scholarly journals The Utility of 18F-Fluorocholine PET/CT in The Imaging of Parathyroid Adenomas

2021 ◽  
Author(s):  
Mazurek Andrzej ◽  
Dziuk Miroslaw ◽  
Witkowska-Patena Ewa ◽  
Chudzinski Witold ◽  
Gizewska Agnieszka ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Parathyroid Tissue ◽  
Nodular Goiter ◽  
Tissue Response ◽  
Parathyroid Scintigraphy ◽  
Parathyroid Surgery ◽  
Chronic Thyroiditis ◽  
Neck Ultrasound ◽  
Pet Ct

Abstract Aim: to estimate sensitivity of 18F-FCH PET/CT in preoperative localisation of hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism (PHPT). Methods: 65 consecutive patients with PHPT who underwent neck ultrasound (US) and 99mTc/99mTc-MIBI dual-phase parathyroid scintigraphy were prospectively enrolled. Twenty-two patients had unsuccessful parathyroid surgery prior to the study. PET/CT scans were performed 65.0 ± 13.3 min after injection of 218.5 ± 31.9 MBq of 18F-fluorocholine (FCH). Three experienced nuclear medicine physicians assessed the detection rate of hyperfunctioning parathyroid tissue. Response to parathyroidectomy and clinical follow-up served as a reference test. Per-patient sensitivity and positive predictive value (PPV) were calculated for patients who underwent surgery.Results: 18F-FCH PET/CT was positive in 61 patients, and negative in four. US and parathyroid scintigraphy showed positive and negative results in 20 , 45 and 17, 48, respectively. US showed nodular goiter in 31 patients and chronic thyroiditis in 9 patients. Parathyroid surgery was performed in 43 (66%) patients. 18F-FCH PET/CT yielded sensitivity of 100% (95% CI [87.99-100]) and PPV of 85.7% (95% CI [70.77-94.06]). Similar values were observed in patients with chronic thyroiditis, nodular goiter, and patients after an unsuccessful parathyroid surgery. PET/CT identified hyperparathyroidism complications (kidney stones, osteoporotic bone fractures and brown tumours) in 11 patients.Conclusions: 18F-FCH PET/CT effectively detected hyperfunctioning parathyroid tissue and its complications. The method showed excellent sensitivity and positive predictive value, including patients with nodular goiter, chronic thyroiditis and prior unsuccessful parathyroidectomy. PET/CT performance was superior to neck ultrasound and parathyroid scintigraphy.

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.

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.

12 week PET-CT has low positive predictive value for nodal residual disease in human papillomavirus-positive oropharyngeal cancers

Oral Oncology ◽  
2019 ◽  
Vol 97 ◽  
pp. 76-81 ◽  
Author(s):  
Robert Rulach ◽  
Suyun Zhou ◽  
Fraser Hendry ◽  
David Stobo ◽  
Allan James ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Residual Disease ◽  
Pet Ct

The Utility of Multidetector Computed Tomography for Detection of Parathyroid Disease in the Setting of Primary Hyperparathyroidism

2012 ◽  
Vol 63 (2) ◽  
pp. 100-108 ◽  
Author(s):  
Dorota D. Linda ◽  
Bernard Ng ◽  
Ryan Rebello ◽  
Srinivasan Harish ◽  
George Ioannidis ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Primary Hyperparathyroidism ◽  
Positive Predictive Value ◽  
Multidetector Computed Tomography ◽  
Predictive Value ◽  
Parathyroid Tissue ◽  
Parathyroid Glands ◽  
Preoperative Imaging ◽  
Average Weight ◽  
Contrast Enhanced

