Quantitation of Cancer Treatment Response by FDG PET/CT: Multi-center Assessment of Measurement Variability Using AUTO-PERCISTTM

Abstract Background: The aim of this study was to assess the reader variability in quantitatively assessing pre- and post-treatment F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scans in a defined set of images of cancer patients using the same semi-automated analytical software (Auto-PERCIST™), which identifies tumor peak standard uptake value corrected for lean body mass (SULpeak) to determine 18F-FDG PET quantitative parameters.Methods: Paired pre- and post-treatment FDG PET/CT images from 30 oncologic patients and Auto-PERCIST™ semi-automated software were distributed to 13 readers across US and international sites. One reader was aware of the relevant medical history of the patients (readreference), whereas the 12 other readers were blinded to history but had access to the correlative images. Auto-PERCIST™ was set up to first automatically identify the liver and compute the threshold for tumor measurability (1.5 x liver mean) + (2 x liver standard deviation [SD]), and then detect all sites with SULpeak greater than the threshold. Next, the readers selected sites they believed to represent tumor lesions. The main performance metric assessed was the percent change in the SULpeak (%ΔSULpeak) of the hottest tumor identified on the baseline and follow up images. Results: The intra-class correlation coefficient (ICC) for the %ΔSULpeak of the hottest tumor was 0.87 (95%CI: [0.78, 0.92]) when all reads were included (n=297). Including only the measurements that selected the same target tumor as the readreference (n=224), the ICC for %ΔSULpeak was 1.00 (95%CI: [1.00, 1.00]). The Krippendorff alpha coefficient for response (complete or partial metabolic response, versus stable or progressive metabolic disease on PET Response Criteria in Solid Tumors 1.0) was 0.91 for all reads (n=380), and 1.00 including for reads with the same target tumor selection (n=270).Conclusion: Quantitative tumor FDG SULpeak changes measured across multiple global sites and readers utilizing Auto-PERCIST™ show very high correlation. Harmonization of methods to single software, Auto-PERCIST™, resulted in virtually identical extraction of quantitative tumor response data from FDG PET images when the readers select the same target tumor.

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Quantitation of cancer treatment response by 2-[18F]FDG PET/CT: multi-center assessment of measurement variability using AUTO-PERCIST™

10.21203/rs.3.rs-93282/v2 ◽

2021 ◽

Author(s):

JooHyun O ◽

Su Jin Lim ◽

Hao Wang ◽

Jeffrey P. Leal ◽

Hui-Kuo G. Shu ◽

...

Keyword(s):

Fdg Pet ◽

Metabolic Response ◽

Standard Uptake Value ◽

Post Treatment ◽

Measurement Variability ◽

Positron Emission ◽

Pet Ct ◽

Oncologic Patients ◽

Set Up ◽

Fdg Pet Ct

Abstract Background: The aim of this study was to assess the reader variability in quantitatively assessing pre- and post-treatment 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) scans in a defined set of images of cancer patients using the same semi-automated analytical software (Auto-PERCIST™), which identifies tumor peak standard uptake value corrected for lean body mass (SULpeak) to determine [18F]FDG PET quantitative parameters.Methods: Paired pre- and post-treatment [18F]FDG PET/CT images from 30 oncologic patients and Auto-PERCIST™ semi-automated software were distributed to 13 readers across US and international sites. One reader was aware of the relevant medical history of the patients (readreference), whereas the 12 other readers were blinded to history but had access to the correlative images. Auto-PERCIST™ was set up to first automatically identify the liver and compute the threshold for tumor measurability (1.5 x liver mean) + (2 x liver standard deviation [SD]), and then detect all sites with SULpeak greater than the threshold. Next, the readers selected sites they believed to represent tumor lesions. The main performance metric assessed was the percent change in the SULpeak (%ΔSULpeak) of the hottest tumor identified on the baseline and follow up images. Results: The intra-class correlation coefficient (ICC) for the %ΔSULpeak of the hottest tumor was 0.87 (95%CI: [0.78, 0.92]) when all reads were included (n=297). Including only the measurements that selected the same target tumor as the readreference (n=224), the ICC for %ΔSULpeak was 1.00 (95%CI: [1.00, 1.00]). The Krippendorff alpha coefficient for response (complete or partial metabolic response, versus stable or progressive metabolic disease on PET Response Criteria in Solid Tumors 1.0) was 0.91 for all reads (n=380), and 1.00 including for reads with the same target tumor selection (n=270).Conclusion: Quantitative tumor [18F]FDG SULpeak changes measured across multiple global sites and readers utilizing Auto-PERCIST™ show very high correlation. Harmonization of methods to single software, Auto-PERCIST™, resulted in virtually identical extraction of quantitative tumor response data from [18F]FDG PET images when the readers select the same target tumor.

