scholarly journals Melanom in izolirane metastaze v vranici-prikaz primera in pregled literature

2015 ◽  
Vol 84 (6) ◽  
Author(s):  
Jerica Škedelj ◽  
Ivana Žagar ◽  
Marko Snoj
Keyword(s):  
Fdg Pet ◽  
Malignant Disease ◽  
Imaging Techniques ◽  
Rare Event ◽  
Stage Iv ◽  
Pet Ct ◽  
S 100 ◽  
Fdg Pet Ct

Background. Metastases to the spleen are considered a rare event generally occurring during the late stage of malignant disease. Isolated metastases are even rarely described. In the past years the number of reported cases in literature has risen mainly due to the improvements of the imaging techniques and the use of FDG-PET/CT in the follow-up of the patients with malignant disease. Even though melanoma can disseminate to any organ, metastases to spleen, found during life, are rare. Moreover, proven isolated metastases in the spleen are even seldomly described. Case report. We report a case of 61-year-old man with known skin melanoma treated in our Institute from 2009. During the regular follow up raised values of S-100 marker and isolated lesions in the spleen found on FDG-PET/CT were described. Due to isolated metastatic disease, splenectomy was indicated.Conclusion. Patients with stage IV. melanoma have poor prognosis, the median survival is estimated to six months. According to studies, metastasectomies for isolated metastases in solid organs can significantly improve survival of these patients. In melanoma patients with FDG-PET/CT proven isolated metastases to the spleen, splenectomy can significantly improve their survival and quality of life.  

scholarly journals The Diagnostic Value of18F-FDG PET/CT in Association with Serum Tumor Marker Assays in Breast Cancer Recurrence and Metastasis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ying Dong ◽  
Haifeng Hou ◽  
Chunyan Wang ◽  
Jing Li ◽  
Qiong Yao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fdg Pet ◽  
Imaging Techniques ◽  
Radical Mastectomy ◽  
Serum Levels ◽  
Ca 125 ◽  
Clinical Value ◽  
Pet Ct ◽  
Fdg Pet Ct

Background. After initial treatment of breast cancer (BC), monitoring locoregional recurrence and distant metastases is a great clinical challenge.Objective. To evaluate the efficacy of PET/CT in association with serum tumor makers in BC follow-up.Methods. Twenty-six women with a history of modified radical mastectomy were evaluated by18F-FDG PET/CT. The results of PET/CT were compared with those of conventional imaging techniques (CITs) (including mammography, chest radiography, CT, MRI, ultrasound, and bone scintigraphy). Serum tumor markers of CEA, CA 125, and CA 15-3 in the BC patients were also analyzed in association with the results of PET/CT.Results. Compared with CITs, PET/CT was more sensitive to detect the malignant foci and had better patient-based sensitivity and specificity. The mean CA 15-3 serum level was significantly higher in the confirmed positive patients of PET/CT results than in the confirmed negative ones, while there were no significant differences in the serum levels of CEA and CA 125 of both groups.Conclusion. PET/CT is a highly efficient tool for BC follow-up compared with CITs. The high serum levels of CA 15-3 in confirmed positive PET/CT patients indicated the clinical value of CA 15-3 in BC follow-up.

18F-FDG-PET/CT response assessment in patients with advanced melanoma treated with combination of low-dose ipilimumab and anti-PD1: A real-world experience.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21533-e21533
Author(s):  
Caio Dabbous Liz ◽  
Marcos Rezende Teixeira ◽  
Luciana Beatriz Mendes Gomes Siqueira ◽  
Jose A. Rinck ◽  
Joao Paulo S. N. Lima ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Low Dose ◽  
Stage Iv ◽  
Complete Response ◽  
Advanced Melanoma ◽  
Response Evaluation ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