Purpose The aim of this study was to evaluate the accuracy of multidetector computed tomography (MDCT) in the detection of parathyroid adenoma and hyperplasia in the setting of primary hyperparathyroidism. Methods Records of 48 patients with biochemically confirmed primary hyperparathyroidism, who underwent preoperative imaging with 16- or 64-slice contrast-enhanced MDCT and subsequent successful parathyroidectomy over a 3-year period, were reviewed. Two radiologists, blinded to the operative and histologic findings, independently evaluated multiplanar computed tomographic images for all patients. Results On pathologic examination, 63 abnormal glands were confirmed in 41 female and 7 male patients (mean age, 63 years). Of the 63 abnormal glands, 40 were adenomatous and 23 were hyperplastic. MDCT demonstrated an 88% (95% confidence interval [CI], 77%–99%) positive predictive value for localizing abnormal hyperfunctioning parathyroid glands. The sensitivity of MDCT in detecting single-gland disease was 80% (95% CI, 68%–92%); whereas the specificity for ruling out hyperfunctioning parathyroid tissue, either adenomatous or hyperplastic, was 75% (95% CI, 51%–99%). The sensitivity for exclusively localizing parathyroid hyperplasia was 17% (95% CI, 2%–33%). The parathyroid adenomas were substantially larger and heavier than their hyperplastic counterparts, with an average weight of 1.51 g (range, 0.08–6.00 g) and 0.42 g (range, 0.02–2.0 g) for adenoma and hyperplasia, respectively. Conclusions Contrast-enhanced MDCT demonstrated an 88% positive predictive value for localizing adenomatous and hyperplastic parathyroid glands. The poor sensitivity for detection of multigland disease was likely a result of the smaller size and weight of the abnormal hyperplastic glands.

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.

scholarly journals Positive predictive value of CEA and Ca19-9 as tumor markers for recurrent colorectal cancer in cases where conventional work-up fail to localize disease.

2015 ◽  
Vol 8 (2) ◽  
Author(s):  
Yana Bocheva ◽  
Pavel Bochev
Keyword(s):  
Colorectal Cancer ◽  
Positive Predictive Value ◽  
Tumor Markers ◽  
Predictive Value ◽  
Conventional Imaging ◽  
Recurrent Colorectal Cancer ◽  
Pet Ct ◽  
Work Up ◽  
Localize Disease

Introduction: Routine surveillance of colorectal cancer includes serial measurements of CEA levels. Although not routinely indicated Ca 19-9 is also a tool for recurrence. When any of these serum markers is elevated during follow up, this could represent a recurrence. The management of elevated tumor marker levels include clinical exams, endoscopy and conventional imaging –ultrasound, CT, MRI.Objective: To evaluate the positive predictive value of CEA and Ca19-9 as tumor markers for recurrent colorectal cancer in cases where conventional imaging and endoscopic studies fail to localize disease.Materials and methods: A total of 75 patients with elevated CEA and/or Ca19-9 serum levels and negative endoscopic exam as well as negative abdominal CT and Chest X-ray were included in the study. CEA levels were tested in 50 patients. Ca 19-9 was tested in 65 patients. 34 of the patients had both markers tested. All patients underwent whole body 18F-FDG PET/CT. Patients with negative of equivocal PET scan were further followed up (10 to 24 months).Results: Based on the reference standard – the results from PET/CT, if positive and the results from follow-up in cases of negative or equivocal scans, the positive predictive value of Ca 19-9 was 84% and that of CEA -83%. There was no significant difference in the PPV of Ca19-9 and CEA.Conclusion: Elevated CEA and Ca 19-9 levels in patients under active surveillance after operation for colorectal cancer have high positive predictive value for recurrence, even in cases where conventional work-up – endoscopy and CT don’t localize disease.

Routine Use of Preoperative Neck Ultrasound in Primary Hyperparathyroidism Identifies Coexisting Thyroid Disease and Improves Parathyroid Localization

2021 ◽  
pp. 000313482199199
Author(s):  
Trenton Foster ◽  
Benzon Dy ◽  
Raffaele Rocco ◽  
Travis Mckenzie ◽  
Geoffrey Thompson ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Needle Aspiration ◽  
Inclusion Criteria ◽  
Neck Ultrasound ◽  
Thyroid Pathology ◽  
Mean Size ◽  
Partial Thyroidectomy ◽  
Parathyroid Localization

