scholarly journals The Value of 18F-FDG PET/CT and Abdominal PET/MRI as a One-Stop Protocol in Patients With Potentially Resectable Colorectal Liver Metastases

2021 ◽  
Vol 11 ◽  
Author(s):  
Nina Zhou ◽  
Xiaoyi Guo ◽  
Hongwei Sun ◽  
Boqi Yu ◽  
Hua Zhu ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Conventional Imaging ◽  
Positron Emission ◽  
Pet Ct ◽  
Mri Scans ◽  
One Stop ◽  
Fdg Pet Ct

PurposeThe aim of this study was to evaluate the clinical value of simultaneous positron emission tomography/computed tomography (PET/CT) and abdominal positron emission tomography/magnet resonance imaging (PET/MRI) in the detection of liver metastases and extrahepatic disease (EHD) in patients with potentially resectable colorectal liver metastases (CLM).MethodsFifty-six patients with CLM underwent conventional imaging (chest and abdomen CT, liver contrast-enhanced CT or MRI) and PET imaging [fluorine-18 fluorodeoxyglucose (18F-FDG) PET/CT and subsequent liver PET/MRI] for staging or restaging. Diagnostic ability of PET imaging was compared with conventional imaging. Abnormal findings were correlated with follow-up imaging and/or histology. The influence of the PET imaging findings was categorized for each patient in relation to operability and other significant findings. The clinical management included three modalities (surgery for resectable CLM, unresectable CLM with conversion treatment, and systemic therapy). The clinical impact of the imaging modality was analyzed. The operative histopathological analysis and/or imaging follow-up were performed as the standard of reference.ResultsThis study enrolled a total of 56 patients (median age 60 years, 62.5% were male, 36 with colon cancer and 20 with rectal cancer). For EHD detection, PET/CT detected more EHD than conventional imaging (60.7% vs. 46.4%). PET/CT had different findings in 19 (33.9%) patients, including downstaging in 4 (7.1%) patients and upstaging in 15 (26.8%) patients. For liver lesion detection, PET/MRI showed comparable detection ability with CE-MRI and CE-CT (99.5%, 99.4%, and 86.5%, respectively) based on lesion analysis, much higher than PET/CT (47.5%). PET imaging had a major impact in 10/56 (17.9%) patients (4 from unresectable to resectable, 6 from resectable to unresectable) and a minor impact in 4/56 (7.1%) patients for changing the surgery extent. The therapeutic strategies had been altered in a total of 14/56 patients (25%) after PET/CT and PET/MRI scans.ConclusionThe results of this study indicate that simultaneous 18F-FDG PET/CT and abdominal PET/MRI scans can provide accurate information regarding CLM status and EHD, and can affect the management of 25% of the patients by changing the therapeutic strategies determined by conventional imaging. This new modality may serve as a new one-stop method in patients with potentially resectable CLM.

scholarly journals Comparison of F18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Dynamic Contrast-Enhanced Magnetic Resonance Imaging as Markers of Graft Viability in Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 47 (1) ◽  
pp. 88-95 ◽  
Author(s):  
Siva Srivastava Garika ◽  
Anshul Sharma ◽  
Abdul Razik ◽  
Akshima Sharma ◽  
Ravindra Mohan Pandey ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Cruciate Ligament ◽  
Acl Graft ◽  
Positron Emission ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Anterior Cruciate ◽  
Fdg Pet Ct ◽  
Ct And Mri

