Visual assessment of 18F-FDG metabolic spatial distribution improves the differential diagnosis of indeterminate pulmonary nodules and masses with high FDG uptake

2020 ◽  
Author(s):  
Jie Lin ◽  
Ling Wang ◽  
Xiaowei Ji ◽  
Xiangwu Zheng ◽  
Kun Tang
Keyword(s):  
Spatial Distribution ◽  
Visual Analysis ◽  
Characteristic Curve ◽  
Pulmonary Nodules ◽  
Distal Region ◽  
Proximal Region ◽  
Benign Lesions ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Malignant Lesions

Abstract Purpose The aim of this study was to evaluate the value of visual analysis of 18 F-fluorodeoxyglucose ( 18 F-FDG) metabolic spatial distribution (V-FMSD) in diagnosis of indeterminate pulmonary nodules and masses with high 18 F-FDG uptake. Methods A total of 301 patients with indeterminate pulmonary nodules or masses who undergone 18 F-FDG positron emission tomography/computed tomography (PET/ CT) imaging were studied retrospectively. The characteristics of 18 F-FDG metabolic spatial distribution (FMSD) of proximal and distal regions of the lesion were visually analyzed using a 5-point scoring system. The sensitivity, specificity, accuracy and area under receiver operating characteristic curve (AUC) were compared between V-FMSD and conventional PET/CT methods for diagnosis of hypermetabolic indeterminate pulmonary nodules and masses. Results The V-FMSD results showed that 180 (92.8%) malignant lesions’ scores were ≥ 3 and 78 (72.9%) benign lesions’ scores were ≤ 2. It indicated that the FMSD in the proximal region of malignant lesions was significantly higher than that of the distal region, and the FMSD in the proximal region of benign lesions was significantly lower than that of the distal region. The specificity of V-FMSD was 72.9%, which was obviously higher than the maximum standard uptake value (SUVmax) (0%, P < 0.001) and retention index (RI) (26.2%, P < 0.001). The AUC of V-FMSD was 0.886, which was significantly larger than SUVmax (0.626, P < 0.001), RI (0.670, P < 0.001) and PET/CT (0.788, P < 0.05). Conclusions The characteristics of FMSD between pulmonary benign and malignant lesions are different. V-FMSD can be taken as a novel auxiliary marker to improve the diagnostic performance for hypermetabolic indeterminate pulmonary nodules and masses.

scholarly journals Thyroid lesions incidentally detected by 18F-FDG PET-CT ― a two centre retrospective study

2015 ◽  
Vol 49 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Jan Jamsek ◽  
Ivana Zagar ◽  
Simona Gaberscek ◽  
Marko Grmek
Keyword(s):  
Fdg Pet ◽  
Malignant Lesion ◽  
Standardized Uptake Value ◽  
Benign Lesions ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Thyroid Uptake ◽  
Malignant Lesions ◽  
Fdg Pet Ct ◽  
Thyroid Lesions

AbstractBackground. Incidental18F-FDG uptake in the thyroid on PET-CT examinations represents a diagnostic challenge. The maximal standardized uptake value (SUVmax) is one possible parameter that can help in distinguishing between benign and malignant thyroid PET lesions.Patients and methods. We retrospectively evaluated18F-FDG PET-CT examinations of 5,911 patients performed at two different medical centres from 2010 to 2011. If pathologically increased activity was accidentally detected in the thyroid, the SUVmaxof the thyroid lesion was calculated. Patients with incidental18F-FDG uptake in the thyroid were instructed to visit a thyroidologist, who performed further investigation including fine needle aspiration cytology (FNAC) if needed. Lesions deemed suspicious after FNAC were referred for surgery.Results. Incidental18F-FDG uptake in the thyroid was found in 3.89% ― in 230 out of 5,911 patients investigated on PET-CT. Malignant thyroid lesions (represented with focal thyroid uptake) were detected in 10 of 66 patients (in 15.2%). In the first medical centre the SUVmaxof 36 benign lesions was 5.6 ± 2.8 compared to 15.8 ± 9.2 of 5 malignant lesions (p < 0.001). In the second centre the SUVmaxof 20 benign lesions was 3.7 ± 2.2 compared to 5.1 ± 2.3 of 5 malignant lesions (p = 0.217). All 29 further investigated diffuse thyroid lesions were benign.Conclusions. Incidental18F-FDG uptake in the thyroid was found in 3.89% of patients who had a PET-CT examination. Only focal thyroid uptake represented a malignant lesion in our study ― in 15.2% of all focal thyroid lesions. SUVmaxshould only serve as one of several parameters that alert the clinician on the possibility of thyroid malignancy.

