scholarly journals Neurovascular, muscle, and skin changes on [18F]FDG PET/MRI in foot complex regional pain syndrome (CRPS)

2020 ◽  
Author(s):  
Daehyun Yoon ◽  
Yingding Xu ◽  
Peter W. Cipriano ◽  
Israt S. Alam ◽  
Carina Mari Aparici ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Fdg Pet ◽  
Pain Syndrome ◽  
Whole Body ◽  
Mri Imaging ◽  
Skin Changes ◽  
Fdg Uptake ◽  
Non Invasive ◽  
Skin Abnormalities ◽  
18F Fdg

Abstract Background: The goal of this study is to demonstrate the feasibility of [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance imaging (MRI) for non-invasive visualization of muscular, neurovascular, and skin changes secondary to complex regional pain syndrome (CRPS). Methods: Seven adult patients with CRPS in the lower extremity and seven healthy adult controls participated in our [18F]FDG PET/MRI study. All participants received whole-body PET/MRI scans one hour after the injection of 10mCi [18F]FDG. Resulting PET/MRI images were reviewed by two radiologists. Metabolic and anatomic abnormalities identified, were grouped into muscular, neurovascular, and skin lesions. The [18F]FDG uptake of each lesion was compared with that of corresponding areas in controls using a Mann-Whitney U-test. Results: On PET images, muscular, neurovascular, and skin abnormalities were found in 5, 4 and 2 patients, respectively. However, on MRI images, no muscular abnormalities were detected. Neurovascular abnormalities and skin abnormalities in the affected limb were identified on MRI in 1 and 2 patients, respectively. The difference in [18F]FDG uptake between the patients and the controls was significant in muscle (p = 0.018) and neurovascular bundle (p = 0.0005).Conclusions: The increased uptake of [18F]FDG in the symptomatic areas likely reflects the increased metabolism due to the inflammatory response causing pain. Therefore, our approach combining metabolic ([18F]FDG PET) and anatomic (MRI) imaging may offer non-invasive monitoring of the distribution and progression of inflammatory changes associated with CRPS. Trial registration: ClinicalTrials.gov, NCT03195270. Registered 19 June 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03195270

scholarly journals Neurovascular, Muscle, and Skin Changes on [18f]FDG PET/MRI in Foot Complex Regional Pain Syndrome (CRPS)

2020 ◽  
Author(s):  
Daehyun Yoon ◽  
Yingding Xu ◽  
Peter W. Cipriano ◽  
Israt S. Alam ◽  
Carina Mari Aparici ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Fdg Pet ◽  
Pain Syndrome ◽  
Whole Body ◽  
Mri Imaging ◽  
Skin Changes ◽  
Fdg Uptake ◽  
Non Invasive ◽  
Skin Abnormalities ◽  
18F Fdg

Abstract Background: The goal of this study is to demonstrate the feasibility of [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance imaging (MRI) for non-invasive visualization of muscular, neurovascular, and skin changes secondary to complex regional pain syndrome (CRPS). Methods: Seven adult patients with CRPS in the lower extremity and seven healthy adult controls participated in our [18F]FDG PET/MRI study. All participants received whole-body PET/MRI scans one hour after the injection of 10mCi [18F]FDG. Resulting PET/MRI images were reviewed by two radiologists. Metabolic and anatomic abnormalities identified, were grouped into muscular, neurovascular, and skin lesions. The [18F]FDG uptake of each lesion was compared with that of corresponding areas in controls using a Mann-Whitney U-test. Results: On PET images, muscular, neurovascular, and skin abnormalities were found in 5, 4 and 2 patients, respectively. However, on MRI images, no muscular abnormalities were detected. Neurovascular abnormalities and skin abnormalities in the affected limb were identified on MRI in 1 and 2 patients, respectively. The difference in [18F]FDG uptake between the patients and the controls was significant in muscle (p = 0.018) and neurovascular bundle (p = 0.0005).Conclusions: The increased uptake of [18F]FDG in the symptomatic areas likely reflects the increased metabolism due to the inflammatory response causing pain. Therefore, our approach combining metabolic ([18F]FDG PET) and anatomic (MRI) imaging may offer non-invasive monitoring of the distribution and progression of inflammatory changes associated with CRPS. Trial registration: ClinicalTrials.gov, NCT03195270. Registered 19 June 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03195270

