scholarly journals Simultaneous use of FDG-18 and 68Ga-citrate PET/CT for the differential diagnosis of sarcoidosis and malignant disease

2020 ◽  
Vol 90 (3) ◽  
Author(s):  
Cuneyt Tetikkurt ◽  
Haluk Sayman ◽  
Selin Ece Dedeoglu ◽  
Bahar Kubat ◽  
Seza Tetikkurt
Keyword(s):  
Fdg Pet ◽  
Malignant Disease ◽  
Pulmonary Function Tests ◽  
Granulomatous Inflammation ◽  
Final Diagnosis ◽  
Middle Lobe ◽  
Pet Ct ◽  
18F Fdg ◽  
Simultaneous Use ◽  
The Right

A 67-year-old male presented with cutaneous rash, lassitude and fatigue of three weeks. Personal history included psoriasis and sarcoidosis. Physical examination revealed macular rash on the anterior chest wall. Laboratory results were within normal limits. Chest X-ray showed normal findings. Pulmonary function tests demonstrated a mild obstructive pattern and a mild decrease in DLCO/VA. Thorax CT revealed two nodules in the right upper and middle lobe. 68Ga-citrate PET/CT did not demonstrate any active inflammatory reaction associated with sarcoidosis while 18F-FDG PET/CT revealed increased FDG uptake in the right middle lobe, upper division bronchus and in the left lower abdominal quadrant. Histopathologic examination of the colon biopsy was compatible with adenocarcinoma and bronchoscopic biopsy of the lung lesions revealed nonspecific granulomatous inflammation. BAL cytology was normal while BAL culture did not grow any pathologic organisms. Simultaneous use of 18F-FDG and 68Ga-citrate PET/CT was the hallmark for the final diagnosis in our patient. While FDG/PET has detected the pulmonary and colonic malignant foci in our patient, 68Ga-citrate PET/CT excluded the presence of active granulomatous inflammation of sarcoidosis. Simultaneous utility of these two imaging modalities in patients with sarcoidosis is of great importance in terms of guiding the clinician towards the accurate diagnostic pathway which is the hallmark for final diagnosis, especially in the presence of concomitant malignant disease.

scholarly journals Leydig cell tumor of the testis: an incidental finding at 18F-FDG PET/CT imaging

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Almalki Yassir
Keyword(s):  
Leydig Cell ◽  
Fdg Pet ◽  
Chronic Rejection ◽  
Ct Imaging ◽  
The Body ◽  
Whole Body ◽  
Pet Ct ◽  
18F Fdg ◽  
The Right ◽  
Fdg Pet Ct

Abstract Background Leydig cell tumors (LCTs) represent the most common form of stromal tumors. We reported the 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings of a patient with testicular LCT. Case presentation A 50-year-old man with a history of end-stage renal disease and renal transplantation 19 years ago. One year earlier, he started to have a chronic rejection. During the investigation to determine the cause of chronic rejection, a suspicious lesion in the graft with a collection around it was seen on ultrasound (US) images, raising the possibility of post-transplant lymphoproliferative disorder (PTLD). The patient was referred for further evaluation by whole body 18F-FDG PET/CT imaging. The image finding revealed an incidental hypermetabolic focal lesion in the right testicle—no other specific findings in the remaining parts of the body nor definitive FDG avid lymphadenopathy to suggest PTLD. Testicular US was requested and showed a well-defined right-sided heterogeneous hypoechoic intratesticular focal mass at the upper pole of the right testis with significant internal vascularity on the color Doppler imaging. The patient underwent a right radical orchidectomy, and the tumor was pathologically confirmed as an LCT. Conclusion In our case, 18F-FDG-PET/CT has been helpful in incidentally detecting this rare testicular tumor in a patient with suspected PTLD.

Abstract 35: DVT Inflammation Assessed by 18F-FDG-PET/CT Predicts Subsequent Vein Wall Scarring

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Chase W Kessinger ◽  
Ahmed Tawakol ◽  
Gregory R Wojtkiewicz ◽  
Peter K Henke ◽  
Ralph Weissleder ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Vena Cava ◽  
Standard Uptake Value ◽  
Vein Wall ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
The Right ◽  
Fdg Pet Ct