Background: F18-fluorodeoxyglucose positron emission tomography/computed tomography (F18-FDG PET/CT) can be used to assess changes in the metabolism of an anterior cruciate ligament (ACL) graft as it is undergoing “ligamentization.” Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is the preferred modality for noninvasive assessment of graft structure and graft vascularity. Purpose: To compare the use of F18-FDG PET/CT and DCE-MRI to assess ligamentization within the ACL graft and correlate the results with clinical tests. Study Design: Case series; Level of evidence, 4. Methods: Among 30 recruited patients, 27 patients (3 females and 24 males) completed 2 follow-up assessments at a mean of 125 ± 22 days and 259 ± 38 days after arthroscopic ACL reconstruction. At both assessments, anterior drawer test, Lachman test, and Lysholm scoring (LS) were conducted. Images from F18-FDG PET/CT and MRI were analyzed qualitatively and quantitatively (maximum standardized uptake value [SUVmax], SUVmax ratio to the contralateral side [SUVmax CL], normalized enhancement [NE]) in 3 zones: femoral, intra-articular (IA), and tibial. Of the 27 recruited patients, 1 patient had reinjury due to a fall. Therefore, 26 patients were considered for the final analysis. Results: A significant improvement ( P = .0001) was found in median LS, from 78.5 (range, 62-90) to 94.5 (range, 84-100), at the second follow-up. All grafts were found to be viable on PET/CT and vascularized on MRI. All grafts were seen as continuous on MRI, with exception of 1 graft at the second follow-up. Dynamic MRI identified single-vessel supply to all of the grafts at the first follow-up and multiple-vessel supply in 10 patients at the second follow-up. Reduction in the median SUVmax, SUVmax CL, and NE at second follow-up was seen in all 3 zones. Only SUVmax CL in the IA zone showed a significant reduction ( P = .032); patients with excellent LS at the second follow-up showed significantly higher reduction ( P = .005) than patients with good LS. NE in the IA zone was correlated (0.39; P = .048) with LS only at the first follow-up, whereas SUVmax CL (–0.52; P = .006) and SUVmax (–0.49, P = .010) in the IA zone negatively correlated with LS at the second follow-up only. No correlation was observed between PET/CT and MRI parameters. Conclusion: Glucose metabolism and vascularity in the graft tissue can be used to assess ligamentization of ACL graft. A viable and vascularized graft at first follow-up is associated with good to excellent final outcome, regardless of LS at this stage. Since no correlation was observed between PET/CT and MRI parameters, they may be assessing different domains of the same process. Higher NE in the IA zone at the first follow-up and lower SUVmax CL in the same region at second follow-up are associated with better outcome.

scholarly journals Positron Emission Tomography for the Response Evaluation following Treatment with Chemotherapy in Patients Affected by Colorectal Liver Metastases: A Selected Review

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Alberto Zaniboni ◽  
Giordano Savelli ◽  
Claudio Pizzocaro ◽  
Pietro Basile ◽  
Valentina Massetti
Keyword(s):  
Liver Metastases ◽  
Fdg Pet ◽  
Therapy Response ◽  
Progression Free Survival ◽  
Free Survival ◽  
Positron Emission ◽  
Response To Chemotherapy ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Ct And Mri

The aim of the present paper is to review the scientific literature concerning the usefulness of18F-FDG PET/CT in the evaluation of response to chemotherapy in patients affected by liver metastases from colorectal cancer.Material and Methods. Studies were identified by searching PubMed electronic databases. Both prospective and retrospective studies were included. Information regarding the figure of merit of PET for the evaluation of therapy response was extracted and analyzed.Results. Existing data suggests that18F-FDG PET/CT may have an outstanding role in evaluating the response. The sensitivity of PET in detecting therapy response seems to be greater than conventional imaging (CT and MRI). PET/CT response is strictly related to better overall survival and progression-free survival.Conclusions. PET/CT is more than a promising technique to assess the response to chemotherapy in colorectal and liver metastases. However, to be fully validated, this examination needs further studies by recruiting more patients.

425. The Decisive Role of FDG PET-CT in the Follow-up of RFA-treated Colorectal Liver Metastases

2012 ◽  
Vol 38 (9) ◽  
pp. 855-856
Author(s):  
K. Nielsen ◽  
A.A.J.M. van Tilborg ◽  
M.R. Meijerink ◽  
S. Meijer ◽  
E.F.I. Comans ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Fdg Pet ◽  
Colorectal Liver Metastases ◽  
Decisive Role ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals IMAGING IN ENDOCRINOLOGY: 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up

2015 ◽  
Vol 173 (3) ◽  
pp. R115-R130 ◽  
Author(s):  
Massimo Salvatori ◽  
Bernadette Biondi ◽  
Vittoria Rufini
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Whole Body ◽  
Clinical Indications ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

