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

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<0.001), lesion size (P<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 >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.

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Riccardo Caruso ◽  
Emilio Vicente ◽  
Yolanda Quijano ◽  
Hipolito Duran ◽  
Isabel Fabra ◽  
...  

Abstract Objectives Neoadjuvant chemoradiation (nCRT) is universally considered to be a valid treatment to achieve downstaging, to improve local disease control and to obtain better resectability in locally advanced rectal cancer (LARC). The aim of this study is to correlate the change in the tumour 18F-FDG PET-CT standardized uptake value (SUV) before and after nCRT, in order to obtain an early prediction of the pathologic response (pR) achieved in patients with LARC. Data description We performed a retrospective analysis of patients with LARC diagnosis who underwent curative resection. All patients underwent a baseline 18F-FDG PET-CT scan within the week prior to the initiation of the treatment (PET-CT SUV1) and a second scan (PET-CT SUV2) within 6 weeks of the completion of nCRT. We evaluated the prognostic value of 18F-FDG PET-CT in terms of disease-free survival (DFS) and overall survival (OS) in patients with LARC.A total of 133 patients with LARC were included in the study. Patients were divided in two groups according to the TRG (tumour regression grade): 107 (80%) as the responders group (TRG0-TRG1) and 26 (25%) as the no-responders group (TRG2-TRG3). We obtained a significant difference in Δ%SUV between the two different groups; responders versus no-responders (p < 0.012). The results of this analysis show that 18F-FDG PET-CT may be an indicator to evaluate the pR to nCRT in patients with LARC. The decrease in 18F-FDG PET-CT uptake in the primary tumour may offer important information in order for an early identification of those patients more likely to obtain a pCR to nCRT and to predict those who are unlikely to significantly regress.


Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 559
Author(s):  
Talitha Bent ◽  
Derya Yakar ◽  
Thomas C. Kwee

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.


2021 ◽  
Vol 20 ◽  
pp. 153303382110246
Author(s):  
Seokmo Lee ◽  
Yunseon Choi ◽  
Geumju Park ◽  
Sunmi Jo ◽  
Sun Seong Lee ◽  
...  

Background and Aims: This study evaluated the prognostic value of 18F-fluorodeoxyglucose positron emission tomography with integrated computed tomography (18F-FDG PET/CT) performed before and after concurrent chemoradiotherapy (CCRT) in esophageal cancer. Methods: We analyzed the prognosis of 50 non-metastatic squamous cell esophageal cancer (T1-4N0-2) patients who underwent CCRT with curative intent at Inje University Busan Paik Hospital and Haeundae Paik Hospital from 2009 to 2019. Median total radiation dose was 54 Gy (range 34-66 Gy). Our aim was to investigate the relationship between PET/CT values and prognosis. The primary end point was progression-free survival (PFS). Results: The median follow-up period was 9.9 months (range 1.7-85.7). Median baseline maximum standard uptake value (SUVmax) was 14.2 (range 3.2-27.7). After treatment, 29 patients (58%) showed disease progression. The 3-year PFS and overall survival (OS) were 24.2% and 54.5%, respectively. PFS was significantly lower ( P = 0.015) when SUVmax of initial PET/CT exceeded 10 (n = 22). However, OS did not reach a significant difference based on maximum SUV ( P = 0.282). Small metabolic tumor volume (≤14.1) was related with good PFS ( P = 0.002) and OS ( P = 0.001). Small total lesion of glycolysis (≤107.3) also had a significant good prognostic effect on PFS ( P = 0.009) and OS ( P = 0.025). In a subgroup analysis of 18 patients with follow-up PET/CT, the patients with SUV max ≤3.5 in follow-up PET/CT showed longer PFS ( P = 0.028) than those with a maximum SUV >3.5. Conclusion: Maximum SUV of PET/CT is useful in predicting prognosis of esophageal cancer patients treated with CCRT. Efforts to find more effective treatments for patients at high risk of progression are still warranted.


