scholarly journals F-18 Fluorodeoxyglucose PET/CT as a Diagnostic Tool in Orbital Inflammatory Disorders

2021 ◽  
Author(s):  
Ghassan Elourimi ◽  
Michael Soussan ◽  
Matthieu Groh ◽  
Antoine Martin ◽  
Françoise Héran ◽  
...  
Keyword(s):  
Autoimmune Diseases ◽  
Diagnostic Tool ◽  
Fdg Pet ◽  
Final Diagnosis ◽  
Diagnostic Workup ◽  
Routine Practice ◽  
Inflammatory Disorders ◽  
Tertiary Referral Center ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: In the last decade, FDG-PET/CT has become routine practice in the management of lymphoma or autoimmune diseases. In the current study, we aimed to assess the usefulness of FDG-PET/CT as a potential diagnostic tool for detecting underlying systemic diseases (SD) in patients with orbital inflammatory disorders (OID).Methods: All consecutive patients managed for new-onset OID between 2011 and 2018 in a tertiary referral center for OID, who underwent FDG-PET/CT as part as the etiological diagnostic workup were enrolled. PET-FDG/CT scans were reviewed blindly and were considered as positive for SD detection if they showed lymphadenopathy and/or other visceral lesions with an uptake above blood pool background. We used the standard diagnostic workup (performed in all patients at presentation) as relevant comparator. To quantify the incremental value of FDG-PET/CT over the standard diagnostic workup, the Net Reclassification Index (NRI) and Integrated Discrimination Index (IDI) were used. The final diagnosis was based on international criteria for autoimmune diseases, or histological confirmation for lymphoma, xanthogranuloma, crystal storing histiocytosis (CSH), or idiopathic orbital inflammation syndrome (IOIS). Results: Among the 22 patients enrolled, 14 (63%) had underlying SD (granulomatosis with polyangiitis (GPA), n=1; IgG4-related disease (IgG4-RD), n=5; CSH, n=1; adult onset asthma and periocular xanthogranuloma (AAPOX), n=3; lymphoma, n=4) while the remaining 8 (37%) patients were diagnosed with IOIS. Eleven (50%) patients had a positive FDG-PET/CT. After clinicobiological evaluation, FDG-PET/CT correctly reclassified 29% of patients with SD (p=0.04) and 13% with IOIS (p=0.3), corresponding to an elevated NRI of 0.41±0.17 (p=0.03). The IDI test used to evaluate the improvement of FDG-PET/CT for SD detection was 0.38±0.08 (p<0.001). After FDG-PET/CT, probability changes for SD and IOIS were measured at 0.14 and -0.24, respectively (relative gain of 3.04 for IDI). FDG-PET/CT successfully detected asymptomatic lesions in all patients with a final diagnosis of lymphoma. Conclusion: FDG-PET/CT enabled accurate reclassification of more than one quarter of patients with SD, suggesting its potential value for detecting SD (especially extraorbital lymphoma).

FDG-PET/CT Imaging in Infectious and Inflammatory Disorders

PET Clinics ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. i
Author(s):  
Lars Christian Gormsen ◽  
Søren Hess
Keyword(s):  
Fdg Pet ◽  
Ct Imaging ◽  
Inflammatory Disorders ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals 18 F‐FDG PET/CT as a Diagnostic Tool in Patients with Extracervical Carcinoma of Unknown Primary Site: A Literature Review

2011 ◽  
Vol 16 (4) ◽  
pp. 445-451 ◽  
Author(s):  
Anne Kirstine Hundahl Moller ◽  
Annika Loft ◽  
Anne Kiil Berthelsen ◽  
Karen Damgaard Pedersen ◽  
Jesper Graff ◽  
...  
Keyword(s):  
Literature Review ◽  
Diagnostic Tool ◽  
Fdg Pet ◽  
Primary Site ◽  
Unknown Primary ◽  
Unknown Primary Site ◽  
Carcinoma Of Unknown Primary ◽  
Pet Ct ◽  
Fdg Pet Ct

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.

