scholarly journals Adrenal Findings in FDG-PET– Analysis of a Cohort of 1021 Patients From a Cancer Center

2021 ◽  
Author(s):  
Joana Maciel ◽  
Daniela Cavaco ◽  
Davide Fraga ◽  
Sara Donato ◽  
Helder Simões ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Malignant Tumors ◽  
Cancer Staging ◽  
Cancer Center ◽  
Pathological Findings ◽  
Adrenal Metastases ◽  
Clinical Challenge ◽  
Pet Ct ◽  
Malignant Lesions ◽  
Fdg Pet Ct

Abstract Purpose: The use of FDG-PET/TC for cancer staging has been leading to the increasing diagnosis of adrenal lesions, which usually represent a clinical challenge. Our aim was to characterize the adrenal lesions found in FDG-PET of patients followed in a cancer center.Methods: Retrospective analysis of all FDG-PET studies performed in our center in the last 10 years. Exams reporting adrenal lesions in the CT component and/or anomalous adrenal FDG uptake were selected. Cases were characterized regarding clinical, laboratorial, imaging and pathological findings. Results: We identified 27,427 FDG-PET studies. Of those, 7.6% evidenced adrenal findings. We included 1364 exams corresponding to 1021 patients. Only 15.6% were referred to the endocrinology department and 38% of the lesions were not studied.Malignant lesions were present in 38.9% of the studied patients: metastases in 37.5%, carcinoma in 1.2% and other malignant tumors in 0.4%. Median SUVmax of malignant lesions was significantly higher than the SUVmax of the benign findings (p<0.05). We also observed a higher median SUVmax in adrenal metastases than in adenomas (p<0.05). There was a tendency for higher SUVmax of adrenal carcinomas when comparing with other malignant lesions (p=0.066). The median SUVmax was not different between pheochromocytomas and other tumors (p>0.05). Conclusion: Occult adrenal lesions discovered during FDG-PET/CT are common in cancer context and are frequently benign. SUVmax may be a useful tool in the workup of adrenal lesions but with several important caveats.

scholarly journals The Value of 18 Fluorine-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Breast Cancer Staging

2020 ◽  
Vol 8 (A) ◽  
pp. 970-975
Author(s):  
Ahmed Tawakol ◽  
Maha Khalil ◽  
Yasser G. Abdelhafez ◽  
Mai Hussein ◽  
Mohamed Fouad Osman
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Fdg Pet ◽  
Cancer Staging ◽  
Emission Tomography ◽  
Breast Cancer Staging ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

BACKGROUND: Accurate staging is important for management decisions in patients with newly diagnosed breast cancer. AIM: This study was conducted to evaluate the value of 18 fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging in breast cancer staging.. METHODS: A prospective study of 80 patients (1 male and 79 female) mean age 51.13 years with histologically confirmed breast cancer. The staging procedures included history, physical examination, mammography, and CT of neck, chest, abdomen, and pelvis; then, PET/CT was performed in a time interval <30 days. The findings of PET/CT were compared with those of the other conventional methods. RESULTS: The agreement between conventional methods (mammography, breast ultrasound, contrast-enhanced CT of the neck, chest, abdomen, and pelvis) and 18F FDG-PET/CT was 0.6 for assessing the T stage, 0.39 for N stage, and 0.75 for M stage. There was moderate agreement between CT and 18F FDG-PET/CT in the detection of nodal lesions (K=0.6) and pulmonary lesions (K=0.51), while a perfect agreement was noted for detecting osseous (K=0.82) and liver lesions (K=0.81). In total, 50 patients (62.5%) were concordantly staged between the conventional imaging and 18F-FDG PET/CT, while 30 patients (37.5%) showed a different tumor, node, and metastasis stage. The changes were driven by the detection of additional findings (n=26) or exclusion of findings (n=4), mainly at the lymph nodes (LNs) and/or distant sites. Regarding N status, 18F FDG-PET/CT revealed previously unknown regional lymphatic spread in supraclavicular (n=4; 5%), infraclavicular (n=11; 13.7%), and internal mammary (n=12; 15%) lymph node groups. 18F-FDG PET/CT changed M status in a total of four patients (5%); three of them were upstaged by detecting distant metastases, while osseous deposits were excluded in one patient leading to downstaging. CONCLUSION: 18F-FDG-PET/CT is considered a valuable imaging tool in the initial staging of breast cancer, which significantly impacts the overall American Joint Committee on Cancer staging in 37.5% of our study population.

scholarly journals Use of F-18 FDG PET/CT Through Delayed Diuretic Imaging for Preoperative Evaluation of Upper Urinary Tract-Occupying Lesions