Objective: While venous thrombosis (VT)-induced inflammation facilitates thrombus resolution, inflammation causes vein wall scarring (VWS). Recently, statins have shown to improve VT resolution and reduce VT inflammatory components. In this study, we hypothesized that early VT inflammation detected by 18F-FDG positron emission tomography/computed tomography (PET/CT) could predict subsequent late stage VWS, and would be attenuated by statin therapy. Methods: Stasis VT was induced in 8-12 week old male C57BL/6 mice (n=31) in either the right jugular vein (n=13) or inferior vena cava (IVC,n=18). Animals in the IVC VT cohort were randomized to statin (n=8) or control (n=10) treatment. Statin, rosuvastatin (5mg/kg), was administered by oral gavage, daily starting 24 hours prior to VT induction; control mice received saline. All mice underwent survival FDG-PET/CT venography imaging on day 2. FDG inflammation signals (standard uptake value=SUV) were measured in the thrombosed vein and compared to the sham-operated venous segments or treatment control. On day 14, mice were sacrificed and VT tissue was resected. Picrosirius red staining allowed measurement of collagen and vein wall thickness in VT sections. Results: FDG-PET/CT at day 2 revealed increased inflammation signal activity in jugular VT (SUV 1.43 ± 0.3 VT vs. 0.81 ± 0.3 contralateral vein, p<0.0001). Statin-treated mice showed a trend of decreased inflammation signal at day 2 in the IVC VT models (SUV 1.02 ± 0.1 statin VT vs. 1.42 ± 0.2 control VT, p=0.07). Day 14 histological analysis revealed significantly reduced vein wall injury in statin-treated animals (thickness, 32±9.4 μm statin; vs. 56.2±14.7 μm control, p=0.02). Day 2 FDG-PET inflammation in VT correlated positively with the magnitude of day 14 VWS (jugular VT, Spearman r=0.62, p=0.02; IVC VT r=0.74, p<0.001, respectively). Conclusions: Quantitative FDG-PET/CT imaging demonstrates that early in vivo VT inflammation predicts subsequent VWS, a driver of post-thrombotic syndrome (PTS). The overall findings strengthen: (i) the link between inflammation and PTS; (ii) the translational potential of FDG-PET inflammation to predict VWS and PTS; and (iii) the concept that statins and other anti-inflammatory therapies could reduce VWS and PTS.

Successful surgical management of hepatic alveolar echinococcosis by inductive therapy with albendazole – a case report

2020 ◽  
Vol 58 (01) ◽  
pp. 63-67 ◽  
Author(s):  
Michael Bartels ◽  
Thomas Schmidt ◽  
Christoph Lübbert
Keyword(s):  
Hepatic Vein ◽  
Fdg Pet ◽  
Alveolar Echinococcosis ◽  
Postoperative Treatment ◽  
Blood Levels ◽  
Hepatic Alveolar Echinococcosis ◽  
Pet Ct ◽  
18F Fdg ◽  
The Right ◽  
Fdg Pet Ct

AbstractWe report the case of a 65-year-old female patient with hepatic alveolar echinococcosis (AE) caused by Echinococcus multilocularis. This infrequent zoonosis has a considerable morbidity and mortality. The malignant appearing hepatic mass was initially misdiagnosed as cholangiocarcinoma of the right hepatic lobe (segments VII, VIII, and IVa, sized 10.9 cm × 7.6 cm) involving the right and middle hepatic vein and extending close to the left hepatic vein. During exploratory laparotomy, the frozen-section biopsy was indicative of AE (World Health Organization [WHO] classification: stage P3N0M0). Due to the high operative risk, it was decided to pretreat the patient with albendazole as inductive therapy in order to remove the AE secondarily in accordance with the patient’s request. After year-long treatment with albendazole (under strict control of the maximum blood levels), a right hemihepatectomy was successfully performed. Postoperative treatment with albendazole had to be stopped prematurely after 11 months due to considerable subjective intolerance and a more-than-tenfold elevation of transaminases despite normal therapeutic albendazole blood levels. A 18F-FDG-PET/CT scan revealed no evidence of AE residues. Conducting follow-up examinations by 18F-FDG-PET/CT scans every 2 years is planned in order to recognize possible recurrence at an early stage.

