scholarly journals Impact of 18F-FDG-PET/CT on Clinical Management in Patients with Cholangiocellular Carcinoma

BJR|Open ◽  
2021 ◽  
pp. 20210008
Author(s):  
Lena Sophie Kiefer ◽  
Julia Sekler ◽  
Brigitte Gückel ◽  
Mareen Sarah Kraus ◽  
Christian la Fougère ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Clinical Management ◽  
Palliative Treatment ◽  
Treatment Strategies ◽  
Cholangiocellular Carcinoma ◽  
Treatment Goal ◽  
Targeted Biopsy ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact

Objective: To determine the impact of 18F-FDG-PET/CT on clinical management of patients with cholangiocellular carcinoma (CCA). Methods: Patients with CCA undergoing clinically indicated 18F-FDG-PET/CT between 04/2013 and 08/2018 were prospectively included in a local PET/CT registry study. Intended clinical management (“non-treatment” such as watchful-waiting or additional diagnostic tests, and “palliative” or “curative treatment”) was recorded before and after PET/CT. Changes in intended management after PET/CT were analyzed. Results: 27 patients (mean age: 60 years, IQR: 51.5–67.5 years, 56% males) with 43 PET/CT-examinations were included. Intended management changed in 35/43 cases (81.4%) following PET/CT. Major changes (i.e., between “non-treatment” and “treatment” strategies or between a “curative” and “palliative” treatment goal) occurred in 27/43 (62.8%) cases. Before PET/CT, additional imaging and/or biopsy was intended in 21/43 (48.8%) and 9/43 (20.9%) cases, respectively. After PET/CT, further imaging was carried out in one case and imaging-targeted biopsy in eight cases. Although the absolute number of biopsies after PET/CT did not decrease, in only one of these eight cases biopsy had already been planned before PET/CT, whereas in the other eight cases the originally planned biopsies were dispensable after PET/CT. Conclusions: 18F-FDG-PET/CT significantly impacts clinical management of patients with CCA. It guides decisions on treatment strategy (especially curative vs palliative treatment goal) and on additional tests, particularly by helping referring clinicians to avoid unnecessary imaging and by guiding targeted biopsy. Advances in knowledge: Systematic implementation of 18F-FDG-PET/CT may enable a more appropriate and tailored treatment of patients with CCA, especially in cases of suspected recurrence.

scholarly journals Malignancy Rate of Indeterminate Findings on FDG-PET/CT in Cutaneous Melanoma Patients

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 883
Author(s):  
Ken Kudura ◽  
Florentia Dimitriou ◽  
Daniela Mihic-Probst ◽  
Urs J. Muehlematter ◽  
Tim Kutzker ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Fdg Pet ◽  
Clinical Management ◽  
Clinical Routine ◽  
Malignancy Rate ◽  
Pet Ct ◽  
Malignant Lesions ◽  
Melanoma Patients ◽  
Fdg Pet Ct ◽  
The Impact

Background: The use of 18F-2-Fluor-2-desoxy-D-glucose Positron Emission Tomography/Computed Tomography FDG-PET/CT in clinical routine for staging, treatment response monitoring and post treatment surveillance in metastatic melanoma patients has noticeably increased due to significant improvement of the overall survival rate in melanoma patients. However, determining the dignity of the findings with increased metabolic activity on FDG-PET/CT can be sometimes challenging and may need further investigation. Purpose: We aimed to investigate the malignancy rate of indeterminate findings on FDG-PET/CT in metastatic cutaneous melanoma patients. Methods: This single-center retrospective study included cutaneous melanoma patients who underwent FDG-PET/CT in clinical routine between 2015 and 2017 with findings reported as indeterminate and therefore requiring further evaluation. The dignity of the included findings was determined by subsequent imaging and, if required, additional histopathology. The impact of the outcome on the clinical management was also reported. Results: A total of 842 FDG-PET/CT reports of 244 metastatic cutaneous melanoma patients were reviewed. Sixty indeterminate findings were included. Almost half of all indeterminate findings were lymph nodes, lung nodules and cerebral lesions. In total, 43.3% of all included findings proved to be malignant. 81% of all malignant lesions were metastases of cutaneous melanoma, while 19% of all malignant lesions could be attributed to other primary malignancies, such as lung, breast, thyroid and colorectal cancers. Malignant findings influenced clinical management in 60% of the cases. Conclusion: Indeterminate findings on FDG-PET/CT in metastatic cutaneous melanoma patients should be further investigated. Almost one out of every two indeterminate findings on FDG-PET/CT is malignant. The majority of the findings are melanoma manifestations, however, in a significant percentage, other primary tumors are found. Upon verification, patient management is changed in most cases.