2020 ◽  
Author(s):  
Qing Han ◽  
Xiang Zhou ◽  
jin ding ◽  
zhaohui zheng ◽  
Fei Kang ◽  
...  

Abstract Backgroud and Objective: Clinical evaluation alone cannot satisfy the prognosis of TAK. PET-CTmolecular imaging may be a useful tool to supplement the prognosis of TAK. The purpose of this study was to observe whether THE TAK patients who achieved clinical remission also achieved imaging remission with PET-CT. Pet-ct plays an important role in the prognosis of TAK patients and further formulation of treatment strategy.Results: 79% patients with TAK in remission were positive for 18F-FDG-PET /CT. The study population had a mean age of 38.8 years and was predominantly female (90%). Their mean disease duration was 3.5 years and they had a mean disease remission period of 9.4 months. Patients had a mean ESR of 37.3 mm/h and a mean CRP level of 13.5 mg/l at the first dignosis time and 4.9 mm/h/3.7 mg/l at the Courrent time point. There was a statistically significant difference between the two groups (p<0.01). All patients on initial treatment received oral glucocorticoids, 25% received methotrexate, 65% received leflumide, and 45% received cyclophosphamide. Quantitative analysis of the SUV of nineteen patients showed an increasing trend (Baseline SUVmax 2.16±0.46 vs Remission SUVmax 2.08±0.49, p=0.56; Baseline SUVmean 2.34±0.57 vs Remission SUVmean 2.42±0.81, p=0.46). The arterial SUVmax uptake was higher in 15 patients with remission than baseline (2.30 ± 0.62 vs 2.48 ± 0.91, p = 0.54). But it was not statistically significant. Most of the patients (13/19, 68%) had an SUVmax value ≥ 2.0 in visual vasculitis with positive PET/CT before treatment, and 32% <2.0. No correlation was found between the type of treatment used, the time that elapsed from remission, or laboratory parameters and the scintigraphic results. Conclusion: TAK's clinical remission criteria are not entirely consistent with actual vascular inflammatory activity. Patients with TAK that achieve clinical remission may not achieve imaging remission with PET-CT, and PET-CT plays an important role in the prognosis of TAK patients and further formulation of treatment strategy.


2021 ◽  
Author(s):  
Riccardo Caruso ◽  
Emilio Vicente ◽  
Yolanda Quijano ◽  
Hipolito Duran ◽  
Isabel Fabra ◽  
...  

Abstract Objectives: Neoadjuvant radiochemotherapy (nCRT) is universally considered to be a valid treatment to achieve downstaging, improve local disease control and obtain better resectability in locally advanced rectal cancer (LARC). The aim of this study is to correlate the change in tumor 18F -FDG PET-CT standardized uptake value (SUV) before and after nCRT, in order to obtain an early prediction of pathologic response (pR) achieved in patients with LARC.Data description: We performed a retrospective analysis of patients with LARC diagnosis who underwent curative resection. All patients received nCRT and surgical treatment was carried after 8/12th. All patients underwent a baseline 18F -FDG PET-CT scan within the week prior to the initiation of the treatment (PET-CT SUV1) and a second scan (PET-C T SUV2) within six weeks of the completion of nCRT. Furthermore, we evaluated the prognostic value of 18F -FDG PET-CT in terms of disease free survival (DFS) and overall survival (OS) in patients with LARC.A total of 133 patients with LARC were included in the study. Patients were divided in two groups according to the TRG (tumor regression grade): 107 (80%) as Responders group (TRG0-TRG1) and 26 (25%) as the No-Responders group (TRG2-TRG3). We obtained a significant difference in Δ%SUV between the two different groups responders vs no responders (p<0.012).The results of this analysis have shown that 18F-FDG PET-CT may be an indicator in order to evaluate the pR to nCRT in patients with LARC. The decrease in 18F-FDG PET-CT uptake in the primary tumor may offer primary information in order to early identify those patients more likely to obtain a pCR to nCRT and predict those unlikely to regress significantly.


Sign in / Sign up

Export Citation Format

Share Document