Multimodality imaging of adult rhabdomyosarcoma: the added value of hybrid imaging

Rhabdomyosarcoma (RMS) represents more than 50% of paediatric soft tissue tumours. Conversely, it is extremely rare among adults, where it shows peculiar biological and clinical features that are still poorly investigated. RMS patients should be referred to a Sarcoma Centre, where the contribution of experienced radiologists plays a relevant role in the diagnostic assessment of the disease, including precise localisation, staging, image-guided biopsy, response evaluation after treatment and follow-up. Besides CT and MRI, hybrid imaging including positron emission tomography (PET)/CT and PET/MRI are giving an increasing contribution to provide functional insights about tumour biology and to improve the diagnostic accuracy of the imaging work-up. This review paper provides a revision of the pathology, clinical and radiological features of adult RMS, with a particular focus on the growing role of hybrid PET-based imaging.

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The role of CT, PET-CT, and MRI in ovarian cancer

British Journal of Radiology ◽

10.1259/bjr.20210117 ◽

2021 ◽

Vol 94 (1125) ◽

pp. 20210117

Author(s):

Maurits Peter Engbersen ◽

Willemien Van Driel ◽

Doenja Lambregts ◽

Max Lahaye

Keyword(s):

Ovarian Cancer ◽

Essential Role ◽

Advanced Ovarian Cancer ◽

Emission Tomography ◽

Current Position ◽

Positron Emission ◽

Pet Ct ◽

New Treatment ◽

Ct And Mri

New treatment developments in ovarian cancer have led to a renewed interest in staging advanced ovarian cancer. The treatment of females with ovarian cancer patients has a strong multidisciplinary character with an essential role for the radiologist. This review aims to provide an overview of the current position of CT, positron emission tomography-CT, and MRI in ovarian cancer and how imaging can be used to guide multidisciplinary team discussions.

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Comparison of F18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Dynamic Contrast-Enhanced Magnetic Resonance Imaging as Markers of Graft Viability in Anterior Cruciate Ligament Reconstruction

The American Journal of Sports Medicine ◽

10.1177/0363546518805092 ◽

2018 ◽

Vol 47 (1) ◽

pp. 88-95 ◽

Cited By ~ 2

Author(s):

Siva Srivastava Garika ◽

Anshul Sharma ◽

Abdul Razik ◽

Akshima Sharma ◽

Ravindra Mohan Pandey ◽

...

Keyword(s):

Fdg Pet ◽

Cruciate Ligament ◽

Acl Graft ◽

Positron Emission ◽

Contrast Enhanced ◽

Pet Ct ◽

Anterior Cruciate ◽

Fdg Pet Ct ◽

Ct And Mri

Background: F18-fluorodeoxyglucose positron emission tomography/computed tomography (F18-FDG PET/CT) can be used to assess changes in the metabolism of an anterior cruciate ligament (ACL) graft as it is undergoing “ligamentization.” Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is the preferred modality for noninvasive assessment of graft structure and graft vascularity. Purpose: To compare the use of F18-FDG PET/CT and DCE-MRI to assess ligamentization within the ACL graft and correlate the results with clinical tests. Study Design: Case series; Level of evidence, 4. Methods: Among 30 recruited patients, 27 patients (3 females and 24 males) completed 2 follow-up assessments at a mean of 125 ± 22 days and 259 ± 38 days after arthroscopic ACL reconstruction. At both assessments, anterior drawer test, Lachman test, and Lysholm scoring (LS) were conducted. Images from F18-FDG PET/CT and MRI were analyzed qualitatively and quantitatively (maximum standardized uptake value [SUVmax], SUVmax ratio to the contralateral side [SUVmax CL], normalized enhancement [NE]) in 3 zones: femoral, intra-articular (IA), and tibial. Of the 27 recruited patients, 1 patient had reinjury due to a fall. Therefore, 26 patients were considered for the final analysis. Results: A significant improvement ( P = .0001) was found in median LS, from 78.5 (range, 62-90) to 94.5 (range, 84-100), at the second follow-up. All grafts were found to be viable on PET/CT and vascularized on MRI. All grafts were seen as continuous on MRI, with exception of 1 graft at the second follow-up. Dynamic MRI identified single-vessel supply to all of the grafts at the first follow-up and multiple-vessel supply in 10 patients at the second follow-up. Reduction in the median SUVmax, SUVmax CL, and NE at second follow-up was seen in all 3 zones. Only SUVmax CL in the IA zone showed a significant reduction ( P = .032); patients with excellent LS at the second follow-up showed significantly higher reduction ( P = .005) than patients with good LS. NE in the IA zone was correlated (0.39; P = .048) with LS only at the first follow-up, whereas SUVmax CL (–0.52; P = .006) and SUVmax (–0.49, P = .010) in the IA zone negatively correlated with LS at the second follow-up only. No correlation was observed between PET/CT and MRI parameters. Conclusion: Glucose metabolism and vascularity in the graft tissue can be used to assess ligamentization of ACL graft. A viable and vascularized graft at first follow-up is associated with good to excellent final outcome, regardless of LS at this stage. Since no correlation was observed between PET/CT and MRI parameters, they may be assessing different domains of the same process. Higher NE in the IA zone at the first follow-up and lower SUVmax CL in the same region at second follow-up are associated with better outcome.

