Diagnostic Value of WB-DWI Versus 18 F-FDG PET/CT for the Detection of Multiple Myeloma

2020 ◽  
Author(s):  
Bei Zhang ◽  
Li Zhang ◽  
Bingyang Bian ◽  
Fang Lin ◽  
Zining Zhu ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
Fdg Pet ◽  
Pet Ct ◽  
Adc Values ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

Abstract BACKGROUND Whole body diffusion weighted imaging (WB-DWI) is commonly used for the detection of multiple myeloma (MM). Comparative data on the efficiency of WB-DWI compared with 18 F positron emission tomography computed tomography ( 18 F-FDG PET/CT) to detect MM are lacking. METHODS This was a retrospective, single-center study of twenty-two patients with MM enrolled from January 2019 to December 2019. All patients underwent WB-DWI and 18 F-FDG PET/CT. Pathological and clinical manifestations as well as radiologic follow-up were used for diagnosis. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value of both methods were compared. The appearance diffusion coefficient (ADC) values of MM lesions and false-positive lesions were estimated. RESULTS A total of 214 MM bone lesions were evaluated. WB-DWI showed a higher overall accuracy than PET/CT (75.7% and 55.6%, respectively; < 0.05). However, for sensitivity, specificity, positive predictive value and negative predictive value, there were no significant differences for WB-DWI vs PET/CT (99.3% and 83.9%, 64.9% and 94.8%, 63.6% and 54.2%, 98.1% and 65.3%, respectively). The ADC value for MM lesions was significantly lower than that for false-positive lesions (p < 0.001). Receiver operating curve (ROC) curve analysis showed that the AUC was 0.846, and when the cut-off value was 0.745×10 -3 mm 2 /s, the sensitivity and specificity were 86.0% and 82.4%, respectively, which distinguished MM lesions from non-MM lesions. CONCLUSION WB-DWI may be a useful tool for the diagnosis of MM bone disease due to to higher overall accuracy and measurements of ADC values compared with PET/CT.

scholarly journals Advantages of 18F-FDG PET/CT Imaging over Modified Duke Criteria and Clinical Presumption in Patients with Challenging Suspicion of Infective Endocarditis

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 720
Author(s):  
Valentin Pretet ◽  
Cyrille Blondet ◽  
Yvon Ruch ◽  
Matias Martinez ◽  
Soraya El Ghannudi ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Predictive Value ◽  
Fdg Pet ◽  
Clinical Suspicion ◽  
Duke Criteria ◽  
High Clinical Suspicion ◽  
Pet Ct ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

According to European Society of Cardiology guidelines (ESC2015) for infective endocarditis (IE) management, modified Duke criteria (mDC) are implemented with a degree of clinical suspicion degree, leading to grades such as “possible” or “rejected” IE despite a persisting high level of clinical suspicion. Herein, we evaluate the 18F-FDG PET/CT diagnostic and therapeutic impact in IE suspicion, with emphasis on possible/rejected IE with a high clinical suspicion. Excluding cases of definite IE diagnosis, 53 patients who underwent 18F-FDG PET/CT for IE suspicion were selected and afterwards classified according to both mDC (possible IE/Duke 1, rejected IE/Duke 0) and clinical suspicion degree (high and low IE suspicion). The final status regarding IE diagnosis (gold standard) was based on the multidisciplinary decision of the Endocarditis Team, including the ‘imaging specialist’. PET/CT images of the cardiac area were qualitatively interpreted and the intensity of each focus of extra-physiologic 18F-FDG uptake was evaluated by a maximum standardized uptake value (SUVmax) measurement. Extra-cardiac 18F-FDG PET/CT pathological findings were considered to be a possible embolic event, a possible source of IE, or even a concomitant infection. Based on the Endocarditis Team consensus, final diagnosis of IE was retained in 19 (36%) patients and excluded in 34 (64%). With a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and global accuracy of 79%, 100%, 100%, 89%, and 92%, respectively, PET/CT performed significantly better than mDC (p = 0.003), clinical suspicion degree (p = 0.001), and a combination of both (p = 0.001) for IE diagnosis. In 41 patients with possible/rejected IE but high clinical suspicion, sensitivity, specificity, PPV, NPV, and global accuracies were 78%, 100%, 100%, 85%, and 90%, respectively. Moreover, PET/CT contributed to patient management in 24 out of 53 (45%) cases. 18F-FDG PET/CT represents a valuable diagnostic tool that could be proposed for challenging IE cases with significant differences between mDC and clinical suspicion degree. 18F-FDG PET/CT allows a binary diagnosis (definite or rejected IE) by removing uncertain diagnostic situations, thus improving patient therapeutic management.

