scholarly journals 18F-FAMT-PET Is Useful for Judging Clinical Complete Response in Advanced Esophageal Cancer Patients Who Have Received Definitive Chemoradiotherapy

2019 ◽  
Vol 103 (11-12) ◽  
pp. 561-566
Author(s):  
Makoto Sohda ◽  
Hiroaki Honjyo ◽  
Keigo Hara ◽  
Daigo Ozawa ◽  
Shigemasa Suzuki ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Fdg Pet ◽  
Complete Response ◽  
Mediastinal Lymphadenopathy ◽  
Definitive Chemoradiotherapy ◽  
Primary Tumors ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Node Metastases

We developed l-[3-18F]-α-methyltyrosine (18F-FAMT) as an amino acid tracer for positron emission tomography (PET) imaging. In esophageal cancer, the specificity of 18F-FAMT PET was significantly higher than that of fluoro-2-deoxy-d-glucose (18F-FDG) PET and computed tomography (CT) in the evaluation of individual lymph node groups. Definitive chemoradiotherapy (CRT) has been considered a potentially curative treatment for locoregional esophageal cancer and may achieve the same survival benefits as surgical resection. Clinical evaluation of complete response (CR) is important using several modalities. We evaluated 6 patients who had been diagnosed with clinical CR by FAMT-PET following definitive CRT for esophageal squamous cell carcinoma between June 2008 and July 2012. Treatment evaluation of 18F-FAMT was performed following CRT and approximately 1 month later. In primary tumors, 66.7% of patients (4/6) showed FDG uptake following CRT, whereas that of FAMT was 33.3% (2/6). In lymph node metastases, 50% of patients (3/6) showed FDG uptake following CRT, whereas that of FAMT was 0% (0/6). In the present study, FAMT-PET following CRT was a useful modality to predict clinical CR in esophageal cancer. There is a limit to judging clinical CR by CT or FDG-PET following CRT, because radiation-related esophagitis and reactive mediastinal lymphadenopathy by FDG and wall thickness by CT still remain 1 month following CRT. FAMT-PET is the most useful modality at the present time.

scholarly journals Use of 68Ga-PSMA-11 and 18F-FDG PET-CT Dual-Tracer to Differentiate Between Lymph Node Metastases and Ganglia

2021 ◽  
Vol 11 ◽  
Author(s):  
Yiping Shi ◽  
Lian Xu ◽  
Yinjie Zhu ◽  
Yining Wang ◽  
Ruohua Chen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Node Metastases ◽  
Ct Data ◽  
Fdg Pet Ct

PurposeDifferentiating lymph node metastases (LNM) from peripheral ganglia by physiological prostate-specific membrane antigen (PSMA) uptake is challenging. Two tracers (68Ga-PSMA-11 and 18F-fluorodeoxyglucose [FDG]) metabolic uptake patterns were evaluated by positron emission tomography-computed tomography (PET-CT), searching for differences that could tell ganglia from LNM.MethodsDual 68Ga-PSMA-11 and 18F-FDG PET-CT data of 138 prostate cancer patients acquired from June 2018 to December 2019 were retrospectively evaluated. Ganglia and LNM with PSMA-11 uptake above local background were analyzed by the location and PSMA-11-PET and FDG-PET maximum standardized uptake value (SUVmax).ResultsPSMA-11-positive ganglia (n = 381) and LNM (n = 83) were identified in 138 and 58 patients, respectively. The LNM SUVmax of PSMA-11-PET (16.4 ± 14.8 vs 2.3 ± 0.7, P < 0.001) and FDG-PET (3.3 ± 3.2 vs 1.5 ± 0.5, P < 0.001) were higher than in ganglia. The probabilities of being an LNM in the low-potential (PSMA-11-PET SUVmax of <4.1 and FDG-PET SUVmax of <2.05), moderate-potential (PSMA-11-PET SUVmax of >4.1 and FDG-PET SUVmax of <2.05, or PSMA-11-PET SUVmax of <4.1 and FDG-PET SUVmax of >2.05), and high-potential (PSMA-11-PET SUVmax of >4.1 and FDG-PET SUVmax of >2.05) groups were 0.9% (3/334), 44.6% (37/83), and 91.5% (43/47), respectively (P < 0.001). The cervical and coeliac ganglia had higher PSMA-11 and FDG uptake than the sacral ganglia (P < 0.001 for all). LNM PSMA-11 and FDG uptake was similar in these three locations.ConclusionThe FDG-PET and PSMA-11-PET SUVmax, especially when combined, could well differentiate LNM from ganglia. The tracers uptake differed between cervical/coeliac and sacral ganglia, so the lesion location should be considered during image assessment.

