scholarly journals 18F-FDG PET-CT in the Management of Patients Receiving Definitive Radiotherapy for Malignancies of the Head and Neck

2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
Benjamin L. Franc ◽  
Christi DeLemos ◽  
Christopher Jones
Keyword(s):  
Metastatic Disease ◽  
Predictive Value ◽  
Fdg Pet ◽  
Intensity Modulated Radiation Therapy ◽  
Concurrent Chemotherapy ◽  
Surveillance Imaging ◽  
Pet Ct ◽  
Recurrent Malignancy ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

The study investigated the utility and timing of 18F-FDG PET-CT to evaluate for residual/recurrent or metastatic HNC in patients treated with definitive intensity modulated radiation therapy (IMRT) with or without chemotherapy, planned with 18F-FDG PET-CT. The incidence and timing of locoregional recurrence, distant metastatic disease, new primary malignancies, and death were evaluated in 261 patients retrospectively. Findings were classified based on pathology or clinical follow-up and the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET-CT were determined overall as well as at the time of each 18F-FDG PET-CT. The overall accuracy for 18F-FDG PET in the detection of residual/recurrent malignancy or metastatic disease was 96.4%. Of those in whom cancer recurred locally, 57% were identified based on physical examination and other imaging findings and 43% were identified initially on 18F-FDG PET-CT surveillance imaging when no disease was evident clinically. 18F-FDG PET-CT has a high diagnostic capability of detecting residual/recurrent malignancy or malignant metastatic disease in patients with HNC following IMRT ± concurrent chemotherapy, supporting 18F- FDG PET-CT’s use to evaluate patients for recurrent malignancy in the post-IMRT period, even without clinical evidence of disease.

scholarly journals Advantages of 18F-FDG PET/CT Imaging over Modified Duke Criteria and Clinical Presumption in Patients with Challenging Suspicion of Infective Endocarditis

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 720
Author(s):  
Valentin Pretet ◽  
Cyrille Blondet ◽  
Yvon Ruch ◽  
Matias Martinez ◽  
Soraya El Ghannudi ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Predictive Value ◽  
Fdg Pet ◽  
Clinical Suspicion ◽  
Duke Criteria ◽  
High Clinical Suspicion ◽  
Pet Ct ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

According to European Society of Cardiology guidelines (ESC2015) for infective endocarditis (IE) management, modified Duke criteria (mDC) are implemented with a degree of clinical suspicion degree, leading to grades such as “possible” or “rejected” IE despite a persisting high level of clinical suspicion. Herein, we evaluate the 18F-FDG PET/CT diagnostic and therapeutic impact in IE suspicion, with emphasis on possible/rejected IE with a high clinical suspicion. Excluding cases of definite IE diagnosis, 53 patients who underwent 18F-FDG PET/CT for IE suspicion were selected and afterwards classified according to both mDC (possible IE/Duke 1, rejected IE/Duke 0) and clinical suspicion degree (high and low IE suspicion). The final status regarding IE diagnosis (gold standard) was based on the multidisciplinary decision of the Endocarditis Team, including the ‘imaging specialist’. PET/CT images of the cardiac area were qualitatively interpreted and the intensity of each focus of extra-physiologic 18F-FDG uptake was evaluated by a maximum standardized uptake value (SUVmax) measurement. Extra-cardiac 18F-FDG PET/CT pathological findings were considered to be a possible embolic event, a possible source of IE, or even a concomitant infection. Based on the Endocarditis Team consensus, final diagnosis of IE was retained in 19 (36%) patients and excluded in 34 (64%). With a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and global accuracy of 79%, 100%, 100%, 89%, and 92%, respectively, PET/CT performed significantly better than mDC (p = 0.003), clinical suspicion degree (p = 0.001), and a combination of both (p = 0.001) for IE diagnosis. In 41 patients with possible/rejected IE but high clinical suspicion, sensitivity, specificity, PPV, NPV, and global accuracies were 78%, 100%, 100%, 85%, and 90%, respectively. Moreover, PET/CT contributed to patient management in 24 out of 53 (45%) cases. 18F-FDG PET/CT represents a valuable diagnostic tool that could be proposed for challenging IE cases with significant differences between mDC and clinical suspicion degree. 18F-FDG PET/CT allows a binary diagnosis (definite or rejected IE) by removing uncertain diagnostic situations, thus improving patient therapeutic management.