scholarly journals The Distribution and Severity of Corrosion Damage at Eight Distinct Zones of Metallic Femoral Stem Implants

Metals ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. 840 ◽  
Author(s):  
Roohollah Milimonfared ◽  
Reza Oskouei ◽  
Mark Taylor ◽  
Lucian Solomon
Keyword(s):  
Spatial Distribution ◽  
Hip Replacement ◽  
Logistic Regression Model ◽  
Statistical Significance ◽  
Femoral Stem ◽  
Corrosion Damage ◽  
Distal Region ◽  
Proximal Region ◽  
Visual Scoring ◽  
Ordinal Logistic Regression Model

Metallic taper junctions of modular total hip replacement implants are analysed for corrosion damage using visual scoring based on different granularity levels that span from analysing the taper holistically to dividing the taper into several distinct zones. This study aims to objectively explore the spatial distribution and the severity of corrosion damage onto the surface of metallic stem tapers. An ordinal logistic regression model was developed to find the odds of receiving a higher score at eight distinct zones of 137 retrieved stem tapers. A method to find the order of damage severity across the eight zones is introduced based on an overall test of statistical significance. The findings show that corrosion at the stem tapers occurred more commonly in the distal region in comparison with the proximal region. Also, the medial distal zone was found to possess the most severe corrosion damage among all the studied eight zones.

A pilot study on the clinical value of 18F-sodium fluoride PET/CT in advanced prostate cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10589-10589
Author(s):  
Joseph W. Kim ◽  
Maria Liza Lindenberg ◽  
William L. Dahut ◽  
James L. Gulley ◽  
Ravi A. Madan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Sodium Fluoride ◽  
Advanced Prostate Cancer ◽  
Bone Scan ◽  
Malignant Lesion ◽  
Benign Lesions ◽  
Pet Ct ◽  
Medicine Physician ◽  
Malignant Lesions

10589 Background: We evaluated the clinical utility of 18F-sodium fluoride PET/CT bone scan (18F-NaF) in the detection of bone metastases in patients (pts) with prostate cancer in comparison with Technetium-99m MDP bone scan (TcBS). Methods: In a prospective study, from October 2010-December 2011, 30 prostate cancer pts (ages 51-79), 21 with known bone metastases and 9 without known bone metastases, had18F-NaF and a TcBS performed. Abnormal foci of uptake on both TcBS and 18F-NaFwere classified as benign, malignant or indeterminate. Benign lesions included uptake in the joints and linear uptake at the endplates of the vertebral bodies consistent with degenerative changes. Malignant uptake on 18F-NaF scans was confirmed by characteristic osteoblastic features on CT. All TcBS and 18F-NaF were reviewed by an experienced nuclear medicine physician. For the patient-based analysis, scan results were categorized as positive (POS) = any malignant lesion; indeterminate (IND) = not distinctly malignant or benign; negative (NEG) = benign lesions only. Results: In the lesion-based analysis, 21 of 30 (70%) pts had more malignant lesions identified on 18F-NaF than on TcBS. The mean number of additional malignant lesions per patient on 18F-NaF vs TcBS was 4. Eight of the 30 pts had same number of malignant lesions identified in both studies. One of 30 pts had one less malignant lesion identified on 18F-NaF than on TcBS. CT correlation by 18F-NaF PET/CT of this particular lesion did not confirm osteoblastic feature. Malignant lesion distribution on 18F-NaF included: spine (28%), thorax (26%), pelvis (24%), long bones (13%) and skull (10%). In the patient-based analysis, 24 pts (80%) were POS by 18F-NaF, of whom 14 pts were POS, 8 were IND, and 2 were NEG by corresponding TcBS; in the 4 pts with NEG 18F-NaF, zero were POS, 2 were IND and 2 were NEG by corresponding TcBS. Conclusions: 18F-NaF identified more malignant lesions than TcBS. 18F-NaF may also add useful information in the management of advanced prostate cancer pts with and without known bone metastases.