In recent years, 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) has emerged as an important tool for the postoperative management of patients with differentiated thyroid cancer (DTC) and it is widely used in selected clinical situations. The most valuable role that FDG-PET/CT plays in clinical practice is that it can be used to obtain prognostic information in patients with increasing thyroglobulin (Tg) levels and negative 131I whole-body scan post-thyroidectomy and radioiodine (RAI) ablation. FDG-PET/CT may also have a potential role in the initial staging and follow-up of high-risk patients with aggressive histological subtypes, in the identification of patients who are at the highest risk of disease-specific mortality, in the management of patients with RAI-refractory disease, in clinical trials of novel targeted therapies in patients with advanced metastatic disease, and in the evaluation of thyroid nodules with indeterminate fine-needle aspiration for cytology. However, several controversies remain to be resolved, namely: the cutoff value of Tg in the selection of DTC patients for FDG-PET/CT, whether FDG-PET/CT scanning should be performed under thyrotropin stimulation or suppression, and the clinical significance of thyroid FDG-PET/CT incidentalomas. The aim of the present article is to provide an overview of the data about the molecular basis for, clinical indications of, and controversies related to the use of FDG-PET/CT in patients with DTC.

Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Interpretation Criteria for Assessment of Antibiotic Treatment Response in Pyogenic Spine Infection

2015 ◽  
Vol 66 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Silvia A. Riccio ◽  
Angel K.M. Chu ◽  
Harvey R. Rabin ◽  
Reinhard Kloiber
Keyword(s):  
Soft Tissue ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Active Infection ◽  
Spine Infection ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Purpose The objective of the study was to determine if fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can assess the response of patients with pyogenic spine infection to antibiotic treatment in a clinically useful time frame. Methods Twenty-eight patients with suspected pyogenic spine infection had baseline 18F-FDG PET/CT. Patients with proven or probable infection were divided into good and poor responders to antibiotic therapy based on clinical criteria. These patients had a follow-up 18F-FDG PET/CT 6-8 weeks later. Results Six of 28 patients were deemed negative for infection based on 18F-FDG PET/CT. Two patients were excluded because of discrepancies in interpretation. Of the 20 patients deemed positive for infection, 13 had a pathogen isolated and all showed 18F-FDG uptake in bone and/or soft tissue at baseline. Patients with a poor clinical response to treatment had persistent 18F-FDG uptake in bone and/or soft tissue on follow-up. Patients with good clinical response had uptake confined to the margins of the destroyed disc. None of these patients had recurrent infection, even if antibiotics had already been discontinued at the time of the follow-up scan. Conclusions 18F-FDG uptake confined to the margins of a destroyed disc after antibiotic therapy of pyogenic spine infection must not be considered indicative of persistent infection and likely represents mechanically induced inflammation. 18F-FDG uptake in bone or soft tissue does indicate active infection. Quantification of activity could not reliably differentiate patients with active infection from those without active infection and those who had had a successful response to therapy. The pattern of activity is critical to accurate interpretation.

Pediatric Bone Sarcoma: Diagnostic Performance of18F-FDG PET/CT Versus Conventional Imaging for Initial Staging and Follow-Up

2015 ◽  
Vol 204 (1) ◽  
pp. 153-160 ◽  
Author(s):  
Natale Quartuccio ◽  
Josef Fox ◽  
Deborah Kuk ◽  
Leonard H. Wexler ◽  
Sergio Baldari ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Diagnostic Performance ◽  
Bone Sarcoma ◽  
Conventional Imaging ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Initial Staging

Fusion of Metabolic Function and Morphology: Sequential [18F]Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Studies Yield New Insights Into the Natural History of Bone Metastases in Breast Cancer

2007 ◽  
Vol 25 (23) ◽  
pp. 3440-3447 ◽  
Author(s):  
Yong Du ◽  
Ian Cullum ◽  
Tim M. Illidge ◽  
Peter J. Ell
Keyword(s):  
Bone Metastases ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Mixed Pattern ◽  
Fdg Pet Ct ◽  
Morphology Changes