Diagnostic Value of WB-DWI Versus 18 F-FDG PET/CT for the Detection of Multiple Myeloma

2020 ◽  
Author(s):  
Bei Zhang ◽  
Li Zhang ◽  
Bingyang Bian ◽  
Fang Lin ◽  
Zining Zhu ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
Fdg Pet ◽  
Pet Ct ◽  
Adc Values ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

Abstract BACKGROUND Whole body diffusion weighted imaging (WB-DWI) is commonly used for the detection of multiple myeloma (MM). Comparative data on the efficiency of WB-DWI compared with 18 F positron emission tomography computed tomography ( 18 F-FDG PET/CT) to detect MM are lacking. METHODS This was a retrospective, single-center study of twenty-two patients with MM enrolled from January 2019 to December 2019. All patients underwent WB-DWI and 18 F-FDG PET/CT. Pathological and clinical manifestations as well as radiologic follow-up were used for diagnosis. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value of both methods were compared. The appearance diffusion coefficient (ADC) values of MM lesions and false-positive lesions were estimated. RESULTS A total of 214 MM bone lesions were evaluated. WB-DWI showed a higher overall accuracy than PET/CT (75.7% and 55.6%, respectively; < 0.05). However, for sensitivity, specificity, positive predictive value and negative predictive value, there were no significant differences for WB-DWI vs PET/CT (99.3% and 83.9%, 64.9% and 94.8%, 63.6% and 54.2%, 98.1% and 65.3%, respectively). The ADC value for MM lesions was significantly lower than that for false-positive lesions (p < 0.001). Receiver operating curve (ROC) curve analysis showed that the AUC was 0.846, and when the cut-off value was 0.745×10 -3 mm 2 /s, the sensitivity and specificity were 86.0% and 82.4%, respectively, which distinguished MM lesions from non-MM lesions. CONCLUSION WB-DWI may be a useful tool for the diagnosis of MM bone disease due to to higher overall accuracy and measurements of ADC values compared with PET/CT.

scholarly journals The Role of 18F-FDG PET/CT in Staging and Prognostication of Mantle Cell Lymphoma: An Italian Multicentric Study

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1831 ◽  
Author(s):  
Domenico Albano ◽  
Riccardo Laudicella ◽  
Paola Ferro ◽  
Michela Allocca ◽  
Elisabetta Abenavoli ◽  
...  
Keyword(s):  
Predictive Value ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
Multicentric Study ◽  
Pet Ct ◽  
Mantle Cell ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

Mantle cell lymphoma (MCL) is an aggressive lymphoma subtype with poor prognosis in which 18F-FDG-PET/CT role in treatment response evaluation and prediction of outcome is still unclear. The aim of this multicentric study was to investigate the role of 18F-FDG-PET/CT in staging MCL and the prognostic role of Deauville criteria (DC) in terms of progression-free survival (PFS) and overall survival (OS). We retrospectively enrolled 229 patients who underwent baseline and end-of-treatment (eot) 18F-FDG-PET/CT after first-line therapy. EotPET/CT scans were visually interpreted according to DC. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT for evaluation of bone marrow (BM) were 27%, 100%, 100%, 48% and 57%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT for evaluation of the gastrointestinal (GI) tract were 60%, 99%, 93%, 90% and 91%, respectively. At a median follow-up of 40 months, relapse occurred in 104 cases and death in 49. EotPET/CT results using DC significantly correlated with PFS, not with OS. Instead, considering OS, only MIPI score was significantly correlated. In conclusion, we demonstrated that MCL is an FDG-avid lymphoma and 18F-FDG-PET/CT is a useful tool for staging purpose, showing good specificity for BM and GI evaluation, but suboptimal sensitivity. EotPET/CT result was the only independent significant prognostic factor that correlated with PFS.

Diagnostic Capabilities of MRI Versus 18F FDG PET-CT in Postoperative Patients with Thyroglobulin Positive, 131I-negative Local Recurrent or Metastatic Thyroid Cancer

2019 ◽  
Vol 15 (10) ◽  
pp. 956-964
Author(s):  
Cesur Samanci ◽  
Yilmaz Onal ◽  
Sait Sager ◽  
Sertac Asa ◽  
Fethi Emre Ustabasioglu ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Study Design ◽  
Predictive Value ◽  
Fdg Pet ◽  
Elevated Serum ◽  
Whole Body ◽  
Pet Ct ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

