scholarly journals Diagnostic Yield of Combined Pulmonary Cryobiopsies and Electromagnetic Navigation in Small Pulmonary Nodules

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Olivier Taton ◽  
Benjamin Bondue ◽  
Pierre Alain Gevenois ◽  
Myriam Remmelink ◽  
Dimitri Leduc
Keyword(s):  
Diagnostic Yield ◽  
Pulmonary Nodules ◽  
Electromagnetic Navigation ◽  
Pet Ct ◽  
Endobronchial Ultrasonography ◽  
Risk Patients ◽  
Peripheral Pulmonary Lesions ◽  
Transbronchial Lung Cryobiopsy ◽  
Fdg Pet Ct ◽  
Small Pulmonary Nodules

Background. An increasing number of pulmonary nodules of unknown nature are detected as a result of screening by CT in high lung cancer risk patients. Objectives. The purposes of this study were to assess the diagnostic yield of electromagnetic navigation bronchoscopy (ENB) combined with transbronchial lung cryobiopsy (TBLC) and to compare it with standard transbronchial biopsy (TBB) in pulmonary nodules of less than 2 cm in diameter. Methods. We prospectively included 32 patients (18 men and 14 women, mean age 68 ± 9 years) with nodules of less than 2 cm in diameter and no metastasis at 18FDG PET-CT. The nodule position was determined by ENB, radial endobronchial ultrasonography miniprobe, and fluoroscopy. Eight samples were obtained, six by TBB and two by TBLC. Results. Nodule diameter averaged 16 ± 3 mm. Twenty-five nodules were malignant and 18 were surgically resected. Surgery was avoided in four patients as the biopsies revealed a benign disease. The samples obtained by TBLC were five times larger than those by TBB. The diagnostic yields of TBLC and TBB were 69% and 38%, respectively (p=0.017). Adverse events consisted in 15 mild or moderate bleedings and one pneumothorax. Conclusions. In the setting of peripheral pulmonary lesions of less than 20 mm in diameter, ENB-combined TBLC is feasible and safe, provides larger samples, and has higher diagnostic yield than TBB.

scholarly journals FDG-PET/CT in intensive care patients with bloodstream infection

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Jordy P. Pijl ◽  
Mark Londema ◽  
Thomas C. Kwee ◽  
Maarten W. N. Nijsten ◽  
Riemer H. J. A. Slart ◽  
...  
Keyword(s):  
Intensive Care ◽  
Image Quality ◽  
Fdg Pet ◽  
Diagnostic Yield ◽  
Unknown Origin ◽  
Intensive Care Patients ◽  
Pet Ct ◽  
Infection Focus ◽  
Focus Of Infection ◽  
Fdg Pet Ct

Abstract Background 2-Deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) is an advanced imaging technique that can be used to examine the whole body for an infection focus in a single examination in patients with bloodstream infection (BSI) of unknown origin. However, literature on the use of this technique in intensive care patients is scarce. The purpose of this study was to evaluate the diagnostic yield of FDG-PET/CT in intensive care patients with BSI. Methods In this retrospective cohort study, all intensive care patients from our Dutch university medical center who had culture-proven BSI between 2010 and 2020 and underwent FDG-PET/CT to find the focus of infection were included. Diagnostic performance was calculated and logistic regression analysis was performed to evaluate the association between FDG-PET/CT outcome and C-reactive protein level (CRP), leukocyte count, duration of antibiotic treatment, duration of ICU stay, quality of FDG-PET/CT, and dependency on mechanical ventilation. In addition, the impact of FDG-PET/CT on clinical treatment was evaluated. Results 30 intensive care patients with BSI were included. In 21 patients, an infection focus was found on FDG-PET/CT which led to changes in clinical management in 14 patients. FDG-PET/CT achieved a sensitivity of 90.9% and specificity of 87.5% for identifying the focus of infection. Poor quality of the FDG-PET images significantly decreased the likelihood of finding an infection focus as compared to reasonable or good image quality (OR 0.16, P = 0.034). No other variables were significantly associated with FDG-PET/CT outcome. No adverse events during the FDG-PET/CT procedure were reported. Conclusion FDG-PET/CT has a high diagnostic yield for detecting the infection focus in patients with BSI admitted to intensive care. Poor PET image quality was significantly associated with a decreased likelihood of finding the infection focus in patients with BSI. This could be improved by adequate dietary preparation and cessation of intravenous glucose and glucose-regulating drugs. Recent advances in PET/CT technology enable higher image quality with shorter imaging time and may contribute to routinely performing FDG-PET/CT in intensive care patients with BSI of unknown origin.

scholarly journals Phantom and clinical assessment of small pulmonary nodules using Q.Clear reconstruction on a silicon-photomultiplier-based time-of-flight PET/CT system

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhifang Wu ◽  
Binwei Guo ◽  
Bin Huang ◽  
Xinzhong Hao ◽  
Ping Wu ◽  
...  
Keyword(s):  
Time Of Flight ◽  
Pulmonary Nodules ◽  
Medium Size ◽  
Ct Reconstruction ◽  
Reconstruction Algorithms ◽  
Silicon Photomultiplier ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
Quantification Accuracy ◽  
Small Pulmonary Nodules

