[18F]Fluorodeoxyglucose-Positron Emission Tomography in Patients with Medulloblastoma

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. 1280-1289 ◽  
Author(s):  
Sridharan Gururangan ◽  
Eugene Hwang ◽  
James E. Herndon ◽  
Herbert Fuchs ◽  
Timothy George ◽  
...  

Abstract OBJECTIVE: We evaluated the [18F]fluorodeoxyglucose (FDG) accumulation during positron emission tomography (PET) in patients with medulloblastoma and examined the relationship of intensity of uptake with patient outcome after the initial scan. METHODS: Magnetic resonance imaging and FDG-PET scans of brain and spine were used to assess FDG uptake by visual grade (qualitative analysis) and metabolic activity ratios (Tmax/Gmean and Tmax/Wmean). Patients were divided into two groups based on either confirmation of tumor by biopsy and/or death resulting from progressive disease after the initial FDG-PET scan (Group A) or no intervention for the suspected lesion shown on magnetic resonance imaging after the initial FDG-PET scan but currently alive without evidence of disease (Group B). RESULTS: Twenty-two patients with either recurrent (n = 21) or newly diagnosed (n = 1) medulloblastoma underwent brain (n = 18) or whole-body (n = 4) FDG-PET scans after magnetic resonance imaging evidence of suspected tumor. The median qualitative analysis was 3 (range, 0–4) in 17 Group A patients compared with 0 (range, 0–1) in 5 Group B patients (P = 0.0003). The mean Tmax/Gmean and Tmax/Wmean ratios for 16 Group A patients were 1.3 (range, 0.1–3.8) and 2.10 (range, 0.4–5.2), respectively, compared with 0.80 (range, 0.20–1.5) and 1.3 (range, 0.5–1.9) in 5 Group B patients (P = 0.2 for both parameters, not significant). There was a significant negative correlation between increased FDG uptake and survival. Higher qualitative analysis and Tmax/Wmean were associated with significantly poorer 2-year overall survival after the initial scan (71% versus 15% for qualitative analysis grade of <3 versus ≥3, P = 0.001; 46% versus 0% for Tmax/Wmean ≤2.5 versus –2.5, P = 0.004). CONCLUSION: Increased FDG uptake is observed in medulloblastoma and is correlated negatively with survival.

2021 ◽  
Vol 10 (6) ◽  
pp. 205846012110224
Author(s):  
Yuka Ishikura ◽  
Rika Yoshida ◽  
Takeshi Yoshizako ◽  
Kouji Kishimoto ◽  
Noriyoshi Ishikawa ◽  
...  

Osteoid osteoma is a benign osteoblastic bone lesion, characterized by nocturnal pain alleviated by salicylates or nonsteroidal anti-inflammatory drugs. This tumor distinctly affects the long bones, typically the femur or tibia and is rarely located in the ribs. Usually, this tumor is usually diagnosed by computed tomography or magnetic resonance imaging, but F-18 fluoro-deoxyglucose positron emission tomographic (FDG-PET)/computed tomography is usually negative and is not used for diagnosis. We recently encountered a case of an osteoid osteoma located in the rib of 44-year-old Asian male with strong FDG uptake as high as 12.0 at the maximum standardized uptake value at FDG-PET/computed tomography. His computed tomography and magnetic resonance imaging showed osteosclerosis, bone marrow edema, and edema of surrounding tissues not only in the bone with nidus but also in the adjacent bone, and pathological findings showed strong infiltration munched radiology. Strong FDG uptake mimicking osteoblastoma. Osteoid osteoma with strong FDG uptake suggested a strong inflammatory response.


2005 ◽  
Vol 23 (13) ◽  
pp. 3030-3037 ◽  
Author(s):  
Lise Borgwardt ◽  
Liselotte Højgaard ◽  
Henrik Carstensen ◽  
Henning Laursen ◽  
Markus Nowak ◽  
...  