Optimization of whole-body 2-[18F]FDG-PET/MRI imaging protocol for the initial staging of patients with myeloma

2021 ◽  
Author(s):  
Robert Burns ◽  
Sébastien Mulé ◽  
Paul Blanc-Durand ◽  
Mojdeh Tofighi ◽  
Karim Belhadj ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Whole Body ◽  
Mri Imaging ◽  
Imaging Protocol ◽  
18F Fdg ◽  
Initial Staging

scholarly journals Beyond lymph nodes: 18F-FDG PET/CT in detection of unusual sites of extranodal lymphoma

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Amal Ibrahim Ahmed Othman ◽  
Merhan Nasr ◽  
Moustafa Abdel-Kawi
Keyword(s):  
Fdg Pet ◽  
Whole Body ◽  
Normal Morphology ◽  
Fdg Uptake ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Disease Staging ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Histopathological Type

Abstract Background The purpose of this study was to compare between contrast-enhanced computer tomography (CE CT) and 18F-FDG PET/CT in the detection of extranodal involvement in lymphoma and to correlate between SUVmax of the extranodal lesion and the hottest LN. One hundred patients with pathologically proven lymphoma underwent whole body 18F-FDG PET/CT and CECT scans. Images were compared regarding the ability of detection of extranodal lymphomatous sites. Kappa agreement was applied to find the degree of agreement between both modalities. Pearson’s correlation was used for correlating SUVmax of the extranodal lesions and hottest LN. The degree of FDG uptake was correlated with histopathological type. Results There was a poor agreement between PET/CT and CECT in the detection of extranodal sites (k = 0.32). There was a significant positive moderate correlation between SUVmax of the extranodal lesions and hottest LN (r = 0.45). PET/CT study resulted in up staging of 10% and down staging of 5% of cases. Conclusion In lymphoma staging, FDG PET/CT enables more detection of extranodal involved sites that show normal morphology at CECT. It differentiates lymphomatous infiltration from benign causes of increased FDG uptake with subsequent proper disease staging.

scholarly journals Cardiac Tuberculosis on 18F-FDG PET Imaging—A Great Masquerader of Cardiac Sarcoidosis

2021 ◽  
Author(s):  
Sumati Sundaraiya ◽  
Abubacker Sulaiman ◽  
Adhithyan Rajendran
Keyword(s):  
Pet Imaging ◽  
Fdg Pet ◽  
Cardiac Sarcoidosis ◽  
Granulomatous Inflammation ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Whole Body ◽  
Left Ventricular Myocardium ◽  
Fdg Uptake ◽  
18F Fdg

AbstractA young gentleman with suspected cardiac sarcoidosis and LV dysfunction whose CMR revealed multifocal subepicardial to mid myocardial linear enhancement in the left ventricular myocardium underwent cardiac 18F-FDG PET imaging. The images revealed patchy regions of increased FDG uptake involving the apical to mid anterolateral, mid to basal anteroseptal/ right ventricular and mildly increased FDG uptake in apical inferior segments of the LV myocardium concordant with CMR findings. Whole body PET CT imaging showed multiple hypermetabolic supra and infra diaphragmatic lymphadenopathy, with no pulmonary lesion identified. Biopsy from the left para aortic lymph node revealed necrotizing granulomatous inflammation consistent with tuberculosis. Based on the histopathological findings of the lymph nodes, diagnosis of cardiac tuberculosis was made, given the similar imaging appearances in both sarcoidosis and TB. This case highlights that cardiac TB although rare, should be included in the differential diagnosis in patients with suspected infiltrative cardiomyopathy, particularly in TB endemic regions.