Background: The detection of recurrence or metastasis might be challenging in patients, who underwent total thyroidectomy and radioactive iodine therapy for Differentiated Thyroid Carcinoma (DTC), with increased serum Thyroglobulin (Tg) levels and negative 131I whole body scan (131I-WBS) results. Aims: The purpose of this study was to compare the ability of Magnetic Resonance Imaging (MRI) and 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F FDG PET-CT) to detect recurrence or cervical and upper mediastinal metastases in postoperative DTC patients who had negative 131I-WBS despite elevated serum Tg levels. Study Design: This study has a retrospective study design. Methods: We evaluated cervical and upper mediastinal MRI and 18F FDG PET-CT of 32 postoperative patients with DTC (26 patients with papillary thyroid carcinoma and 6 patients with follicular thyroid carcinoma). Results: We evaluated 44 lesions in 32 patients. For all lesions, the Positive Predictive Value, (PPV) Negative Predictive Value (NPV), sensitivity, specificity, and accuracy of MRI were 81.4%, 76.4%, 84.6%, 72.2%, and 79.5% respectively. The PPV, NPV, sensitivity, specificity, and accuracy of 18F FDG PET-CT were 100.0%, 85.7%, 88.4%, 100.0%, and 93.1%, respectively. Conclusion: Although we could not replace 18F FDG PET-CT, MRI might be used as an adjunct to 18F FDG PET-CT for the evaluation of recurrent or cervical and upper mediastinal metastatic thyroid cancers; however, MRI is inadequate for the detection of metastases in small lymph nodes.

scholarly journals How can we Use PET/ CT More Accurately for Characterization of Asbestos-related Pleural Thickening?

2021 ◽  
Author(s):  
F Selcuk Simsek ◽  
Muharrem cakmak ◽  
Duygu Kuslu ◽  
Tansel Balci ◽  
Erdal In ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Predictive Value ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Pleural Thickening ◽  
Pet Ct ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

IntroductionThere is no consensus about standardized uptake value maximum (SUVmax) cut-off value to characterize pleural thickening worldwide. Sometimes, this causes unnecessary invasive diagnostic procedures. Our first aim is to determine a cut-off value for SUVmax. Secondly, we try to answer this question “If we use this cut-off value together with morphological parameters, can we differentiate benign thickening from Malignant pleural mesothelioma (MPM) more accurately”.Material and methodsThirty-seven patients with performed 2-deoxy-2-[18F]-fluoro-D-glucose ([18F]FDG-PET/CT) before pleural biopsy included the study. All of patients had histopathologically proven primary pleural disease. Their [18F]FDG-PET/CT imaging reports were re-assessed. If patient’s SUVmax or size of the thickening was not mentioned in report, we calculated them with their [18F]FDG-PET/CT.ResultsAge, pleural effusion, size, and SUVmax were found a relationship with MPM. We found the size>14 mm, and SUVmax>4.0 as cut-off values for MPM. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for size>14 mm were found as 86.4%, 85.2%, 82.6%, 88.5%, respectively. For SUVmax>4.0; sensitivity, specificity, PPV, NPV were 90.9%, 87.0%, 85.1%, 92.2%, respectively.ConclusionsIf a patient has SUVmax>4.0 and/or size>14 mm, the risk of MPM is high. These patients should be undergone biopsy. If patient’s SUVmax<4.0, size<14 mm and does not have pleural effusion, he/she has low risk for MPM. These patients can be undergone to the follow-up. If a patient's SUVmax<4, Size<14, and has pleural effusion MPM risk is approximately 4%. These patients can be undergone biopsy/cytology/follow-up. Novel studies are needed for these patients.

scholarly journals FDG PET/CT to detect bone marrow involvement in the initial staging of patients with aggressive non-Hodgkin lymphoma: results from the prospective, multicenter PETAL and OPTIMAL>60 trials

2021 ◽  
Author(s):  
Dominic Kaddu-Mulindwa ◽  
Bettina Altmann ◽  
Gerhard Held ◽  
Stephanie Angel ◽  
Stephan Stilgenbauer ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Predictive Value ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
Non Hodgkin Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Initial Staging