scholarly journals 18F-FDG PET-CT in the Management of Patients Receiving Definitive Radiotherapy for Malignancies of the Head and Neck

2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
Benjamin L. Franc ◽  
Christi DeLemos ◽  
Christopher Jones
Keyword(s):  
Metastatic Disease ◽  
Predictive Value ◽  
Fdg Pet ◽  
Intensity Modulated Radiation Therapy ◽  
Concurrent Chemotherapy ◽  
Surveillance Imaging ◽  
Pet Ct ◽  
Recurrent Malignancy ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

The study investigated the utility and timing of 18F-FDG PET-CT to evaluate for residual/recurrent or metastatic HNC in patients treated with definitive intensity modulated radiation therapy (IMRT) with or without chemotherapy, planned with 18F-FDG PET-CT. The incidence and timing of locoregional recurrence, distant metastatic disease, new primary malignancies, and death were evaluated in 261 patients retrospectively. Findings were classified based on pathology or clinical follow-up and the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET-CT were determined overall as well as at the time of each 18F-FDG PET-CT. The overall accuracy for 18F-FDG PET in the detection of residual/recurrent malignancy or metastatic disease was 96.4%. Of those in whom cancer recurred locally, 57% were identified based on physical examination and other imaging findings and 43% were identified initially on 18F-FDG PET-CT surveillance imaging when no disease was evident clinically. 18F-FDG PET-CT has a high diagnostic capability of detecting residual/recurrent malignancy or malignant metastatic disease in patients with HNC following IMRT ± concurrent chemotherapy, supporting 18F- FDG PET-CT’s use to evaluate patients for recurrent malignancy in the post-IMRT period, even without clinical evidence of disease.

Combined escBEACOPP-ABVD Therapy for Advanced Hodgkin’s Lymphoma Patients with High IPS Score: An Effective Regimen and Low Positive Predictive Value of Early FDG-PET/CT Scan.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2319-2319 ◽  
Author(s):  
Abraham Avigdor ◽  
Shlomo Bulvik ◽  
Eldad Dann ◽  
Itai Levi ◽  
Galit Perez-Avraham ◽  
...  
Keyword(s):  
High Risk ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Fdg Pet ◽  
Survival Rates ◽  
Hodgkin's Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
To Receive

Abstract The expected 5-year freedom from progression of advanced stage Hodgkin’s lymphoma (HL) patients (pts) with IPS≥3, treated with COPP-ABVD, was reported as 55%. While the superiority of escalated (esc) BEACOPP regimen over COPP-ABVD was shown for all risk groups, it was more pronounced in pts with a poor IPS. However, pts receiving escBEACOPP had more acute and long-term toxicities including a higher incidence of MDS/AML. In an attempt to reduce this toxicity, while preserving improved initial tumor control in this high risk group of pts, we conducted a phase II study, which tested the feasibility, toxicity and efficacy of a regimen which utilized the combination of escBEACOPP and ABVD. Newly diagnosed HL pts, with unfavorable stage IIB or stages III–IV with IPS≥3 were initially received two cycles of escBEACOPP followed by reevaluation with FDG- PET/CT scans. When complete or partial response (CR, PR) was achieved, pts then continued to receive four cycles of ABVD, while pts who failed to obtain this response were planned to receive salvage therapy. Since starting in late 2001, 40 eligible pts received this regimen. Median age at diagnosis was 27 years (range 18–56) and 29 (73%) were males. Histology included nodular sclerosis (n=30), mixed cellularity (n=6) and unclassified (n=4). Stage IV, III and IIB were evident in 29 (73%), 8 (20%) and 3 (7%) pts, respectively and extranodal involvement was noted in 28 (70%). Following the first two cycles of escBEACOPP the overall response rate (CR+PR) was 100% and at the end of all therapy 36 (90%) pts were in CR, 2 (5%) in PR and 2 (5%) pts had progressive disease. After a median follow-up of 30 months (range 7–61), 38 pts are alive while two pts died from progressive HL. The estimated 5-year Progression free survival (PFS) and overall survival rates were 78% (95% CI, 64–92%) and 91% (95% CI, 78–100%), respectively. The 5-year cumulative incidence of relapse was 13% (95% CI, 5-33%). These survival rates are higher than those expected for ABVD containing regimens and comparable with the reported estimated long term survival rates achieved with the poor prognostic subgroup of pts, receiving eight cycles of escBEACOPP in the GHLSG HD9 trial. Furthermore, the estimated 5-year PFS rate for early PET negative pts (n=27) and for early PET positive pts (n=11) was 82% (95% CI, 66–98%) and 64% (95%, CI 35–92%), respectively (P=0.14) (in 2 pts early PET results were not conclusive). In terms of treatment failure, the positive predictive value was only 35%, while the negative predictive value was 85%. As expected, the incidence of acute hematologic toxicities was more common in the escBEACOPP than in the ABVD phase. Non hematologic adverse effects included grade III–IV infection (n=1), avascular necrosis of the hip (n=1) and cognitive impairment (n=1). In conclusion, combined escBEACOPP-ABVD therapy is well tolerated and may improve the outcome in pts with advanced HL who have high IPS scores. Larger scale randomized studies, comparing this combination regimen with previously reported dose-intensified chemotherapy regimens, are required in order to verify its true merit in this high risk subgroup of pts.