Purpose By monitoring bone metastases with sequential [18F]fluorodeoxyglucose positron-emission tomography/computed tomography ([18F]FDG-PET/CT) imaging, this study investigates the clinical relevance of [18F]FDG uptake features of bone metastases with various radiographic appearances. Patients and Methods Bone metastases were found in 67 of 408 consecutive patients with known/suspected recurrent breast cancer on [18F]FDG-PET/CT, characterized by CT morphology changes and/or bony [18F]FDG uptake. Twenty-five of the patients had sequential [18F]FDG-PET/CT examinations (86 studies) over an average follow-up period of 23 months. The temporal changes in [18F]FDG uptake and corresponding CT morphology features of 146 bone lesions identified in these 25 patients were followed up and correlated with therapeutic outcome retrospectively. Results The 146 lesions were classified as osteolytic (77), osteoblastic (41), mixed-pattern (11), or no change/negative (17) on CT. The majority of the osteolytic (72; 93.5%) and mixed-pattern lesions (nine; 81.8%), but fewer of the osteoblastic lesions (25; 61%), showed increased [18F]FDG uptake. After treatment, 58 osteolytic lesions (80.5%) became [18F]FDG negative and osteoblastic on CT and only 14 relatively large lesions (19.5%) remained [18F]FDG avid. Of the 25 [18F]FDG-avid osteoblastic lesions, 13 (52%) became [18F]FDG negative, but 12 (48%) remained [18F]FDG avid and increased in size on CT. Five of the mixed-pattern lesions remained [18F]FDG avid after treatment. All 17 CT-negative lesions became [18F]FDG negative; however, nine of them became osteoblastic. None of the initially [18F]FDG-negative lesions showed [18F]FDG avidity during follow-up. Conclusion [18F]FDG uptake reflects the immediate tumor activity of bone metastases, whereas the radiographic morphology changes vary greatly with time among patients.

scholarly journals Prediction of the aggressiveness of non-functional pancreatic neuroendocrine tumors based on the dual-tracer PET/CT

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Susanna Majala ◽  
Hanna Seppänen ◽  
Jukka Kemppainen ◽  
Jari Sundström ◽  
Camilla Schalin-Jäntti ◽  
...  
Keyword(s):  
Pet Imaging ◽  
Fdg Pet ◽  
Tumor Grade ◽  
Pancreatic Neuroendocrine Tumors ◽  
Ki 67 ◽  
Pet Ct ◽  
Well Differentiated ◽  
Fdg Pet Ct ◽  
Dual Tracer

Abstract Background Predicting the aggressive behavior of non-functional pancreatic neuroendocrine tumors (NF-PNET) remains controversial. We wanted to explore, in a prospective setting, whether the diagnostic accuracy can be improved by dual-tracer functional imaging 68Ga-DOTANOC and 18F-FDG-PET/CT in patients with NF-PNETs. Methods Thirty-one patients with NF-PNET (90% asymptomatic) underwent PET-imaging with 18F-FDG and 68Ga-DOTANOC, followed by surgery (n = 20), an endoscopic ultrasonography and fine-needle biopsy (n = 2) or follow-up (n = 9). A focal activity on PET/CT greater than the background that could not be identified as physiological activity was considered to indicate tumor tissue. The imaging results were compared to histopathology. The mean follow-up time was 31.3 months. Results Thirty-one patients presented a total of 53 lesions (40 histologically confirmed) on PET/CT. Thirty patients had a 68Ga-DOTANOC-positive tumor (sensitivity 97%) and 10 patients had an 18F-FDG-positive tumor. In addition, one 68Ga-DOTANOC-negative patient was 18F-FDG-positive. 18F-FDG-PET/CT was positive in 19% (3/16) of the G1 tumors, 63% (5/8) of the G2 tumors and 1/1 of the well-differentiated G3 tumor. 68Ga-DOTANOC-PET/CT was positive in 94% of the G1 tumors, 100% of the G2 tumors and 1/1 of the well-differentiated G3 tumor. Two out of six (33%) of the patients with lymph node metastases (LN+) were 18F-FDG-positive. The 18F-FDG-PET/CT correlated with tumor Ki-67 (P = 0.021). Further, the Krenning score correlated with tumor Ki-67 (P = 0.013). 18F-FDG-positive tumors were significantly larger than the 18F-FDG-negative tumors (P = 0.012). 18F-FDG-PET/CT showed a positive predictive value of 78% in the detection of potentially aggressive tumors (G2, G3, or LN + PNETs); the negative predictive value was 69%. Conclusions 18F-FDG-PET/CT is useful to predict tumor grade but not the LN+ of NF-PNETs. Patients with 18F-FDG-avid NF-PNETs should be referred for surgery. The 68Ga-DOTANOC-PET/CT also has prognostic value since the Krenning score predicts the histopathological tumor grade. Trial registration The study has been registered at ClinicalTrials.gov; Non-functional Pancreatic NET and PET imaging, NCT02621541.

