scholarly journals 18F-FDG PET/CT in the post-operative monitoring of patients with adrenocortical carcinoma

2015 ◽  
Vol 173 (6) ◽  
pp. 749-756 ◽  
Author(s):  
A Ardito ◽  
C Massaglia ◽  
E Pelosi ◽  
B Zaggia ◽  
V Basile ◽  
...  

ContextThe role of 18F-labeled 2-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the post-operative monitoring of patients with adrenocortical carcinoma (ACC) is still unclear.ObjectiveTo assess the accuracy of FDG PET/CT to diagnose ACC recurrence in a real world setting.Design and methodsRetrospective evaluation of data of 57 patients with presumed ACC recurrence at CT scan who underwent FDG PET/CT within a median time of 20 days. We compared the results of either FDG PET/CT or CT with a gold standard confirmation of recurrence (positive histopathology report of removed/biopsied lesions or radiological progression of target lesions at follow-up) to assess their diagnostic performance at different body sites to correctly categorize target lesions. We also assessed whether FDG PET/CT findings may be useful to inform the management strategy.ResultsIn 48 patients with confirmed ACC recurrence, we found that FDG PET/CT had lower sensitivity than CT in diagnosing liver and lung recurrences of ACC. FDG PET/CT had higher specificity than CT in categorizing liver lesions. FDG PET/CT had a greater positive likelihood ratio than CT to identify liver and abdominal ACC recurrences. The management strategy was changed based on FDG PET/CT findings in 12 patients (21.1%).ConclusionsThe greater sensitivity of CT may be partly expected due the specific inclusion criteria of the study; however, the greater specificity of FDG PET/CT was particularly useful in ruling out suspected ACC recurrences found by CT. Thus, use of FDG PET/CT as a second-line test in the post-operative surveillance of ACC patients following CT finding of a potential recurrence may have a significant impact on patient management.

2013 ◽  
Vol 52 (03) ◽  
pp. 101-106 ◽  
Author(s):  
K. Chun ◽  
Y. Hong ◽  
J. Hah ◽  
I. Cho ◽  
E. Kong

Summary Purpose: Kikuchi disease (KD) is a benign and self-limited syndrome characterized by cervical lymphadenopathy. This study evaluated 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (FDG PET/ CT) findings in patients with KD and analyzed their imaging features. Patients, material, methods: We evaluated the FDG PET/CT findings of 22 patients (14 men, 8 women) with KD, ranging in age from 9 to 73 years. All patients had been diagnosed based on the pathological findings of biopsy. We examined the locations, metabolic activity and size of hypermetabolic lymph nodes (LNs) on FDG PET/CT imaging with medical history including laboratory results. Results: Among the 22 patients, we identified 619 hypermetabolic LNs which had maximum standard uptake value (SUVmax) above 3.0. The 16 patients were studied with FDG PET/CT to identify the cause of fever, another 5 patients for their neck masses, and the remaining patient for his left inguinal mass. Hypermetabolic LNs were noted in neck (18 bilaterally, 2 right, 1 left) of 21 patients, axilla of 10, mediastinum of 9, abdomen of 17, pelvis of 6, and inguinal area of 3. The SUVmax of FDG uptake in affected LNs by patient base analysis were 6.2–29.4. Of the 619 hypermetabolic LNs identified, 440 LNs (71.1%) were less than 10 mm in their short axis determined by CT, and were occasionally aggregated. No patient showed solid organ hypermetabolic lesion in FDG PET/CT. Conclusion: Kikuchi disease could present multiple hypermetabolic LNs in body on FDG PET/CT. Based on the physical findings, consideration of the generalized distribution of the relatively small-sized hypermetabolic LNs, FDG PET/CT may be useful as a diagnostic tool in cases of Kikuchi disease.


2021 ◽  
Author(s):  
BOBY VARKEY MARAMATTOM ◽  
Geetha Philips ◽  
Shagos Gopalan Nair Santhamma

Abstract We describe 18 fluorodeoxyglucose positron emission tomography/computed tomography (18FDG-PET-CT) findings in a patient that inadvertently betrayed features of MIS-A. The findings were suggestive of an exaggerated Systemic inflammatory response syndrome (SIRS)- a prequel to MIS-A. MIS-A has been recently described in 2020 as a post-infectious or para-infectious sequela of COVID-19. Within 12 weeks of symptomatic or asymptomatic COVID-19 illness (diagnosed by serum SARS CoV2 antibodies), patients present with an illness requiring hospitalization that can rapidly progress to myocardial dysfunction and cardiogenic shock. (1) As with any illness, there is a period of ‘quiet before the storm’. Identification of patients early in the course of the illness and prompt treatment can improve clinical outcomes in MIS-A.


2020 ◽  
pp. 028418512096671
Author(s):  
Noriaki Tomura ◽  
Toshiyuki Saginoya ◽  
Hiromi Goto

Background Positron emission tomography (PET) findings for gliomatosis and lymphomatosis have been rarely reported. Purpose To compare PET/computed tomography (CT) findings using 11C-methionine (MET) from PET/CT findings using 18F-fluorodeoxy glucose (FDG) for patients with lymphomatosis or gliomatosis of the brain. Material and Methods Participants comprised all 10 patients with lymphomatosis or gliomatosis of the brain treated at our institution in the past 12 years. Underlying pathologies comprised intravascular lymphoma (n = 1), lymphomatosis (n = 3), and gliomatosis (n = 6). All cases were pathologically diagnosed. In seven patients, both MET-PET/CT and FDG-PET/CT were performed simultaneously in a single study. In three patients, only FDG-PET/CT was performed. The degree of tracer accumulation to the lesion was evaluated qualitatively. Quantitatively, the ratio of maximum standard uptake value (SUVmax) in tumor to that in normal tissue (T/N ratio) was measured and compared between FDG and MET. Results Qualitatively, MET accumulated to part of the lesion in six of seven patients and almost all of the lesion in one in seven patients. FDG accumulated to part of the lesion in three of ten patients and almost all of the lesion in one of ten patients. No FDG accumulation was seen in the lesion in six patients. Quantitatively, mean ± SD T/N ratio was significantly higher with MET (2.11 ± 0.63) than with FDG (1.18 ± 0.84; P < 0.05, Wilcoxon signed-rank test). Conclusion In lymphomatosis and gliomatosis, FDG accumulates in only part of the lesion. FDG is thus less suitable than MET for depicting these lesions.


