PET/computed tomography shows association between subjective pain in knee joints and fluorine-18-fluorodeoxyglucose uptake.

OBJECTIVE: The aim of this study was to evaluate the capability of fluorine-18-fluorodeoxyglucose (F-FDG)-PET/computed tomography (CT) in screening for musculoskeletal inflammation and injury in the knee region. METHODS: The study included 12 subjects (6 men and 6 women) who complained of knee pain at rest and 94 controls who did not. Maximum standardized uptake value (SUV)max was calculated for the right and left knees and compared via a 4-point numerical rating scale (NRS) for subjective knee pain. Correlations between SUV values were also evaluated. RESULTS: SUVmax was significantly higher in knee joints with resting and/or walking pain than in pain-free knee joints. SUVmax in knee joints with walking pain were significantly correlated with NRS category (ß = 0.129, P < 0.001). CONCLUSION: F-FDG-PET/CT may be useful in screening for musculoskeletal inflammation and injury in the knee region. As knee pain is common, especially among elderly individuals, we should consider conducting further examinations when F-FDG uptake is identified in knee joints.

Ionic Liquid-Mediated Hydrofluorination of o-Azaxylylenes Derived from 3-Bromooxindoles.

The hydrofluorination reaction of 3-bromooxindole using mild HF reagents in an ionic liquid is described. This transformation can operate at room temperature to give a series of 3-substituted 3-fluorooxindole derivatives including racemic BMS 204352 (MaxiPost). The mechanistic study about interactions between HF and 3-butyl-1-methylimidazolium tetrafluoroborate [bmim][BF4] is also discussed on the basis of energy calculations.

PET-CT observations of cortical activity in pre-lingually deaf adolescent and adult patients with cochlear implantation.

CONCLUSIONS: The present study yielded useful information concerning pre-lingually deaf adolescents and adults who try or manage to understand languages. PET-CT can provide insights into brain plasticity and elucidate which mode of communication is the most effective for education of such patients. OBJECTIVES: To study the cortical activity in pre-lingually deaf adolescent and adult cochlear implants (CI) users who have been trained in auditory-verbal/oral communication since childhood. METHODS: Using positron emission tomography (PET) and 18F-fluorodeoxyglucose (FDG), brain activities in six pre-lingually and two post-lingually deaf CI users (mean age at CI surgery = , 20.3 years; three males, five females) were compared with those of 10 normal age-matched controls (mean age = 27.1 years). Regional cerebral blood flow changes were measured during an acoustic presentation of a story. RESULTS: In compliant CI users, the number of hypermetabolic auditory-related areas was greater in those who had a CI in their 20s than in those who did so in their adolescence. In poor and non-compliant users, hypermetabolism was not seen in the auditory association area, but in the primary auditory areas (BA41) and the Broca's area (BA45). In post-lingually deaf CI users, no increase in the number of hypermetabolic areas was found in auditory-related regions.

Uptake of aortic 18F-FDG is correlated with low-density lipoprotein cholesterol and leptin in a general population.

OBJECTIVE: This study investigated the relationship between aortic 18F-fluoro-2-deoxy-D-glucose (18F-FDG) uptake and clinical and laboratory findings related to atherosclerosis in a general population. METHODS: 18F-FDG uptake in the ascending aorta was measured on the positron emission tomography/computed tomography (PET/CT) scans of 211 Japanese adults. The maximum target-to-background ratio (TBR) was compared with clinical and laboratory atherosclerosis findings. RESULTS: By multivariate regression analysis adjusted for age and sex, TBR-ascending aorta (TBR-A) was significantly correlated with various clinical and laboratory parameters, such as body mass index, log visceral fat area, low-density lipoprotein cholesterol (LDL-C), log fasting immunoreactive insulin, log homeostasis model assessment of insulin resistance, log total adiponectin and log-leptin, in all subjects. Furthermore, by multivariate linear regression analysis adjusted for confounding factors, TBR-A was significantly correlated with LDL-C (ß = 0.001, p = 0.03) and log-leptin (ß = 0.336, p<0.01) in all subjects. CONCLUSION: TBR-A was significantly correlated with LDL-C and log-leptin independent from confounding factors. Our results suggest that aortic 18F-FDG uptake is a good marker of atherosclerosis, even in a general population.

PET/CT shows subjective pain in shoulder joints to be associated with uptake of (18)F-FDG.

OBJECTIVES: The aim of the study was to evaluate the capability of fluorine-18-fluorodeoxyglucose (F-FDG)-positron emission tomography (PET)/computed tomography (CT) in the screening of musculoskeletal inflammation and injury of the shoulder region. MATERIALS AND METHODS: The study included 122 participants (69 men and 53 women) who complained of shoulder pain at rest and 122 age-matched and sex-matched controls who did not experience pain at rest. Standardized uptake values (SUVs) were calculated for both the left and right shoulders and compared using a four-point visual analog scale of subjective shoulder pain. Correlations between SUVs and uric acid and C-reactive proteins were also evaluated. RESULTS: SUVs for shoulder joints with rest and/or motion pain were significantly higher than those for pain-free shoulder joints. SUVs associated with mild and severe pain at rest were significantly higher than those associated with absence of pain at rest, and SUVs associated with moderate and severe pain on motion were significantly higher than those associated with absence of motion pain. Furthermore, SUVs were significantly correlated with uric acid in men (ß=0.21, P=0.02) and in all participants (ß=0.22, P<0.001). CONCLUSION: F-FDG-PET/CT may be useful for the screening of musculoskeletal inflammation and injury of the shoulder region. As shoulder pain is common, especially among elderly individuals, we should carefully consider the necessity of further examination when identifying the uptake of F-FDG in shoulder joints.

