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1.
Mol Imaging Biol ; 24(1): 60-69, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34622425

RESUMO

PURPOSE: To evaluate the correlation of radiomic features in pelvic [2-deoxy-2-18F]fluoro-D-glucose positron emission tomography/magnetic resonance imaging and computed tomography ([18F]FDG PET/MRI and [18F]FDG PET/CT) in patients with primary cervical cancer (CCa). PROCEDURES: Nineteen patients with histologically confirmed primary squamous cell carcinoma of the cervix underwent same-day [18F]FDG PET/MRI and PET/CT. Two nuclear medicine physicians performed a consensus reading in random order. Free-hand regions of interest covering the primary cervical tumors were drawn on PET, contrast-enhanced pelvic CT, and pelvic MR (T2 weighted and ADC) images. Several basic imaging features, standard uptake values (SUVmean, SUVmax, and SUVpeak), total lesion glycolysis (TLG), metabolic tumor volume (MTV), and more advanced texture analysis features were calculated. Pearson's correlation test was used to assess the correlation between each pair of features. Features were compared between local and metastatic tumors, and their role in predicting metastasis was evaluated by receiver operating characteristic curves. RESULTS: For a total of 101 extracted features, 1104/5050 pairs of features showed a significant correlation (ρ ≥ 0.70, p < 0.05). There was a strong correlation between 190/484 PET pairs of features from PET/MRI and PET/CT, 91/418 pairs of CT and PET from PET/CT, 79/418 pairs of T2 and PET from PET/MRI, and 50/418 pairs of ADC and PET from PET/MRI. Significant difference was seen between eight features in local and metastatic tumors including MTV, TLG, and entropy on PET from PET/CT; MTV and TLG on PET from PET/MRI; compactness and entropy on T2; and entropy on ADC images. CONCLUSIONS: We demonstrated strong correlation of many extracted radiomic features between PET/MRI and PET/CT. Eight radiomic features calculated on PET/CT and PET/MRI were significantly different between local and metastatic CCa. This study paves the way for future studies to evaluate the diagnostic and predictive potential of radiomics that could guide clinicians toward personalized patients care.


Assuntos
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias do Colo do Útero , Feminino , Fluordesoxiglucose F18 , Humanos , Imageamento por Ressonância Magnética , Projetos Piloto , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Carga Tumoral , Neoplasias do Colo do Útero/diagnóstico por imagem
2.
Hell J Nucl Med ; 25(1): 63-70, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35503557

RESUMO

To determine whether the prognostic stratification of non-small cell lung cancer (NSCLC) patients could be made by fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)-derived parameters such as maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). A total of 106 patients who were initially diagnosed with NSCLC with clinical stage III or stage IV at our hospital from January 2015 to January 2018 were included. The metabolic and volumetric parameters of 18F-FDG PET/CT were systematically collected, and their optimal cut-off values were determined on the basis of the receiver operating characteristic (ROC) curves. Kaplan-Meier methods and log-rank test were used to evaluate the relationships between 18F-FDG PET/CT-derived parameters and overall survival (OS) of NSCLC patients. The univariate and multivariate Cox analysis were conducted to identify the independent predictors of OS. The optimal cut-off value of SUVmax was 8.94 and area under the curve (AUC) for identifying patients with mortality risk was 0.618 (95% confidence interval [CI]: 0.490-0.745), with a sensitivity of 78.6% and specificity of 53.3%. The optimal cut-off value of MTV40 was 12.44 and the AUC value was 0.785 (95%CI: 0.676-0.893), with a sensitivity of 85.7% and specificity of 71.7%. Furthermore, the ROC curves identified 71.95 as the optimal cut-off value of TLG40, and the AUC value, sensitivity and specificity were 0.782 (95%CI: 0.681-0.883), 78.6% and 70.4%, respectively. The Kaplan-Meier curves showed that SUVmax (HR for SUVmax >8.94: 3.501, 95%CI: 1.133-10.817, P=0.029), MTV40 (HR: 6.926 for MTV40 >12.44, 95%CI: 2.244-21.378, P=0.001) and TLG40 (HR: 4.314 for TLG40 >71.95, 95%CI: 1.503-12.381, P=0.007) were significantly associated with poor OS of NSCLC patients. However, only MTV40 (HR: 4.235, 95%CI: 1.324-13.526, P=0.015) was shown to have an independent role in the multivariate Cox analysis. Metabolic tumor volume had a superiority in predicting the prognosis of NSCLC patients compared with other metabolic and volumetric parameters, suggesting that it might be a valuable prognostic marker.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Carcinoma Pulmonar de Células não Pequenas/patologia , Fluordesoxiglucose F18/metabolismo , Glicólise , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/metabolismo , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Prognóstico , Compostos Radiofarmacêuticos/metabolismo , Estudos Retrospectivos , Carga Tumoral
3.
J Nanobiotechnology ; 20(1): 211, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35524274