scholarly journals Diagnostic Value of 18F-FDG-PET/CT in Patients with FUO

2020 ◽  
Vol 9 (7) ◽  
pp. 2112
Author(s):  
Stamata Georga ◽  
Paraskevi Exadaktylou ◽  
Ioannis Petrou ◽  
Dimitrios Katsampoukas ◽  
Vasilios Mpalaris ◽  
...  
Keyword(s):  
Predictive Value ◽  
Fdg Pet ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Whole Body ◽  
Considerable Proportion ◽  
Clinical Criteria ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Conventional diagnostic imaging is often ineffective in revealing the underlying cause in a considerable proportion of patients with fever of unknown origin (FUO). The aim of this study was to assess the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with FUO. We retrospectively reviewed 18F-FDG-PET/CT scans performed on 50 consecutive adult patients referred to our department for further investigation of classic FUO. Final diagnosis was based on histopathological and microbiological findings, clinical criteria, or clinical follow-up. Final diagnosis was established in 39/50 (78%) of the patients. The cause of FUO was infection in 20/50 (40%), noninfectious inflammatory diseases in 11/50 (22%), and malignancy in 8/50 (16%) patients. Fever remained unexplained in 11/50 (22%) patients. 18F-FDG-PET/CT scan substantially contributed to the diagnosis in 70% of the patients, either by identifying the underlying cause of FUO or by directing to the most appropriate site for biopsy. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18F-FDG-PET/CT for active disease detection in patients with FUO were 94.7%, 50.0%, 84.0%, 85.7%, and 75.0%, respectively. In conclusion, whole-body 18F-FDG-PET/CT is a highly sensitive method for detection of the underlining cause of FUO or for correctly targeting suspicious lesions for further evaluation.

scholarly journals Staging Pathways in Recurrent Colorectal Carcinoma: Is Contrast-Enhanced 18F-FDG PET/CT the Diagnostic Tool of Choice?

2008 ◽  
Vol 49 (3) ◽  
pp. 354-361 ◽  
Author(s):  
J. D. Soyka ◽  
P. Veit-Haibach ◽  
K. Strobel ◽  
S. Breitenstein ◽  
A. Tschopp ◽  
...  
Keyword(s):  
Colorectal Carcinoma ◽  
Diagnostic Tool ◽  
Fdg Pet ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Recurrent Colorectal Carcinoma

scholarly journals The Use of 18F-FDG-PET/CT in the Diagnostic Workup of CIED Infections: Another Perspective

2012 ◽  
Vol 60 (15) ◽  
pp. 1435-1436 ◽  
Author(s):  
Paola Anna Erba ◽  
Francesco Bandera ◽  
Martina Sollini ◽  
Carlo Tascini
Keyword(s):  
Fdg Pet ◽  
Diagnostic Workup ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals NETest liquid biopsy is diagnostic of small intestine and pancreatic neuroendocrine tumors and correlates with imaging

2019 ◽  
Vol 8 (4) ◽  
pp. 442-453 ◽  
Author(s):  
Anna Malczewska ◽  
Magdalena Witkowska ◽  
Karolina Makulik ◽  
Agnes Bocian ◽  
Agata Walter ◽  
...  
Keyword(s):  
Small Intestine ◽  
Neuroendocrine Tumors ◽  
Fdg Pet ◽  
Disease Status ◽  
Blood Draw ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Disease Extent ◽  
Tertiary Referral Center ◽  
Pet Ct ◽  
Fdg Pet Ct

Introduction Current monoanalyte biomarkers are ineffective in gastroenteropancreatic neuroendocrine tumors (GEP-NETs). NETest, a novel multianalyte signature, provides molecular information relevant to disease biology. Aim(s) Independently validate NETest to diagnose GEP-NETs and identify progression in a tertiary referral center. Materials and methods Cohorts are 67 pancreatic NETs (PNETs), 44 small intestine NETs (SINETs) and 63 controls. Well-differentiated (WD) PNETs, n = 62, SINETs, all (n = 44). Disease extent assessment at blood draw: anatomical (n = 110) CT (n = 106), MRI (n = 7) and/or functional 68Ga-SSA-PET/CT (n = 69) or 18F-FDG-PET/CT (n = 8). Image-positive disease (IPD) was defined as either CT/MRI or 68Ga-SSA-PET/CT/18F-FDG-PET/CT-positive. Both CT/MRI and 68Ga-SSA-PET/CT negative diagnosis in WD-NETs was considered image-negative disease (IND). NETest (normal: 20): PCR (spotted plates). Data: mean ± SD. Results Diagnosis NETest was significantly increased in NETs (n = 111; 26 ± 21) vs controls (8 ± 4, p < 0.0001). Seventy-five (42 PNET, 33 SINET) were image positive. Eleven (8 PNET, 3 SINET; all WD) were IND. In IPD, NETest was significantly higher (36 ± 22) vs IND (8 ± 7, P < 0.0001). NETest accuracy, sensitivity and specificity are 97, 99 and 95%, respectively Concordance with imaging NETest was 92% (101/110) concordant with anatomical imaging, 94% (65/69) with 68Ga-SSA-PET/CT and 96% (65/68) dual modality (CT/MRI and 68Ga-SSA-PET/CT). In 70 CT/MRI positive, NETest was elevated in all (37 ± 22). In 40 CT/MRI negative, NETest was normal (11 ± 10) in 31. In 56 68Ga-SSA-PET/CT positive, NETest was elevated (36 ± 22) in 55. In 13 68Ga-SSA-PET/CT negative, NETest was normal (9 ± 8) in ten. Disease status NETest was significantly higher in progressive (61 ± 26; n = 11) vs stable disease (29 ± 14; n = 64; P < 0.0001) (RECIST 1.1). Conclusion NETest is an effective diagnostic for PNETs and SINETs. Elevated NETest is as effective as imaging in diagnosis and accurately identifies progression.