Comparison of MR imaging and FDG-PET/CT in the differential diagnosis of benign and malignant vertebral compression fractures

2011 ◽  
Vol 14 (2) ◽  
pp. 177-183 ◽  
Author(s):  
Won-Ik Cho ◽  
Ung-Kyu Chang
Keyword(s):  
Mr Imaging ◽  
Fdg Pet ◽  
Vertebral Compression Fractures ◽  
Benign Lesions ◽  
Fracture Group ◽  
Radiotracer Uptake ◽  
Pet Ct ◽  
Malignant Lesions ◽  
Fdg Pet Ct ◽  
Mass Formation

Object Differentiation between malignant and benign vertebral compression fractures (VCFs) is important but sometimes difficult, especially in elderly cancer patients. The authors investigated the findings of MR imaging and FDG-PET/CT for the differentiation of VCFs. Methods Between 2007 and 2008, the authors evaluated and treated 102 VCFs in 96 patients. The final diagnosis, based on biopsy results or clinical follow-up, was benign fracture in 67 lesions in 65 patients and malignant fracture in 35 lesions in 31 patients. Magnetic resonance images were obtained in all patients, and FDG-PET/CT was performed in 17 patients in the benign fracture group and 20 in the malignant fracture group. The prevalence of 3 significant MR imaging findings (posterior cortical bulging, epidural mass formation, and pedicle enhancement) and the presence of radiotracer uptake on FDG-PET/CT were evaluated in the 2 groups. The maximum standardized uptake value (SUVmax) on FDG-PET/CT was compared between the 2 groups, and diagnostic threshold value was sought to confirm malignancy. The diagnostic accuracy of MR imaging and FDG-PET/CT was compared in the differentiation of malignant from benign VCFs. Results Posterior cortical bulging was seen in 26 (74%) of 35 malignant lesions and 30 (45%) of 67 benign ones, epidural mass formation in 27 (77%) of the malignant lesions and 25% of the benign ones, and pedicle enhancement in 30 (91%) of the 33 malignant lesions and 18 (39%) of the 46 benign ones evaluated with Gd-enhanced MR imaging. These differences were statistically significant for each feature. Sensitivity and specificity for predicting malignancy were, respectively, 74% and 55% for posterior cortical bulging, 77% and 74% for epidural mass formation, and 90% and 61% for pedicle enhancement. Simultaneous occurrence of 3 significant features was found in 21 (64%) of the 33 malignant and 8 (17%) of the 46 benign lesions for which complete MR imaging data were available and showed sensitivity of 64% and specificity of 83%. The presence of radiotracer uptake on FDG-PET/CT was seen in all 20 (100%) of the 20 malignant lesions and 12 (71%) 17 of the benign lesions evaluated by FDG-PET/CT and showed a sensitivity of 100% and specificity of 29%. There was a significant difference in mean (± SD) SUVmax for the malignant (6.29 ± 3.50) and benign (2.38 ± 1.90) lesions (p < 0.001). The most reliable threshold for SUVmax was found to be 4.25, which yielded a sensitivity of 85% and a specificity of 71%. Conclusions When MR imaging findings are equivocal, FDG-PET/CT can be considered as an adjunctive diagnostic method for differentiating malignant from benign VCFs. In comparison with MR imaging, FDG-PET/CT showed slightly higher sensitivity and lower specificity.

