Relevance of Brain 18F-FDG PET Imaging in Probable Seronegative Encephalitis With Catatonia: A Case Report

Autoimmune encephalitis (AIE) is a rare, severe, and rapidly progressive encephalopathy, and its diagnosis is challenging, especially in adolescent populations when the presentation is mainly psychiatric. Currently, cerebral 18-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) imaging is not included in the diagnosis algorithm. We describe a 16-year-old patient with probable seronegative encephalitis with catatonia for which several cerebral PET scans were relevant and helpful for diagnosis, treatment decision making, and follow-up monitoring. The patient recovered after 2 years of treatment with etiologic treatment of AIE and treatment of catatonia. This case suggests a more systematic assessment of the clinical relevance of 18F-FDG-PET imaging in probable seronegative AIE.

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Fluorodesoxyglucose uptake in the remaining adrenal glands during the follow-up of patients with adrenocortical carcinoma: do not consider it as malignancy

Acta Endocrinologica ◽

10.1530/eje-10-0666 ◽

2011 ◽

Vol 164 (1) ◽

pp. 89-94 ◽

Cited By ~ 15

Author(s):

S Leboulleux ◽

D Deandreis ◽

C Escourrou ◽

A Al Ghuzlan ◽

F Bidault ◽

...

Keyword(s):

Adrenocortical Carcinoma ◽

Fdg Pet ◽

Adrenal Glands ◽

Single Centre ◽

Adrenal Cancer ◽

Fdg Uptake ◽

Positron Emission ◽

Computed Tomography Scans ◽

Pet Scans

ObjectiveTo make the specificity of fluorodesoxyglucose (18FDG) positron emission tomography (PET) precise, in the follow-up of patients with adrenal cancer.DesignThis single centre retrospective study assessed the frequency and outcome of 18FDG uptake in the remaining adrenal glands after adrenalectomy for adrenocortical carcinoma (ACC) or malignant phaeochromocytoma (PH).ResultsTwo hundred and ten 18FDG PET scans in 62 ACC patients, all under 1,ortho-1,para′-dichloro-diphenyl-dichloro-ethane (o,p′-DDD) treatment, and 30 18FDG PET scans in 8 PH patients were reviewed. Abnormal 18FDG uptake in the remaining adrenal glands was found in 19 (8%) 18FDG PET scans, in 10 (16%) ACC patients and in none of the PH patients. 18FDG uptake was found in 4% of the patients before the onset of o,p′-DDD, in 29% of the patients 0–6 months after the onset of o,p′-DDD (P=0.05), in 26% of the patients 6–12 months (P=0.072) after the onset of o,p′-DDD and in 14% of the patients 12–24 months after the onset of o,p′-DDD. It was never found later than 24 months after the onset of o,p′-DDD. Adrenal glands with 18FDG uptake were normal on computed tomography scans with i.v. contrast agent in all cases. 18FDG uptake in the remaining adrenal glands decreased and disappeared on subsequent FDG PET imaging in eight of the patients with follow-up available.Conclusions18FDG uptake in the remaining adrenal glands occurred in 14–29% of the patients followed for ACC within 24 months after adrenalectomy and onset of o,p′-DDD. This uptake is transient and should not be considered as suspicious for malignancy.

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An appraisal of 18F-FDG PET imaging in post-therapy surveillance of uterine cancers: Clinical evidence and a research proposal

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200303000-00022 ◽

2003 ◽

Vol 13 (2) ◽

pp. 228-233 ◽

Cited By ~ 4

Author(s):

T. Belhocine

Keyword(s):

Pet Imaging ◽

Fdg Pet ◽

Combined Therapy ◽

Metabolic Imaging ◽

Asymptomatic Patients ◽

Positron Emission ◽

Previously Treated ◽

Uterine Cancers ◽

Post Therapy

Despite important advances in screening for preinvasive forms of uterine cancers and more efficient combined therapy modalities, the surveillance of women previously treated either for a cervical or an endometrial cancer remains problematic. The follow-up protocols commonly applied in practice usually include a physical examination at control visits and clinically oriented morphologic imaging procedures. These routine protocols are, however, not standardized. Moreover, their sensitivity for accurately detecting a recurrent disease is most often suboptimal, especially in asymptomatic patients. On the other hand, the performances of a high-technology imaging such as positron emission tomography (PET) using 18F-fluoro-2-deoxy-D-glucose (18FDG) are nowadays firmly established in the post-treatment monitoring of oncology patients. The purpose of the present paper is to review both the advantages and the limitations of 18FDG PET imaging in the surveillance of women previously treated for uterine cancers. Based on the encouraging literature data, a well-designed research protocol is proposed in order to more objectively assess the contribution of metabolic imaging in the post-therapy management of these gynecological malignancies.