scholarly journals Infectious endocarditis: Improving Diagnostic Performance in Native and Prosthetic Valve Infection with 18F-FDG PET/CT

2020 ◽  
Author(s):  
Ana Vera Marinho ◽  
José Paulo Almeida ◽  
Paula Soeiro ◽  
Rodolfo Silva ◽  
Francisco Gonçalves ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Diagnostic Performance ◽  
Final Diagnosis ◽  
Prosthetic Material ◽  
Native Valve ◽  
Clinical Challenge ◽  
Duke Criteria ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract BackgroundThe diagnosis of infective endocarditis (IE) remains a clinical challenge. Diagnostic accuracy of the modified Duke criteria is suboptimal for native valve endocarditis (NVE) and even worse in the presence of prosthetic material-related infection (PVE). We aim to evaluate the diagnostic performance of 18F-FDG PET in patients with suspected IE referred to perform PET/CT.Methods: Consecutive patients with suspected IE, referred to perform PET/CT between May 2016 and June 2019 were included. Diagnostic performance of modified Duke criteria (mDC) and PET/ CT for IE for NVE and PVE was determined.Results: In total, 82 patients (mean age of 61 ± 19 years, 62% of male gender) were enrolled. There were 67 18F-FDG PET/CT concordant results with final diagnosis, corresponding to a 96% of agreement, k=0.91(p=0.04). A SUVmax cutoff value of ≥3.1 identified positive cases with 88.9% sensitivity and 70.0% specificity. In patients with NVE, the addition of PET/CT to the mDC resulted in a reduction of the number of possible IE cases (from 58% to 4.3%). In patients with PVE/intracardiac devices, PET/CT allowed reclassification of 67.4% of possible cases to 4.2%. An alternative diagnosis was provided in 55.6% of the negative IE cases.Conclusions: 18F-FDG PET/CT proved to be a useful diagnostic tool in patients with both suspected NVE and PVE with good sensitivity and specificity, resulting in a significant decrease of the number of possible endocarditis. Furthermore, it allowed the identification of the cause of clinical scenario in more than 50% of patients in which the diagnosis was excluded.

scholarly journals Place of the 18F-FDG-PET/CT in the Diagnostic Workup in Patients with Classical Fever of Unknown Origin (FUO)

2021 ◽  
Vol 10 (17) ◽  
pp. 3831
Author(s):  
Simon Letertre ◽  
Pierre Fesler ◽  
Laetitia Zerkowski ◽  
Marie-Christine Picot ◽  
Jean Ribstein ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Fever Of Unknown Origin ◽  
Real Life ◽  
Unknown Origin ◽  
Diagnostic Workup ◽  
University Hospital ◽  
True Positive ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Objective: To explore the diagnostic contribution of the 18F-FDG-PET/CT in a population of patients with classical fever of unknown origin (FUO), to pinpoint its place in the diagnostic decision tree in a real-life setting, and to identify the factors associated with a diagnostic 18F-FDG-PET/CT. Method: All adult patients (aged ≥ 18 years) with a diagnosis of classical FUO who underwent an 18F-FDG-PET/CT in the University Hospital of Montpellier (France) between April 2012 and December 2017 were included. True positive 18F-FDG-PET/CT, which evidenced a specific disease causing FUO, were considered to be contributive. Results: Forty-four patients with FUO have been included (20 males, 24 females; mean age 57.5 ± 17.1 years). Diagnoses were obtained in 31 patients (70.5%), of whom 17 (38.6%) had non-infectious inflammatory diseases, 9 had infections (20.5%), and 3 had malignancies (6.8%). 18F-FDG-PET/CT was helpful for making a final diagnosis (true positive) in 43.6% of all patients. Sensitivity and specificity levels were 85% and 37%, respectively. A total of 135 investigations were performed before 18F-FDG-PET/CT, mostly CT scans (93.2%) and echocardiography (59.1%), and 108 after 18F-FDG-PET/CT, mostly biopsies (including the biopsy of a temporal artery) (25%) and MRIs (34%). In multivariate analysis, the hemoglobin level was significantly associated with a helpful 18F-FDG-PET/CT (p = 0.019, OR 0.41; 95% CI (0.20–0.87)), while the CRP level was not associated with a contributive 18F-FDG-PET/CT. Conclusion: 18F-FDG-PET/CT may be proposed as a routine initial non-invasive procedure in the diagnostic workup of FUO, especially in anemic patients who could be more likely to benefit from 18F-FDG-PET/CT.

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