scholarly journals A Review on the Value of Imaging in Differentiating between Large Vessel Vasculitis and Atherosclerosis

2021 ◽  
Vol 11 (3) ◽  
pp. 236
Author(s):  
Pieter H. Nienhuis ◽  
Gijs D. van Praagh ◽  
Andor W. J. M. Glaudemans ◽  
Elisabeth Brouwer ◽  
Riemer H. J. A. Slart
Keyword(s):  
Fdg Pet ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Current Evidence ◽  
Future Directions ◽  
Inflammatory Conditions ◽  
Positron Emission ◽  
Magnetic Resonance Imaging Mri ◽  
Review Reports ◽  
Ct Studies

Imaging is becoming increasingly important for the diagnosis of large vessel vasculitis (LVV). Atherosclerosis may be difficult to distinguish from LVV on imaging as both are inflammatory conditions of the arterial wall. Differentiating atherosclerosis from LVV is important to enable optimal diagnosis, risk assessment, and tailored treatment at a patient level. This paper reviews the current evidence of ultrasound (US), 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET), computed tomography (CT), and magnetic resonance imaging (MRI) to distinguish LVV from atherosclerosis. In this review, we identified a total of eight studies comparing LVV patients to atherosclerosis patients using imaging—four US studies, two FDG-PET studies, and two CT studies. The included studies mostly applied different methodologies and outcome parameters to investigate vessel wall inflammation. This review reports the currently available evidence and provides recommendations on further methodological standardization methods and future directions for research.

Effect of Treatment on Imaging, Clinical, and Serologic Assessments of Disease Activity in Large-vessel Vasculitis

2019 ◽  
Vol 47 (1) ◽  
pp. 99-107 ◽  
Author(s):  
Shubhasree Banerjee ◽  
Kaitlin A. Quinn ◽  
K. Bates Gribbons ◽  
Joel S. Rosenblum ◽  
Ali Cahid Civelek ◽  
...  
Keyword(s):  
Disease Activity ◽  
Fdg Pet ◽  
Randomized Clinical Trials ◽  
Large Vessel Vasculitis ◽  
Vascular Imaging ◽  
Large Vessel ◽  
Reactive Protein ◽  
Positron Emission ◽  
Observational Cohort ◽  
Effect Of Treatment

Objective.Disease activity in large-vessel vasculitis (LVV) is traditionally assessed by clinical and serological variables rather than vascular imaging. This study determined the effect of treatment on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) vascular activity in relation to clinical- and serologic-based assessments.Methods.Patients with giant cell arteritis (GCA) or Takayasu arteritis (TA) were prospectively evaluated at 6-month intervals in an observational cohort. Treatment changes were made at least 3 months before the followup visit and categorized as increased, decreased, or unchanged. Imaging (FDG-PET qualitative analysis), clinical, and serologic (erythrocyte sedimentation rate, C-reactive protein) assessments were determined at each visit and compared over interval visits.Results.Serial assessments were performed in 52 patients with LVV (GCA = 31; TA = 21) over 156 visits. Increased, decreased, or unchanged therapy was recorded for 36-, 23-, and 32-visit intervals, respectively. When treatment was increased, there was significant reduction in disease activity by imaging, clinical, and inflammatory markers (p ≤ 0.01 for each). When treatment was unchanged, all 3 assessments of disease activity remained similarly unchanged over 6-month intervals. When treatment was reduced, PET activity significantly worsened (p = 0.02) but clinical and serologic activity did not significantly change. Treatment of GCA with tocilizumab and of TA with tumor necrosis factor inhibitors resulted in significant improvement in imaging and clinical assessments of disease activity, but only rarely did the assessments both become normal.Conclusion.In addition to clinical and serologic assessments, vascular imaging has potential to monitor disease activity in LVV and should be tested as an outcome measure in randomized clinical trials.

FDG-PET/CT Assessment of Pulmonary Sarcoidosis: A Guide for Internists

2018 ◽  
Vol 15 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Marco Tana ◽  
Silvio di Carlo ◽  
Marcello Romano ◽  
Massimo Alessandri ◽  
Cosima Schiavone ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Fdg Pet ◽  
Correct Diagnosis ◽  
Pulmonary Sarcoidosis ◽  
High Resolution Computed Tomography ◽  
Inflammatory Conditions ◽  
Positron Emission ◽  
Pet Ct ◽  
Noncaseating Granulomas ◽  
Fdg Pet Ct

Background:18F-fluorodeoxyglucose positron emission tomography integrated with computed tomography (18-F-FDG-PET/CT) is getting wide consensus in the diagnosis and staging of neoplastic disorders and represents a useful tool in the assessment of various inflammatory conditions. </P><P> Discussion: Sarcoidosis is an uncommon disease characterized by the systemic formation of noncaseating granulomas. Lungs are the sites most often affected, and investigation with high resolution computed tomography and biopsy is essential to achieve a correct diagnosis. 18-F-FDGPET/ CT is effective in the assessment of pulmonary sarcoidosis by demonstrating pulmonary and extrathoracic involvement and findings correlate well with pulmonary function in patients affected.Conclusion:This review would illustrate the usefulness and limits of 18-F-FDG-PET/CT in the assessment of pulmonary sarcoidosis.