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Radiology of the head and neck

10.1093/med/9780199682874.003.0218 ◽

2021 ◽

pp. 973-976

Author(s):

Ivan Zammit-Maempel

Keyword(s):

Head And Neck ◽

Imaging Techniques ◽

Cone Beam Ct ◽

Neck Mass ◽

Positron Emission ◽

Pet Ct ◽

Magnetic Resonance Imaging Mri ◽

Video Fluoroscopy

Various imaging techniques are used in the staging and follow-up of head and neck cancer and evaluating patients presenting with a neck mass. The workhorses in imaging the neck are ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) with positron emission tomography CT (PET-CT) increasingly being requested. Plain radiographs, contrast studies, video fluoroscopy, angiography, and cone beam CT have limited but important roles. This chapter discusses the role of some of these modalities.

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P273 The role of multimodality imaging in the evaluation of arteritis

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.130 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

T M Matajira Chia ◽

M Castineira Busto ◽

M Cespon Fernandez ◽

B Gimena Reyes ◽

F Calvo Iglesias ◽

...

Keyword(s):

Antinuclear Antibodies ◽

Aortic Wall ◽

Multimodality Imaging ◽

Lateral Wall ◽

Ascending Aorta ◽

Iliac Arteries ◽

Positron Emission ◽

Nuclear Antigens ◽

Pet Ct

Abstract A 61-year-old man was admitted to the hospital with an atypical pain lumbar with oligoanuria. Other comorbidities were: arterial hypertension, diabetes mellitus and smoking .On examination the patient was comfortable at rest, with a heart rate of 89 b.p.m. and a blood pressure of 147/2 mmHg. Normal S1 and S2 heart sounds were present. There were no signs of heart failure present. Patients complained of pain in hypogastrium on palpation. Creatinine 2.33 mg / dL. PCR 72. The immunological studies were normal (including IgG and IgA serological levels, antinuclear antibodies, extractable nuclear antigens, anti-neutrophil cytoplasmic antibodies. An Body CT was performed, it shows mass that includes the ureters as well as the iliac arteries and parietal thickening in aorta wall. The positron emission tomography–computed tomography (PET CT) scans was performed that evidences pathological hypermetabolism that surrounds both primitive iliac arteries with maximum SUV 12 g / ml. Pathological hypermetabolism in ascending aorta until reaching arch with maximum SUV of 9.1 mg / ml compatible with periaortitis in the ascending aorta. A study was completed with retroperitoneal mass biopsy that showed areas of retroperitoneal fibrosis with predominantly lymphoplasmacytic areas. IgG4 / IgG> 40% , Obliterative involvement of small venules suggestive of IgG4 disease. A transthoracic echocardiogram was performed which showed normal biventricular function, absence of significant valvular disease and thickening of the aortic wall compatible with periaortitis. The patient started glucocorticoid therapy with favorable response. A PET CT control was performed that showed disappearing retroperitoneal masses around iliac vessels and disappearance of activity in lateral wall of aorta and decrease activity about ascendent aorta. DIAGNOSIS : IgG4 -related aortitis Abstract P273 Figure.