Background In Jan 2018, we began routinely obtaining neck ultrasound (US) with 123I/99Tc-sestamibi (MIBI) for parathyroid gland localization and to identify thyroid pathology in the setting of primary hyperparathyroidism (1HPT). The aim of this study is to assess if routine neck US is a useful adjunct to 123I/99Tc-MIBI in 1HPT. Methods Patients undergoing surgery for 1HPT with both 123I/99Tc-MIBI and US at our institution after implementation of routine US were reviewed. Biopsy and surgical management of thyroid pathology was evaluated. 123I/99Tc-MIBI and US results were compared to intraoperative findings to determine sensitivity and positive predictive value (PPV) for parathyroid localization. Results From January 2018 to September 2019, there were 423 patients (mean, 61 years) that met inclusion criteria (80% women). Thyroid nodules were found on US in 57%, mean size 1.3 + 0.8 cm. Fine needle aspiration (FNA) was performed in 87 patients with nodules (36%). 35 patients (8.5%) required total or partial thyroidectomy for diagnoses/treatment. Papillary thyroid cancer (PTC) was found in 3.5% of the cohort with micro-PTC 53% and PTC 1-2 cm 40%. A successful parathyroid operation for 1HPT was achieved in 98.6% of patients. Positive predictive value for localization of abnormal parathyroid glands was 97% when US and 123I/99Tc-MIBI had concordant findings. Discussion Routine use of US in 1HPT commonly identifies nodules that are benign or low-risk PTC. Ultrasound is less sensitive for parathyroid localization but when used with 123I/99Tc-MIBI, concordant imaging has a high PPV.

scholarly journals To Enhance or Not to Enhance? The Role of Contrast Medium 18F-FDG PET/CT in Recurrent Ovarian Carcinomas

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 561
Author(s):  
Michela Massollo ◽  
Francesco Fiz ◽  
Gianluca Bottoni ◽  
Martina Ugolini ◽  
Francesco Paparo ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Positive Predictive Value ◽  
Contrast Medium ◽  
Predictive Value ◽  
Ground Truth ◽  
Ovarian Carcinomas ◽  
Positron Emission ◽  
Pet Ct ◽  
Lesion Level ◽  
Sensitivity Specificity

Background and Objectives: 18F-fluorodeoxyglucose (FDG) positron emission tomography/X-ray computed tomography (PET/CT) represents the mainstay diagnostic procedure for suspected ovarian cancer (OC) recurrence. PET/CT can be integrated with contrast medium and in various diagnostic settings; however, the effective benefit of this procedure is still debated. We aimed to compare the diagnostic capabilities of low-dose and contrast-enhanced PET/CT (PET/ldCT and PET/ceCT) in patients with suspected ovarian cancer relapse. Materials and Methods: 122 OC patients underwent both PET/ldCT and PET/ceCT. Two groups of nuclear medicine physicians and radiologists scored the findings as positive or negative. Clinical/radiological follow-up was used as ground truth. Sensitivity, specificity, negative/positive predictive value, and accuracy were calculated at the patient and the lesion level. Results: A total of 455 and 474 lesions were identified at PET/ldCT and PET/ceCT, respectively. At the lesion level, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were not significantly different between PET/ldCT and PET/ceCT (98%, 93.3%, 97.4%, 94.9%, and 96.9% for PET/ldCT; 99%, 95.5%, 98.3%, 97%, and 98% for PET/ceCT, p = ns). At the patient level, no significant differences in these parameters were identified (e.g., p = 0.22 and p = 0.35 for accuracy, in the peritoneum and lymph nodes, respectively). Smaller peritoneal/lymph node lesions close to physiological FDG uptake sources were found in the cases of misidentification by PET/ldCT. PET/ceCT prompted a change in clinical management in four cases (3.2%) compared to PET/ldCT. Conclusions: PET/ceCT does not perform better than PET/ldCT but can occasionally clarify doubtful peritoneal findings on PET/ldCT. To avoid unnecessary dose to the patient, PET/ceCT should be excluded in selected cases.

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