18F-fluorodeoxyglucose Positron Emission Tomography/computed Tomography Comparison of Gastric Lymphoma and Gastric Carcinoma

Author(s):  
Qiaoling Xu ◽  
Najing Wu ◽  
Huihui He ◽  
Xiaoqing Du ◽  
Yanjuan Wang ◽  
...  

Abstract ObjectiveThis study aimed to compare the characteristics of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in gastric lymphoma (GL) and gastric carcinoma (GC).METHODSPatients with newly diagnosed GL or GC who underwent 18F-FDG PET/CT prior to treatment were included in this study. The PET/CT features of gastric wall lesions, including FDG avidity, pattern, and intensity [maximal standard uptake value (SUVmax)] were reviewed and analyzed. The correlation of SUVmax with gastric clinicopathological variables was investigated by Student’s t test, Mann-Whitney U test, chi-square test, and receiver-operating characteristic (ROC) curve analysis to determine the differential diagnostic value of SUVmax-associated parameters in GL and GC.RESULTSA total of 68 patients with GL and 117 with GC were included in this study. Abnormal gastric FDG accumulation was found in 66 (97.05%) patients with GL and 109 (93.16%) patients with GC. Majority of the GL patients presented with type I and III lesions, whereas GC patients mainly with type II and III lesions. The SUVmax [14.89(6.56,22.12) vs 4.08(5.75,10.24), P<0.001) and SUVmax/THKmax (maximal thickness) [0.72(0.50,1,10) vs 0.39(0.28,0.64), P<0.000] were both higher in patients with GL when compared with GC. The SUVmax was higher in GL patients with DLBCL than in those with MALT (17.51±10.31 vs 4.97±2.92, P =0.0010) and higher in patients with advanced Lugano stage (II1/II2/IV) than in those with stage I (18.27±10.19 vs 9.92±9.22, P = 0.002). In GC patients, the SUVmax was higher in T3+T4 than in T1+T2 [6.79(4.47,12.41) vs 4.09(2.32,6.31), P = 0.000], but there were no significant differences between TNM stage I+II and TNM stage III+IV. The ROC curve analysis suggested a better performance of SUVmax/THKmax in evaluating gastric lesions between GL and GC when compared to SUVmax alone. The sensitivity of SUVmax and SUVmax/THKmax for differential diagnosis of GL and GC were 0.917 and 0.578, respectively. However, the specificity of SUVmax/THKmax for differential diagnosis of GL and GC was higher than that of SUVmax alone (0.894 VS 0.485).CONCLUSIONThe PET/CT features differed between GL and GC, and these can improve the evaluation of PET/CT of gastric wall lesions and help differentiate GL from GC.

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1258
Author(s):  
Lu Han ◽  
Qi Wang ◽  
Lanbo Zhao ◽  
Xue Feng ◽  
Yiran Wang ◽  
...  

Backgrounds: The purpose of this paper is to investigate the prognostic value of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters in patients treated with concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC). Methods: Studies that met the following criteria were retrieved from PubMed and Embase: patients treated with CCRT for LACC; FDG PET/CT scans performed before CCRT treatment; and a detected relationship between the parameters of FDG PET/CT and the prognosis of patients. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to estimate the overall survival (OS) or event-free survival (EFS). Results: In total, 14 eligible studies with 1313 patients were included in this meta-analysis. Patients with a high maximum standardized uptake value (SUVmax) have a shorter OS than those with a low SUVmax (HR = 2.582, 95% = CI 1.936–3.443, p < 0.001). Primary tumor SUVmax values (HR = 1.938, 95% CI = 1.203–3.054, p = 0.004) were significantly correlated with EFS, with a relatively high heterogeneity (I2 = 84% and I2 = 69.4%, respectively). Based on the limited data, the combined HR for EFS with the highest primary tumor total lesion glycolysis (TLG) and metabolic tumor volume (MTV) was 1.843 (95% CI = 1.100–3.086, p = 0.02) and 2.06 (95% CI = 1.21–3.51, p = 0.007), respectively. Besides, the combined HR for OS with the highest nodal SUVmax was 2.095 (95% CI = 2.027–2.166, p < 0.001). Conclusion: A high primary SUVmax has a significant correlation with the OS and EFS of patients treated with CCRT for LACC and may therefore serve as a prognostic predictor. Due to the limited data, to explore the correlation between survival and TLG, MTV, and nodal SUVmax, further large-scale prospective studies are needed.


2012 ◽  
Vol 78 (10) ◽  
pp. 1109-1113
Author(s):  
Yosef Nasseri ◽  
Ariel J. Ourian ◽  
Alan Waxman ◽  
Alessandro D'Angolo ◽  
Louise E. Thomson ◽  
...  