2021 ◽  
Vol 11 ◽  
Author(s):  
Jun Wang ◽  
Liang Zhang ◽  
Jian Guo Wu ◽  
Ruohua Chen ◽  
Jia lin Shen
Keyword(s):  
Urinary Tract ◽  
Fdg Pet ◽  
Malignant Tumors ◽  
Upper Urinary Tract ◽  
Characteristic Analysis ◽  
Patient Age ◽  
Patient Âgé ◽  
Pet Ct ◽  
Significant Difference ◽  
Fdg Pet Ct

PurposeTo evaluate the value of F-18 FDG PET/CT in the differentiation of malignant and benign upper urinary tract-occupying lesions.Patients and Methods64 patients with upper urinary tract-occupying lesions underwent F-18 FDG PET/CT at RenJi Hospital from January 2015 to February 2019 in this retrospective study. Of the 64 patients, 50 patients received nephroureterectomy or partial ureterectomy; 14 patients received ureteroscopy and biopsy. The comparisons of PET/CT parameters and clinical characteristics between malignant and benign upper urinary tract-occupying lesions were investigated.ResultsOf the 64 patients, 49 were found to have malignant tumors. Receiver operating characteristic analysis determined the lesion SUVmax value of 6.75 as the threshold for predicting malignant tumors. There were significant associations between malignant and benign upper urinary tract-occupying lesions and SUVmax of lesion (P&lt;0.001), lesion size (P&lt;0.001), and patient age (P=0.011). Multivariate analysis showed that SUVmax of lesion (P=0.042) and patient age (P=0.009) as independent predictors for differentiation of malignant from benign upper urinary tract-occupying lesions. There was a significant difference in tumor size between the positive (SUVmax &gt;6.75) and negative (SUVmax ≤6.75) PET groups in 38 of the 49 patients with malignant tumors.ConclusionThe SUVmax of lesion and patient age is associated with the nature of upper urinary tract-occupying lesions. F-18 FDG PET/CT may be useful to distinguish between malignant and benign upper urinary tract-occupying lesions and determine a suitable therapeutic strategy.

scholarly journals 99mTc-DMSA (V) in Evaluation of Osteosarcoma: Comparative Studies with 18F-FDG PET/CT in Detection of Primary and Malignant Lesions

ISRN Oncology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-11
Author(s):  
G. P. Bandopadhyaya ◽  
Priyanka Gupta ◽  
Archana Singh ◽  
Jaya Shukla ◽  
S. Rastogi ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Lung Nodule ◽  
Inflammatory Lesion ◽  
Primary Site ◽  
Whole Body ◽  
Metastatic Lesions ◽  
Pet Ct ◽  
Malignant Lesions ◽  
Fdg Pet Ct

To evaluate the role of 99mTc-DMSA (V) and [18F]FDG PET-CT in management of patients with osteosarcoma, 22 patients were included in our study. All patients underwent both 99mTc-DMSA (V) and whole-body [18F]FDG PET-CT scans within an interval of 1 week. 555–740 MBq of 99mTc-DMSA (V) was injected i.v. the whole-body planar, SPECT images of primary site and chest were performed after 3-4 hours. [18F]FDG PET-CT images were obtained 60 minutes after i.v. injection of 370 MBq of F-18 FDG. Both FDG PET-CT (mean SUVmax = 7.1) and DMSA (V) scans showed abnormal uptake at primary site in all the 22 patients (100% sensitivity for both). Whole-body PET-CT detected metastasis in 11 pts (lung mets in 10 and lung + bone mets in 1 patient). Whole-body planar DMSA (V) and SPECT detected bone metastasis in one patient, lung mets in 7 patients and LN in 1 patient. HRCT of chest confirmed lung mets in 10 patients and inflammatory lesion in one patient. 7 patients positive for mets on DMSA (V) scan had higher uptake in lung lesions as compared to FDG uptake on PET-CT. Three patients who did not show any DMSA uptake had subcentimeter lung nodule. Resuts of both 99mTc-DMSA (V) (whole-body planar and SPECT imaging) and [18F]FDG PET-CT were comparable in evaluation of primary site lesions and metastatic lesions greater than 1 cm. Though 99mTc-DMSA (V) had higher uptake in the lesions as compared to [18F]FDG PET-CT, the only advantage [18F]FDG PET-CT had was that it could also detect subcentimeter lesions.

