Patients Undergoing Multiple 18F-FDG PET/CT Scans: 11-Year Study At A High-Capacity Center

Abstract Purpose To assess frequency, clinical indications, and cumulative effective dose (CED) of patients undergoing multiple 18F-FDG PET/CT imaging. Methods Retrospective analysis of 18F-FDG PET/CT scans performed at a University hospital for 11 years was done. Effective dose was computed from activity administered and dose-length-product. Results A total of 55,424 18F-FDG PET/CT scans were performed in 32,658 patients. The average injected activity was 421 MBq and median 417 MBq. 24.2% of the patients were scanned 2-5 times in a year, 16.7% of them being unique patients (not counted as separate patient in different years). The maximum PET/CT scans in a year was five. 23571 (72.2 %) patients underwent a single 18F-FDG PET/CT scan, while 9087 (27.8%) unique patients underwent 2 - 23 scans during 11 years. 82% of the scanned patients had malignant disease, 2.4% among the patients with ≥ 2 18F-FDG PET/CT scans in a year were with non-malignant indications. 1.4% of patients received CED ≥100 mSv in one year from multiple 18F-FDG PET/CT scans and 0.8% of them received ≥ 100 mSv in a year more than one time, the CED of 27.8% (9087 patients) who underwent 2 to 23 18F-FDG PET/CT scans over 11-years ranged from 38 to 575 mSv (median: 271 mSv). Conclusion This first and largest ever study covering analysis of 11-years’ data of 18F-FDG PET/CT patients showed that a sizeable number of patients, largely (82%) with malignant disease undergo recurrent imaging during one year and non-ignorable fraction exceed 100 mSv in one year.

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Prevalence of incidental thyroid malignancy on routine 18F-fluorodeoxyglucose PET-CT in a large teaching hospital

European Journal of Hybrid Imaging ◽

10.1186/s41824-020-00089-5 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Shea Roddy ◽

Thomas Biggans ◽

Ahmad K. Raofi ◽

Avinash Kanodia ◽

Thiru Sudarshan ◽

...

Keyword(s):

Teaching Hospital ◽

Fdg Pet ◽

Tracer Uptake ◽

Ct Scans ◽

Study Group ◽

Thyroid Malignancy ◽

Focal Lesions ◽

Number Of Patients ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Purpose To quantify incidental thyroid pathology including malignancy on routine 18F-FDG PET-CT scans To compare standardised uptake values (SUVmax) in thyroid malignancy subtypes Methods and materials This is a retrospective study of all 18F-FDG PET-CT scans (n = 6179) performed in a teaching hospital between June 2010 and May 2019. RIS database search of reports for the word “thyroid” was performed. Studies with evidence of thyroid uptake were included. Patient age and gender, primary indication for PET scan (malignant or non-malignant), thyroid result on PET (diffuse or focal tracer uptake, SUVmax), ultrasound and FNAC results were recorded. Results Incidental abnormal thyroid tracer uptake as a proportion of all 18F-FDG PET-CT scans was 4.37% (n = 270). Out of region patients (n = 87) whose records could not be obtained were excluded leaving a study group of n = 183. Ninety-four in this group had focal uptake, and 89 had diffuse uptake. Fifty-five patients in the focal group had undergone further investigations. Of these, 30 were thought to be benign on USS alone, and 25 patients underwent USS/FNAC. Thirteen (24%) malignancies were identified (5 papillary, 6 follicular, 1 poorly differentiated thyroid cancer, 1 metastatic malignancy). Mean SUVmax for papillary carcinoma was noted to be 8.2 g/ml, and follicular carcinoma was 12.6 g/ml. Conclusion Incidental abnormal thyroid 18F-FDG PET-CT uptake in PET-CT scans of 4.37% is in keeping with the known limited literature. Rather similar number of patients was noted in the focal and diffuse tracer uptake categories in the final study group. Around quarter of the focal lesions were identified to be malignant, implying focal lesions should always be further investigated.

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Malignes Melanom

Onkologische Welt ◽

10.1055/a-1351-7165 ◽

2021 ◽

Vol 12 (01) ◽

pp. 48-48

Author(s):

Ine Schmale

Keyword(s):

Fdg Pet ◽

Malignes Melanom ◽

Ct Scans ◽

Pet Ct ◽

Fdg Pet Ct

In einer multizentrischen Studie wurde untersucht, ob mithilfe eines FDG-PET-CT-Scans die Entscheidung zum Beenden der Therapie mit Checkpoint-Inhibitoren möglicherweise verbessert werden kann.