Observation of cortical activity during speech stimulation in prelingually deafened adults with cochlear implantation by positron emission tomography-computed tomography.

OBJECTIVES: We evaluated the cortical activity of 2 successful prelingually deafened adult cochlear implant (CI) users who have been trained by auditory-verbal/oral communication since childhood. METHODS: Changes in regional cerebral blood flow were measured by positron emission tomography using '8F-fluorodeoxyglucose while the subjects were receiving auditory language stimuli by listening to a story. Ten normal-hearing volunteers were observed as age-matched control subjects. RESULTS: In both cases, the auditory-related regions, when compared to same regions in the control subjects, showed hypermetabolism in the left dorsolateral prefrontal cortex and the left precentral gyrus--similar to that in successful CI users who are prelingually deafened children or postlingually deafened adults. Both subjects had the ability to activate these areas, and this ability might be one of the reasons that accounts for such exceptionally good performance in older prelingually deaf CI users. As for the visual-related regions, hypometabolism was observed in Brodmann areas 18 and 19, and this finding might be related to the intensive auditory-verbal/oral education that the subjects had received since childhood. CONCLUSIONS: Despite the limits imposed by the small sample size and the spatial resolution of positron emission tomography, this study yielded insights into the nature of the brain plasticity in prelingually deafened adults who are successful CI users.

Significance of PET/CT in determining actual TNM staging for patients with various lung cancers.

We investigated the difference in TNM stage of lung cancer provided by PET/CT (combining positron emission tomography and computed tomography) as compared with TNM stage obtained with conventional imaging studies (CI) with contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) with iron contrast media. Sixty-seven cases of lung cancer were included in this study. Overall, the rate of correction of TNM staging was 70.1% after PET/CT. The correction rate for each factor was 32.8% in T, 37.3% in N, and 37.3% in M. High rates of correction were observed in small cell lung cancer (SCLC), with 75% (6/8 cases) obtained by PET/CT. When SCLCs were divided into limited disease (n = 6) involving 1 hemithorax, including mediastinal and contralateral hilar lymph nodes, and others (extensive disease, n = 2), the correction rate was as high as 80% for limited disease. In conclusion, PET/CT can provide actual TNM staging and recognition for oncologists in staging, which would not mislead to selection of inadequate subsequent treatment.

Spontaneously Ruptured Giant Splenic Cyst with Elevated Serum Levels of CA 19-9, CA 125 and Carcinoembryonic Antigen.

Splenic cyst is a relatively rare disease; however, the occurrence of complications associated with its rupture is even more rare. A 20-year-old female patient who had severe abdominal and left shoulder pain was admitted to our hospital. The patient's abdomen was hard and tender to the touch and she presented with a high fever. The patient's serum levels of the tumor markers carbohydrate antigen 19-9, cancer antigen 125 and carcinoembryonic antigen were high. Ultrasonography and computed tomography of the abdomen showed an 11-cm multilocular cystic lesion in the spleen and the presence of free intraperitoneal fluid. Peritonitis with ruptured splenic cyst was diagnosed, and the patient underwent an emergency laparotomy. The abdominal cavity was filled with purulent fluid. The cyst was localized to the spleen and had already ruptured. Total splenectomy and cyst resection were performed. The postoperative course was uneventful. The patient was discharged on day 9 following surgery. The histological findings showed the lesion to be a benign epidermoid cyst completely lined with inner stratified squamous epithelium with a capsule of connective tissue. In the immunostaining analyses, the squamous epithelium was positive for carcinoembryonic antigen. A ruptured splenic cyst causes sudden onset of severe peritonitis and elevation of serous tumor markers. An emergency operation is indicated as the treatment for a ruptured splenic cyst with peritonitis, after which a favorable outcome can be expected.

PET features of aortic diseases.

OBJECTIVE: Recently, several reports have highlighted the potential role of (18)F-FDG PET for the assessment of various aortic diseases based on FDG accumulation. In this article, we divided various aortic diseases into the following three groups on the basis of the mechanism of FDG accumulation: atherosclerosis, aortitis or periaortitis, and thrombus. Elucidating the mechanisms and patterns of FDG uptake in various aortic diseases provides valuable information for clinical management. CONCLUSION: PET findings can provide additional information for the diagnosis of aortic diseases and valuable information for clinical management. It is essential to understand the characteristics of FDG uptake in various aortic diseases for proper appreciation of PET findings.