scholarly journals Detection of Ureteral Stump Transitional Cell Carcinoma, Presenting as Bone Metastases from Unknown Primary by 18F-FDG PET/CT: A Case Report with Review of Literature

2022 ◽  
Author(s):  
Petya N. Nikolova ◽  
Valeria H. Hadzhiyska ◽  
Kiril B. Mladenov ◽  
Mihaela G. Ilcheva ◽  
Stefani Veneva ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Metastases ◽  
Fdg Pet ◽  
Transitional Cell ◽  
Pain Syndrome ◽  
Whole Body ◽  
Unknown Primary ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

AbstractA case of occult carcinoma of the ureteral stump is reported. A 67-year-old man presented with pain syndrome due to multiple bone metastases from unknown primary origin detected by previous imaging studies as magnetic resonance imaging, whole body contrast-enhanced computed tomography (CT), and technetium-99m methyldiphosphonate bone scan. He had undergone a right nephrectomy for a benign disease previously. He was referred to our department for an 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) to help localize possible primary tumor. Our observations in this case show that the use of 18F-FDG PET/CT successfully and more accurately evaluated the overall tumor burden and led to a rapid decision of an adequate therapeutic approach.

scholarly journals The Multicenter Italian Trial Assesses the Performance of FDG-PET /CT Related to Pre-Test Cancer Risk in Patients with Solitary Pulmo n ary Nodules and Introduces a Segmental Thoracic Diagnostic Strategy

2020 ◽  
Vol 13 (3) ◽  
pp. 243-248
Author(s):  
Marco Spadafora ◽  
Laura Evangelista ◽  
Salvatore Fiordoro ◽  
Francesco Porcaro ◽  
Marilena Sicignano ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Radiation Exposure ◽  
Fdg Pet ◽  
Whole Body ◽  
Predictive Values ◽  
Fdg Uptake ◽  
Scan Time ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Purpose: The Italian Tailored Assessment of Lung Indeterminate Accidental Nodule (ITALIAN) trial is a trial drawn to determine the performance of 18F-FDG-PET/CT in patients with solitary pulmonary nodules (SPN), stratified for a different kind of risk. An additional end-point was to compare the diagnostic information and estimated dosimetry, provided by a segmental PET/CT (s-PET/CT) acquisition instead of a whole body PET/CT (wb-PET/CT), in order to evaluate if segmental thoracic PET/CT can be used in patients with SPN. Methods: 18F-FDG PET/CT of 502 patients, stratified for pre-test cancer risk, was retrospectively analyzed. FDG uptake in SPN was assessed by a 4-point scoring (4PS) system and a semiquantitative analysis using the ratio between SUVmax in SPN and SUVmean in mediastinal blood pool (BP), and between SUVmax in SPN and SUVmean in the liver (L). Histopathology and/or follow-up data were used as a standard of reference. Data obtained on the thoracic part of wb-PET/CT, defined as s - PET/CT, were compared with those deriving from wb-PET/CT. Results: SPNs were malignant in 180 patients (36%), benign in 175 (35%), and indeterminate in 147 (29%). The 355 patients diagnosed with a definitive SPN nature (malignant or benign) were considered for the analysis of PET performance. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy were 85.6%, 85.7%, 86%, 85.2%, and 85.6%, respectively. Sensitivity and PPV were higher in intermediate and high-risk patients. : 18F-FDG uptake indicative of thoracic and extra-thoracic lesions was detectable in 13% and 3% of the patients. Compared to wb-PET/CT, s-PET/CT could save about 2/3 of 18F-FDG dose, radiation exposure or scan-time, without affecting the clinical impact of PET/CT. Conclusion: In patients with SPN, the pre-test likelihood of malignancy stratification allows to better define PET clinical setting and its diagnostic power. In subjects with low-intermediate pre-test likelihood of malignancy, s-PET/CT might be planned in advance. The adoption of this segmental strategy could reduce radiation exposure, scan-time, and might allow individually targeted protocols.