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The role of FDG PET/CT or PET/MRI in assessing response to neoadjuvant therapy for patients with borderline or resectable pancreatic cancer: a systematic literature review

Annals of Nuclear Medicine ◽

10.1007/s12149-021-01629-0 ◽

2021 ◽

Author(s):

Laura Evangelista ◽

Pietro Zucchetta ◽

Lucia Moletta ◽

Simone Serafini ◽

Gianluca Cassarino ◽

...

Keyword(s):

Neoadjuvant Therapy ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Response To Therapy ◽

Ductal Adenocarcinoma ◽

Resectable Pancreatic Cancer ◽

Number Of Patients ◽

Pet Ct ◽

Fdg Pet Ct

AbstractThe aim of the present systematic review is to examine the role of fluorodeoxyglucose (FDG) positron emission tomography (PET) associated with computed tomography (CT) or magnetic resonance imaging (MRI) in assessing response to preoperative chemotherapy or chemoradiotherapy (CRT) for patients with borderline and resectable pancreatic ductal adenocarcinoma (PDAC). Three researchers ran a database query in PubMed, Web of Science and EMBASE. The total number of patients considered was 488. The most often used parameters of response to therapy were the reductions in the maximum standardized uptake value (SUVmax) or the peak standardized uptake lean mass (SULpeak). Patients whose SUVs were higher at the baseline (before CRT) were associated with a better response to therapy and a better overall survival. SUVs remaining high after neoadjuvant therapy correlated with a poor prognosis. Available data indicate that FDG PET/CT or PET/MRI can be useful for predicting and assessing response to CRT in patients with resectable or borderline PDAC.

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Clinical and FDG-PET/CT Suspicion of Malignant Disease: Is Biopsy Confirmation Still Necessary?

Diagnostics ◽

10.3390/diagnostics11030559 ◽

2021 ◽

Vol 11 (3) ◽

pp. 559

Author(s):

Talitha Bent ◽

Derya Yakar ◽

Thomas C. Kwee

Keyword(s):

Fdg Pet ◽

Malignant Disease ◽

Invasive Procedure ◽

Clinical Suspicion ◽

Tissue Sampling ◽

Positron Emission ◽

Pet Ct ◽

Significant Difference ◽

Biopsy Confirmation ◽

Fdg Pet Ct

Background: Biopsy of 18F-fluoro-2-deoxy-D-glucose (FDG)-avid lesions suspected for malignancy remains an invasive procedure associated with a variety of risks. It is still unclear if the positive predictive value (PPV) of positron emission tomography (PET)/computed tomography (CT) is sufficiently high to avoid tissue sampling. Therefore, the purpose of this study was to determine the PPV of 18F-FDG-PET/CT for malignancy in patients with a clinical suspicion of active malignant disease. Methods: This single-center retrospective study included 83 patients who had undergone FDG-PET/CT within 60 days before CT- or ultrasonography-guided tissue sampling and whose request form for CT- or US-guided tissue sampling requested mutation analyses. The latter implies a high clinical suspicion of active malignant disease. The nature of each biopsied lesion was determined based on the results of the pathological analysis and/or clinical and imaging follow-up of at least 12 months. Results: In total, eighty-eight FDG-avid lesions were biopsied. The PPV of FDG-PET/CT for malignancy was 98.9% (95% CI: 93.8–99.8%). For patients with an oncological history, the PPV was 98.7% (95% CI: 92.9–99.8%), and for patients with no oncological history, the PPV was 100% (95% CI: 74.1–100.0%). There was no significant difference between the PPV of the group with and without an oncological history (p = 0.71). In two cases, an unsuspected malignancy was diagnosed. Conclusion: Although the PPV of FDG-PET/CT for malignancy in patients with a clinical suspicion of active malignant disease is high, biopsy remains recommended to avoid inappropriate patient management due the non-negligible chance of dealing with FDG-avid benign disease or unexpected malignancies.