Correlations Between 18F-FDG PET/CT Parameters and Pathological Findings in Patients With Rectal Cancer

2014 ◽  
Vol 39 (1) ◽  
pp. e40-e45 ◽  
Author(s):  
Chih-Ying Liao ◽  
Shang-Wen Chen ◽  
Yi-Chen Wu ◽  
William Tzu-Liang Chen ◽  
Kuo-Yang Yen ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Fdg Pet ◽  
Pathological Findings ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Comparison of MR imaging and FDG-PET/CT in the differential diagnosis of benign and malignant vertebral compression fractures

2011 ◽  
Vol 14 (2) ◽  
pp. 177-183 ◽  
Author(s):  
Won-Ik Cho ◽  
Ung-Kyu Chang
Keyword(s):  
Mr Imaging ◽  
Fdg Pet ◽  
Vertebral Compression Fractures ◽  
Benign Lesions ◽  
Fracture Group ◽  
Radiotracer Uptake ◽  
Pet Ct ◽  
Malignant Lesions ◽  
Fdg Pet Ct ◽  
Mass Formation

Object Differentiation between malignant and benign vertebral compression fractures (VCFs) is important but sometimes difficult, especially in elderly cancer patients. The authors investigated the findings of MR imaging and FDG-PET/CT for the differentiation of VCFs. Methods Between 2007 and 2008, the authors evaluated and treated 102 VCFs in 96 patients. The final diagnosis, based on biopsy results or clinical follow-up, was benign fracture in 67 lesions in 65 patients and malignant fracture in 35 lesions in 31 patients. Magnetic resonance images were obtained in all patients, and FDG-PET/CT was performed in 17 patients in the benign fracture group and 20 in the malignant fracture group. The prevalence of 3 significant MR imaging findings (posterior cortical bulging, epidural mass formation, and pedicle enhancement) and the presence of radiotracer uptake on FDG-PET/CT were evaluated in the 2 groups. The maximum standardized uptake value (SUVmax) on FDG-PET/CT was compared between the 2 groups, and diagnostic threshold value was sought to confirm malignancy. The diagnostic accuracy of MR imaging and FDG-PET/CT was compared in the differentiation of malignant from benign VCFs. Results Posterior cortical bulging was seen in 26 (74%) of 35 malignant lesions and 30 (45%) of 67 benign ones, epidural mass formation in 27 (77%) of the malignant lesions and 25% of the benign ones, and pedicle enhancement in 30 (91%) of the 33 malignant lesions and 18 (39%) of the 46 benign ones evaluated with Gd-enhanced MR imaging. These differences were statistically significant for each feature. Sensitivity and specificity for predicting malignancy were, respectively, 74% and 55% for posterior cortical bulging, 77% and 74% for epidural mass formation, and 90% and 61% for pedicle enhancement. Simultaneous occurrence of 3 significant features was found in 21 (64%) of the 33 malignant and 8 (17%) of the 46 benign lesions for which complete MR imaging data were available and showed sensitivity of 64% and specificity of 83%. The presence of radiotracer uptake on FDG-PET/CT was seen in all 20 (100%) of the 20 malignant lesions and 12 (71%) 17 of the benign lesions evaluated by FDG-PET/CT and showed a sensitivity of 100% and specificity of 29%. There was a significant difference in mean (± SD) SUVmax for the malignant (6.29 ± 3.50) and benign (2.38 ± 1.90) lesions (p < 0.001). The most reliable threshold for SUVmax was found to be 4.25, which yielded a sensitivity of 85% and a specificity of 71%. Conclusions When MR imaging findings are equivocal, FDG-PET/CT can be considered as an adjunctive diagnostic method for differentiating malignant from benign VCFs. In comparison with MR imaging, FDG-PET/CT showed slightly higher sensitivity and lower specificity.

scholarly journals Value of 18-F-FDG PET/CT and CT in the Diagnosis of Indeterminate Adrenal Masses

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Nathalie Launay ◽  
Stéphane Silvera ◽  
Florence Tenenbaum ◽  
Lionel Groussin ◽  
Frédérique Tissier ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Malignant Tumors ◽  
Apparent Diffusion Coefficient Values ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
Adrenal Masses ◽  
18F Fdg ◽  
Ct Data ◽  
Adrenocortical Carcinomas ◽  
Fdg Pet Ct

The purpose of this paper was to study the value of 18-FDG PET/CT and reassess the value of CT for the characterization of indeterminate adrenal masses. 66 patients with 67 indeterminate adrenal masses were included in our study. CT/MRI images and 18F-FDG PET/CT data were evaluated blindly for tumor morphology, enhancement features, apparent diffusion coefficient values, maximum standardized uptake values, and adrenal-to-liver maxSUV ratio. The study population comprised pathologically confirmed 16 adenomas, 19 metastases, and 32 adrenocortical carcinomas. Macroscopic fat was observed in 62.5% of the atypical adenomas at CT but not in malignant masses. On 18F-FDG PET/CT, SUVmax and adrenal-to-liver maxSUV ratio were significantly lower in adenomas than in malignant tumors. An SUVmax value of less than 3.7 or an adrenal-to-liver maxSUV ratio of less than 1.29 is highly predictive of benignity.

