◽  
Fdg Pet ◽  
Small Cell ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Lung cancer is one of the leading causes of death in the world. It is generally divided in two groups: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Positron emission tomography (PET)/CT using the glucose analogue labeled with 18-fluor (F-18): fluoro-deoxy-glucose (F-18-FDG), is unique integrated imaging modality that offers simultaneous anatomic and metabolic information valuable in the diagnosis, staging and follow-up of both types of lung cancer and in particular in NSCLC. FDG accumulation in tissue is proportional to the amount of glucose utilization. Increased consumption of glucose is a characteristic of almost all types of lung cancer except in bronchoalveolar carcinoma and well differentiated neuroendocrine tumors. The objective of this brief review is to highlight the clinical role of F-18-FDG PET/CT in detection, staging, re-staging, and assessment of therapy response and follow up in lung cancer. The performance of F-18-FDG PET/CT in specific clinical situations is of special interest: in the differentiation of indeterminate lung lesions, the staging of NSCLC for lymph node and extra thoracic metastases, for therapy planning, the detection of recurrent lung cancer and the use in SCLC. In conclusion, F-18-FDG PET/CT helps in characterization of suspicious lesions, provides more precise staging of NSCLC than other imaging techniques, allows better patients? selection for new modalities of treatment, helps in restaging after induction therapy, allows better delineation for radiotherapy planning and helps in follow up evaluation by differentiating residual or recurrent tumor from post treatment scar.

scholarly journals The impact of particulate electron paramagnetic resonance oxygen sensors on fluorodeoxyglucose imaging characteristics detected via positron emission tomography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Philip E. Schaner ◽  
Ly-Binh-An Tran ◽  
Bassem I. Zaki ◽  
Harold M. Swartz ◽  
Eugene Demidenko ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Oxygen Sensor ◽  
Oxygen Sensors ◽  
Paramagnetic Resonance ◽  
Imaging Characteristics ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact ◽  
Electron Paramagnetic

AbstractDuring a first-in-humans clinical trial investigating electron paramagnetic resonance tumor oximetry, a patient injected with the particulate oxygen sensor Printex ink was found to have unexpected fluorodeoxyglucose (FDG) uptake in a dermal nodule via positron emission tomography (PET). This nodule co-localized with the Printex ink injection; biopsy of the area, due to concern for malignancy, revealed findings consistent with ink and an associated inflammatory reaction. Investigations were subsequently performed to assess the impact of oxygen sensors on FDG-PET/CT imaging. A retrospective analysis of three clinical tumor oximetry trials involving two oxygen sensors (charcoal particulates and LiNc-BuO microcrystals) in 22 patients was performed to evaluate FDG imaging characteristics. The impact of clinically used oxygen sensors (carbon black, charcoal particulates, LiNc-BuO microcrystals) on FDG-PET/CT imaging after implantation in rat muscle (n = 12) was investigated. The retrospective review revealed no other patients with FDG avidity associated with particulate sensors. The preclinical investigation found no injected oxygen sensor whose mean standard uptake values differed significantly from sham injections. The risk of a false-positive FDG-PET/CT scan due to oxygen sensors appears low. However, in the right clinical context the potential exists that an associated inflammatory reaction may confound interpretation.

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