Purpose Positron emission tomography (PET) has been used in grading of CNS tumors in adults, whereas studies of children have been limited. Patients and Methods Nineteen boys and 19 girls (median age, 8 years) with primary CNS tumors were studied prospectively by fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG) PET with (n = 16) or without (n = 22) H215O-PET before therapy. Image processing included coregistration to magnetic resonance imaging (MRI) in all patients. The FDG uptake in tumors was semiquantitatively calculated by a region-of-interest–based tumor hotspot/brain index. Eight tumors without histologic confirmation were classified as WHO grade 1 based on location, MRI, and clinical course (22 to 42 months). Results Four grade 4 tumors had a mean index of 4.27 ± 0.5, four grade 3 tumors had a mean index of 2.47 ± 1.07, 10 grade 2 tumors had a mean index of 1.34 ± 0.73, and eight of 12 grade 1 tumors had a mean index of −0.31 ± 0.59. Eight patients with no histologic confirmation had a mean index of 1.04. For these 34 tumors, FDG uptake was positively correlated with malignancy grading (n = 34; r = 0.72; P < .01), as for the 26 histologically classified tumors (n = 26; r = 0.89; P < .01). The choroid plexus papilloma (n = 1) and the pilocytic astrocytomas (n = 3) had a mean index of 3.26 (n = 38; r = 0.57; P < .01). H215O-uptake showed no correlation with malignancy. Digitally performed PET/MRI coregistration increased information on tumor characterization in 90% of cases. Conclusion FDG PET of the brain with MRI coregistration can be used to obtain a more specific diagnosis with respect to malignancy grading. Improved PET/MRI imaging of the benign hypermetabolic tumors is needed to optimize clinical use.


2021 ◽  
Vol 13 (9) ◽  
pp. 1595-1602
Author(s):  
Yuli Wu ◽  
Junwei Song ◽  
Shengcui Liu ◽  
Xianglei Wei ◽  
Weiwei Chen

This study aimed to explore the application of super paramagnetic gold magnetic nanoparticles (Au-M-NPs) in the magnetic resonance imaging (MRI) images for targeted diagnosis and treatment of breast cancer. The reducibility of ethylene glycol to ferric chloride (FeCl3) was adopted to synthesize the Au-M-NPs by solvothermal method by taking acetic acid as the base source and trisodium citrate as the stabilizer. Besides, the synthesized Au-M-NPs were applied in the MRI images for targeted therapy of breast cancer. Patients from a blank group (group A), a control group (group B), and an experimental group (group C) received the traditional clinical diagnosis treatment, MRI diagnosis, and Au-M-NPs targeted therapy with MRI in turn. The results showed that the prepared Au-M-NPs were featured with small particle size and good dispersibility, and were monodispersive after surface modification. The intraoperative blood loss of patients from group A (115.3±9.33 mL) and group B (94.6±9.72 mL) was obviously higher than the loss of group C (68.4±8.7 mL) (P < 0.05). The drainage volume of patients from group B (162.4±12.3 mL) and group C (131.9±11.8 mL) decreased sharply after surgery compared with group A (193.7±11.8 mL), and that in group C was the lowest (P < 0.05). The proportion of local recurrence in patients from group B (12.3%) and group C (6.4%) dropped steeply in contrast to the proportion of group A (13.2%) (P < 0.05). The proportion of tumor metastasis in patients from group B (11.2%) and group C (8.4%) was greatly lower than that of group A (14.8%) (P < 0.05). In conclusion, the application of Au-M-NPs in the diagnosis and treatment of breast cancer with MRI could effectively reduce the incidence of intraoperative and postoperative adverse reactions.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Soo Hyun Shin ◽  
Sang Hyun Park ◽  
Se Hun Kang ◽  
Seung Won Kim ◽  
Minsun Kim ◽  
...  

The presence of tumor-associated macrophages (TAMs) is significantly associated with poor prognosis of tumors. Currently, magnetic resonance imaging- (MRI-) based TAM imaging methods that use nanoparticles such as superparamagnetic iron oxide and perfluorocarbon nanoemulsions are available for quantitative monitoring of TAM burden in tumors. However, whether MRI-based measurements of TAMs can be used as prognostic markers has not been evaluated yet. In this study, we used positron emission tomography (PET) with 18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) as a radioactive tracer and fluorine-19- (19F-) MRI for imaging mouse breast cancer models to determine any association between TAM infiltration and tumor metabolism. Perfluorocarbon nanoemulsions were intravenously administered to track and quantify TAM infiltration using a 7T MR scanner. To analyze glucose uptake in tumors, 18F-FDG-PET images were acquired immediately after 19F-MRI. Coregistered 18F-FDG-PET and 19F-MR images enabled comparison of spatial patterns of glucose uptake and TAM distribution in tumors. 19F-MR signal intensities from tumors exhibited a strong inverse correlation with 18F-FDG uptake while having a significant positive correlation with tumor growth from days 2 to 7. These results show that combination of 19F-MRI and 18F-FDG-PET can improve our understanding of the relationship between TAM and tumor microenvironment.