Diagnostic accuracy of 18F-FDG PET or PET/CT for large vessel vasculitis

2015 ◽  
Vol 75 (9) ◽  
pp. 924-931 ◽  
Author(s):  
Y.H. Lee ◽  
S.J. Choi ◽  
J.D. Ji ◽  
G.G. Song
Keyword(s):  
Diagnostic Accuracy ◽  
Fdg Pet ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Pet Ct ◽  
18F Fdg

scholarly journals Clinical and Pathological Evidence of Anti-GD2 Immunotherapy Induced Differentiation in Relapsed/Refractory High-Risk Neuroblastoma

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1264
Author(s):  
Jaume Mora ◽  
Alicia Castañeda ◽  
Maria Cecilia Colombo ◽  
Maite Gorostegui ◽  
Fernando Gomez ◽  
...  
Keyword(s):  
High Risk ◽  
Fdg Pet ◽  
Current Therapy ◽  
Bone Lesions ◽  
Functional Magnetic Resonance ◽  
Positron Emission ◽  
Apparent Diffusion ◽  
Neuroblastic Tumors ◽  
Direct Cell ◽  
Magnetic Resonance Imaging Mri

Background: Neuroblastic tumors (NBTs) originate from a block in the process of differentiation. Histologically, NBTs are classified in neuroblastoma (NB), ganglioneuroblastoma (GNB), and ganglioneuroma (GN). Current therapy for high-risk (HR) NB includes chemotherapy, surgery, radiotherapy, and anti-GD2 monoclonal antibodies (mAbs). Anti-GD2 mAbs induce immunological cytoxicity but also direct cell death. Methods: We report on patients treated with naxitamab for chemorefractory NB showing lesions with long periods of stable disease. Target lesions with persisting 123I-Metaiodobenzylguanidine (MIBG) uptake after 4 cycles of immunotherapy were further evaluated by functional Magnetic Resonance Imaging (MRI) and/or Fluorodeoxyglucose (FDG)-positron emission tomography (PET). MIBG avid lesions that became non-restrictive on MRI (apparent diffusion coefficient (ADC) > 1) and/or FDG-PET negative (SUV < 2) were biopsied. Results: Twenty-seven relapse/refractory (R/R) HR-NB patients were enrolled on protocol Ymabs 201. Two (7.5%) of the 27 showed persistent bone lesions on MIBG, ADC high, and/or FDG-PET negative. Forty-four R/R HR-NB patients received chemo-immunotherapy. Twelve (27%) of the 44 developed persistent MIBG+ but FDG-PET- and/or high ADC lesions. Twelve (86%) of the 14 cases identified were successfully biopsied producing 16 evaluable samples. Histology showed ganglioneuroma maturing subtype in 6 (37.5%); ganglioneuroma mature subtype with no neuroblastic component in 4 (25%); differentiating NB with no Schwannian stroma in 5 (31%); and undifferentiated NB without Schwannian stroma in one (6%). Overall, 10 (62.5%) of the 16 specimens were histopathologically fully mature NBTs. Conclusions: Our results disclose an undescribed mechanism of action for naxitamab and highlight the limitations of conventional imaging in the evaluation of anti-GD2 immunotherapy clinical efficacy for HR-NB.

scholarly journals Cervical Cancer: Associations between Metabolic Parameters and Whole Lesion Histogram Analysis Derived from Simultaneous 18F-FDG-PET/MRI

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Hans-Jonas Meyer ◽  
Sandra Purz ◽  
Osama Sabri ◽  
Alexey Surov
Keyword(s):  
Cervical Cancer ◽  
Fdg Pet ◽  
Metabolic Tumor Volume ◽  
Total Lesion Glycolysis ◽  
Histogram Analysis ◽  
Whole Body ◽  
Standardized Uptake Values ◽  
Positron Emission ◽  
18F Fdg ◽  
Magnetic Resonance Imaging Mri