scholarly journals SAT-157 Diagnostic Performance of 18F-fluorodeoxyglucose Positron Emission Tomography in Indeterminate Adrenal Tumors

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Daria Ladygina ◽  
Dmitry Beltsevich ◽  
Michael Dolgushin ◽  
Akgul Odzharova ◽  
Alexander Martinovich ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
High Risk ◽  
Diagnostic Performance ◽  
Emission Tomography ◽  
High Risk Population ◽  
Benign Lesions ◽  
18Fdg Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Malignant Lesions

Abstract Evidence on the diagnostic performance of 18F-fluorodeoxyglucose(18FDG) positron emission tomography(PET)/CT imaging of adrenal lesions is limited. We aimed to assess the diagnostic performance of this diagnostic modality in a high risk population for adrenal malignancy using an optimal reference standard. We included 21 patients operated in our clinic during 2019 for whom 8FDG PET was performed before adrenalectomy. 3 patients with pheochromocytoma were later excluded from statistical analysis, they were sent to PET before increased urine metanephrines were received. Unenhanced abdominal CT was performed in all the patients; median size was 4,5 (2.3-10) cm and median radiodensity was 32 (-7 to 43) Hounsfield units (HU). All patients with adrenocortical carcinoma and metastasis to adrenals from other organs had radiodensity of &gt;10 HU. Maximum standardized uptake (SUV max) was higher in malignant lesions when compared to benign lesions (median = 10,9 [5.4-29.6] vs 4.1 [2.6-7.22], respectively, P=.003). Similarly, median SUV max lesion to SUV max liver ratio (ALR) in malignant lesions was higher than in benign lesions (median = 2,18 [1.41-5.53] vs. 1.29 [0.67-2.13], respectively, P=.017).18FDG- PET/CT SUV max lesion &gt; 6.7 diagnosed malignancy with a sensitivity of 83,3%, specificity of 91,7%. Conclusion: Noncontract CT radiodensity of ≤10 HU excludes malignancy even in a high risk population. For indeterminate adrenal lesions, given a superior specificity, 18FDG PET/CT could be considered as a second stage imaging.

scholarly journals Spectral CT Analysis of Solitary Pulmonary Nodules for Differentiating Malignancy from Benignancy: The Value of Iodine Concentration Spatial Distribution Difference

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Linyu Wu ◽  
Guoquan Cao ◽  
Liang Zhao ◽  
Kun Tang ◽  
Jie Lin ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Sensitivity And Specificity ◽  
Pulmonary Nodules ◽  
Iodine Concentration ◽  
Proximal Region ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Solitary Pulmonary Nodules ◽  
Multiple Parameters ◽  
Benign Nodules