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Imaging in polymyalgia rheumatica

Reumatismo ◽

10.4081/reumatismo.2018.1040 ◽

2018 ◽

Vol 70 (1) ◽

pp. 51 ◽

Cited By ~ 3

Author(s):

N. Possemato ◽

C. Salvarani ◽

N. Pipitone

Keyword(s):

Polymyalgia Rheumatica ◽

Morning Stiffness ◽

Imaging Techniques ◽

Review Article ◽

Inflammatory Disorder ◽

Chronic Inflammatory Disorder ◽

Pet Ct ◽

Ct And Mri

Polymyalgia rheumatica (PMR) is a chronic, inflammatory disorder of unknown cause clinically characterized by pain and prolonged morning stiffness affecting the shoulders and often the pelvic girdle and neck. Imaging has substantially contributed to defining PMR as a disease mainly involving extra-articular structures. This review article analyses the role of the different imaging techniques in the diagnosis and follow-up of patients with PMR with particular emphasis on the role of ultrasound, PET/CT and MRI.

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68Ga-DOTATATE PET/CT and MRI with Diffusion-Weighted Imaging (DWI) in Short- and Long-Term Assessment of Tumor Response of Neuroendocrine Liver Metastases (NELM) Following Transarterial Radioembolization (TARE)

Cancers ◽

10.3390/cancers13174321 ◽

2021 ◽

Vol 13 (17) ◽

pp. 4321

Author(s):

Maria Ingenerf ◽

Sophia Kiesl ◽

Salma Karim ◽

Leonie Beyer ◽

Harun Ilhan ◽

...

Keyword(s):

Progression Free Survival ◽

Response Assessment ◽

Early Response ◽

Pet Ct ◽

Adc Values ◽

Short And Long Term ◽

Ct And Mri

The aim of this study was to evaluate the role of SUV and ADC in assessing early response in patients with NELM following TARE. Thirty-two patients with pre- and postinterventional MRI with DWI and 68Ga-DOTATATE PET/CT were included. ADC and SUV of three target lesions and of tumor-free spleen and liver tissue were determined on baseline and first follow-up imaging, and tumor to spleen (T/S) and tumor to liver (T/L) ratios were calculated. Response was assessed by RECIST 1.1 and mRECIST on first follow-up, and long-term response was defined as hepatic progression-free survival (HPFS) over 6, 12, and <24 months. In responders, intralesional ADC values increased and SUV decreased significantly regardless of standard of reference for response assessment (mRECIST/RECIST/HPFS > 6/12/24 m). Using ROC analysis, ΔSUV T/S ratio (max/max) and ΔSUV T/L ratio (max/mean) were found to be the best and most robust metrics to correlate with longer HPFS and were superior to ΔADC. ΔT/S ratio (max/max) < 23% was identified as an optimal cut-off to discriminate patients with longer HPFS (30.2 m vs. 13.4 m; p = 0.0002). In conclusion, early percentage changes in SUV tumor-to-organ ratios on first follow-up seem to represent a prognostic marker for longer HPFS and may help in assessing therapeutic strategies.

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MRI versus CT and PET/CT in the Preoperative Assessment of Hodgkin and Non-Hodgkin Lymphomas

Hemato ◽

10.3390/hemato2040041 ◽

2021 ◽

Vol 2 (4) ◽

pp. 635-644

Author(s):

Francesca Maccioni ◽

Alessandro Calabrese ◽

Lucia Manganaro ◽

Carlo de Felice ◽

Sara Cardaccio ◽

...

Keyword(s):