e21533 Background: Combination therapy with anti-PD1 and low-dose ipilimumab has shown reduced rate of immune-related adverse effects compared with standard dose used in the Checkmates studies 067 and 204. However, the discussion whether low-dose ipilimumab may hamper the response rate in advanced melanoma is still open. Methods: We conducted a retrospective analysis of response evaluation based on 18F-FDG PET/CT for patients with advanced melanoma treated with combination of nivolumab 3mg/kg plus ipilimumab 1mg/kg for 4 cycles (N3+I1) followed by anti-PD1 maintenance therapy and compared the results to RECIST 1.1 response criteria in the same population. Results: Between December 2017 and August 2020, 45 patients with advanced melanoma treated with N3+I1 in first-line setting were identified. Unresectable stage III/stage IV were 2/43 patients, respectively. Among stage IV patients, 60.5% were M1c, 23.3% had elevated LDH and 28% had brain metastasis (3 or more brain lesions: 58%). At a median follow-up of 16.7 months, 11 patients (24.4%) had G3/G4 toxicity. During induction phase, three patients (6.6%) discontinued all drugs and 2 other patients (4.4%) interrupted only ipilimumab. Review of response evaluation by RECIST was possible in 36 patients and showed an objective response of 50%. Complete response (CR): 11% and partial response (PR): 39%. Eight percent presented progressive disease (PD). In 37 patients, review of response evaluation using 18F-FDG PET/CT was possible. Twenty-four patients (65%) achieved metabolic CR, 5 (13.5%) PD and 8 (21.5%) were classified as non-CR non-PD. Median progression-free survival (PFS) and overall survival(OS) were not reached. 12-month PFS and OS were: 72.5 and 89%, respectively. During the study follow-up, only 1 patient with metabolic complete response relapsed and 3 out of 8 with non-CR non-PD progressed. Conclusions: Using low-dose ipilimumab combination does not hamper the response rates and, possibly due to fewer protocol interruptions, these patients may achieve more complete responses as showed by 18F-FDG PET/CT evaluation.

Prediction of lymph node metastase in NSCLC

2010 ◽  
Vol 01 (05) ◽  
pp. 219-226 ◽  
Author(s):  
F. Beyer ◽  
B. Buerke ◽  
J. Gerss ◽  
K. Scheffe ◽  
M. Puesken ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Fdg Pet ◽  
Automatic Segmentation ◽  
Correlation Coefficients ◽  
Mediastinal Lymph Nodes ◽  
Intra Class Correlation ◽  
Axial Diameter ◽  
Pet Ct ◽  
Fdg Pet Ct

SummaryPurpose: To distinguish between benign and malignant mediastinal lymph nodes in patients with NSCLC by comparing 2D and semiautomated 3D measurements in FDG-PET-CT.Patients, material, methods: FDG-PET-CT was performed in 46 patients prior to therapy. 299 mediastinal lymph-nodes were evaluated independently by two radiologists, both manually and by semi-automatic segmentation software. Longest-axial-diameter (LAD), shortest-axial-diameter (SAD), maximal-3D-diameter, elongation and volume were obtained. FDG-PET-CT and clinical/FDG-PET-CT follow up examinations and/or histology served as the reference standard. Statistical analysis encompassed intra-class-correlation-coefficients and receiver-operator-characteristics-curves (ROC). Results: The standard of reference revealed involvement in 87 (29%) of 299 lymph nodes. Manually and semi-automatically measured 2D parameters (LAD and SAD) showed a good correlation with mean

Restaging of patients with lymphoma

2008 ◽  
Vol 47 (01) ◽  
pp. 37-42 ◽  
Author(s):  
T. Pfluger ◽  
V. Schneider ◽  
M. Hacker ◽  
N. Bröckel ◽  
D. Morhard ◽  
...  
Keyword(s):  
Low Dose ◽  
Non Hodgkin Lymphoma ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Significant Difference ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

