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 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 Evaluation of Gynecologic Cancer with MR Imaging, 18F-FDG PET/CT, and PET/MR Imaging

2015 ◽  
Vol 56 (3) ◽  
pp. 436-443 ◽  
Author(s):  
S. I. Lee ◽  
O. A. Catalano ◽  
F. Dehdashti
Keyword(s):  
Mr Imaging ◽  
Fdg Pet ◽  
Gynecologic Cancer ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

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.

scholarly journals Comparison of Whole-Body18F FDG PET/MR Imaging and Whole-Body18F FDG PET/CT in Terms of Lesion Detection and Radiation Dose in Patients with Breast Cancer

Radiology ◽  
2016 ◽  
Vol 281 (1) ◽  
pp. 193-202 ◽  
Author(s):  
Amy N. Melsaether ◽  
Roy A. Raad ◽  
Akshat C. Pujara ◽  
Fabio D. Ponzo ◽  
Kristine M. Pysarenko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Dose ◽  
Mr Imaging ◽  
Fdg Pet ◽  
Lesion Detection ◽  
Pet Ct ◽  
Fdg Pet Ct

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.

scholarly journals Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F- FDG PET/CT-derived parameters

2020 ◽  
Author(s):  
Bo Chen ◽  
Hongbo Feng ◽  
Jinghui Xie ◽  
Chun Li ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Regression Model ◽  
Fdg Pet ◽  
Univariate Analysis ◽  
Ct Imaging ◽  
Bone Lesions ◽  
Benign Lesions ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: Accurate differentiation between malignant and benign in soft tissue and bone lesions is essential for the prevention of excessive pathological biopsy and unplanned surgical resection. However, it remains a challenge and a standard diagnosis modality is urgently needed. The purpose of this study is to evaluate the usefulness of 18F- FDG PET/CT-derived parameters to differentiate soft tissue sarcoma (STS) and bone sarcoma (BS) from benign lesions.Methods: Patients who underwent pretreatment 18F-FDG PET/CT imaging and subsequent biopsy to confirm malignant (STS and BS, n=37) and benign (n=33) soft tissue and bone lesions were retrospectively reviewed. The tumor size, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and heterogeneous factor (HF) of each lesion were measured. Univariate analysis and multivariate logistic regression analysis were performed to screen the significant risk factors to distinguish STS and BS from benign lesions. To establish a regression model based on independent risk factors, receiver operating characteristic (ROC) analysis was performed to assess the diagnostic performances.Results: Univariate analysis results showed that tumor size, SUVmax, MTV, TLG and HF of 18F-FDG PET/CT imaging in STS and BS group were all higher than benign lesions group, the difference were statistically significant (all P value were<0.01). However, the multivariate regression model only included SUVmax and HF as independent risk factors, odds radios were 1.135(95%CI: 1.026~1.256, P =0.014), 7.869(95%CI: 2.119~29.230, P =0.002), respectively. The regression model was as follow: Logit (P) = -2.461+0.127SUVmax+2.063HF. The area under the ROC was 0.860 (95%CI: 0.771~0.948, P <0.001) higher than SUVmax 0.744(95%CI: 0.628~0.860, P <0.001) and HF 0.790 (95%CI:0.684~0.896, P <0.001).Conclusion: The regression model including SUVmax and HF based on 18F-FDG PET/CT imaging may be useful for differentiating STS and BS from benign lesions.

Sign in / Sign up

Export Citation Format

Share Document