2020 ◽  
pp. 096452842092028
Author(s):  
Jiping Zhang ◽  
Taibiao Lyu ◽  
Yicheng Yang ◽  
Yanjie Wang ◽  
Yu Zheng ◽  
...  

Objective The aim of this study was to investigate the effects of acupuncture at LR3 and KI3 on hypertension at different time points and on related cerebral regions using resting-state functional magnetic resonance imaging (rs-fMRI). Methods We randomly divided 29 subjects into two groups: Group A (receiving acupuncture at LR3 + KI3; 15 subjects) and group B (receiving acupuncture at LR3 and a sham location not corresponding to any traditional acupuncture point; 14 subjects). Acupuncture was performed. Blood pressure (BP) changes were recorded and analyzed using SPSS 20.0 statistical software. We used a 3.0T MRI scanner and standard GE 8 channel head coil to collect whole brain fMRI data in both groups. Data analysis and processing was based on the R2009a MATLAB platform. REST 1.8 software was used to analyze the whole brain amplitude of low-frequency fluctuation (ALFF). Results After acupuncture, a statistically significant reduction in BP at different time points was observed in group A. In group B, a statistically significant reduction was found only in diastolic blood pressure (DBP) and was not sustained. Acupuncture at LR3 + KI3 specifically affected brain areas involved in BP regulation, as well as those involved in auditory sense, speech, vision, movement and sensation. Conclusion Acupuncture at LR3 + KI3 showed positive immediate and long-term effects on BP, particularly systolic blood pressure (SBP). After ALFF analysis, we concluded that LR3 + KI3 activates brain areas related to BP regulation. In addition, after acupuncture at LR3 + KI3, a highly targeted effect was observed in brain areas associated with BP. In addition, extracerebral areas involving vision, motion control, cognition and hearing were activated, which could potentially contribute to the mitigation of hypertensive complications in patients in an advanced stage of the disease.


Author(s):  
Boby Varkey Maramattom ◽  
Shagos Gopalan Nair Santhamma

Neurotuberculosis (NT) continues to be a global health problem with severe morbidity and mortality. The manifestations of NT are well-known and encompass forms such as meningitis, tuberculomas, military tuberculosis, ventriculitis, and brain abscess. Data of all patients with central nervous system tuberculosis who underwent magnetic resonance imaging (MRI) and/or 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography–computed tomography (PET-CT) were analyzed. Over a 7-year period (2014–2021), we encountered three patients who had dense neurological deficits and 18F-FDG PET-CT results suggesting focal cortical encephalitis. 18F-FDG PET-CT demonstrated focal hypermetabolism involving focal–regional areas of the left hemisphere that corresponded to clinical deficits in two of the three patients. Follow-up 18F-FDG PET-CT showed improvement in cortical hypermetabolism in all three patients that corresponded with clinical improvement. MRI of the brain with contrast showed subtle leptomeningeal enhancement in these areas, along with other features of NT, but it could not detect cortical involvement. A literature review also revealed some previous descriptions that seemed to be consistent with tuberculous encephalitis (TbE). TbE seems to be a distinct subset of NT and may coexist with other features of NT or disseminated tuberculosis. It may be detected by 18F-FDG PET-CT even when brain MRI does not show any evident abnormality to explain a focal neurological deficit. 18F-FDG PET-CT can be considered during the evaluation and monitoring of NT to detect TbE. The presence of TbE may affect the prognosis and treatment duration of NT.


2020 ◽  
Vol 7 (10) ◽  
pp. 3219
Author(s):  
Sushil Bhogawar ◽  
Prasanth Asher ◽  
Sunilkumar Balakrishnan Sreemathyamma ◽  
Anilkumar Peethambaran