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FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma

Blood ◽

10.1182/blood-2005-06-2252 ◽

2006 ◽

Vol 107 (1) ◽

pp. 52-59 ◽

Cited By ~ 507

Author(s):

Martin Hutchings ◽

Annika Loft ◽

Mads Hansen ◽

Lars Møller Pedersen ◽

Thora Buhl ◽

...

Keyword(s):

Prognostic Factors ◽

Hodgkin Lymphoma ◽

Fdg Pet ◽

Progression Free Survival ◽

Free Survival ◽

Positron Emission ◽

Lymphoma Treatment ◽

Extranodal Disease ◽

Pet Scans

Abstract Risk-adapted lymphoma treatment requires early and accurate assessment of prognosis. This investigation prospectively assessed the value of positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET) after two cycles of chemotherapy for prediction of progression-free survival (PFS) and overall survival (OS) in Hodgkin lymphoma (HL). Seventy-seven consecutive, newly diagnosed patients underwent FDG-PET at staging, after two and four cycles of chemotherapy, and after completion of chemotherapy. Median follow-up was 23 months. After two cycles of chemotherapy, 61 patients had negative FDG-PET scans and 16 patients had positive scans. Eleven of 16 FDG-PET–positive patients progressed and 2 died. Three of 61 FDG-PET–negative patients progressed; all were alive at latest follow-up. Survival analyses showed strong associations between early FDG-PET after two cycles and PFS (P < .001) and OS (P < .01). For prediction of PFS, interim FDG-PET was as accurate after two cycles as later during treatment and superior to computerized tomography (CT) at all times. In regression analyses, early interim FDG-PET was stronger than established prognostic factors. Other significant prognostic factors were stage and extranodal disease. Early interim FDG-PET is a strong and independent predictor of PFS in HL. A positive early interim FDG-PET is highly predictive of progression in patients with advanced-stage or extranodal disease.

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FDG-Positron Emission Tomography in T-Cell Lymphoma

Blood ◽

10.1182/blood.v118.21.1614.1614 ◽

2011 ◽

Vol 118 (21) ◽

pp. 1614-1614

Author(s):

Chiara Rusconi ◽

Cristina Gabutti ◽

Vittorio Ruggero Zilioli ◽

Erika Meli ◽

Maddalena Mazzucchelli ◽

...

Keyword(s):

