scholarly journals 18F-FDG-PET/CT Evaluation of Indeterminate Adrenal Masses in Noncancer Patients

2021 ◽  
Author(s):  
Xin He ◽  
Elaine M Caoili ◽  
Anca M Avram ◽  
Barbra S Miller ◽  
Tobias Else
Keyword(s):  
Fdg Pet ◽  
False Negative ◽  
Blood Pool ◽  
Adrenal Tumors ◽  
Negative Results ◽  
False Negative Results ◽  
Pet Ct ◽  
Adrenal Masses ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract Context Adrenal tumors in noncancer patients are common. Objective Evaluate performance of 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) in distinguishing between benign and malignant adrenal tumors. Design Retrospective chart review 2010-2019. Setting Academic institution. Patients One hundred and seventeen noncancer patients, defined as having no history of cancer or with cancer in remission for ≥5 years, completed 18F-FDG-PET/CT to evaluate adrenal masses, with pathologic diagnoses or imaging follow-up (≥12 months). Intervention 18F-FDG-PET/CT of 117 indeterminate adrenal masses. Main Outcome Measures Receiver operator characteristic curve of the ratios of adrenal lesion standardized uptake value (SUV)max to liver SUVmean and of adrenal lesion SUVmax to aortic arch blood pool SUVmean were constructed. Results Seventy benign and 47 malignant masses (35 adrenocortical carcinomas [ACCs], 12 adrenal metastases) were identified. Malignant masses had higher median liver SUV and blood pool SUV ratios than benign masses (6.2 and 7.4 vs 1.4 and 2.0, P < .001). Median liver and blood pool SUV ratios of ACC (6.1 and 7.3, respectively) and metastases (6.7 and 7.7, respectively) were higher than those of than adenomas (1.4 and 2.2, P < .05 for all comparisons). Optimal liver SUV ratio to discern between benign and malignant masses was 2.5, yielding 85% sensitivity, 90% specificity, and 7 false negative results (including 3 ACCs). Optimal blood pool SUV ratio was 3.4, yielding 83% sensitivity, 90% specificity, and 8 false negative results (including 4 ACCs). Conclusion When used in conjunction with other clinical assessments, 18F-FDG-PET/CT can be a valuable tool in evaluating adrenal masses in noncancer patients.

FDG PET/CT and N0 mediastinal nodal status in early stage non-small cell lung cancer: A single institution retrospective experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 11570-11570
Author(s):  
Shashank Reddy Cingam ◽  
Sean Connor ◽  
Abhishek Harshad Patel ◽  
Samip R. Master ◽  
Amol Takalkar
Keyword(s):  
Fdg Pet ◽  
Early Stage ◽  
False Negative ◽  
Nodal Involvement ◽  
True Negative ◽  
Negative Results ◽  
Early Stage Nsclc ◽  
False Negative Results ◽  
Pet Ct ◽  
Fdg Pet Ct

11570 Background: The increasing use of CT and now low-dose screening CT scans for at-risk patients have led to increasing detection of lung cancer at early stages. FDG PET/CT is used as an adjunct to conventional imaging to assess loco-regional lymph node spread. However, there is a potential for false-negative results, especially in smaller lesions or early nodal involvement. The main objective of this study was to study the value of PET/CT scan to evaluate for true negative mediastinal nodes in patients with early stage NSCLC. Accurate determination of N0 status can have a significant impact on the cost-effectiveness and timely management of early stage NSCLC. Methods: Of a total of 404 patients with NSCLC managed at our facility between 2008 to 2015, 29 adult patients whose PET scan showed no or equivocal mediastinal nodal involvement and subsequently underwent surgical exploration of mediastinal lymph nodes were included in the study. Data variables that were collected included the cancer site, date of PET, node status on PET, type and date of surgery, cancer histology, and the tissue diagnosis of the sampled nodes. SAS software was used for the analysis of the data. Results: Of the 29 patients with N0 or equivocal nodes on FDG PET/CT, 7 (24.13%) had evidence of malignancy on biopsy of the surgically resected lymph nodes. No statistically significant differences were noted between the site of the neoplastic lesion, cancer histology, duration between the date of PET and the date of surgery in the true negative (TN) and false negative (FN) groups. The recurrence rate was higher in the FN group 60 % (3/5) compared to 21 % (4/19) in the TN group who had follow up for atleast 2 years. Conclusions: Our findings suggest incidence of false negative results of FDG PET/CT for evaluation of N0 nodes in early stage NSCLC is 24.13%. This is comparatively higher than false negatives rates with mediastinoscopy (5-10%) reported in other studies. Although our sample size is small, if confirmed, such a relatively high incidence of false negative results on FDG PET/CT for N0 disease supports the current recommendations for exploratory mediastinoscopy and/or surgery for definitive staging in early stage NSCLC.

scholarly journals Adenocarcinoma with BAC Features Presented as the Nonsolid Nodule Is Prone to Be False-Negative on18F-FDG PET/CT

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Hu-bing Wu ◽  
Lijuan Wang ◽  
Quan-shi Wang ◽  
Yan-jian Han ◽  
Hong-sheng Li ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Detection Rate ◽  
False Negative ◽  
General Linear Model ◽  
Lesion Size ◽  
Blood Pool ◽  
Pet Ct ◽  
Blood Pool Activity ◽  
18F Fdg ◽  
Fdg Pet Ct