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Quantitation of cancer treatment response by 2-[18F]FDG PET/CT: multi-center assessment of measurement variability using AUTO-PERCIST™

EJNMMI Research ◽

10.1186/s13550-021-00754-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Joo Hyun O ◽

◽

Su Jin Lim ◽

Hao Wang ◽

Jeffrey P. Leal ◽

...

Keyword(s):

Fdg Pet ◽

Metabolic Response ◽

Standard Uptake Value ◽

Post Treatment ◽

Measurement Variability ◽

Positron Emission ◽

Pet Ct ◽

Oncologic Patients ◽

Set Up ◽

Fdg Pet Ct

Abstract Background The aim of this study was to assess the reader variability in quantitatively assessing pre- and post-treatment 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) scans in a defined set of images of cancer patients using the same semi-automated analytical software (Auto-PERCIST™), which identifies tumor peak standard uptake value corrected for lean body mass (SULpeak) to determine [18F]FDG PET quantitative parameters. Methods Paired pre- and post-treatment [18F]FDG PET/CT images from 30 oncologic patients and Auto-PERCIST™ semi-automated software were distributed to 13 readers across US and international sites. One reader was aware of the relevant medical history of the patients (readreference), whereas the 12 other readers were blinded to history but had access to the correlative images. Auto-PERCIST™ was set up to first automatically identify the liver and compute the threshold for tumor measurability (1.5 × liver mean) + (2 × liver standard deviation [SD]) and then detect all sites with SULpeak greater than the threshold. Next, the readers selected sites they believed to represent tumor lesions. The main performance metric assessed was the percent change in the SULpeak (%ΔSULpeak) of the hottest tumor identified on the baseline and follow-up images. Results The intra-class correlation coefficient (ICC) for the %ΔSULpeak of the hottest tumor was 0.87 (95%CI: [0.78, 0.92]) when all reads were included (n = 297). Including only the measurements that selected the same target tumor as the readreference (n = 224), the ICC for %ΔSULpeak was 1.00 (95%CI: [1.00, 1.00]). The Krippendorff alpha coefficient for response (complete or partial metabolic response, versus stable or progressive metabolic disease on PET Response Criteria in Solid Tumors 1.0) was 0.91 for all reads (n = 380) and 1.00 including for reads with the same target tumor selection (n = 270). Conclusion Quantitative tumor [18F]FDG SULpeak changes measured across multiple global sites and readers utilizing Auto-PERCIST™ show very high correlation. Harmonization of methods to single software, Auto-PERCIST™, resulted in virtually identical extraction of quantitative tumor response data from [18F]FDG PET images when the readers select the same target tumor.

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18F-FDG-PET/CT in radiation therapy-induced parotid gland inflammation

European Journal of Hybrid Imaging ◽

10.1186/s41824-020-00091-x ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Alaa Mouminah ◽

Austin J. Borja ◽

Emily C. Hancin ◽

Yu Cheng Chang ◽

Thomas J. Werner ◽

...

Keyword(s):

Parotid Gland ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Post Treatment ◽

Parotid Glands ◽

Positron Emission ◽

Pet Ct ◽

Average Maximum ◽

Pre Treatment ◽

Fdg Pet Ct

Abstract Background 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used in the clinical management of oncologic and inflammatory pathologies. It may have utility in detecting radiotherapy (RT)-induced damage of oral tissues. Thus, the aim of the present study was to use FDG-PET/CT to evaluate parotid gland inflammation following RT in patients with head and neck cancer (HNC). Methods This retrospective study included patients with HNC treated with photon, proton, or combined photon/proton RT, in addition to chemotherapy. All patients received FDG-PET/CT imaging pre-treatment and 3 months post-treatment. The average mean standardized uptake value (Avg SUVmean) and the average maximum standardized uptake value (Avg SUVmax) of the left and right parotid glands were determined by global assessment of FDG activity using OsiriX MD software. A two-tailed paired t test was used to compare Avg SUVmean and Avg SUVmax pre- and post-RT. Results Forty-seven HNC patients were included in the study. Parotid gland Avg SUVmean was significantly higher at 3 months post-treatment than pre-treatment (p < 0.05) in patients treated with photon RT, but no significant differences were found between pre- and post-treatment Avg SUVmean in patients treated with proton RT or combined photon/proton RT. Conclusion Our results suggest that photon RT may cause radiation-induced inflammation of the parotid gland, and that proton RT, which distributes less off-target radiation, is a safer treatment alternative.