AbstractTo evaluate the quantification accuracy of different positron emission tomography-computed tomography (PET/CT) reconstruction algorithms, we measured the recovery coefficient (RC) and contrast recovery (CR) in phantom studies. The results played a guiding role in the partial-volume-effect correction (PVC) for following clinical evaluations. The PET images were reconstructed with four different methods: ordered subsets expectation maximization (OSEM), OSEM with time-of-flight (TOF), OSEM with TOF and point spread function (PSF), and Bayesian penalized likelihood (BPL, known as Q.Clear in the PET/CT of GE Healthcare). In clinical studies, SUVmax and SUVmean (the maximum and mean of the standardized uptake values, SUVs) of 75 small pulmonary nodules (sub-centimeter group: < 10 mm and medium-size group: 10–25 mm) were measured from 26 patients. Results show that Q.Clear produced higher RC and CR values, which can improve quantification accuracy compared with other methods (P < 0.05), except for the RC of 37 mm sphere (P > 0.05). The SUVs of sub-centimeter fludeoxyglucose (FDG)-avid pulmonary nodules with Q.Clear illustrated highly significant differences from those reconstructed with other algorithms (P < 0.001). After performing the PVC, highly significant differences (P < 0.001) still existed in the SUVmean measured by Q.Clear comparing with those measured by the other algorithms. Our results suggest that the Q.Clear reconstruction algorithm improved the quantification accuracy towards the true uptake, which potentially promotes the diagnostic confidence and treatment response evaluations with PET/CT imaging, especially for the sub-centimeter pulmonary nodules. For small lesions, PVC is essential.

Comparison of Quantitatively Analyzed Dynamic Area-Detector CT Using Various Mathematic Methods With FDG PET/CT in Management of Solitary Pulmonary Nodules

2013 ◽  
Vol 200 (6) ◽  
pp. W593-W602 ◽  
Author(s):  
Yoshiharu Ohno ◽  
Mizuho Nishio ◽  
Hisanobu Koyama ◽  
Yasuko Fujisawa ◽  
Takeshi Yoshikawa ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Pulmonary Nodules ◽  
Solitary Pulmonary Nodules ◽  
Area Detector ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Dual time-point FDG PET-CT for differentiating benign from malignant solitary pulmonary nodules in a TB endemic area

2010 ◽  
Vol 100 (9) ◽  
pp. 598 ◽  
Author(s):  
Mike Machaba Sathekge ◽  
Alex Maes ◽  
Hans Pottel ◽  
Anton Stoltz ◽  
Christophe Van de Wiele
Keyword(s):  
Fdg Pet ◽  
Endemic Area ◽  
Pulmonary Nodules ◽  
Solitary Pulmonary Nodules ◽  
Pet Ct ◽  
Dual Time Point ◽  
Fdg Pet Ct ◽  
Time Point

Computed Tomography–Guided Methylene Blue Labeling Prior to Thoracoscopic Resection of Small Deeply Placed Pulmonary Nodules. Do We Really Need Palpation?

2017 ◽  
Vol 65 (05) ◽  
pp. 387-391 ◽  
Author(s):  
S. Demiröz ◽  
Selma Apaydın ◽  
Hakan Ertürk ◽  
Suzan Biri ◽  
Funda Incekara ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Thoracic Surgery ◽  
Fdg Pet ◽  
Pulmonary Nodules ◽  
Blue Staining ◽  
Ct Guided ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Background Video-assisted thoracic surgery (VATS) is widely used for thoracic surgery operations, and day by day it becomes routine for the excision of undetermined pulmonary nodules. However, it is sometimes hard to reach millimetric nodules through a VATS incision. Therefore, some additional techniques were developed to reach such nodules little in size and which are settled on a challenging localization. In the literature, coils, hook wires, methylene blue, lipidol, and barium staining, and also ultrasound guidance were described for this aim. Herein we discuss our experience with CT-guided methylene blue labeling of small, deeply located pulmonary nodules just before VATS excision. Method From April 2013 to October 2016, 11 patients with millimetric pulmonary nodules (average 8, 7 mm) were evaluated in our clinic. For all these patients who had strong predisposing factors for malignancy, an 18F-FDG PET-CT scan was also performed. The patients whose nodules were decided to be excised were consulted the radiology clinic. The favorable patients were taken to CT room 2 hours prior to the operation, and CT-guided methylene blue staining were performed under sterile conditions. Results Mean nodule size of 11 patients was 8.7 mm (6, 2–12). Mean distance from the visceral pleural surface was 12.7 mm (4–29.3). Four of the nodules were located on the left (2 upper lobes, 2 lower lobes), and seven of them were on the right (four lower lobes, two upper lobes, one middle lobe). The maximum standardized uptake values (SUV max) on 18F-FDG PET/CT scan ranged between 0 and 2, 79. Conclusion CT-guided methylene blue staining of millimetric deeply located pulmonary nodules is a safe and feasible technique that helps surgeon find these undetermined nodules by VATS technique without any need of digital palpation.

Diagnostic value of 18F-FDG-PET/CT for the evaluation of solitary pulmonary nodules

2017 ◽  
Vol 38 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Zong Ruilong ◽  
Xie Daohai ◽  
Geng Li ◽  
Wang Xiaohong ◽  
Wang Chunjie ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Pulmonary Nodules ◽  
Diagnostic Value ◽  
Solitary Pulmonary Nodules ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct
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