scholarly journals Diagnostic Value of 18F-FDG-PET/CT in Patients with FUO

2020 ◽  
Vol 9 (7) ◽  
pp. 2112
Author(s):  
Stamata Georga ◽  
Paraskevi Exadaktylou ◽  
Ioannis Petrou ◽  
Dimitrios Katsampoukas ◽  
Vasilios Mpalaris ◽  
...  
Keyword(s):  
Predictive Value ◽  
Fdg Pet ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Whole Body ◽  
Considerable Proportion ◽  
Clinical Criteria ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Conventional diagnostic imaging is often ineffective in revealing the underlying cause in a considerable proportion of patients with fever of unknown origin (FUO). The aim of this study was to assess the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with FUO. We retrospectively reviewed 18F-FDG-PET/CT scans performed on 50 consecutive adult patients referred to our department for further investigation of classic FUO. Final diagnosis was based on histopathological and microbiological findings, clinical criteria, or clinical follow-up. Final diagnosis was established in 39/50 (78%) of the patients. The cause of FUO was infection in 20/50 (40%), noninfectious inflammatory diseases in 11/50 (22%), and malignancy in 8/50 (16%) patients. Fever remained unexplained in 11/50 (22%) patients. 18F-FDG-PET/CT scan substantially contributed to the diagnosis in 70% of the patients, either by identifying the underlying cause of FUO or by directing to the most appropriate site for biopsy. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18F-FDG-PET/CT for active disease detection in patients with FUO were 94.7%, 50.0%, 84.0%, 85.7%, and 75.0%, respectively. In conclusion, whole-body 18F-FDG-PET/CT is a highly sensitive method for detection of the underlining cause of FUO or for correctly targeting suspicious lesions for further evaluation.

scholarly journals Changes in 18F-FDG PET-CT Appearances of Treated Malignant Melanoma Metastases within the Right Atrium

2015 ◽  
Vol 24 (suppl 1) ◽  
pp. 25-27
Author(s):  
Luke Ienari Sonoda ◽  
Bal Sanghera ◽  
Katharine Nowlan ◽  
Emma Roantree ◽  
Thomas Wagner ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Right Atrium ◽  
Fdg Pet ◽  
Pet Ct ◽  
Melanoma Metastases ◽  
18F Fdg ◽  
The Right ◽  
Fdg Pet Ct

scholarly journals Infectious endocarditis: Improving Diagnostic Performance in Native and Prosthetic Valve Infection with 18F-FDG PET/CT

2020 ◽  
Author(s):  
Ana Vera Marinho ◽  
José Paulo Almeida ◽  
Paula Soeiro ◽  
Rodolfo Silva ◽  
Francisco Gonçalves ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Diagnostic Performance ◽  
Final Diagnosis ◽  
Prosthetic Material ◽  
Native Valve ◽  
Clinical Challenge ◽  
Duke Criteria ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract BackgroundThe diagnosis of infective endocarditis (IE) remains a clinical challenge. Diagnostic accuracy of the modified Duke criteria is suboptimal for native valve endocarditis (NVE) and even worse in the presence of prosthetic material-related infection (PVE). We aim to evaluate the diagnostic performance of 18F-FDG PET in patients with suspected IE referred to perform PET/CT.Methods: Consecutive patients with suspected IE, referred to perform PET/CT between May 2016 and June 2019 were included. Diagnostic performance of modified Duke criteria (mDC) and PET/ CT for IE for NVE and PVE was determined.Results: In total, 82 patients (mean age of 61 ± 19 years, 62% of male gender) were enrolled. There were 67 18F-FDG PET/CT concordant results with final diagnosis, corresponding to a 96% of agreement, k=0.91(p=0.04). A SUVmax cutoff value of ≥3.1 identified positive cases with 88.9% sensitivity and 70.0% specificity. In patients with NVE, the addition of PET/CT to the mDC resulted in a reduction of the number of possible IE cases (from 58% to 4.3%). In patients with PVE/intracardiac devices, PET/CT allowed reclassification of 67.4% of possible cases to 4.2%. An alternative diagnosis was provided in 55.6% of the negative IE cases.Conclusions: 18F-FDG PET/CT proved to be a useful diagnostic tool in patients with both suspected NVE and PVE with good sensitivity and specificity, resulting in a significant decrease of the number of possible endocarditis. Furthermore, it allowed the identification of the cause of clinical scenario in more than 50% of patients in which the diagnosis was excluded.

scholarly journals Infectious endocarditis: Improving diagnostic performance in native and prosthetic valve infection with 18F-FDG PET/CT