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Abstract 35: DVT Inflammation Assessed by 18F-FDG-PET/CT Predicts Subsequent Vein Wall Scarring

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.36.suppl_1.35 ◽

2016 ◽

Vol 36 (suppl_1) ◽

Author(s):

Chase W Kessinger ◽

Ahmed Tawakol ◽

Gregory R Wojtkiewicz ◽

Peter K Henke ◽

Ralph Weissleder ◽

...

Keyword(s):

Fdg Pet ◽

Vena Cava ◽

Standard Uptake Value ◽

Vein Wall ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

The Right ◽

Fdg Pet Ct

Objective: While venous thrombosis (VT)-induced inflammation facilitates thrombus resolution, inflammation causes vein wall scarring (VWS). Recently, statins have shown to improve VT resolution and reduce VT inflammatory components. In this study, we hypothesized that early VT inflammation detected by 18F-FDG positron emission tomography/computed tomography (PET/CT) could predict subsequent late stage VWS, and would be attenuated by statin therapy. Methods: Stasis VT was induced in 8-12 week old male C57BL/6 mice (n=31) in either the right jugular vein (n=13) or inferior vena cava (IVC,n=18). Animals in the IVC VT cohort were randomized to statin (n=8) or control (n=10) treatment. Statin, rosuvastatin (5mg/kg), was administered by oral gavage, daily starting 24 hours prior to VT induction; control mice received saline. All mice underwent survival FDG-PET/CT venography imaging on day 2. FDG inflammation signals (standard uptake value=SUV) were measured in the thrombosed vein and compared to the sham-operated venous segments or treatment control. On day 14, mice were sacrificed and VT tissue was resected. Picrosirius red staining allowed measurement of collagen and vein wall thickness in VT sections. Results: FDG-PET/CT at day 2 revealed increased inflammation signal activity in jugular VT (SUV 1.43 ± 0.3 VT vs. 0.81 ± 0.3 contralateral vein, p<0.0001). Statin-treated mice showed a trend of decreased inflammation signal at day 2 in the IVC VT models (SUV 1.02 ± 0.1 statin VT vs. 1.42 ± 0.2 control VT, p=0.07). Day 14 histological analysis revealed significantly reduced vein wall injury in statin-treated animals (thickness, 32±9.4 μm statin; vs. 56.2±14.7 μm control, p=0.02). Day 2 FDG-PET inflammation in VT correlated positively with the magnitude of day 14 VWS (jugular VT, Spearman r=0.62, p=0.02; IVC VT r=0.74, p<0.001, respectively). Conclusions: Quantitative FDG-PET/CT imaging demonstrates that early in vivo VT inflammation predicts subsequent VWS, a driver of post-thrombotic syndrome (PTS). The overall findings strengthen: (i) the link between inflammation and PTS; (ii) the translational potential of FDG-PET inflammation to predict VWS and PTS; and (iii) the concept that statins and other anti-inflammatory therapies could reduce VWS and PTS.

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18F-FDG PET/CT findings in patients with Kikuchi disease

Nuklearmedizin ◽

10.3413/nukmed-0513-12-06 ◽

2013 ◽

Vol 52 (03) ◽

pp. 101-106 ◽

Cited By ~ 4

Author(s):

K. Chun ◽

Y. Hong ◽

J. Hah ◽

I. Cho ◽

E. Kong

Keyword(s):