Purpose. The present study investigated which type of adenocarcinoma with BAC features was prone to be false-negative on 18F-FDG PET/CT.Materials and Methods. A retrospective study was performed on 51 consecutive patients with localized adenocarcinoma with BAC features. CT and PET were assessed for lesion size, GGO percentage, and SUVmax. Lesions with FDG uptake the same as or more than mediastinal blood-pool activity were considered as PET-positive.Results. Of the 51 cases, 19.6% presented as pure GGO nodules, 31.4% as mixed nodules, and 49.0% as solid nodules. None of the pure GGO nodules was 18F-FDG avid, compared with 37.5% of mixed nodules and 96.0% of solid nodules (χ2=31.55,P=0.000). In the mixed nodule group, SUVmax was negatively correlated with GGO percentage (r=-0.588;P=0.021). The positive detection rate of 18F-FDG PET/CT was 50.0%, 55.6%, and 100% in tumors 1.1–2.0 cm, 2.1–3.0 cm, and >3.0 cm in diameter, respectively (χ2=5.815,P=0.055). General linear model factor analysis showed that the GGO was an important factor contributing to false-negative PET/CT results (F=23.992,P=0.000), but lesion size was not (F=0.602,P=0.866).Conclusions. The present study indicated that the adenocarcinoma with BAC features presented as nonsolid nodule is prone to be false negative on 18F-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.

Diagnosis of infective endocarditis by 18F-FDG-PET/CT, presentation of a false negative result

2018 ◽  
Vol 150 (6) ◽  
pp. 247-248
Author(s):  
Beatriz Colina Andrés ◽  
Maite Arbulu Tapia ◽  
Miguel Ángel Goenaga Sánchez
Keyword(s):  
Infective Endocarditis ◽  
Fdg Pet ◽  
False Negative ◽  
False Negative Result ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Value of 18-F-FDG PET/CT and CT in the Diagnosis of Indeterminate Adrenal Masses

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Nathalie Launay ◽  
Stéphane Silvera ◽  
Florence Tenenbaum ◽  
Lionel Groussin ◽  
Frédérique Tissier ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Malignant Tumors ◽  
Apparent Diffusion Coefficient Values ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
Adrenal Masses ◽  
18F Fdg ◽  
Ct Data ◽  
Adrenocortical Carcinomas ◽  
Fdg Pet Ct

The purpose of this paper was to study the value of 18-FDG PET/CT and reassess the value of CT for the characterization of indeterminate adrenal masses. 66 patients with 67 indeterminate adrenal masses were included in our study. CT/MRI images and 18F-FDG PET/CT data were evaluated blindly for tumor morphology, enhancement features, apparent diffusion coefficient values, maximum standardized uptake values, and adrenal-to-liver maxSUV ratio. The study population comprised pathologically confirmed 16 adenomas, 19 metastases, and 32 adrenocortical carcinomas. Macroscopic fat was observed in 62.5% of the atypical adenomas at CT but not in malignant masses. On 18F-FDG PET/CT, SUVmax and adrenal-to-liver maxSUV ratio were significantly lower in adenomas than in malignant tumors. An SUVmax value of less than 3.7 or an adrenal-to-liver maxSUV ratio of less than 1.29 is highly predictive of benignity.

Fever of unknown origin: Importance of 18F-FDG PET/CT in the diagnosis of a late infectious complication after aneurysm bypass

VASA ◽  
2011 ◽  
Vol 40 (5) ◽  
pp. 418-421 ◽  
Author(s):  
Goudard ◽  
Pierret ◽  
Dusaud ◽  
Falzone ◽  
Tourtier ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Secondary Infection ◽  
False Negative ◽  
Artery Aneurysm ◽  
Low Grade ◽  
Popliteal Artery Aneurysm ◽  
Popliteal Aneurysm ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Persistent blood flow in aneurysmal sac after bypass-exclusion is well documented in the literature. Aneurysm enlargement, local compressive symptoms and even sac rupture are commonly described complications. Late secondary infection of popliteal artery aneurysm (PAA) following ligation and venous bypass is exceptional. We report the case of late PAA infection six years after bypass-exclusion in a 75 year-old man which was diagnosed by 18F-FDG PET/CT. The patient was successfully treated by aneurysm resection and antibiotics. The diagnosis of popliteal aneurysm infection is often clinical, echographic and sonographic, but computed tomography scan can be false negative in chronic low-grade infection. 18F-FDG PET/CT is able to accurately diagnose and localize infection with high sensibility and specificity.

Large adrenal mass heralding the diagnosis of occult extra-adrenal malignancy in two patients

2021 ◽  
Vol 14 (2) ◽  
pp. e239463
Author(s):  
James Anderton ◽  
Marios Ghobrial ◽  
Vasilis Kosmoliaptsis ◽  
Ruth Casey
Keyword(s):  
Fdg Pet ◽  
Adrenal Mass ◽  
Metastatic Carcinoma ◽  
High Avidity ◽  
Positron Emission ◽  
Pet Ct ◽  
Suprarenal Mass ◽  
Adrenal Masses ◽  
18F Fdg ◽  
Fdg Pet Ct

We report two cases highlighting the role of fluorine-18-fluorodeoxyglucose positron emission tomography/computerised tomography (18F FDG PET/CT) in the diagnostic and preoperative workup of indeterminate adrenal masses. Case 1: a 60-year-old man was diagnosed with a large left-sided adrenal mass with indeterminate radiological characteristics on CT. Biochemical investigations ruled out tumour hypersecretion. 18F FDG PET/CT was performed to exclude metastases and identified a pulmonary nodule in the left upper lobe. Histology of the resected adrenal tumour demonstrated a secondary metastasis from an adenocarcinoma of the lung. Case 2: an 88-year-old male was found to have a heterogeneous and vascular left-sided suprarenal mass and a smaller right-sided adrenal nodule. Both adrenal nodules had indeterminate radiological characteristics. Biochemical investigations were negative. PET/CT demonstrated high avidity in the bilateral adrenal nodules but no extra-adrenal FDG avid disease. Histology demonstrated a metastatic carcinoma of pulmonary origin.

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