Usefulness of Positron Emission Tomography Using 18F-FDG Performed At Diagnosis and During Initial Chemotherapy for Imaging Primary Central Nervous System Lymphoma: A 24 Immunocompetent patient's Study.

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1597-1597 ◽  
Author(s):  
Herve Ghesquieres ◽  
Céline Ferlay ◽  
Bertrand Richioud ◽  
Vanina Isnardi ◽  
Emmanuelle Nicolas-Virlizier ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Central Nervous System Lymphoma ◽  
Emission Tomography ◽  
Positron Emission ◽  
Systemic Spread ◽  
Pet Ct ◽  
The Mean ◽  
Fdg Pet Ct

Abstract Abstract 1597 Background: Primary central nervous system lymphoma (PCNSL) is a rare brain tumor potentially curable by chemotherapy alone or a combination of chemotherapy and radiation therapy. At staging, gadolinium-enhanced magnetic resonance imaging (MRI) is the standard method to evaluate CNS lesions and computed tomography (CT) is perform at diagnosis to detect the presence of a systemic disease. The initial tumor response to therapy is usually assessed by MRI. At present, there are no established imaging markers of prognosis in patients with PCNSL. Positron emission tomography (PET) using 18F-Fluorodeoxyglucose (FDG) is routinely used for the initial staging and the evaluation of treatment response in systemic Diffuse Large B-cell Lymphoma (DLBCL). In PCNSL, the clinical relevance of positron emission tomography FDG PET/CT is not well known. The aim of our study was to determine the added value of FDG PET/CT in the management of PCNSL performed at diagnosis and during initial treatment to assess whether it could predict the outcome of PCNSL patients. Patients and methods: From august 2008 to may 2011, we enrolled 24 consecutive PCNSL immunocompetent patients with histological proven DLBCL who underwent FDG PET/CT before specific treatment. The mean age of patients was 63.7 years (range, 51.7–78.8). Follow-up FDG PET/CT examinations were performed in 14 of them (58%) after 2 cycles of chemotherapy and in patients who relapsed. All PET images were acquired 1 hour after FDG injection and interpreted qualitatively and semi quantitatively by 2 nuclear medicine physician. The maximum standard uptake value (maxSUV) corrected to body weight and injected FDG activity was measured for each patient into the most hypermetabolic CNS lesion (TmaxSUV). The results were compared to the clinical and conventional imaging data. The correlation between TmaxSUV and respectively the Progression Free Survival (PFS) and Overall Survival (OS) was statistically analysed. We also evaluated for 15 patients, the correlation between the Ki67 index on tumors and TmaxSUV. Results: All the patients presented with brain lesions. The spinal cord was also involved in 1 of them. The sensitivity of FDG PET/CT for the detection of CNS lesions was 91.7 %. Two out of 24 patients were considered as false negative. The mean TmaxSUV was 13.9 +/− 9.3 (range, 4.9–38). FDG PET/CT found systemic spread of lymphoma in 2 patients (8.3%). Follow-up ranged from 3.2 to 33.8 months (mean, 20.6 months). After 2 cycles of chemotherapy, FDG PET/CT was considered as negative in 14/14 patients whereas gadolinium-enhanced MRI showed lesions with residual contrast-enhancement in 7 of them. Four patients who were PET- and MRI + after 2 cycles of chemotherapy relapsed exclusively into the CNS (n=2) and/or outside (n=2). FDG PET/CT showed all the sites of relapse. At last follow-up, 18 patients were alive and six died of progressive disease. No correlation between TmaxSUV at diagnosis and PFS (P =.15), OS (P =.14) and Ki67 index was respectively observed. Conclusions: Although the physiologic glucose metabolism in normal brain tissue is high, FDG PET/CT has a good sensitivity to detect PCNSL. FDG PET/CT could be useful to detect any systemic spread of PCNSL at staging and is able to diagnose disease relapse. Pretreatment Tmax SUV is not correlated with PFS and OS in our study. Moreover, FDG PET/CT seems not to be reliable for the prediction of relapse when it is performed after 2 cycles of chemotherapy. Others type of TEP tracers need to be study in PCNSL for response assessment and the prediction of patient's outcome. Disclosures: No relevant conflicts of interest to declare.

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