Lymph Nodes ◽

Preoperative Assessment ◽

Added Value ◽

Pet Ct ◽

Disease Staging ◽

Total Body ◽

Histological Confirmation ◽

Sensitivity Specificity ◽

Ct And Mri

(1) Background: The purpose of this study is to retrospectively compare CT, MRI, and PET/CT in detecting lymphadenopathies and extra-nodal lesions in lymphoma and in disease staging. (2) Methods: Inclusion criteria were the availability of TB (Total Body) CT and/or PET/CT performed before treatment; MRI performed no later than 2 weeks after TBCT; histological confirmation of lymphoma; clinical-diagnostic follow-up. Using these criteria, we included 64/353 patients with TBCT and MRI performed at our hospital; 20/64 had PET/CT performed in other hospitals. Histology and follow-up were gold standard. (3) Results: The sensitivity, specificity, and accuracy in lymph nodes detection was 84.5%, 94.4%, and 91% for CT and 95%, 98.9%, and 95.6% for MRI. High agreement was observed between CT and MRI regarding the number and size of positive lymph nodes and for disease staging. MRI identified eight more extra-nodal lesions than CT. In the subgroup of 20 patients, PET/CT did not show a significant superiority in sensitivity, specificity, accuracy, and staging ability than CT and MRI. (4) Conclusions: Our study demonstrates a mild superiority of MRI over CT in lymphoma staging. Although PET/CT remains the reference standard, MRI demonstrated a similar diagnostic accuracy, with the added value of being radiation-free.

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

Archive of oncology ◽

10.2298/aoo1204107s ◽

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.

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Whole-body integrated imaging for multiple myeloma: the gold standard

Journal of Advanced Health Care ◽

10.36017/jahc2010-004 ◽

2020 ◽

Author(s):

Nappa Elena ◽

Notorio Maurizio ◽

Russo Salvatore

Keyword(s):

Multiple Myeloma ◽

Gold Standard ◽

Imaging Techniques ◽

Added Value ◽

Whole Body ◽

Study Protocols ◽

Pet Ct ◽

Cancer Network ◽

Work Up

The article aims to describe the study protocols of multiple myeloma with different imaging techniques. The guidelines of the major scientific reference societies for multiple myeloma - IMWG (International Myeloma Working Group) and NCCN (National Comprehensive Cancer Network) - provide for the study of CT WB, RM WB and PET / CT, which have completely outclassed traditional radiology. Each method contributes to acquiring an added value in the work up and follow up of patients suffering from multiple myeloma.

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Role of 18F-Fluorodeoxyglucose–Positron Emission Tomography/Computed Tomography Imaging in the Prediction of Prognosis in Patients With Indolent Lymphoma: Prospective Study (Preprint)

10.2196/preprints.24936 ◽

2020 ◽

Author(s):

Nawal Faiez AlShehry ◽

Raja Shanker ◽

Syed Ziauddin Ahmed Zaidi ◽

Fahad AlGhmlas ◽

Ibraheem Hussein Motabi ◽

...

Keyword(s):

Overall Survival ◽

Emission Tomography ◽

Indolent Lymphoma ◽

Interim Pet ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct ◽

Fluorodeoxyglucose Positron Emission

BACKGROUND The role of fluorodeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) in indolent lymphoma has been minimally studied. OBJECTIVE This study aims to assess the value of FDG-PET/CT in predicting the prognosis of indolent lymphoma. METHODS We prospectively recruited 42 patients with indolent lymphoma. A total of 2 patients were excluded, and 40 underwent baseline PET/CT and follow-up at various time points. A total of 9 patients were observed only, 7 received 4 doses of rituximab alone, and 24 received chemoimmunotherapy. Metabolic response on follow-up PET/CT was assessed using the maximum standardized uptake value (SUVmax) and Deauville criteria (DC). We aimed to obtain the best SUVmax and DC to predict optimal survival rates, risk stratification, and optimize therapeutic strategies. The mean follow-up from the initial diagnosis was 33.83 months. RESULTS SUVmax <4.35 at interim PET/CT provided the best discrimination, with a progression-free survival (PFS) of 100% and a median survival time of 106.67 months compared with SUVmax ≥4.35 (<i>P</i>=.04), which had a PFS of 43.8% and a median survival time of 50.17 months. This cutoff was also valuable in predicting overall survival at baseline, that is, 100% overall survival with baseline SUVmax <4.35, versus 58.4% for SUVmax ≥4.35 (<i>P</i>=.13). The overall survival of patients with a baseline DC score <3.0 was 100%, with a median overall survival of 106.67 months. CONCLUSIONS We demonstrated the utility of PET/CT in indolent lymphomas. SUVmax (<4.35 vs ≥4.35) on interim PET/CT performed best in predicting PFS. CLINICALTRIAL

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