Prospective Study of Fluorodeoxyglucose–Positron Emission Tomography Imaging of Lymph Node Basins in Melanoma Patients Undergoing Sentinel Node Biopsy

1999 ◽  
Vol 17 (5) ◽  
pp. 1508-1508 ◽  
Author(s):  
Jeffrey D. Wagner ◽  
Donald Schauwecker ◽  
Darrell Davidson ◽  
John J. Coleman III ◽  
Scott Saxman ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Node ◽  
Lymph Node Metastases ◽  
Fdg Pet ◽  
Regional Lymph Node ◽  
Emission Tomography ◽  
Node Biopsy ◽  
Positron Emission ◽  
Node Metastases

PURPOSE: To prospectively compare positron emission tomography (PET) imaging of regional lymph node basins to sentinel node biopsy (SNB) in patients with American Joint Committee on Cancer (AJCC) stage I, II, and III melanoma localized to the skin. METHODS: Patients with cutaneous melanoma with Breslow's depth greater than 1 mm (AJCC T2-4N0M0) or localized regional cutaneous recurrence (TxN2bM0) underwent whole-body imaging of glucose metabolism with fluorodeoxyglucose (FDG) PET followed by SNB. PET scans were interpreted in a blinded fashion and compared with histologic analyses of SNB specimens and clinical follow-up examination. Nodal tumor volumes were estimated. RESULTS: Eighty-nine lymph node basins were evaluated by FDG-PET and SNB in 70 assessable patients. Eighteen patients (25.7%) had lymph node metastases at the time of FDG-PET imaging: 17 proved by SNB (24.3%) and one by follow-up examination (1.4%). Median tumor volume in positive sentinel node basins was 4.3 mm3 (range, 0.07 to 523 mm3). Sensitivity of SNB for detection of occult regional lymph node metastases was 94.4%, specificity was 100%, positive predictive value (PPV) was 100%, and negative predictive value (NPV) was 98.6%. Sensitivity of FDG-PET was 16.7%, specificity was 95.8%, PPV was 50%, and NPV was 81.9%. At a median follow-up duration of 16.6 months, seven patients (10%) developed recurrent disease. PET predicted one recurrence (14.3%) in a node basin missed by SNB. CONCLUSION: FDG-PET is an insensitive indicator of occult regional lymph node metastases in patients with melanoma because of the minute tumor volumes in this population. FDG-PET does not have a primary role for staging regional nodes in patients with clinically localized melanoma.

scholarly journals Definitive Chemoradiotherapy and Salvage Esophagectomy for Esophageal Cancer Associated With Multiple Lung Metastases: A Case Report

2014 ◽  
Vol 99 (5) ◽  
pp. 640-644
Author(s):  
Yoshihiko Fujinaka ◽  
Masaru Morita ◽  
Takefumi Ohga ◽  
Yoshihiro Kakeji ◽  
Tokujiro Yano ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Case Report ◽  
Distant Metastasis ◽  
Multimodal Therapy ◽  
Lung Metastases ◽  
Salvage Surgery ◽  
Complete Response ◽  
Definitive Chemoradiotherapy ◽  
Node Metastases ◽  
Salvage Esophagectomy

Abstract The prognosis of esophageal cancer with distant metastasis is dismal. We report a 70-year-old man with esophageal cancer and multiple lung and lymph node metastases. Complete response was achieved following definitive chemoradiotherapy. Twenty-four months after the initial chemoradiotherapy, local recurrence was detected but there was no evidence of distant metastasis. Therefore, the patient underwent salvage esophagectomy. The surgery was well tolerated without any postoperative complications. The patient is still alive 48 months after the salvage surgery. Our experience suggests that salvage esophagectomy is an important component of multimodal therapy for the recurrence of esophageal cancer.