Multimodal imaging has been increasingly used in oncology, especially in cervical cancer. By using a simultaneous positron emission (PET) and magnetic resonance imaging (MRI, PET/MRI) approach, PET and MRI can be obtained at the same time which minimizes motion artefacts and allows an exact imaging fusion, which is especially important in anatomically complex regions like the pelvis. The associations between functional parameters from MRI and 18F-FDG-PET reflecting different tumor aspects are complex with inconclusive results in cervical cancer. The present study correlates histogram analysis and 18F-FDG-PET parameters derived from simultaneous FDG-PET/MRI in cervical cancer. Overall, 18 female patients (age range: 32–79 years) with histopathologically confirmed squamous cell cervical carcinoma were retrospectively enrolled. All 18 patients underwent a whole-body simultaneous 18F-FDG-PET/MRI, including diffusion-weighted imaging (DWI) using b-values 0 and 1000 s/mm2. Apparent diffusion coefficient (ADC) histogram parameters included several percentiles, mean, min, max, mode, median, skewness, kurtosis, and entropy. Furthermore, mean and maximum standardized uptake values (SUVmean and SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were estimated. No statistically significant correlations were observed between SUVmax or SUVmean and ADC histogram parameters. TLG correlated inversely with p25 (r=−0.486,P=0.041), p75 (r=−0.490,P=0.039), p90 (r=−0.513,P=0.029), ADC median (r=−0.497,P=0.036), and ADC mode (r=−0.546,P=0.019). MTV also showed significant correlations with several ADC parameters: mean (r=−0.546,P=0.019), p10 (r=−0.473,P=0.047), p25 (r=−0.569,P=0.014), p75 (r=−0.576,P=0.012), p90 (r=−0.585,P=0.011), ADC median (r=−0.577,P=0.012), and ADC mode (r=−0.597,P=0.009). ADC histogram analysis and volume-based metabolic 18F-FDG-PET parameters are related to each other in cervical cancer.

FRI0262 The Role of 18F-FDG-PET/CT in the Diagnosis and Follow-Up of Large Vessel Vasculitis

2015 ◽  
Vol 74 (Suppl 2) ◽  
pp. 519.2-519
Author(s):  
G. Pazzola ◽  
M. Casali ◽  
F. Muratore ◽  
N. Pipitone ◽  
L. Boiardi ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals The role of 18F-FDG PET/CT in the management of large-vessel vasculitis: applications and limitations in clinical practice

2012 ◽  
pp. 249-254
Author(s):  
Maria V. Mattoli ◽  
Giorgio Treglia ◽  
Lucia Leccisotti ◽  
Alessandro Giordano
Keyword(s):  
Clinical Practice ◽  
Fdg Pet ◽  
False Negative ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Metabolic Imaging ◽  
Small Vessel Vasculitis ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Introduction: 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) plays a key role in oncology, and it is now being used increasingly to diagnose, characterize, and monitor disease activity in inflammatory disorders, including vasculitis. Unfortunately, its role in the management of vasculitis is still not well-defined, and clinicians are often unsure how this metabolic imaging technique should be used in these diseases, although its usefulness in diagnosing large-vessel vasculitis has been clearly demonstrated. Materials and methods: We reviewed the literature about the use of PET/CT in the management of vasculitis in an attempt to identify the applications and the limitations of this technique in clinical practice. Results and discussion: Our literature review revealed that 18F-FDG PET/CT is a useful tool for diagnosing vasculitis (especially when the symptoms of the disease are non-specific); guiding biopsy procedures (areas with high glucose consumption); evaluating disease extension; and monitoring treatment responses. The main limitations of this method are the relatively low spatial resolution of the tomograph, which can lead to false-negative results in the presence of small-vessel vasculitis, and risk of false positive results, especially those related to the presence of atherosclerosis and to post-treatment vascular remodeling.

Revisional Analysis of Electroencephalography and Magnetoencephalography Based on Comprehensive Epilepsy Conference

2020 ◽  
pp. 191-197
Author(s):  
Nobukazu Nakasato ◽  
Akitake Kanno ◽  
Makoto Ishida ◽  
Shin-ichiro Osawa ◽  
Masaki Iwasaki ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Principal Component ◽  
Clinical Decision ◽  
Case Conference ◽  
Positron Emission ◽  
Source Models ◽  
Magnetic Resonance Imaging Mri ◽  
Spike Analysis ◽  
No Gold Standard ◽  
Analysis Models

This chapter highlights the importance of the revised analysis of electroencephalography (EEG) and magnetoencephalography (MEG) spike source estimation based on comprehensive case conference discussion. It discusses two typical cases of localization-related epilepsy: case 1 as a simple situation and case 2 as a complicated situation. No “gold standard” for epileptic spike analysis in EEG or MEG has been established, so several methods must be adopted to achieve the most reasonable interpretation. However, such intense and revisional analyses may be too time-consuming in clinical settings and result in arbitrary conclusions. Therefore, the authors currently use a simple method first, that is, a single dipole model for the peak or preceding upward slope of unaveraged single spikes. In the following case conference, EEG and MEG data are reviewed with seizure semiology, anatomical magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). If all the findings almost agree, the clinical decision can be easily made. If not, revisional analysis of EEG/MEG is recommended using averaged spikes and principal component analysis models as well as distributed source models. In addition to EEG/MEG, the authors often order revisional analysis and additional MRI and FDG-PET studies after the conference. Even further history taking will be recommended if necessary.

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