T Cell ◽

Fdg Pet ◽

Cell Lymphoma ◽

Clinical Stage ◽

T Cell Lymphoma ◽

Emission Tomography ◽

Positron Emission ◽

Pet Scans

Abstract Abstract 1614 Background: Few data are available on the role of fluoro-deoxy-glucose positron emission tomography (FDG-PET) in T-cell non Hodgkin Lymphoma (NHL). We compared standard contrast-enhanced computerized tomography (CECT) and FDG-PET for initial staging and restaging after treatment in T-cell NHL. Methods: We reviewed 58 FDG-PET scans performed in 29 patients (pts) affected by T-cell NHL and we focused on the 42 cases for which a simultaneous standard CECT was available for comparison. The specific T-cell histology was Peripheral T-Cell Lymphoma Not Otherwise Specified in 12 pts, Angioimmunoblastic T-Cell Lymphoma in 4 pts, Anaplastic Large Cell Lymphoma in 10 pts, other T-NHL hystologies in 3 pts. Twelve pts were males and median age at diagnosis was 57 years (range: 25–77). Baseline FDG-PET scans were 20, while FDG-PET performed for disease reassessment were 22. Results: FDG-PET performed at baseline was positive in all cases. In 6 cases (30%) FDG-PET identified fewer disease sites than CECT, while in 14 cases (70%) FDG-PET identified additional disease sites. New sites identified by FDG-PET were: other nodal sites (11 pts), spleen (2 pts), nasopharynx (1 pt) and testicles (1 pt). Different disease extent evaluation according to FDG-PET modified clinical stage in 10 pts (50%): one pt was downstaged and 9 pts were upstaged. FDG-PET-based stage was not considered for therapeutic decision. FDG-PET scans performed at restaging were negative in 16 cases (72%) and positive in the remaining 6 cases (28%). In 13/16 (81%) negative cases CECT was concordant and showed a complete remission, while in the remaining 3 cases CECT showed a residual nodal disease. In the 6 FDG-PET positive cases, CECT was as follows: abnormal in the same site of FDG-PET in 1 case, abnormal in fewer sites than FDG-PET in 3 cases and abnormal in more sites than FDG-PET in 2 cases. With a median follow-up of 32 months, the median overall survival (OS) of the 6 positive FDG-PET cases at restaging was 26 months. With a median follow-up of 23 months, the median OS of the 16 negative FDG-PET cases at restaging was not reached. Conclusion: FDG-PET can be useful in the initial staging of T-cell NHL, since it can allow a more accurate disease extension evaluation: in our experience it could identify additional sites, both nodal and extra-nodal, in 70% of pts. A change in clinical stage according to FDG-PET was observed in 50% of cases, with an upstaging in the majority of pts. We could confirm the high sensitivity of baseline FDG-PET in T-cell NHL. A high level of concordance was observed between PET and CECT at restaging. However, independently on CECT result, the worse OS of FDG-PET positive cases confirms the role of FDG-PET as prognostic factor for survival. Larger prospective trials are needed to confirm the utility of FDG-PET in baseline staging, reassessment after chemotherapy and treatment planning. Disclosures: No relevant conflicts of interest to declare.

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Predictive Impact of 2-18Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography for Residual Postchemotherapy Masses in Patients With Bulky Seminoma

Journal of Clinical Oncology ◽

10.1200/jco.2001.19.17.3740 ◽

2001 ◽

Vol 19 (17) ◽

pp. 3740-3744 ◽

Cited By ~ 101

Author(s):

Maria De Santis ◽

Carsten Bokemeyer ◽

Alexander Becherer ◽

Franz Stoiber ◽

Karin Oechsle ◽

...

Keyword(s):

Positron Emission Tomography ◽

Fdg Pet ◽

Tumor Tissue ◽

Emission Tomography ◽

Viable Tumor ◽

Positron Emission ◽

Viable Tumor Tissue ◽

Pet Scans ◽

Residual Lesions

PURPOSE: To establish the predictive potential of 2-18fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) for detecting viable tumor tissue in residual postchemotherapy masses of seminoma patients. PATIENTS AND METHODS: In this prospective multicenter trial, results of FDG PET studies in seminoma patients with postchemotherapy masses ≥ 1 cm were correlated with either the histology of the resected lesion or the clinical outcome on follow-up without resection. Negative PET scans of residual lesions that were devoid of viable tumor tissue on resection or disappeared, shrunk, or remained stable in size for at least 2 years were rated as true-negative (TN). Positive scans without histologic or clinical evidence of tumor tissue were classified as false-positive. In patients with histologically positive or progressive lesions, positive PET scans were defined as true-positive (TP) and negative scans, false-negative (FN). RESULTS: Thirty-seven PET scans of 33 patients were assessable at a median follow-up time of 23 months (range, 2 to 46 months). Histologic data were available from nine patients who had undergone resection. Twenty-eight patients were followed-up clinically and radiologically. Twenty-eight scans were TN, eight were TP, and one was FN. All 14 residual lesions more than 3 cm and 22 (96%) of the 23 ≤ 3 cm were correctly predicted by FDG PET. The specificity (100%; 95% confidence interval [CI], 87.7% to 100%), sensitivity (89%; 95% CI, 51.7% to 99.7%), positive predictive value (100%), and the negative predictive value (97%) of FDG PET were superior to data obtained by assessing residual tumor size (≤ or > 3 cm). CONCLUSION: FDG PET is a clinically useful predictor of viable tumor in postchemotherapy residuals of pure seminoma, especially those greater than 3 cm.

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[18F]Fluorodeoxyglucose Positron Emission Tomography for Detection of Bone Marrow Involvement in Children and Adolescents With Hodgkin's Lymphoma

Journal of Clinical Oncology ◽

10.1200/jco.2010.32.4996 ◽

2011 ◽

Vol 29 (26) ◽

pp. 3523-3528 ◽

Cited By ~ 73

Author(s):

Sandra Purz ◽

Christine Mauz-Körholz ◽

Dieter Körholz ◽

Dirk Hasenclever ◽

Antje Krausse ◽

...