FDG PET for Esophageal Cancer Complicated by Sarcoidosis Mimicking Mediastinal and Hilar Lymph Node Metastases

2008 ◽  
Vol 33 (4) ◽  
pp. 258-261 ◽  
Author(s):  
Kentaro Takanami ◽  
Tomohiro Kaneta ◽  
Takayuki Yamada ◽  
Shigeo Kinomura ◽  
Shogo Yamada ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Fdg Pet ◽  
Hilar Lymph Node ◽  
Node Metastases

Prognostic impact of hexokinase and glucose transporter expressions and clinicopathologic features related to F-18-FDG uptake in esophageal cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 39-39
Author(s):  
Liesbeth M Schreurs ◽  
Bareld B Pultrum ◽  
Kirill Pavlov ◽  
Jan Pruim ◽  
Henk Groen ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Glucose Transporter ◽  
Disease Free Survival ◽  
Prognostic Impact ◽  
Primary Tumors ◽  
P53 Expression ◽  
Expression Levels ◽  
Fdg Uptake ◽  
Prognostic Predictors

39 Background: Elucidation of prognostic predictors based on biological viability may be useful for a better detection of patients with a high risk of relapse or death from esophageal cancer. Methods: Maximum standardized uptake values (SUVmax) were measured in the preoperative 18F-FDG positron emission tomography (PET) scans of 47 patients who had a radical esophageal resection without previous treatment. Expression levels of hexokinase-II (HK-II), glucose transporter I (GLUT-I), hypoxia inducible factor-1α (HIF-Iα), vascular endothelial growth factor (VEGF), p53 and the proliferative activity (MIB-I score) were determined immunohistochemically on paraffin-embedded tumor tissue. Correlations and survival functions were calculated to identify independent correlations between FDG-uptake and prognostic expression levels. Results: High HK-II expression was significantly correlated with reduced SUVmax values (p= 0.002) and HK-II expression was significant higher among adenocarcinomas than squamous cell carcinomas (36/37 vs. 5/9, p= 0.004). The five years survival was significant better for patients with SUVmax≤ 3 in their primary tumors (75% vs. 25%) and a lymph node (LN) ratio ≤0.20 (40% vs. 6%). There were also significant disease free survival benefits for different expression rates of GLUT-I, p53 and MIB (log rank p= 0.03, p= 0.03 and p= 0.04 respectively) in patients with a lymph node ratio >0.20. Conclusions: FDG-uptake and LN ratio are strong prognostic predictors in patients with esophageal cancer. The level of GLUT-I and p53 expression and the MIB score may be useful prognostic markers that provide information about tumor aggressiviness in esophageal cancer.

Prospective Comparison of [18F]Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography in Patients With Melanoma With Palpable Lymph Node Metastases: Diagnostic Accuracy and Impact on Treatment

2009 ◽  
Vol 27 (28) ◽  
pp. 4774-4780 ◽  
Author(s):  
Esther Bastiaannet ◽  
Theo Wobbes ◽  
Otto S. Hoekstra ◽  
Eric J. van der Jagt ◽  
Adrienne H. Brouwers ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Fdg Pet ◽  
Distant Metastases ◽  
Positron Emission ◽  
Node Metastases ◽  
Impact On Treatment ◽  
Metastatic Sites ◽  
Additional Value ◽  
Palpable Lymph Node