2020 ◽  
Author(s):  
Ana Vera Marinho ◽  
José Paulo Almeida ◽  
Paula Soeiro ◽  
Rodolfo Silva ◽  
Francisco Gonçalves ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Diagnostic Performance ◽  
Final Diagnosis ◽  
Prosthetic Material ◽  
Native Valve ◽  
Clinical Challenge ◽  
Duke Criteria ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract Background: The diagnosis of infective endocarditis (IE) remains a clinical challenge. Diagnostic accuracy of the modified Duke criteria is suboptimal for native valve endocarditis (NVE) and even worse in the presence of prosthetic material-related infection (PVE). We aim to evaluate the diagnostic performance of 18F-FDG PET in patients with suspected IE referred to perform PET/CT.Methods: Consecutive patients with suspected IE, referred to perform PET/CT between May 2016 and June 2019 were included. Diagnostic performance of modified Duke criteria (mDC) and PET/ CT for IE for NVE and PVE was determined.Results: In total, 82 patients (mean age of 61 ± 19 years, 62% of male gender) were enrolled. There were 67 18F-FDG PET/CT concordant results with final diagnosis, corresponding to a 96% of agreement, k=0.91(p=0.04). A SUV max cutoff value of ≥3.1 identified positive cases with 88.9% sensitivity and 70.0% specificity. In patients with NVE, the addition of PET/CT to the mDC resulted in a reduction of the number of possible IE cases (from 58% to 4.3%). In patients with PVE/intracardiac devices, PET/CT allowed reclassification of 67.4% of possible cases to 4.2%. An alternative diagnosis was provided in 55.6% of the negative IE cases.Conclusions: 18F-FDG PET/CT proved to be a useful diagnostic tool in patients with both suspected NVE and PVE with good sensitivity and specificity, resulting in a significant decrease of the number of possible endocarditis. Furthermore, it allowed the identification of the cause of clinical scenario in more than 50% of patients in which the diagnosis was excluded.

18F-FDG-PET/CT in unexplained elevated inflammatory markers

2016 ◽  
Vol 55 (06) ◽  
pp. 242-249 ◽  
Author(s):  
Isabell Braune ◽  
Birgit Meller ◽  
Carsten Sahlmann ◽  
Carsten Ritter ◽  
Johannes Meller ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Unknown Origin ◽  
Final Diagnosis ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Pet Ct ◽  
Significant Difference ◽  
18F Fdg ◽  
Fdg Pet Ct

SummaryThe diagnostic strategy in patients with fever or inflammation of unknown origin remains a major clinical challenge. The aim of this study was to evaluate the role of 18F-FDG-PET/CT in patients with unexplained elevated C-reactive protein with or without fever. Contribution of 18F-FDG-PET/CT to the final diagnosis was evaluated. In addition we determined whether a differentiation between patients with or without fever is clinically reasonable. Patients, methods: We retrospectively analysed 72 consecutive patients with unexplained elevated C-reactive protein levels (above 8mg/l) that underwent 18F-FDG-PET/ CT in our facility between 10/2009 and 11/2012. 18F-FDG-PET/CT was considered a so-called diagnostic scan when results decisively led to a final diagnosis and adequate therapy with a response of symptoms was initiated due to the PET/CT result. Results: In 60/72 patients (83%) a final diagnosis was established. Diagnoses included infections (58%), non-infectious inflammatory diseases (29%) and malignancies (8%). 18F-FDG-PET/CT was true positive in 47 cases (65%) and the diagnostic scan in 29 patients (40%). Sensitivity of 18F-FDG-PET/CT was 81% and specificity was 86%. Diagnostics, final diagnoses, 18F-FDG-PET/CT results, SUVmax, C-reactive protein levels and the diagnostic scan did not differ significantly between patients with fever and patients without fever. Conclusion: 18F-FDG-PET/CT is a useful method in the diagnostic workup of patients with inflammation of unknown origin. In our series there was no significant difference between patients with or without fever. Regarding 18F-FDG-PET/CT-imaging inflammation of unknown origin and unexplained fever can be joined to one entity.

Malignant disease as an incidental finding at 18F-FDG-PET/CT scanning in patients with granulomatous lung disease

2015 ◽  
Vol 36 (5) ◽  
pp. 430-437 ◽  
Author(s):  
Helmut Huber ◽  
Marina Hodolic ◽  
Ingrid Stelzmüller ◽  
Rainer Wunn ◽  
Margit Hatzl ◽  
...  
Keyword(s):  
Lung Disease ◽  
Fdg Pet ◽  
Malignant Disease ◽  
Incidental Finding ◽  
Ct Scanning ◽  
Pet Ct ◽  
Granulomatous Lung Disease ◽  
18F Fdg ◽  
Fdg Pet Ct
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