Fdg Pet ◽

Cervical Lymphadenopathy ◽

Standard Uptake Value ◽

Solid Organ ◽

Imaging Features ◽

Neck Masses ◽

Ct Findings ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct

Summary Purpose: Kikuchi disease (KD) is a benign and self-limited syndrome characterized by cervical lymphadenopathy. This study evaluated 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (FDG PET/ CT) findings in patients with KD and analyzed their imaging features. Patients, material, methods: We evaluated the FDG PET/CT findings of 22 patients (14 men, 8 women) with KD, ranging in age from 9 to 73 years. All patients had been diagnosed based on the pathological findings of biopsy. We examined the locations, metabolic activity and size of hypermetabolic lymph nodes (LNs) on FDG PET/CT imaging with medical history including laboratory results. Results: Among the 22 patients, we identified 619 hypermetabolic LNs which had maximum standard uptake value (SUVmax) above 3.0. The 16 patients were studied with FDG PET/CT to identify the cause of fever, another 5 patients for their neck masses, and the remaining patient for his left inguinal mass. Hypermetabolic LNs were noted in neck (18 bilaterally, 2 right, 1 left) of 21 patients, axilla of 10, mediastinum of 9, abdomen of 17, pelvis of 6, and inguinal area of 3. The SUVmax of FDG uptake in affected LNs by patient base analysis were 6.2–29.4. Of the 619 hypermetabolic LNs identified, 440 LNs (71.1%) were less than 10 mm in their short axis determined by CT, and were occasionally aggregated. No patient showed solid organ hypermetabolic lesion in FDG PET/CT. Conclusion: Kikuchi disease could present multiple hypermetabolic LNs in body on FDG PET/CT. Based on the physical findings, consideration of the generalized distribution of the relatively small-sized hypermetabolic LNs, FDG PET/CT may be useful as a diagnostic tool in cases of Kikuchi disease.

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Abstract 530: In vivo DVT Inflammation Presages Vein Wall Injury, and is Ameliorated by Statin Therapy

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.37.suppl_1.530 ◽

2017 ◽

Vol 37 (suppl_1) ◽

Author(s):

Chase W Kessinger ◽

Guanming Qi ◽

Ahmed Tawakol ◽

Peter K Henke ◽

Farouc A Jaffer

Keyword(s):

Statin Therapy ◽

Fdg Pet ◽

Ex Vivo ◽

Vena Cava ◽

Standard Uptake Value ◽

Vein Wall ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct

Objective: Inflammation mediates early venous thrombosis (VT) resolution and can induce vein wall scarring (VWS), a key driver of the morbid post-thrombotic syndrome (PTS). Statins exhibit anti-inflammatory properties, and may positively impact VWS after VT. However, whether early inflammation contributes to this process and can be detected is not known. In this study, we hypothesized that early VT inflammation detected by 18F-fludeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) could predict subsequent VWS and that both VT inflammation and VWS would be attenuated by statin therapy. Methods: Stasis VT was induced by complete ligation in male C57BL/6J mice (n=55) in either the infrarenal inferior vena cava (IVC, n=42) or right jugular vein (n=13). IVC VT mice were randomized to statin or control groups. Statin (rosuvastatin 5mg/kg) was given by oral gavage starting one day prior to VT induction; control mice received PBS. All mice underwent survival FDG-PET/CT venography imaging on day 2. FDG-PET inflammation signals (standard uptake value (SUV), SUVmax, target-to-background ratios (TBR)) were measured. Picrosirius red staining of day 14 VT sections measured vein wall collagen/thickness. Ex vivo VT tissue gamma counting of a subgroup was performed at day 2. Whole-thrombus protein/mRNA and VT tissue sections assessed neutrophil content. Results: FDG-PET/CT at day 2 revealed increased FDG uptake in jugular VT over the contralateral sham surgery vein (p<0.001). Statin-treated mice showed a decrease in FDG-PET SUV, SUVmax and TBR (p<0.05 for all). Whole-thrombus analyses and tissue section immunostaining showed reduced thrombus neutrophil content at day 2, without reducing GLUT1 or MPO expression (p>0.05). At day 14, statin therapy significantly reduced VWS (p=0.02). In mice undergoing survival imaging, the day 2 FDG-PET VT inflammation signal correlated significantly with the magnitude of day 14 VWS (IVC VT r=0.74, p<0.001) and jugular models of VT (r=0.62, p=0.02). Conclusions: Quantitative FDG inflammation imaging demonstrates that early VT inflammation presages subsequent VWS, and is ameliorated by prophylactic statin therapy. The overall findings support the concept that statins and could reduce VWS and PTS.