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Non-Hodgkin lymphoma of multiple extranodal involvement seen on MRI, FDG PET–CT scans

Medicine ◽

10.1097/md.0000000000008456 ◽

2017 ◽

Vol 96 (45) ◽

pp. e8456 ◽

Cited By ~ 1

Author(s):

Shan Wang ◽

Meng Meng ◽

Qiuhu Wang ◽

Kai Xu

Keyword(s):

Hodgkin Lymphoma ◽

Fdg Pet ◽

Ct Scans ◽

Extranodal Involvement ◽

Non Hodgkin Lymphoma ◽

Pet Ct ◽

Fdg Pet Ct

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IMPROVEMENT IN LARGE DENSITY HDL PARTICLE NUMBER BY NMR IS ASSOCIATED WITH IMPROVEMENT IN VASCULAR INFLAMMATION BY 18-FDG PET/CT AT ONE-YEAR IN PSORIASIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)32229-0 ◽

2018 ◽

Vol 71 (11) ◽

pp. A1688 ◽

Cited By ~ 1

Author(s):

Amit Dey ◽

Martin Playford ◽

Aditya Joshi ◽

Agastya Belur ◽

Aditya Goyal ◽

...

Keyword(s):

Fdg Pet ◽

Particle Number ◽

Vascular Inflammation ◽

Large Density ◽

Pet Ct ◽

One Year ◽

Fdg Pet Ct

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Volume of interest delineation techniques for 18F-FDG PET-CT scans during neoadjuvant extremity soft tissue sarcoma treatment in adults: a feasibility study

EJNMMI Research ◽

10.1186/s13550-018-0397-1 ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

Marc G. Stevenson ◽

Lukas B. Been ◽

Harald J. Hoekstra ◽

Albert J. H. Suurmeijer ◽

Ronald Boellaard ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Fdg Pet ◽

Ct Scans ◽

Volume Of Interest ◽

Extremity Soft Tissue Sarcoma ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Sarcoma Treatment

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Hounsfield unit value has null effect on thyroid nodules at 18F-FDG PET/CT scans

Archives of Endocrinology and Metabolism ◽

10.20945/2359-3997000000063 ◽

2018 ◽

Vol 62 (4) ◽

pp. 460-465

Author(s):

Filiz Eksi Haydardedeoglu ◽

Gulay Simsek Bagir ◽

Nese Torun ◽

Emrah Kocer ◽

Mehmet Reyhan ◽

...

Keyword(s):

Fdg Pet ◽

Thyroid Nodules ◽

Hounsfield Unit ◽

Ct Scans ◽

Null Effect ◽

Unit Value ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Clinical Value of Fluorine-18 2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography/Computed Tomography in Bladder Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2010.28.7052 ◽

2010 ◽

Vol 28 (25) ◽

pp. 3973-3978 ◽

Cited By ~ 93

Author(s):

Andrea B. Apolo ◽

Jamie Riches ◽

Heiko Schöder ◽

Oguz Akin ◽

Alisa Trout ◽

...

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Bladder Cancer ◽

Sensitivity And Specificity ◽

Fdg Pet ◽

Malignant Disease ◽

Emission Tomography ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct

Purpose Fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) has been approved for imaging in many malignancies but not for bladder cancer. This study investigated the value of FDG-PET/CT imaging in the management of patients with advanced bladder cancer. Patients and Methods Between May 2006 and February 2008, 57 patients with bladder cancer at our center underwent FDG-PET/CT after CT (n = 52) or magnetic resonance imaging (MRI; n = 5). The accuracy of FDG-PET/CT was assessed using both organ-based and patient-based analyses. FDG-PET/CT findings were validated by either biopsy or serial CT/MRI. Clinician questionnaires performed before and after FDG-PET/CT assessed whether those scan results affected management. Results One hundred thirty-five individual lesions were evaluable in 47 patients for the organ-based analysis. Overall sensitivity and specificity were 87% (95% CI, 76% to 94%) and 88% (95% CI, 78% to 95%), respectively. In the patient-based analysis, malignant disease was correctly diagnosed in 25 of 31 patients, resulting in a sensitivity of 81% (95% CI, 63% to 93%). FDG-PET/CT was negative in 15 of 16 patients without malignant lesions for a specificity of 94% (95% CI, 71% to 100%). Pre- and post-PET surveys revealed that FDG-PET/CT detected more malignant disease than conventional CT/MRI in 40% of patients. Post-PET surveys showed that clinicians changed their planned management in 68% of patients based on the FDG-PET/CT results. Conclusion FDG-PET/CT has excellent sensitivity and specificity in the detection of metastatic bladder cancer and provides additional diagnostic information that enhances clinical management more than CT/MRI alone. FDG-PET/CT scans may provide better accuracy in clinical information for directing therapy.

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