Background: Cervical spondylotic myelopathy (CSM) is a commonly seen spinal cord disease. There are no well-defined indications and optimal timing for surgical intervention. Therefore, defining predictors for outcome after surgical intervention will have great advantage in taking decisions for interventions.Methods: A consecutive series of all patients having signs and symptoms of cervical spondylotic myelopathy admitted to Department of Neurosurgery, Medical College, Thiruvananthapuram who underwent decompressive surgery with or without stabilization in one year were studied. Pre-operative magnetic resonance imaging (MRI) findings were correlated with post-operative surgical outcomes (Nurick grade) after 3 months of follow up. The pattern of spinal cord signal intensity was classified as: group A (MRI N/N) - no SI T1WI or T2WI, group B (MRI N/Hi) - no SI T1WI and high SI on T2WI and, group C (MRI Lo/Hi) - low SI T1WI and high SI on T2WI. CSM clinical outcomes were evaluated using Nurick grading system, which was used pre- and post-operatively (pre op and post op).Results: Post operatively improvement was seen in 75% of group A and 61.35 % of group B patients, but among group C only 25% patient improved according to Nurick grading pre op and post op.Conclusions: Patients with high intramedullary signal intensity on T2WI may experience a good surgical outcome. A less favorable surgical outcome is predicted by the presence of low intramedullary signal on T1WI.


Neurosurgery ◽  
2002 ◽  
Vol 50 (2) ◽  
pp. 404-408 ◽  
Author(s):  
Benoit Pirotte ◽  
Serge Goldman ◽  
Danielle Baleriaux ◽  
Jacques Brotchi

ABSTRACT OBJECTIVE AND IMPORTANCE Lhermitte-Duclos disease (LDD) represents a focally indolent dysplastic growth of the cerebellar cortex. The 106 cases reported previously in the literature show an extremely slow evolution, and the operative indications and techniques for this disease entity are still controversial. The authors present the first case of LDD studied with positron emission tomography using the labeled tracers [18F]2-fluoro-2-deoxy-d-glucose ([18F]FDG) and 11C-labeled methionine ([11C]Met) to study the glucose and protein metabolism of the lesion. CLINICAL PRESENTATION A 40-year-old woman suddenly became unconscious then completely recovered 5 minutes later. Magnetic resonance imaging of her brain showed a well-delineated 10 × 5-cm abnormal area with enlarged cerebellar folia, which led to the diagnosis of LDD. TECHNIQUE On positron emission tomographic scans, [18F]FDG and [11C]Met uptake in the normal cerebral and cerebellar cortex appeared higher than normal, reaching levels found in patients with primary malignant brain tumors. Moreover, the uptake of both tracers was heterogeneous, in contrast to the homogeneous uptake visualized on magnetic resonance imaging scans. The areas of greatest [11C]Met and [18F]FDG uptake were discordant. Some areas of greater than normal [18F]FDG uptake corresponded to areas of moderate or low [11C]Met uptake. Because of the important mass effect in the posterior fossa, total surgical resection was performed. A histological examination confirmed the diagnosis of LDD. CONCLUSION This first reported metabolic study of LDD supports the view that LDD is an active and evolving disease. These data should prompt reevaluation of the indications for surgery in patients with this disease as well as the timing of surgery.


2020 ◽  
pp. 028418512094490
Author(s):  
Mervi Tenhami ◽  
Johanna Virtanen ◽  
Saila Kauhanen ◽  
Jukka Koffert ◽  
Jukka Kemppainen ◽  
...  

Background The clinical utility of positron emission tomography/magnetic resonance imaging (PET/MRI) in comparison to standard work-up with patients with known or suspected inflammatory bowel disease (IBD) is unknown. Purpose To evaluate the value of 18F-fluorodeoxyglucose (18F-FDG) PET/MRI in the diagnostics of IBD and further compare the data obtained using PET/MRI to histological findings. Materials and Methods Ten patients with relapse in IBD or with symptoms of suspected IBD were recruited either from a gastroenterology outpatient clinic or from a hospital ward. Intestinal inflammation was assessed with histology and 18F-FDG PET/MRI. Maximum standard uptake values (SUVmax) were calculated in six regions of the intestine (small bowel, ascending, transverse, descending and sigmoid colon, and rectum) and compared to histological analysis of inflammation activity. Results The study showed that both the inflammation activity ( P = 0.008) and the region of the biopsy in the intestine ( P = 0.015) had a significant effect on SUV. SUVs obtained from severe inflammation activity emerged significantly from the background ( P = 0.006). In addition, the SUVs obtained from moderate inflammation raised from background, but the difference was not statistically significant ( P = 0.083), while SUVs of mild inflammation were at the same level with SUVs of normal bowel wall ( P = 0.988). Conclusion 18F-FDG PET/MRI is a promising method of detecting especially severe inflammatory bowel lesions. More data are required to define its sensitivity and specificity.


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