scholarly journals Thyroid lesions incidentally detected by 18F-FDG PET-CT ― a two centre retrospective study

2015 ◽  
Vol 49 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Jan Jamsek ◽  
Ivana Zagar ◽  
Simona Gaberscek ◽  
Marko Grmek
Keyword(s):  
Fdg Pet ◽  
Malignant Lesion ◽  
Standardized Uptake Value ◽  
Benign Lesions ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Thyroid Uptake ◽  
Malignant Lesions ◽  
Fdg Pet Ct ◽  
Thyroid Lesions

AbstractBackground. Incidental18F-FDG uptake in the thyroid on PET-CT examinations represents a diagnostic challenge. The maximal standardized uptake value (SUVmax) is one possible parameter that can help in distinguishing between benign and malignant thyroid PET lesions.Patients and methods. We retrospectively evaluated18F-FDG PET-CT examinations of 5,911 patients performed at two different medical centres from 2010 to 2011. If pathologically increased activity was accidentally detected in the thyroid, the SUVmaxof the thyroid lesion was calculated. Patients with incidental18F-FDG uptake in the thyroid were instructed to visit a thyroidologist, who performed further investigation including fine needle aspiration cytology (FNAC) if needed. Lesions deemed suspicious after FNAC were referred for surgery.Results. Incidental18F-FDG uptake in the thyroid was found in 3.89% ― in 230 out of 5,911 patients investigated on PET-CT. Malignant thyroid lesions (represented with focal thyroid uptake) were detected in 10 of 66 patients (in 15.2%). In the first medical centre the SUVmaxof 36 benign lesions was 5.6 ± 2.8 compared to 15.8 ± 9.2 of 5 malignant lesions (p < 0.001). In the second centre the SUVmaxof 20 benign lesions was 3.7 ± 2.2 compared to 5.1 ± 2.3 of 5 malignant lesions (p = 0.217). All 29 further investigated diffuse thyroid lesions were benign.Conclusions. Incidental18F-FDG uptake in the thyroid was found in 3.89% of patients who had a PET-CT examination. Only focal thyroid uptake represented a malignant lesion in our study ― in 15.2% of all focal thyroid lesions. SUVmaxshould only serve as one of several parameters that alert the clinician on the possibility of thyroid malignancy.

scholarly journals The Role of [18F]FDG-PET/CT in Predicting Malignant Transformation of Plexiform Neurofibromas in Neurofibromatosis-1

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
David Tovmassian ◽  
Muzib Abdul Razak ◽  
Kevin London
Keyword(s):  
Systematic Review ◽  
Peripheral Nerve ◽  
Fdg Pet ◽  
Neurofibromatosis 1 ◽  
Noninvasive Test ◽  
Plexiform Neurofibromas ◽  
Pet Ct ◽  
Significant Difference ◽  
Malignant Lesions ◽  
Fdg Pet Ct

Background. Malignant peripheral nerve sheath tumours (MPNSTs) are difficult to diagnose and treat and contribute to significant morbidity and mortality for patients with Neurofibromatosis-1 (NF-1). FDG-PET/CT is being increasingly used as an imaging modality to discriminate between benign and malignant plexiform neurofibromas. Objectives. To assess the value of FDG-PET/CT in differentiating between benign and malignant peripheral nerve lesions for patients with Neurofibromatosis-1. Methods. A systematic review of the literature was performed prior to application of stringent selection criteria. Ultimately 13 articles with 796 tumours were deemed eligible for inclusion into the review. Results. There was a significant difference between mean SUVmax of benign and malignant lesions (1.93 versus 7.48, resp.). Sensitivity ranged from 89 to 100% and specificity from 72 to 94%. ROC analysis was performed to maximise sensitivity and specificity of SUVmax cut-off; however no clear value was identified (range 3.1–6.1). Significant overlap was found between the SUVmax of benign and malignant lesions making differentiation of lesions difficult. Many of the studies suffered from having a small cohort and from not providing histological data on all lesions which underwent FDG-PET/CT. Conclusion. This systematic review is able to demonstrate that FDG-PET/CT is a useful noninvasive test for discriminating between benign and malignant lesions but has limitations and requires further prospective trials.

Sign in / Sign up

Export Citation Format

Share Document