SummaryAim: Assessment of the clinical benefit of i.v. contrast enhanced diagnostic CT (CE-CT) compared to low dose CT with 20 mAs (LD-CT) without contrast medium in combined [18F]-FDG PET/CT examinations in restaging of patients with lymphoma. Patients, methods: 45 patients with non-Hodgkin lymphoma (n = 35) and Hodgkin's disease (n = 10) were included into this study. PET, LD-CT and CECT were analyzed separately as well as side-by-side. Lymphoma involvement was evaluated separately for seven regions. Indeterminate diagnoses were accepted whenever there was a discrepancy between PET and CT findings. Results for combined reading were calculated by rating indeterminate diagnoses according the suggestions of either CT or PET. Each patient had a clinical follow-up evaluation for >6 months. Results: Region-based evaluation suggested a sensitivity/specificity of 66/93% for LD-CT, 87%/91% for CE-CT, 95%/96% for PET, 94%/99% for PET/LD-CT and 96%/99% for PET/CE-CT. The data for PET/CT were obtained by rating indeterminate results according to the suggestions of PET, which turned out to be superior to CT. Lymphoma staging was changed in two patients using PET/ CE-CT as compared to PET/LD-CT. Conclusion: Overall, there was no significant difference between PET/LD-CT and PET/CE-CT. However, PET/CE-CT yielded a more precise lesion delineation than PET/LD-CT. This was due to the improved image quality of CE-CT and might lead to a more accurate investigation of lymphoma.

Hybrid Imaging in Evaluation of Abdominal Sarcoidosis

2018 ◽  
Vol 15 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Isidora Grozdic Milojevic ◽  
Dragana Sobic-Saranovic ◽  
Nebojsa Petrovic ◽  
Slobodanka Beatovic ◽  
Marijana Tadic ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Therapy Response ◽  
Ct Examination ◽  
Abdominal Disease ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Total Remission ◽  
Active Disease

Objective: To determine the prevalence of abdominal involvement, distribution pattern and evaluate role of hybrid molecular imaging in patients with abdominal sarcoidosis. Methods: Between January 2010 and December 2011, 98 patients with chronic sarcoidosis and presence of prolonged symptoms or other findings suggestive of active disease were referred to FDG PET/CT examination. Active disease was found in 82 patients, and they all were screened for the presence of abdominal sarcoidosis on FDG PET/CT. All patients also underwent MDCT and assessment of serum ACE level. Follow up FDG PET/CT examination was done 12.3±5.4 months after the baseline. Results: Abdominal sarcoidosis was present in 31/82 patients with active sarcoidosis. FDG uptake was present in: retroperitoneal lymph nodes (77%), liver (26%), spleen (23%), adrenal gland (3%). Majority of patients had more than two locations of disease. Usually thoracic disease was spread into the extrathoracic localizations, while isolated abdominal sarcoidosis was present in 10% of patients. After first FDG PET/CT examination therapy was changed in all patients. Eleven patients came to the follow up examination where SUVmax significantly decreased in the majority of them. Three patients had total remission, three had absence of abdominal disease but discrete findings in thorax and others had less spread disease. ACE levels did not correlate with SUVmax level. Conclusion: FDG PET/CT can be a useful tool for detection of abdominal sarcoidosis and in the evaluation of therapy response in these patients. Awareness of the presence of intra-abdominal sarcoidosis is important in order to prevent long-standing unrecognized disease.

The utility of FDG-PET/CT and other imaging techniques in the evaluation of IgG4-related disease

2014 ◽  
Vol 81 (4) ◽  
pp. 331-336 ◽  
Author(s):  
Hiroyuki Takahashi ◽  
Hiroyuki Yamashita ◽  
Miyako Morooka ◽  
Kazuo Kubota ◽  
Yuko Takahashi ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Imaging Techniques ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Clinical and FDG-PET/CT Suspicion of Malignant Disease: Is Biopsy Confirmation Still Necessary?