Objective. The objective is to assess the value of spatial distribution difference in iodine concentration between malignant and benign solitary pulmonary nodules (SPNs) by analyzing multiple parameters of spectral CT. Methods. Sixty patients with 39 malignant nodules and 21 benign nodules underwent chest contrast CT scans using spectral imaging mode during pulmonary arterial phase (PP), arterial phase (AP), and venous phase (VP). Iodine concentrations of proximal and distal regions in pulmonary nodules on iodine-based material decomposition images were recorded. Normalized iodine concentration (NIC) and the differences in NIC between the proximal and the distal regions (dNIC) were calculated. The two-sample t-test and Mann–Whitney U-test were performed to compare the multiple parameters generated from spectral CT between malignant and benign nodules. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity. Results. NIC in the proximal region (NICpro) and NIC in the distal region (NICdis) between malignant and benign nodules at AP (NICpro, P=0.012; NICdis, P=0.024), and VP (NICpro, P=0.005; NICdis, P =0.004) were significantly different. NICpro at PP (P = 0.037) was also found significantly different between malignant and benign nodules; however, no significant differences were found in NICdis at PP (P = 0.093). In addition, the dNIC of malignant nodules was significantly higher than that of benign ones at PP (median and interquartiles (0.31, 0.11, 0.57 versus -0.26, -0.5, -0.1); p≤0.001), AP (mean dNIC, 0.093 ±0.094 versus -0.075±0.060; p≤0.001), and VP (mean dNIC, 0.171±0.137 versus -0.183±0.127; p≤0.001). The sensitivity and specificity (93%, 95%, respectively) of dNIC during VP were higher than other parameters, with a threshold value of -0.07. Conclusions. Spectral CT imaging with multiple parameters such as NICpro, NICdis, and dNIC may be a new method for differentiating malignant SPNs from benign ones.

PET/CT Parameters are Useful in Discrimination of Incidental Benign, Premalignant and Malignant Colonic Lesions

2020 ◽  
Vol 59 (03) ◽  
pp. 235-240
Author(s):  
Emine Budak ◽  
Ahmet Yanarateş
Keyword(s):  
Tumor Volume ◽  
Standardized Uptake Value ◽  
Metabolic Tumor Volume ◽  
Total Lesion Glycolysis ◽  
Premalignant Lesions ◽  
Benign Lesions ◽  
Pet Ct ◽  
Malignant Lesions ◽  
Fdg Pet Ct

Abstract Aim The present study evaluates the role of PET parameters pertaining to incidentally detected foci of colorectal uptake (IFCU) on FDG PET/CT in the differentiation of benign, premalignant and malignant lesions. Methods This retrospective study included 74 patients. The colonoscopic and histopathological findings were regarded as the reference standards. The results were evaluated on a lesion basis by dividing the lesions into three groups as benign, premalignant and malignant. The maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume(MTV) and total lesion glycolysis(TLG) values of the three groups were compared. Results There were 88 IFCU in a total of 74 patients (27 female, 47 male, mean age 65 years). Of the 88 IFCU, 26 were qualified as benign, 42 as premalignant and 20 as malignant. Malignant + premalignant lesions were found in 62/88 (70.4 %) of the IFCU. The SUVmax of the benign lesions was significantly lower than those of the premalignant and malignant lesions; and SUVmean was lower than that of the malignant lesions. The MTV of the malignant lesions was significantly higher than that of the premalignant and benign lesions; and TLG was higher than that of the premalignant lesions. The optimum cut-off value in differentiating between the malignant and non-malignant lesions was 9.15 for SUVmax, 5.05 for SUVmean, 4.7 for MTV and 30.25 for TLG. Conclusion PET parameters can guide the differentiation of benign, premalignant and malignant lesions with IFCU. Besides, patients with IFCU should undergo further evaluation due to high probability of premalignant and malignant lesions.

scholarly journals Proposal for a Quantitative 18F-FDG PET/CT Metabolic Parameter to Assess the Intensity of Bone Involvement in Multiple Myeloma

