scholarly journals Differential Diagnosis of Pulmonary Fungal Infection and Lung Cancer via 18F-FDG PET/CT: A Retrospective Study

2021 ◽  
Author(s):  
Xin Feng ◽  
Chunmei Deng ◽  
Xiaofeng Li ◽  
Ye Qiu ◽  
Jiehua Deng ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Differential Diagnosis ◽  
Fungal Infection ◽  
Fdg Pet ◽  
Pathological Examination ◽  
Imaging Features ◽  
Antigen Test ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: There is limited evidence regarding the 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) characteristics of lung fungal (LF) infections with nodules or masses, which are often misdiagnosed as lung cancer (LC) with indications for surgery. We aimed to investigate the PET/CT findings of LF infections with nodules in comparison to those of LC and clarify the diagnostic value of 18F-FDG PET/CT in the differential diagnosis of LF infections.Methods: We enrolled 21 patients who presented with pulmonary nodules or masses on CT, were diagnosed with LF infections, and underwent PET/CT as the LF group and randomly selected 42 patients with LC diagnosed by pathology as the LC group. Clinical and PET/CT imaging data were statistically analyzed.Results: LC was the most common misdiagnosed disease in the LF group (52.38%). There were no significant differences in lung imaging features between the two groups. The levels of white blood cells, neutrophils, and IgG and the positive rates for fungal antigen test in the LF group were significantly higher than those in the LC group (P<0.05). Lung masses larger than 3 cm were more common in the LC group (P<0.05). Overall, 80.95% (17/21) of patients in the LF group showed increased 18F-FDG uptake. There were no significant between-group differences in the maximal standardized uptake value (SUVmax, 8.20 [2.70, 12.95] vs. 8.80 [7.00, 12.38]). In the LF group, eight, five, and eight patients had cryptococcal, Aspergillus, and Talaromyces marneffei infections, respectively, with no significant difference in SUVmax among them (5.10 [1.70, 14.40] vs. 8.20 [1.50, 8.20] vs. 8.50 [5.10, 11.30]). Conclusions: Both LF infection and LC can present with increased 18F-FDG uptake on PET/CT. Thus, it is difficult to distinguish between them according to lung PET/CT and CT manifestations. Patients presenting with pulmonary masses should also be suspected to have fungal infection, even those with an increased SUVmax and simultaneous lymph node and bone involvement; particular attention is needed for patients with abnormal inflammation indexes and fungal antigen test. We should be emphasized preoperative pathological examination and fungal etiology.

scholarly journals Imaging features and prognostic value of 18F-FDG PET/CT detection of soft-tissue metastasis from lung cancer: a retrospective study

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tingting Xu ◽  
Xinyi Zhang ◽  
Shumao Zhang ◽  
Chunfeng Liu ◽  
Wenhui Fu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Retrospective Study ◽  
Soft Tissue ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Imaging Features ◽  
Soft Tissue Metastasis ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Diagnosis of solitary eosinophilic granuloma by CT, MRI, and 18F-FDG PET/CT: two clinical cases

2021 ◽  
Vol 2 (1) ◽  
pp. 75-82
Author(s):  
Pavel B. Gelezhe ◽  
Dmitriy V. Bulanov
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Fdg Pet ◽  
Eosinophilic Granuloma ◽  
Pathological Examination ◽  
Pet Ct ◽  
18F Fdg ◽  
Eosinophilic Granuloma Of Bone ◽  
Fdg Pet Ct ◽  
Clinical Cases

This paper presents two clinical cases of eosinophilic granuloma of bone diagnosed by CT, MRI, and 18F-FDG PET/CT. In both cases the patients were admitted to the clinic with suspected primary malignant bone tumor and the diagnosis of a solitary eosinophilic granuloma was made based on the results of comprehensive radiological diagnostic examination and histological verification. Solitary eosinophilic granuloma of bone is an infrequent condition, occurring in less than 1% of cases of skeletal tumor masses. The most common eosinophilic granuloma is found in the parietal and frontal bones of the skull and is an osteolytic volumetric mass that gradually increases in size. Although most bone tumors can be detected by radiography, computed tomography is preferred, primarily because of its superior ability to detect cortical bone destruction. The diagnostic accuracy of computed tomography and magnetic resonance imaging may be different. The combined use of radiological and radionuclide methods allows us to narrow the spectrum of differential diagnosis. Unfortunately, relatively low specificity of existing radiological diagnostic studies in most cases does not allow to establish a precise diagnosis, and biopsy with subsequent pathological examination remains the method of choice. These clinical observations demonstrate the need to include eosinophilic granuloma in the differential diagnosis when a solitary osteolytic focus is detected.

scholarly journals The role of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography in the differential diagnosis of pericardial disease