Keyword(s):

Positron Emission Tomography ◽

Bone Marrow ◽

Fdg Pet ◽

Emission Tomography ◽

Fluorodeoxyglucose Positron Emission Tomography ◽

Positron Emission ◽

Pet Scans ◽

Initial Staging ◽

Fluorodeoxyglucose Positron Emission

Purpose Currently, a routine bone marrow biopsy (BMB) is performed to detect bone marrow (BM) involvement in pediatric Hodgkin's lymphoma (HL) stage greater than IIA. [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) is increasingly used for the initial staging of HL. The value of using FDG-PET to detect BM involvement has not been sufficiently defined. We compared the results of BMBs and FDG-PET for the diagnosis of BM involvement in a large pediatric group with HL. Patients and Methods The initial staging of 175 pediatric patients with newly diagnosed classical HL stage greater than IIA was determined by using BMB, FDG-PET, chest computed tomography (CT), and magnetic resonance imaging (MRI) or CT of the neck, abdomen, and pelvis. Staging images were prospectively evaluated by a central review board. Skeletal regions that were suggestive of BM involvement by either method were re-evaluated by using different imaging modalities. In suspicious cases, bone scintigraphy was performed. If follow-up FDG-PET scans were available, the remission of skeletal lesions during treatment was evaluated. Results BMB results were positive in seven of 175 patients and were identified by FDG-PET. FDG-PET scans showed BM involvement in 45 patients. In addition, the lesions of 32 of these 45 patients had a typical multifocal pattern. In 38 of 39 follow-up positron emission tomography scans, most of the skeletal lesions disappeared after chemotherapy. There was no patient with skeletal findings suggestive of BM involvement by MRI or CT with a negative FDG-PET. Conclusion FDG-PET is a sensitive and specific method for the detection of BM involvement in pediatric HL. The sensitivity of a BMB appears compromised by the focal pattern of BM involvement. Thus, FDG-PET may safely be substituted for a BMB in routine staging procedures.

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

Frontiers in Oncology ◽

10.3389/fonc.2021.714948 ◽

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.

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Brain FDG PET for the Etiological Diagnosis of Clinically Uncertain Cognitive Impairment During Delirium in Remission

Journal of Alzheimer s Disease ◽

10.3233/jad-200530 ◽

2020 ◽

Vol 77 (4) ◽

pp. 1609-1622

Author(s):

Franziska Mathies ◽

Catharina Lange ◽

Anja Mäurer ◽

Ivayla Apostolova ◽

Susanne Klutmann ◽

...

Keyword(s):

Cognitive Impairment ◽

Fdg Pet ◽

False Negative ◽

Ground Truth ◽

Etiological Diagnosis ◽

Geriatric Unit ◽

Positron Emission ◽

The Brain ◽

Hospitalized Geriatric Patients

Background: Positron emission tomography (PET) of the brain with 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG) is widely used for the etiological diagnosis of clinically uncertain cognitive impairment (CUCI). Acute full-blown delirium can cause reversible alterations of FDG uptake that mimic neurodegenerative disease. Objective: This study tested whether delirium in remission affects the performance of FDG PET for differentiation between neurodegenerative and non-neurodegenerative etiology of CUCI. Methods: The study included 88 patients (82.0±5.7 y) with newly detected CUCI during hospitalization in a geriatric unit. Twenty-seven (31%) of the patients were diagnosed with delirium during their current hospital stay, which, however, at time of enrollment was in remission so that delirium was not considered the primary cause of the CUCI. Cases were categorized as neurodegenerative or non-neurodegenerative etiology based on visual inspection of FDG PET. The diagnosis at clinical follow-up after ≥12 months served as ground truth to evaluate the diagnostic performance of FDG PET. Results: FDG PET was categorized as neurodegenerative in 51 (58%) of the patients. Follow-up after 16±3 months was obtained in 68 (77%) of the patients. The clinical follow-up diagnosis confirmed the FDG PET-based categorization in 60 patients (88%, 4 false negative and 4 false positive cases with respect to detection of neurodegeneration). The fraction of correct PET-based categorization did not differ between patients with delirium in remission and patients without delirium (86% versus 89%, p = 0.666). Conclusion: Brain FDG PET is useful for the etiological diagnosis of CUCI in hospitalized geriatric patients, as well as in patients with delirium in remission.

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