Abstract Purpose Fluorine-18 fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG PET/CT) is the standard for staging aggressive non-Hodgkin lymphoma (NHL). Limited data from prospective studies is available to determine whether initial staging by FDG PET/CT provides treatment-relevant information of bone marrow (BM) involvement (BMI) and thus could spare BM biopsy (BMB). Methods Patients from PETAL (NCT00554164) and OPTIMAL>60 (NCT01478542) with aggressive B-cell NHL initially staged by FDG PET/CT and BMB were included in this pooled analysis. The reference standard to confirm BMI included a positive BMB and/or FDG PET/CT confirmed by targeted biopsy, complementary imaging (CT or magnetic resonance imaging), or concurrent disappearance of focal FDG-avid BM lesions with other lymphoma manifestations during immunochemotherapy. Results Among 930 patients, BMI was detected by BMB in 85 (prevalence 9%) and by FDG PET/CT in 185 (20%) cases, for a total of 221 cases (24%). All 185 PET-positive cases were true positive, and 709 of 745 PET-negative cases were true negative. For BMB and FDG PET/CT, sensitivity was 38% (95% confidence interval [CI]: 32–45%) and 84% (CI: 78–88%), specificity 100% (CI: 99–100%) and 100% (CI: 99–100%), positive predictive value 100% (CI: 96–100%) and 100% (CI: 98–100%), and negative predictive value 84% (CI: 81–86%) and 95% (CI: 93–97%), respectively. In all of the 36 PET-negative cases with confirmed BMI patients had other adverse factors according to IPI that precluded a change of standard treatment. Thus, the BMB would not have influenced the patient management. Conclusion In patients with aggressive B-cell NHL, routine BMB provides no critical staging information compared to FDG PET/CT and could therefore be omitted. Trial registration NCT00554164 and NCT01478542

scholarly journals PREDICTIVE VALUE OF QUANTITATIVE 18 F‐FDG‐PET‐CT RADIOMICS ANALYSIS IN 174 PATIENTS WITH RELAPSED/REFRACTORY CLASSICAL HODGKIN LYMPHOMA

2021 ◽  
Vol 39 (S2) ◽  
Author(s):  
J Driessen ◽  
G. J. C Zwezerijnen ◽  
H Schöder ◽  
A. J Moskowitz ◽  
M. J Kersten ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Predictive Value ◽  
Fdg Pet ◽  
Classical Hodgkin Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct

N-Staging in Large Cell Neuroendocrine Carcinoma of the Lung: Diagnostic Value of FDG PET/CT Compared to the Histopathology Reference Standard

2021 ◽  
Author(s):  
Hubertus Hautzel ◽  
Yazan Alnajdawi ◽  
Wolfgang P Fendler ◽  
Christoph Rischpler ◽  
Kaid Darwiche ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Fdg Pet ◽  
Interrater Reliability ◽  
Glucose Turnover ◽  
Glucose Transporter 1 ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
N Staging

Abstract Background:Large cell neuroendocrine carcinomas of the lung (LCNEC) is a rare entity occurring in less than 4% of all lung cancers. Due to its low differentiation and high glucose transporter 1 (GLUT1) expression LCNEC demonstrates an increased glucose turnover. Thus, PET/CT with 2-[18F]-fluoro-deoxyglucose (FDG) is suitable for LCNEC staging. Surgery with curative intent is the treatment of choice in early stage LCNEC. Prerequisite for this is correct lymph node staging. This study aimed at evaluating the diagnostic performance of FDG PET/CT validated by histopathology following surgical resection or mediastinoscopy. N-staging interrater-reliability was assessed to test for robustness of the FDG PET/CT findings.Methods:Between 03/2014 and 12/2020 46 patients with LCNEC were included in this single center retrospective analysis. All underwent FDG PET/CT for pre-operative staging and subsequently either surgery (n=38) or mediastinoscopy (n=8). Regarding the lymph node involvement, sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated for FDG PET/CT using the final histopathological N-staging (pN0 to pN3) as reference.Results:Per patient 14 ± 7 (range 4 - 32) lymph nodes were resected and histologically processed. 31/46 patients had no LCNEC spread into the lymph nodes. In 8/46 patients final stage was pN1, in 5/46 pN2 and in 2/46 pN3. FDG PET/CT diagnosed lymph node metastasis of LCNEC with a sensitivity of 93%, a specificity of 87%, an accuracy of 89%, a PPV of 78% and a NPV of 96%. Interrater-reliability was high with a strong level of agreement (κ=0.82).Conclusions:In LCNEC N-staging with FDG PET/CT demonstrates both high sensitivity and specificity, an excellent NPV but a slightly reduced PPV. Accordingly, preoperative invasive mediastinal staging may be omitted in cases with cN0 disease by FDG PET/CT. In FDG PET/CT cN1-cN3 stages histological confirmation is warranted, particularly in case of only moderate FDG uptake.

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