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Cheol Won Hyeon ◽  
Hyun Kyung Yi ◽  
Eun Kyoung Kim ◽  
Sung-Ji Park ◽  
Sang-Chol Lee ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Fdg Pet ◽  
Diagnostic Yield ◽  
Emission Tomography ◽  
Pericardial Disease ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractThis study aimed to assess the role of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) in the differential diagnosis of pericardial disease. The diagnosis is often troublesome because pericardial fluid analysis or biopsy does not always provide answers. 18FDG-PET/CT can visualize both inflammation and malignancy and offers a whole-body assessment. Patients who visited the Pericardial Disease Clinic of Samsung Medical Center with an 18FDG-PET/CT order code were extracted. Exclusion criteria were as follows: (1) the purpose of the differential diagnosis was not pericardial disease; (2) the patient had a known advanced-stage malignancy; (3) the patient already have confirmative diagnosis using a serology, pericardial effusion analysis or biopsy. The analysis included 107 patients. The most common final diagnosis was idiopathic (n = 46, 43.0%), followed by tuberculosis (n = 30, 28.0%) and neoplastic (n = 11, 10.3%). A maximum standardized uptake value (SUVmax) ≥ 5 typically indicates tuberculosis or neoplastic pericarditis except in just one case of autoimmune pericarditis); especially all of the SUVmax scores ≥ 10 had tuberculosis. The diagnostic yield of pericardial biopsy was very low (10.2%). Interestingly, all of the pericardium with an SUVmax < 4.4 had nondiagnostic results. In contrast, targeted biopsies based on 18FDG uptake demonstrated a higher diagnostic yield (38.7%) than pericardium. The sensitivity of 18FDG-PET/CT was 63.6%. The specificity was 71.9%. The positive predictive value was 20.6%. The negative predictive value 94.5%, and the accuracy was 71.0% for excluding malignancy based upon the FDG uptake patterns. It is possible to explore the differential diagnosis in some patients with difficult pericardiocentesis or pericardial biopsy in a noninvasive manner using on the SUVmax or uptake patterns. In addition, the biopsy strategy depending on 18FDG uptake is helpful to achieve biopsy more safely and with a higher yield. 18FDG-PET may enhance the diagnostic efficacy in patients with pericardial disease.

scholarly journals Eosinophilic Cystitis Presenting as Possible Pediatric Rhabdomyosarcoma in Conventional Imaging Including 18F-FDG-PET/CT/MRI—A Rare Case

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 672
Author(s):  
Naja Enevold Olsen ◽  
Marie Øbro Fosbøl ◽  
Jorgen Thorup ◽  
Helle Hjorth Johannesen ◽  
Lise Borgwardt
Keyword(s):  
Differential Diagnosis ◽  
Fdg Pet ◽  
Imaging Modality ◽  
Whole Body ◽  
Fdg Uptake ◽  
Eosinophilic Cystitis ◽  
Potential Biomarker ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Eosinophilic cystitis (EC) is a relatively rare, but benign inflammatory bladder disease compared to that of the malignant pediatric rhabdomyosarcoma (RMS), in which it can be mimicking on initial suspicion. The origin, symptoms and findings of both EC and RMS are still discussed and hence, lead to the challenge in distinguishing them by cystoscopy and several image modalities. We present a case in which cross-sectional imaging modalities including fluorine-18-fluro-2-deoxy-D-glucose (18F-FDG)-positron emission tomography (PET) / computed tomography (CT) / magnetic resonance imaging (MRI) (18F-FDG-PET/CT/MRI (The imaging modality 18F-FDG-PET/CT/MRI referring to two continuous scans scanned on the same 18F-FDG-tracer dose for both the whole-body 18F-FDG-PET/CT and the regional 18F-FDG-PET/MRI of the pelvis.)) raised suspicion of RMS. Hence, the final diagnosis of EC was established by repeated histopathology. It is important to have EC in mind when seeking differential diagnosis of malignant diseases like RMS in order to provide the correct treatment for the patient and highly homogenously increased 18F-FDG-uptake should raise the suspicion of EC as a differential diagnosis. Furthermore, 18F-FDG-uptake rate is suggested as a future potential biomarker for monitoring of therapeutic response in eosinophilic inflammatory diseases, thus more research on this topic is needed.

scholarly journals 18F-FDG PET/CT features of ureteral metastases from breast cancer: a case report