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 559
Author(s):  
Talitha Bent ◽  
Derya Yakar ◽  
Thomas C. Kwee
Keyword(s):  
Fdg Pet ◽  
Malignant Disease ◽  
Invasive Procedure ◽  
Clinical Suspicion ◽  
Tissue Sampling ◽  
Positron Emission ◽  
Pet Ct ◽  
Significant Difference ◽  
Biopsy Confirmation ◽  
Fdg Pet Ct

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.

scholarly journals FDG PET/CT imaging of desmoplastic small round cell tumor: findings at staging, during treatment and at follow-up

2015 ◽  
Vol 45 (9) ◽  
pp. 1308-1315 ◽  
Author(s):  
Austin Ostermeier ◽  
M. Beth McCarville ◽  
Fariba Navid ◽  
Scott E. Snyder ◽  
Barry L. Shulkin
Keyword(s):  
Fdg Pet ◽  
Ct Imaging ◽  
Cell Tumor ◽  
Round Cell ◽  
Round Cell Tumor ◽  
Small Round Cell Tumor ◽  
Small Round Cell ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Quantitative analysis of myocardial metabolic heterogeneity is superior to visual assessment for the detection of active cardiac sarcoidosis by F-18 FDG PET-CT imaging

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M Malik ◽  
M Yazdani ◽  
SM Gould ◽  
E Reyes
Keyword(s):  
Fdg Pet ◽  
Cardiac Sarcoidosis ◽  
Visual Assessment ◽  
Ct Imaging ◽  
Myocardial Inflammation ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Metabolic Heterogeneity ◽  
Fdg Pet Ct

Abstract Funding Acknowledgements Type of funding sources: None. Background Myocardial inflammation may occur in the context of a multisystem disease such as sarcoidosis, adversely affecting prognosis. A definitive diagnosis of cardiac sarcoidosis (CS) is essential to implementing life-saving treatment but this is complicated by the invasive nature of endomyocardial biopsy (EMB) and its low accuracy. Positron emission tomography (PET) assists in diagnosis, which relies on visual interpretation of myocardial F-18 FDG uptake. The value of quantitative analysis and its application to clinical practice remain uncertain. Purpose To investigate the power of quantitative F-18 FDG PET-CT imaging analysis for detecting CS in patients with suspected disease. Methods All patients underwent F-18 FDG PET-CT after a 24-hour low-carbohydrate diet and 15-hour fasting as part of their diagnostic work-up for suspected cardiac inflammation. Cardiovascular magnetic resonance acted as gatekeeper to PET-CT in 8 of every 10 scans. Myocardial F-18 FDG uptake was assessed qualitatively and quantitatively using both manually drawn regions of interest and automatic polar maps to measure global and segmental standardised F-18 FDG uptake values (SUV).  The coefficient of variation (CoV) was calculated to determine uptake heterogeneity. To confirm diagnosis, follow-up data regarding disease progression, further testing and treatment were collected. To allow for sufficient follow-up time, the first 40 consecutive patients from a prospective registry (n= 214; Sep 2017-Jun 2020) were included. Results A comprehensive clinical picture was obtained successfully in 37 patients (median [IQR], 17 [13.5] months) and a final diagnosis of CS reached in 7 (disease prevalence, 19%). EMB was performed in 2 patients only while 3 underwent PPM/ICD implantation. Significant predictors of CS were fulfilment of Japanese Ministry of Health and Welfare criteria (Wald, 6.44; p = 0.01) and left ventricular dysfunction (Wald 6.72; p = 0.01). Qualitative F-18 FDG PET-CT had a high negative (95%) but low positive (45%) predictive value for CS (sensitivity, 83%; specificity, 77%). F-18 FDG SUV CoV was the strongest imaging predictor (Wald, 6.77; p = 0.009) and was significantly higher in CS than non-CS (CoV median [quartiles], 0.26 [0.21, 0.36] and 0.12 [0.11, 0.14] respectively; p = 0.004). As per ROC curve analysis (AUC, 0.84), a CoV threshold of 0.20 was highly specific (93%) and sensitive (86%) for CS. Conclusion In a referring population with a low prevalence of cardiac sarcoidosis, F-18 FDG PET-CT imaging is sensitive for the detection of myocardial inflammation with active disease unlikely in patients with a negative scan. Quantitative evaluation of metabolic heterogeneity within the myocardium provides a strong, independent marker of active disease and should be considered alongside visual assessment.

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