2016 ◽  
Vol 55 (01) ◽  
pp. N1-N3
Author(s):  
C. Ferrari ◽  
A. Niccoli Asabella ◽  
C. Altini ◽  
G. Rubini
Keyword(s):  
Fdg Pet ◽  
Pet Ct ◽  
18F Fdg ◽  

Author(s):  
Marco Tana ◽  
Silvio di Carlo ◽  
Marcello Romano ◽  
Massimo Alessandri ◽  
Cosima Schiavone ◽  
...  

Background:18F-fluorodeoxyglucose positron emission tomography integrated with computed tomography (18-F-FDG-PET/CT) is getting wide consensus in the diagnosis and staging of neoplastic disorders and represents a useful tool in the assessment of various inflammatory conditions. </P><P> Discussion: Sarcoidosis is an uncommon disease characterized by the systemic formation of noncaseating granulomas. Lungs are the sites most often affected, and investigation with high resolution computed tomography and biopsy is essential to achieve a correct diagnosis. 18-F-FDGPET/ CT is effective in the assessment of pulmonary sarcoidosis by demonstrating pulmonary and extrathoracic involvement and findings correlate well with pulmonary function in patients affected.Conclusion:This review would illustrate the usefulness and limits of 18-F-FDG-PET/CT in the assessment of pulmonary sarcoidosis.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Philip E. Schaner ◽  
Ly-Binh-An Tran ◽  
Bassem I. Zaki ◽  
Harold M. Swartz ◽  
Eugene Demidenko ◽  
...  

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.


Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 559
Author(s):  
Talitha Bent ◽  
Derya Yakar ◽  
Thomas C. Kwee

Background: Biopsy of 18F-fluoro-2-deoxy-D-glucose (FDG)-avid lesions suspected for malignancy remains an invasive procedure associated with a variety of risks. It is still unclear if the positive predictive value (PPV) of positron emission tomography (PET)/computed tomography (CT) is sufficiently high to avoid tissue sampling. Therefore, the purpose of this study was to determine the PPV of 18F-FDG-PET/CT for malignancy in patients with a clinical suspicion of active malignant disease. Methods: This single-center retrospective study included 83 patients who had undergone FDG-PET/CT within 60 days before CT- or ultrasonography-guided tissue sampling and whose request form for CT- or US-guided tissue sampling requested mutation analyses. The latter implies a high clinical suspicion of active malignant disease. The nature of each biopsied lesion was determined based on the results of the pathological analysis and/or clinical and imaging follow-up of at least 12 months. Results: In total, eighty-eight FDG-avid lesions were biopsied. The PPV of FDG-PET/CT for malignancy was 98.9% (95% CI: 93.8–99.8%). For patients with an oncological history, the PPV was 98.7% (95% CI: 92.9–99.8%), and for patients with no oncological history, the PPV was 100% (95% CI: 74.1–100.0%). There was no significant difference between the PPV of the group with and without an oncological history (p = 0.71). In two cases, an unsuspected malignancy was diagnosed. Conclusion: Although the PPV of FDG-PET/CT for malignancy in patients with a clinical suspicion of active malignant disease is high, biopsy remains recommended to avoid inappropriate patient management due the non-negligible chance of dealing with FDG-avid benign disease or unexpected malignancies.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hye Seong ◽  
Yong Hyu Jeong ◽  
Woon Ji Lee ◽  
Jun Hyoung Kim ◽  
Jung Ho Kim ◽  
...  

AbstractKikuchi-Fujimoto disease (KFD) is usually self-limiting, but prolonged systemic symptoms often result in frequent hospital visits, long admission durations, or missed workdays. We investigated the role of fluorine-18 fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing KFD severity. We reviewed the records of 31 adult patients with pathologically confirmed KFD who underwent 18F-FDG PET/CT between November 2007 and April 2018 at a tertiary-care referral hospital. Disease severity was assessed using criteria based on clinical manifestations of advanced KFD. Systemic activated lymph nodes and severity of splenic activation were determined using semi-quantitative and volumetric PET/CT parameters. The median of the mean splenic standardized uptake value (SUVmean) was higher in patients with severe KFD than those with mild KFD (2.38 ± 1.18 vs. 1.79 ± 0.99, p = 0.058). Patients with severe KFD had more systemically activated volume and glycolytic activity than those with mild KFD (total lesion glycolysis: 473.5 ± 504.4 vs. 201.6 ± 363.5, p = 0.024). Multivariate logistic regression showed that myalgia (odds ratio [OR] 0.035; 95% confidence interval [CI] 0.001–0.792; p = 0.035), total lymph node SUVmax (cutoff 9.27; OR 24.734; 95% CI 1.323–462.407; p = 0.032), and spleen SUVmean (cutoff 1.79; OR 37.770; 95% CI 1.769–806.583; p = 0.020) were significantly associated with severe KFD. 18F-FDG PET/CT could be useful in assessing KFD severity.


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