Purpose Patients with melanoma with potentially resectable lymph node metastases require accurate staging to prevent unnecessary surgery. [18F]Fluorodeoxyglucose (FDG) positron emission tomography (PET) is attractive for this because melanoma typically is FDG avid. The aim of this prospective multicenter study was to perform a head-to-head comparison of FDG-PET and computed tomography (CT) in staging of patients with melanoma with palpable lymph node metastases in terms of diagnostic accuracy and impact on treatment. Patients and Methods All consecutive patients with palpable, proven lymph node metastases of melanoma between mid 2003 and 2007 were prospectively included. The number/site of distant metastases detected with FDG-PET and CT were recorded. Histology/cytology or 6 months follow-up were the reference standard. Intended and performed treatment was recorded. Results Distant metastases were suspected by FDG-PET in 32% of the 251 patients and by CT in 29% (P = .26). Upstaging was correct in 27% by FDG-PET and in 24% by CT (P = .18). FDG-PET detected more metastatic sites (133 v 112, P = .03), detecting significantly more bone and subcutaneous metastases. Treatment changed in 19% of patients; in 79% as a result of both scans, in 17% exclusively by FDG-PET, and in 4% exclusively by CT. In 34 patients (14%), FDG-PET had an additional value over spiral CT, and in 23 patients (9%), CT had additional value over FDG-PET. Conclusion As a result of FDG-PET and CT, 27% of patients were upstaged, and treatment changed in one of five patients. FDG-PET and CT are equivalent in upstaging; however, FDG-PET detected more metastatic sites, especially bone and subcutaneous. FDG-PET and/or CT are indicated in the staging of patients with melanoma with palpable lymph node metastases.

scholarly journals Improved cancer detection in Waldeyer’s tonsillar ring by 68Ga-FAPI PET/CT imaging

2020 ◽  
Author(s):  
S. Serfling ◽  
Y. Zhi ◽  
A. Schirbel ◽  
T. Lindner ◽  
T. Meyer ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Fdg Pet ◽  
Detection Rate ◽  
Cup Syndrome ◽  
Primary Tumors ◽  
Pet Ct ◽  
Node Metastases ◽  
The Mean ◽  
Fdg Pet Ct

Abstract Purpose In cancer of unknown primary (CUP), positron emission tomography/computed tomography (PET/CT) with the glucose analog [18F]FDG represents the standard imaging approach for localization of the malignant primary. Frequently, however, [18F]FDG PET/CT cannot precisely distinguish between small occult tumors and chronic inflammation, especially in Waldeyer’s tonsillar ring. To improve the accuracy for detecting primary tumors in the Waldeyer’s tonsillar ring, the novel PET tracer [68Ga]Ga-FAPI-4 for specific imaging of fibroblast activation protein (FAP) expression was used as a more specific target for cancer imaging. Methods Eight patients with suspicion of a malignant tumor in Waldeyer’s tonsillar ring or a CUP syndrome were examined. PET/CT scans with [18F]-FDG and [68Ga]Ga-FAPI-4 were performed for pre-operative tumor localization. After surgical resection, histopathological and immunohistochemical results were compared to PET/CT findings. Results Histopathology revealed a palatine or lingual tonsil carcinoma in all patients. In case of lymph node metastases smaller than 7 mm in size, the [18F]FDG PET/CT detection rate of cervical lymph node metastases was higher than that of [68Ga]FAPI PET/CT, while both tracers identified the primary tumors in all eight cases. The size of the primary and the lymph node metastases was directly correlated to the respective FAP expression, as detected by immunohistochemistry. The mean SUVmax for the primary tumors was 21.29 ± 7.97 for 18F-FDG and 16.06 ± 6.29 for 68Ga-FAPI, respectively (p = 0.2). The mean SUVmax for the healthy contralateral tonsils was 8.38 ± 2.45 for [18F]FDG and 3.55 ± 0.47 for [68Ga]FAPI (p < 0.001). The SUVmax ratio of [68Ga]FAPI was significantly different from [18F] FDG (p = 0.03). Mean TBRmax for the [68Ga]Ga-FAPI-4 tracer was markedly higher in comparison to [18F]FDG (10.90 vs. 4.11). Conclusion Non-invasive imaging of FAP expression by [68Ga]FAPI PET/CT resulted in a better visual detection of the malignant primary in CUP, as compared to [18F]FDG imaging. However, the detection rate of lymph node metastases was inferior, presumably due to low FAP expression in small metastases. Nevertheless, by offering a detection method for primary tumors with the potential of lower false positive rates and thus avoiding biopsies, patients with CUP syndrome may benefit from [68Ga]FAPI PET/CT imaging.