scholarly journals Negative Predictive Value of NI-RADS Category 2 in the First Posttreatment FDG-PET/CT in Head and Neck Squamous Cell Carcinoma

2018 ◽  
Vol 39 (10) ◽  
pp. 1884-1888 ◽  
Author(s):  
P. Wangaryattawanich ◽  
B.F. Branstetter ◽  
M. Hughes ◽  
D.A. Clump ◽  
D.E. Heron ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Negative Predictive Value ◽  
Squamous Cell ◽  
Predictive Value ◽  
Fdg Pet ◽  
Neck Squamous Cell Carcinoma ◽  
Pet Ct ◽  
Fdg Pet Ct

Negative predictive value of "split-dose" technique for FDG PET/CT-guided percutaneous ablation

2014 ◽  
Vol 25 (3) ◽  
pp. S184
Author(s):  
E. Violari ◽  
J.P. Erinjeri ◽  
C.T. Sofocleous ◽  
E.N. Petre ◽  
R.H. Siegelbaum ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Fdg Pet ◽  
Percutaneous Ablation ◽  
Ct Guided ◽  
Split Dose ◽  
Pet Ct ◽  
Fdg Pet Ct

ATL

2014 ◽  
Vol 24 (3) ◽  
pp. 454-460 ◽  
Author(s):  
Yuko Tanizaki ◽  
Aya Kobayashi ◽  
Michihisa Shiro ◽  
Nami Ota ◽  
Rei Takano ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Fdg Pet ◽  
Clear Cell ◽  
Benign Tumors ◽  
Clear Cell Adenocarcinoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Fdg Accumulation

ObjectiveThe objective of this study was to investigate the preoperative diagnostic value of18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) in patients with ovarian cancer.MethodsOne hundred sixty patients suspected of having malignant ovarian tumors were included in this study. All patients underwent FDG-PET/CT scans before operation, and the maximum standardized uptake value (SUVmax) of the primary tumor was measured. We evaluated the diagnostic accuracy of SUVmaxfor detecting malignancy and its relationship with histological findings.ResultsPostoperative pathological diagnoses showed that 67 were malignant, 14 were borderline malignant, and 79 were benign tumors. With the use of a cutoff SUVmaxof 2.9 obtained from the receiver operating characteristic curve analysis, the sensitivity, specificity, positive predictive value, and negative predictive value for detecting malignancy were 80.6%, 94.6%, 91.5%, and 87.1%, respectively. Positive FDG accumulation (SUVmax≥ 2.9) was shown in 89.5% of serous adenocarcinoma and in 92.3% of endometrioid adenocarcinoma. In contrast, lower frequencies of positive FDG accumulation were shown in clear cell adenocarcinoma (54.5%), mucinous adenocarcinoma (66.7%), and metastatic carcinoma (66.7%), and the median SUVmaxof these 3 histological types were significantly lower than those of serous and endometrioid types. In addition, a positive FDG accumulation was shown in all patients with malignant transformation of mature cystic teratoma. Finally, of the 14 borderline malignant tumors, only 2 (14.3%) showed positive FDG accumulation.ConclusionsThe SUVmaxon FDG-PET/CT is useful for differentiating ovarian cancer from borderline or benign tumor with a high specificity and positive predictive value. However, our data also demonstrated a lower FDG uptake value in clear cell or mucinous histological finding, suggesting that SUVmaxmay vary depending on the tumor histological subtype.

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