Although hepatobiliary iminodiacetic acid (HIDA) scan is often used when the diagnosis of cholecystitis remains questionable after ultrasound, it carries a high false-positive rate and has other limitations. Fluorodeoxyglucose positron emission tomography–computed tomography (18FDG PET-CT) has recently gained enthusiasm for its ability to detect infection and inflammation. In this study, we evaluate the accuracy of 18FDG PET-CT in diagnosing cholecystitis. Nineteen patients with suspected cholecystitis (Group S) underwent PET-CT and 10 had positive PET-CT findings. Of these 10, nine underwent cholecystectomies, and pathology confirmed cholecystitis in all nine. One patient was managed nonoperatively as a result of multiple comorbidities. Of the nine patients with negative PET-CT, six were managed nonoperatively, safely discharged, and had no readmissions at 3-month follow-up. The other three patients with negative PET-CT underwent cholecystectomies, and two showed no cholecystitis on pathology. The third had mild to moderate cholecystitis with focal mucosal erosion/ulceration without gallbladder wall thickening on pathology. 18FDG PET-CT detected gallbladder inflammation in all but one patient with pathology-proven cholecystitis with a sensitivity and specificity of 0.90 and 1.00, respectively. 18FDG-PET-CT appears to be a promising, rapid, direct, and accurate test in diagnosing cholecystitis and could replace HIDA scan in cases that remain equivocal after ultrasound.


2019 ◽  
Vol 103 (11) ◽  
pp. 1650-1655 ◽  
Author(s):  
Pierre Chauvelot ◽  
Andrea Skanjeti ◽  
Yvan Jamilloux ◽  
Audrey de Parisot ◽  
Christiane Broussolle ◽  
...  

AimTo assess the usefulness of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) and the predictive factors for the diagnosis of sarcoidosis in patients with uveitis who have normal thoracic tomography.MethodsWe retrospectively reviewed 67 consecutive patients with uveitis of unknown aetiology or a suspected sarcoidosis. All patients with normal thoracic tomography underwent an 18F-FDG PET/CT, which was blindly reinterpreted. We then assessed the proportion of positive 18F-FDG PET/CT and the impact on the final aetiology, using Abad’s criteria for the diagnosis of intraocular sarcoidosis.Results19 of the 67 patients (28.4%) had mediastinal hypermetabolic foci on their 18F-FDG PET/CT consistent with sarcoidosis. It identified a biopsy site in two cases, which were consistent with sarcoidosis. At the end of the study, six patients (10%) had a proven sarcoidosis, six patients (9%) were considered as having a presumed sarcoidosis and 18 patients (26.9%) as having indeterminate sarcoidosis. 18F-FDG PET/CT enabled the diagnosis of presumed sarcoidosis in these six patients. An older age at diagnosis (p=0.004) and the presence of synechiae (p=0.02) were significantly related to an abnormal 18F-FDG PET/CT, with a trend for an elevated ACE (p=0.0993). We established a nomogram to estimate the probability of having positive findings on the 18F-FDG PET/CT according to different predictive factors.Conclusion18F-FDG PET/CT enabled the diagnosis of intraocular sarcoidosis even in patients with a normal CT scan. Older age at diagnosis, presence of synechiae and elevated ACE are associated with positive findings on 18F-FDG PET/CT consistent with sarcoidosis.


Oncology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Daiki Yamashige ◽  
Yusuke Kawamura ◽  
Masahiro Kobayashi ◽  
Junichi Shindoh ◽  
Yuta Kobayashi ◽  
...  

<b><i>Background:</i></b> The sensitivity of <sup>18</sup>F-fluorodeoxyglucose positron emission tomography/computed tomography (<sup>18</sup>F-FDG-PET/CT) in hepatocellular carcinoma (HCC) is low; however, clinical evidence demonstrating its prognostic value in patients with HCC has recently been reported. This study aimed to assess the value of <sup>18</sup>F-FDG-PET/CT as a tool for evaluating the response of HCC to lenvatinib treatment. <b><i>Methods:</i></b> We evaluated 11 consecutive patients with HCC diagnosed by dynamic CT or magnetic resonance imaging combined with <sup>18</sup>F-FDG-PET/CT from April 2018 to December 2019. The tumor-to-normal liver ratio (TLR) of the target tumor was measured before and during the course of lenvatinib treatment with <sup>18</sup>F-FDG-PET/CT (pre and post analysis, respectively), with a TLR ≥2 classified as PET-positive HCC. At the time of each evaluation, we also used the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, the modified RECIST (mRECIST), and the tumor marker alfa-fetoprotein (AFP). <b><i>Results:</i></b> Of 11 patients, 3 (27%) and 8 (73%) had an objective response to lenvatinib treatment at the time of post-analysis by RECIST 1.1 and mRECIST, respectively. There were 3 (27%) and 7 (64%) patients with PET-positive HCC at the time of pre- and post-analysis, respectively. There was a significant correlation between the rates of change in AFP and TLR during lenvatinib treatment (<i>r</i> = 0.69, <i>p</i> = 0.019). Based on these results, we were able to perform liver resection on 4 patients with PET-positive HCC as conversion therapy. Three samples from these patients showed poorly differentiated tumors. <b><i>Conclusion:</i></b> <sup>18</sup>F-FDG-PET/CT has potential as an evaluation tool for describing biological tumor behavior and reflecting disease progression, location, and treatment response. This modality may provide useful information for considering prognosis and subsequent therapy.


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