scholarly journals Comparison of the Impact of 68 Ga-DOTATATE and 18 F-FDG PET/CT on Clinical Management in Patients with Neuroendocrine Tumors

2016 ◽  
Vol 58 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Emmanouil Panagiotidis ◽  
Alshaima Alshammari ◽  
Sofia Michopoulou ◽  
Evangelia Skoura ◽  
Keval Naik ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Fdg Pet ◽  
Clinical Management ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact

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.

scholarly journals Utility of Contrast-Enhanced FDG-PET/CT in the Clinical Management of Pancreatic Cancer

Pancreas ◽  
2013 ◽  
Vol 42 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Akinori Asagi ◽  
Koji Ohta ◽  
Junichirou Nasu ◽  
Minoru Tanada ◽  
Seijin Nadano ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Fdg Pet ◽  
Clinical Management ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals 18F-FDG-PET/CT Plays a Key Role in Formulating Treatment Strategies for Takayasu Arteritis

2020 ◽  
Author(s):  
Qing Han ◽  
Xiang Zhou ◽  
jin ding ◽  
zhaohui zheng ◽  
Fei Kang ◽  
...  
Keyword(s):  
Treatment Strategy ◽  
Fdg Pet ◽  
Clinical Remission ◽  
Treatment Strategies ◽  
Pet Ct ◽  
Significant Difference ◽  
Remission Criteria ◽  
Study Population ◽  
Predominantly Female ◽  
Fdg Pet Ct

Abstract Backgroud and Objective: Clinical evaluation alone cannot satisfy the prognosis of TAK. PET-CTmolecular imaging may be a useful tool to supplement the prognosis of TAK. The purpose of this study was to observe whether THE TAK patients who achieved clinical remission also achieved imaging remission with PET-CT. Pet-ct plays an important role in the prognosis of TAK patients and further formulation of treatment strategy.Results: 79% patients with TAK in remission were positive for 18F-FDG-PET /CT. The study population had a mean age of 38.8 years and was predominantly female (90%). Their mean disease duration was 3.5 years and they had a mean disease remission period of 9.4 months. Patients had a mean ESR of 37.3 mm/h and a mean CRP level of 13.5 mg/l at the first dignosis time and 4.9 mm/h/3.7 mg/l at the Courrent time point. There was a statistically significant difference between the two groups (p<0.01). All patients on initial treatment received oral glucocorticoids, 25% received methotrexate, 65% received leflumide, and 45% received cyclophosphamide. Quantitative analysis of the SUV of nineteen patients showed an increasing trend (Baseline SUVmax 2.16±0.46 vs Remission SUVmax 2.08±0.49, p=0.56; Baseline SUVmean 2.34±0.57 vs Remission SUVmean 2.42±0.81, p=0.46). The arterial SUVmax uptake was higher in 15 patients with remission than baseline (2.30 ± 0.62 vs 2.48 ± 0.91, p = 0.54). But it was not statistically significant. Most of the patients (13/19, 68%) had an SUVmax value ≥ 2.0 in visual vasculitis with positive PET/CT before treatment, and 32% ＜2.0. No correlation was found between the type of treatment used, the time that elapsed from remission, or laboratory parameters and the scintigraphic results. Conclusion: TAK's clinical remission criteria are not entirely consistent with actual vascular inflammatory activity. Patients with TAK that achieve clinical remission may not achieve imaging remission with PET-CT, and PET-CT plays an important role in the prognosis of TAK patients and further formulation of treatment strategy.