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The role of positron emission tomography in the selection of patients for salvage hysterectomy following chemoradiotherapy for locally advanced cervical cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2018-000088 ◽

2019 ◽

Vol 29 (2) ◽

pp. 266-271

Author(s):

Chrishanthi Rajasooriyar ◽

Ming-Yin Lin ◽

Rashi Kalra ◽

Andrew Lim ◽

Kailash Narayan

Keyword(s):

Cervical Cancer ◽

Fdg Pet ◽

Ct Scanning ◽

Post Treatment ◽

Emission Tomography ◽

Positron Emission ◽

Pet Ct ◽

Selection For ◽

Fdg Pet Ct

BackgroundPatients selection for salvage hysterectomy following chemoradiotherapy of cervical cancer is vital to avoid significant morbidity. The purpose of this study was to describe the role of post-treatment F18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography scanning (FDG-PET/CT) in patient selection for salvage hysterectomy.MethodsThis was a retrospective analysis of 49 patients with cervical cancer treated between January 1996 and December 2012 who were candidates for salvage hysterectomy.ResultsThree groups were defined based on institutional treatment guidelines, as experience in using post-treatment FDG-PET/CT to guide management evolved. Group 1 consisted of 15 patients who underwent planned hysterectomy based on clinical, cytological, or histological suspicion. Of these, only three (20%) patients had residual disease on histology. Group 2 consisted of 13 patients who had post-treatment FDG-PET/CT 3–6 months after the completion of chemoradiotherapy due either to suspicion of recurrence on examination or patients thought to be at high risk of recurrence at the primary site. Of these, eight patients had hysterectomy and four patients showed positive histology for residual tumor. Group 3 had 21 patients who showed isolated FDG uptake at the primary site on first FDG-PET/CT scanning at 6 months. A subsequent FDG-PET/CT scan after 3 months showed disease progression in seven and complete metabolic response in 14, and surgery was avoided in all patients.ConclusionFDG-PET/CT scanning at 6 months after radiotherapy is a good tool for assessing treatment response in patients with cervical cancer. In patients with persistent uptake on 6 months post-treatment FDG-PET/CT, repeat imaging at a 3-month interval helps in selecting patients for salvage hysterectomy.

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Evaluation of Malignancy Risk in 18F-FDG PET/CT Thyroid Incidentalomas

Diagnostics ◽

10.3390/diagnostics9030092 ◽

2019 ◽

Vol 9 (3) ◽

pp. 92 ◽

Cited By ~ 1

Author(s):

Larg ◽

Apostu ◽

Peștean ◽

Gabora ◽

Bădulescu ◽

...

Keyword(s):

Fdg Pet ◽

Standard Uptake Value ◽

Needle Aspiration ◽

Malignancy Risk ◽

Positron Emission ◽

Pet Ct ◽

Thyroid Uptake ◽

Risk Of Malignancy ◽

Ct Data ◽

Fdg Pet Ct

Thyroid incidentalomas detected by 18 fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography/computed tomography (PET/CT) are a real challenge for nuclear medicine physicians and clinicians. This study aimed to evaluate the risk of malignancy for patients with focal thyroid incidentalomas (TIs) diagnosed through FDG PET/CT. Data from 6900 patients, with a known primary tumor, who had an FDG PET/CT investigation performed were analyzed for the presence of incidental thyroid uptake. The focal TIs were reported, and the patients were referred for further investigation to the endocrinology department. There were 126 patients (1.82%) who presented with focal thyroid uptake, and for 87 of them, investigations were completed with ultrasonography (US), and for 29 with a fine needle aspiration biopsy (FNAB) procedure. Malignancy was detected in 7.93% (10/126) of cases. An arbitrary cutoff value of four was established for the standard uptake value lean body mass (SUVlbm Max) to differentiate the malignant nodules from the benign ones, and this value was significantly associated with malignancy (p = 0.0168). TIs are not so frequent, but they have a potential malignancy risk, and a proper evaluation is required. Even though SUVlbm Max is a predictive factor for malignancy, the FNAB remains the main diagnostic method for the therapeutic management of these patients.

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ATL: Does Metabolic Response Predicts Survival?

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000038 ◽

2014 ◽

Vol 24 (2) ◽

pp. 312-320 ◽

Cited By ~ 8

Author(s):

Varun Singh Dhull ◽

Punit Sharma ◽

Daya Nand Sharma ◽

Sagar Maharjan ◽

Sudhir Suman KC ◽

...