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Maria E. S. Takahashi ◽  
Camila Mosci ◽  
Edna M. Souza ◽  
Sérgio Q. Brunetto ◽  
Elba Etchebehere ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Fdg Pet ◽  
Visual Analysis ◽  
Hepatic Uptake ◽  
Bone Involvement ◽  
Whole Body ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Many efforts have been made to standardize the interpretation of 18F-FDG PET/CT in multiple myeloma (MM) with qualitative visual analysis or with quantitative metabolic parameters using various methods for lesion segmentation of PET images. The aim of this study was to propose a quantitative method for bone and bone marrow evaluation of 18F-FDG PET/CT considering the extent and intensity of bone 18F-FDG uptake: Intensity of Bone Involvement (IBI). Whole body 18F-FDG PET/CT of 59 consecutive MM patients were evaluated. Compact bone tissue was segmented in PET images using a global threshold for HU of the registered CT image. A whole skeleton mask was created and the percentage of its volume with 18F-FDG uptake above hepatic uptake was calculated (Percentage of Bone Involvement - PBI). IBI was defined by multiplying PBI by mean SUV above hepatic uptake. IBI was compared with visual analysis performed by two experienced nuclear medicine physicians. IBI calculation was feasible in all images (range:0.00–1.35). Visual analysis categorized PET exams into three groups (negative/mild, moderate and marked bone involvement), that had different ranges of IBI (multi comparison analysis, p < 0.0001). There was an inverse correlation between the patients’ hemoglobin values and IBI (r = −0.248;p = 0.02). IBI score is an objective measure of bone and bone marrow involvement in MM, allowing the categorization of patients in different degrees of aggressiveness of the bone disease. The next step is to validate IBI in a larger group of patients, before and after treatment and in a multicentre setting.

scholarly journals Comparison of Radiomic Models Based on Low-Dose and Standard-Dose CT for Prediction of Adenocarcinomas and Benign Lesions in Solid Pulmonary Nodules

2021 ◽  
Vol 10 ◽  
Author(s):  
Jieke Liu ◽  
Hao Xu ◽  
Haomiao Qing ◽  
Yong Li ◽  
Xi Yang ◽  
...  
Keyword(s):  
Low Dose ◽  
Validation Cohort ◽  
Standard Dose ◽  
Characteristic Curve ◽  
Pulmonary Nodules ◽  
Reconstruction Method ◽  
Solitary Pulmonary Nodules ◽  
Benign Lesions ◽  
Difference Matrix ◽  
Benign Nodules

ObjectivesThis study aimed to develop radiomic models based on low-dose CT (LDCT) and standard-dose CT to distinguish adenocarcinomas from benign lesions in patients with solid solitary pulmonary nodules and compare the performance among these radiomic models and Lung CT Screening Reporting and Data System (Lung-RADS). The reproducibility of radiomic features between LDCT and standard-dose CT were also evaluated.MethodsA total of 141 consecutive pathologically confirmed solid solitary pulmonary nodules were enrolled including 50 adenocarcinomas and 48 benign nodules in primary cohort and 22 adenocarcinomas and 21 benign nodules in validation cohort. LDCT and standard-dose CT scans were conducted using same acquisition parameters and reconstruction method except for radiation dose. All nodules were automatically segmented and 104 original radiomic features were extracted. The concordance correlation coefficient was used to quantify reproducibility of radiomic features between LDCT and standard-dose CT. Radiomic features were selected to build radiomic signature, and clinical characteristics and radiomic signature were combined to develop radiomic nomogram for LDCT and standard-dose CT, respectively. The performance of radiomic models and Lung-RADS was assessed by area under curve (AUC) of receiver operating characteristic curve, sensitivity, and specificity.ResultsShape and first order features, and neighboring gray tone difference matrix features were highly reproducible between LDCT and standard-dose CT. No significant differences of AUCs were found among radiomic signature and nomogram of LDCT and standard-dose CT in both primary and validation cohort (0.915 vs. 0.919 vs. 0.898 vs. 0.909 and 0.976 vs. 0.976 vs. 0.985 vs. 0.987, respectively). These radiomic models had higher specificity than Lung-RADS (all correct P &lt; 0.05), while there were no significant differences of sensitivity between Lung-RADS and radiomic models.ConclusionsThe diagnostic performance of LDCT-based radiomic models to differentiate adenocarcinomas from benign lesions in solid pulmonary nodules were equivalent to that of standard-dose CT. The LDCT-based radiomic model with higher specificity and lower false-positive rate than Lung-RADS might help reduce overdiagnosis and overtreatment of solid pulmonary nodules in lung cancer screening.

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