scholarly journals Relative clinical utility of simultaneous 18F-fluorodeoxyglucose PET/MRI and PET/CT for preoperative cervical cancer diagnosis

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110191
Author(s):  
Jing Gong ◽  
Honghong Liu ◽  
Zhaoliang Bao ◽  
Lihua Bian ◽  
Xiuzhen Li ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Lymph Node Status ◽  
Radiographic Images ◽  
Primary Tumors ◽  
Specificity And Sensitivity ◽  
Positron Emission ◽  
Pet Ct

Objective To investigate the utility of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) for the preoperative diagnosis of cervical cancer. Methods We retrospectively analyzed 114 patients who were diagnosed with cervical cancer and underwent PET/MRI (n = 59) or PET/computed tomography (PET/CT) (n = 65) before surgery. The maximal standardized uptake value (SUVmax) and mean SUV (SUVmean) were determined for regions of interest in the resultant radiographic images. Results Relative to PET/CT, 18F-FDG PET/MRI exhibited higher specificity and sensitivity in defining the primary tumor bounds and higher sensitivity for detection of bladder involvement. The SUVmax and SUVmean of PET/MRI were remarkably higher than those of PET/CT as a means of detecting primary tumors, bladder involvement, and the lymph node status. However, no significant differences in these values were detected when comparing the two imaging approaches as a means of detecting vaginal involvement or para-aortic lymph node metastasis. Conclusions These outcomes may demonstrate the capability of 18F-FDG PET/MRI to clarify preoperative cervical cancer diagnoses in the context of unclear PET/CT findings. However, studies directly comparing SUVs in different lesion types from patients who have undergone both PET/MRI and PET/CT scans are essential to validate and expand upon these findings.

Tonic-clonic seizures as first symptom of a disseminated supraglottic laryngeal cancer

2020 ◽  
Vol 13 (3) ◽  
pp. e233584
Author(s):  
Christian Danstrup ◽  
Maria Andersen
Keyword(s):  
Lymph Node ◽  
Laryngeal Cancer ◽  
Primary Tumour ◽  
Duodenal Mucosa ◽  
Cervical Lymph Nodes ◽  
Sagittal Sinus ◽  
Whole Brain Radiation ◽  
Positron Emission ◽  
Node Metastases ◽  
Clonic Seizures

A 60-year-old man was found unconscious at work, without any signs of trauma. At the site, he presented with tonic-clonic seizures, central facial palsy and eye deviation. A CT scan of the cerebrum did not find bleeding or thrombosis, but contrast enhancement at the superior sagittal sinus and pathological cervical lymph nodes. The MRI demonstrated multiple intracerebral metastases, while a supplementary fluoro-deoxy-glucose positron emission tomography scan revealed metastatic lesions above and below the diaphragm, without signs of a primary tumour. An ear, nose and throat examination found a small supraglottic tumour and cervical lymph node metastases. Following a multidisciplinary team discussion, biopsies from the duodenal mucosa and an inguinal lymph node were performed, showing squamous cell carcinoma with its origin in the head and neck. The patient was diagnosed with a T1N2cM1 supraglottic laryngeal cancer, receiving palliative whole brain radiation therapy but died 11 weeks after the debut of symptoms.

Sign in / Sign up

Export Citation Format

Share Document