Keyword(s):

Fdg Pet ◽

Metabolic Response ◽

Progression Free Survival ◽

Response Evaluation ◽

Carcinoma Cervix ◽

Free Survival ◽

Treatment Response Evaluation ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct

PurposeThis study aimed to assess the role of18F-fluorodeoxyglucose positron emission tomography–computed tomography (18F-FDG PET-CT) in response assessment of patients with recurrent carcinoma cervix and in evaluating the predictive value of metabolic response for progression-free survival (PFS) and overall survival (OS).MethodsThirty-six patients with histopathologically or clinically evident recurrent cervical carcinoma underwent a pretherapy and a posttherapy18F-FDG PET-CT for treatment response evaluation. Positron emission tomography–CT images were analyzed by 2 experienced nuclear medicine physicians. Response was categorized using European Organization for Research and Treatment of Cancer (EORTC) criteria into complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), and progressive metabolic disease (PMD). Clinical/imaging follow-up (minimum of 6 months) and/or histopathologic findings were taken as reference standard. Patients were categorized into 2 groups, those with PMD and those without PMD (ie, CMR, PMR, and SMD). Progression-free survival and OS based on PET-CT response were measured from the date of posttherapy PET-CT to the first documentation of progression of disease and death, respectively.ResultsOn the basis of metabolic response on posttherapy PET-CT, 6 patients had CMR, 12 patients had PMR, 7 patients had SMD, and 11 patients had PMD. Progression-free survival for patients with cervical carcinoma ranged from 0.5 to 26.5 months (mean [SD], 6.7 [6.1] months). Median PFS for patients with PMD was 3.1 months, whereas median PFS for those without PMD was not reached. Patients who did not show PMD on posttherapy PET-CT had a significantly better PFS than those patients who showed PMD (P< 0.0001; HR, 0.14). There was no statistically significant difference in OS between the 2 groups (P= 0.187; HR, 0.39).Conclusions18F-fluorodeoxyglucose PET-CT is an effective tool for treatment response evaluation in recurrent carcinoma cervix. Patients with metabolically progressive disease on posttherapy18F-FDG PET-CT have a significantly shorter PFS.

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PET findings in lymphomatosis and gliomatosis of the brain: a comparison of C-11 methionine PET/CT and F-18 FDG PET/CT

Acta Radiologica ◽

10.1177/0284185120966710 ◽

2020 ◽

pp. 028418512096671

Author(s):

Noriaki Tomura ◽

Toshiyuki Saginoya ◽

Hiromi Goto

Keyword(s):

Fdg Pet ◽

Standard Uptake Value ◽

Rank Test ◽

Ct Findings ◽

Positron Emission ◽

Pet Ct ◽

Signed Rank Test ◽

Almost All ◽

Fdg Pet Ct ◽

The Brain

Background Positron emission tomography (PET) findings for gliomatosis and lymphomatosis have been rarely reported. Purpose To compare PET/computed tomography (CT) findings using 11C-methionine (MET) from PET/CT findings using 18F-fluorodeoxy glucose (FDG) for patients with lymphomatosis or gliomatosis of the brain. Material and Methods Participants comprised all 10 patients with lymphomatosis or gliomatosis of the brain treated at our institution in the past 12 years. Underlying pathologies comprised intravascular lymphoma (n = 1), lymphomatosis (n = 3), and gliomatosis (n = 6). All cases were pathologically diagnosed. In seven patients, both MET-PET/CT and FDG-PET/CT were performed simultaneously in a single study. In three patients, only FDG-PET/CT was performed. The degree of tracer accumulation to the lesion was evaluated qualitatively. Quantitatively, the ratio of maximum standard uptake value (SUVmax) in tumor to that in normal tissue (T/N ratio) was measured and compared between FDG and MET. Results Qualitatively, MET accumulated to part of the lesion in six of seven patients and almost all of the lesion in one in seven patients. FDG accumulated to part of the lesion in three of ten patients and almost all of the lesion in one of ten patients. No FDG accumulation was seen in the lesion in six patients. Quantitatively, mean ± SD T/N ratio was significantly higher with MET (2.11 ± 0.63) than with FDG (1.18 ± 0.84; P < 0.05, Wilcoxon signed-rank test). Conclusion In lymphomatosis and gliomatosis, FDG accumulates in only part of the lesion. FDG is thus less suitable than MET for depicting these lesions.

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