scholarly journals Evaluation of FDG-PET/CT Use in Children with Suspected Infection or Inflammation

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 715
Author(s):  
Fabienne G. Ropers ◽  
Robin M. P. van Mossevelde ◽  
Chantal P. Bleeker-Rovers ◽  
Floris H. P. van Velden ◽  
Danielle M. E. van Assema ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Final Diagnosis ◽  
Management Decisions ◽  
Multicenter Cohort Study ◽  
Disease Manifestation ◽  
Suspected Infection ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact

[18F]-FDG-PET/CT ([18F]-fluoro-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT)) is increasingly used as a diagnostic tool in suspected infectious or inflammatory conditions. Studies on the value of FDG-PET/CT in children are scarce. This study assesses the role of FDG-PET/CT in suspected infection or inflammation in children. In this multicenter cohort study, 64 scans in 59 children with suspected infection or inflammation were selected from 452 pediatric FDG-PET/CT scans, performed in five hospitals between January 2016 and August 2017. Main outcomes were diagnostic information provided by FDG-PET/CT for diagnostic scans and impact on clinical management for follow-up scans. Of these 64 scans, 50 were performed for primary diagnosis and 14 to monitor disease activity. Of the positive diagnostic scans, 23/27 (85%) contributed to establishing a diagnosis. Of the negative diagnostic scans, 8/21 (38%) contributed to the final diagnosis by narrowing the differential or by providing information on the disease manifestation. In all follow-up scans, FDG-PET/CT results guided management decisions. CRP was significantly higher in positive scans than in negative scans (p = 0.004). In 6% of diagnostic scans, relevant incidental findings were identified. In conclusion, FDG-PET/CT performed in children with suspected infection or inflammation resulted in information that contributed to the final diagnosis or helped to guide management decisions in the majority of cases. Prospective studies assessing the impact of FDG-PET/CT results on diagnosis and patient management using a structured diagnostic protocol are feasible and necessary.

A single institution’s experience with the value of FDG-PET-CT imaging in patients with newly diagnosed stage IIB-IIIB breast cancer.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 123-123
Author(s):  
Gary Schnur ◽  
Katherine Glass ◽  
Chad W Cummings ◽  
Alberto J. Montero ◽  
Jame Abraham ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Ct Imaging ◽  
Stage Iiib ◽  
Breast Cancer Patients ◽  
Pet Ct ◽  
Tumor Boards ◽  
Fdg Pet Ct ◽  
The Impact

123 Background: The Cleveland Clinic is utilizing disease specific teams to craft care paths for value based disease management. The report by Groheux (JNCI 2012; 104:1879-1887), reported 18 FDG-PET-CT detected distant metastasis in 10.7, 17.5 and 36.5% of stage IIB- IIIB breast cancer patients. Based on this report, the breast team incorporated 18 FDG-PET- CT imaging for initial staging of IIB-IIIB patients. Methods: Treatment algorithms were developed by a multi-disciplinary breast cancer team. The content was reviewed by stakeholders throughout the health system, and feedback was incorporated into the care paths as appropriate. Content was communicated using physician meetings, electronic communication, tumor boards, and operational pilots. The treatment algorithm, along with the supporting narrative, was placed on the cancer center intranet, accessible to all practicing physicians. Additional intranet analysis was performed using Google Analytics, which identifies the site location and frequency of document downloads. We retrospectively examined the impact of this posting after one year (7/2014-7/2015). Manual chart review identified new patient consults for Stage IIB-IIIB breast cancer at our main campus and highest volume regional sites. Results: PET scans were ordered in 36 stage IIB, 19 stage IIIA, and 3 stage IIIB patients. Of the 36 IIB patients scanned, occult metastatic disease was noted in 1, and 2 patients migrated to IIIA without a change in treatment. 19 IIIA patients had no change in stage, although an asymptomatic second primary lung cancer was discovered in 1 .Three stage IIIB patients were without staging change. Conclusions: PET/CT imaging did not contribute to patient management for stage IIB-IIIB breast cancer patients at our institution, unlike the results reported elsewhere. Analysis of care path metrics allows us to expediently review and adjust recommendations to affiliated physicians.

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