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 Hepatic 18F-FDG Uptake Measurements on PET/MR: Impact of Volume of Interest Location on Repeatability

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Liran Domachevsky ◽  
Hanna Bernstine ◽  
Meital Nidam ◽  
Dan Stein ◽  
Natalia Goldberg ◽  
...  
Keyword(s):  
Portal Vein ◽  
Fdg Pet ◽  
Intraclass Correlation ◽  
Standardized Uptake Value ◽  
Left Lobe ◽  
Whole Body ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Resonance Test ◽  
18F Fdg

Background. To investigate same day 18F-FDG (Fluorodeoxyglucose) PET (Positron Emission Tomography)/MR (Magnetic Resonance) test-retest repeatability of Standardized Uptake Value measurements normalized for body weight (SUV) and lean body mass (SUL) in different locations in the liver. Methods. This prospective study was IRB approved with written informed consent obtained. 35 patients (20 women and 15 men, 61±11.2 years) that performed a whole-body 18F-FDG PET/MR followed by liver-dedicated contrast-enhanced 18F-FDG PET/MR were included. SUV/L max, mean, and peak were measured inferior to, superior to, and at the right portal vein and in the left lobe of the liver. The coefficient of variation (CV) and intraclass correlation coefficient (ICC) were calculated and Bland-Altman plots were obtained. Results. The variability for SUV/L’s measurements was lowest inferior to the portal vein (<9.2%) followed by measurements performed at the level of the portal vein (<14.6%). Conclusion. The area inferior to the portal vein is the most reliable location for hepatic 18F-FDG uptake measurements on PET/MR.

The therapeutic impact of 18F-FDG whole body PET

2005 ◽  
Vol 44 (01) ◽  
pp. 8-14 ◽  
Author(s):  
B. Dietl ◽  
J. Marienhagen
Keyword(s):  
Fdg Pet ◽  
Diagnostic Information ◽  
Whole Body ◽  
Therapeutic Concept ◽  
Therapeutic Impact ◽  
Additional Diagnostic Information ◽  
Therapeutic Decisions ◽  
Target Volumes ◽  
18F Fdg ◽  
Pet Scans

Summary Aims: An explorative analysis of the diagnostic as well as therapeutic impact of 18F-FDG whole body PET on patients with various tumours in the setting of an university hospital radiation therapy was performed. Patients and methods: 222 FDG PET investigations (148 initial stagings, 74 restagings) in 176 patients with diverse tumour entities (37 lung carcinoma, 15 gastrointestinal tumours, 38 head and neck cancer, 30 lymphoma, 37 breast cancer, 19 sarcoma and 16 other carcinomas) were done. All PET scans were evaluated in an interdisciplinary approach and consecutively confirmed by other imaging modalities or biopsy. Unconfirmed PET findings were ignored. Proportions of verified PET findings, additional diagnostic information (diagnostic impact) and changes of the therapeutic concept intended and documented before PET with special emphasis on radiooncological decisions (therapeutic impact) were analysed. Results: 195/222 (88%) FDG-PET findings were verified, 104/222 (47%) FDG-PET scans yielded additional diagnostic information (38 distant, 30 additional metastasis, 11 local recurrencies, 10 primary tumours and 15 residual tumours after chemoptherapy). The results of 75/222 (34%) scans induced changes in cancer therapy and those of 58/222 (26%) scans induced modifications of radiotherapeutic treatment plan (esp. target volumes). Conclusion: 18F-FDG whole body PET is a valuable diagnostic tool for therapy planning in radiooncology with a high impact on therapeutic decisions in initial staging as well as in restaging. Especially in a curative setting it should be used for definition of target volumes.

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