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110140
Author(s):  
Yuanbi Huang ◽  
Huajie He ◽  
Wei Wei ◽  
Qiguang Li ◽  
Xian Long ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fdg Pet ◽  
Cancer Metastasis ◽  
Standardized Uptake Value ◽  
Tamoxifen Treatment ◽  
Pathological Examination ◽  
Imaging Features ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Breast cancer metastasis to the ureter is rare. Fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET)/computed tomography (CT) is widely used to identify primary lesions of metastatic tumours, however, 18F-FDG PET/CT imaging features of ureteral metastasis from breast cancer are rarely reported. Herein, the case of a 46-year-old woman with recurrent left flank pain for 5 months, who was admitted to the Cancer Hospital of Guangxi Medical University and Guangxi Cancer Research Institute, is described. She had undergone right radical mastectomy 5 years previously and had received tamoxifen treatment for 5 years. Assessment by 18F-FDG PET/CT revealed tumours on the ureter presenting as a long segmental lesion, radioactive concentrations, and a low maximum standardized uptake value (SUVmax), with no radioactive concentrations in the urine and no significant change in the ureteral contour. The severity of the ureteral lesion was not consistent with the severity of hydronephrosis. A tumour biopsy was performed laparoscopically, and postoperative pathological examination confirmed a primary breast cancer tumour. The patient did not consent to treatment and was lost to follow-up.

scholarly journals Recent and Current Advances in FDG-PET Imaging within the Field of Clinical Oncology in NSCLC: A Review of the Literature

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 561 ◽  
Author(s):  
Kaoru Kaseda
Keyword(s):  
Lung Cancer ◽  
Clinical Oncology ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Field Analysis ◽  
Imaging Features ◽  
Term Survival ◽  
Full Field ◽  
Pet Ct ◽  
Fdg Pet Ct

Lung cancer is the leading cause of cancer-related deaths around the world, the most common type of which is non-small-cell lung cancer (NSCLC). Computed tomography (CT) is required for patients with NSCLC, but often involves diagnostic issues and large intra- and interobserver variability. The anatomic data obtained using CT can be supplemented by the metabolic data obtained using fluorodeoxyglucose F 18 (FDG) positron emission tomography (PET); therefore, the use of FDG-PET/CT for staging NSCLC is recommended, as it provides more accuracy than either modality alone. Furthermore, FDG-PET/magnetic resonance imaging (MRI) provides useful information on metabolic activity and tumor cellularity, and has become increasingly popular. A number of studies have described FDG-PET/MRI as having a high diagnostic performance in NSCLC staging. Therefore, multidimensional functional imaging using FDG-PET/MRI is promising for evaluating the activity of the intratumoral environment. Radiomics is the quantitative extraction of imaging features from medical scans. The chief advantages of FDG-PET/CT radiomics are the ability to capture information beyond the capabilities of the human eye, non-invasiveness, the (virtually) real-time response, and full-field analysis of the lesion. This review summarizes the recent advances in FDG-PET imaging within the field of clinical oncology in NSCLC, with a focus on surgery and prognostication, and investigates the site-specific strengths and limitations of FDG-PET/CT. Overall, the goal of treatment for NSCLC is to provide the best opportunity for long-term survival; therefore, FDG-PET/CT is expected to play an increasingly important role in deciding the appropriate treatment for such patients.

Enhancing 18F-FDG-PET/CT analysis in lung cancer patients

2015 ◽  
Vol 54 (06) ◽  
pp. 247-254 ◽  
Author(s):  
A. Kapfhammer ◽  
T. Winkens ◽  
T. Lesser ◽  
A. Reissig ◽  
M. Steinert ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Image Fusion ◽  
Chest Wall ◽  
Fdg Pet ◽  
Ct Image ◽  
Lung Cancers ◽  
Pet Ct ◽  
Peripheral Lung ◽  
Fdg Pet Ct ◽  
Tumour Infiltration

SummaryAim: To retrospectively evaluate the feasibility and value of CT-CT image fusion to assess the shift of peripheral lung cancers with/-out chest wall infiltration, comparing computed tomography acquisitions in shallow-breathing (SB-CT) and deep-inspiration breath-hold (DIBH-CT) in patients undergoing FDG-PET/ CT for lung cancer staging. Methods: Image fusion of SB-CT and DIBH-CT was performed with a multimodal workstation used for nuclear medicine fusion imaging. The distance of intrathoracic landmarks and the positional shift of tumours were measured using semitransparent overlay of both CT series. Statistical analyses were adjusted for confounders of tumour infiltration. Cutoff levels were calculated for prediction of no-/infiltration. Results: Lateral pleural recessus and diaphragm showed the largest respiratory excursions. Infiltrating lung cancers showed more limited respiratory shifts than non-infiltrating tumours. A large respiratory tumour-motility accurately predicted non-infiltration. However, the tumour shifts were limited and variable, limiting the accuracy of prediction. Conclusion: This pilot fusion study proved feasible and allowed a simple analysis of the respiratory shifts of peripheral lung tumours using CT-CT image fusion in a PET/CT setting. The calculated cutoffs were useful in predicting the exclusion of chest wall infiltration but did not accurately predict tumour infiltration. This method can provide additional qualitative information in patients with lung cancers with contact to the chest wall but unclear CT evidence of infiltration undergoing PET/CT without the need of additional investigations. Considering the small sample size investigated, further studies are necessary to verify the obtained results.

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