RESUMO

BACKGROUND: Injectable hydrogels have great promise in the treatment of myocardial infarction (MI); however, the lack of electromechanical coupling of the hydrogel to the host myocardial tissue and the inability to monitor the implantation may compromise a successful treatment. The introduction of conductive biomaterials and mesenchymal stem cells (MSCs) may solve the problem of electromechanical coupling and they have been used to treat MI. In this study, we developed an injectable conductive nanocomposite hydrogel (GNR@SN/Gel) fabricated by gold nanorods (GNRs), synthetic silicate nanoplatelets (SNs), and poly(lactide-co-glycolide)-b-poly (ethylene glycol)-b-poly(lactide-co-glycolide) (PLGA-PEG-PLGA). The hydrogel was used to encapsulate MSCs and 68Ga3+ cations, and was then injected into the myocardium of MI rats to monitor the initial hydrogel placement and to study the therapeutic effect via 18F-FDG myocardial PET imaging. RESULTS: Our data showed that SNs can act as a sterically stabilized protective shield for GNRs, and that mixing SNs with GNRs yields uniformly dispersed and stabilized GNR dispersions (GNR@SN) that meet the requirements of conductive nanofillers. We successfully constructed a thermosensitive conductive nanocomposite hydrogel by crosslinking GNR@SN with PLGA2000-PEG3400-PLGA2000, where SNs support the proliferation of MSCs. The cation-exchange capability of SNs was used to adsorb 68Ga3+ to locate the implanted hydrogel in myocardium via PET/CT. The combination of MSCs and the conductive hydrogel had a protective effect on both myocardial viability and cardiac function in MI rats compared with controls, as revealed by 18F-FDG myocardial PET imaging in early and late stages and ultrasound; this was further validated by histopathological investigations. CONCLUSIONS: The combination of MSCs and the GNR@SN/Gel conductive nanocomposite hydrogel offers a promising strategy for MI treatment.


Assuntos
Células-Tronco Mesenquimais , Infarto do Miocárdio , Animais , Fluordesoxiglucose F18/uso terapêutico , Radioisótopos de Gálio/uso terapêutico , Ouro/uso terapêutico , Hidrogéis , Células-Tronco Mesenquimais/patologia , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/tratamento farmacológico , Nanogéis , Poliglactina 910 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Ratos
4.
Neuroimaging Clin N Am ; 32(2): 287-298, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35526957

RESUMO

18FDG-PET plays an important role in cancer imaging. However, there are certain challenges with interpreting head and neck 18FDG-PET. In this article, examples of technical issues that can undermine the interpretation of the scans, normal physiologic activity that can mimic lesions or obscure lesions, and causes of false positives and false negatives on posttreatment cancer imaging are discussed. In addition, suggestions for addressing potential pitfalls on head and neck 18FDG-PET are highlighted.


Assuntos
Fluordesoxiglucose F18 , Neoplasias de Cabeça e Pescoço , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos
5.
BMC Neurol ; 22(1): 165, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35501715

RESUMO

BACKGROUND: As a debilitating syndrome, paraneoplastic cerebellar degeneration (PCD) remains challenging to treat. Further, anti-Yo antibody (directed against human cerebellar degeneration-related protein 2) detection in patients with PCD is associated with unsatisfactory responses to existing therapies. Here, we present the case of a 60-year-old woman who developed PCD with anti-Yo antibodies and a submandibular gland tumor. CASE PRESENTATION: A 60-year-old woman presented with a 5-day history of unsteadiness of gait and inadequate coordination of her extremities, along with truncal instability. Although walking without aid was possible, dysmetria of all four limbs, trunk, and gait ataxia was observed. While routine biochemical and hematological examinations were normal, the patient's blood was positive for anti-Yo antibodies. When the neurological symptoms deteriorated despite administration of intravenous methylprednisolone, fluorodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) images with contrast enhancement were performed, which showed a tumor in the left submaxillary gland. She underwent total left submandibular gland resection, including the tumor; histological and immunohistochemical results revealed a salivary duct carcinoma. She was administered intravenous methylprednisolone, followed by 10 plasma exchange sessions, intravenous immunoglobulins, and cyclophosphamide therapy. Following treatment, her symptoms were not alleviated, even after the reduction of anti-Yo titers. CONCLUSIONS: Although tumor detection was delayed, early tumor detection, diagnosis, and PCD treatment are essential because any delay can result in the progression of the disorder and irreversible neurological damage. Therefore, we recommend that the possibility of a salivary gland tumor should be considered, and whole-body dual-modality CT, including the head and neck, and FDG-PET should be performed at the earliest for patients with well-characterized paraneoplastic antibodies when conventional imaging fails to identify a tumor.


Assuntos
Degeneração Paraneoplásica Cerebelar , Neoplasias da Glândula Submandibular , Anticorpos Antineoplásicos , Autoanticorpos , Feminino , Fluordesoxiglucose F18 , Humanos , Metilprednisolona , Pessoa de Meia-Idade , Degeneração Paraneoplásica Cerebelar/complicações , Degeneração Paraneoplásica Cerebelar/diagnóstico , Neoplasias da Glândula Submandibular/complicações
6.
Clin Nucl Med ; 47(6): 551-552, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35507434

RESUMO

ABSTRACT: A 55-year-old man was diagnosed with gastric adenocarcinoma. 18F-FDG PET/CT was performed, which detected an enlarged nodule with increased uptake located in the omentum between the transverse colon and liver, thus lymph node metastasis was under suspicion. The patient subsequently underwent 68Ga-FAPI PET/MRI clinical trial after signing the informed consent, which also revealed the abnormal focus with intense uptake. However, the histopathology of the nodule was unexpectedly diagnosed as fibrous hyperplasia after lymphadenectomy.


Assuntos
Adenocarcinoma , Neoplasias Gástricas , Adenocarcinoma/diagnóstico por imagem , Erros de Diagnóstico , Fluordesoxiglucose F18 , Humanos , Hiperplasia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Omento , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Quinolinas , Neoplasias Gástricas/diagnóstico por imagem
7.
Clin Nucl Med ; 47(6): e446-e447, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35507436

RESUMO

ABSTRACT: Infectious causes of pulmonary artery invasion are extremely rare. A 71-year-old man had history of progressive dyspnea with abnormal salty taste. Contrast CT showed a filling defect mass in the main pulmonary artery with extraluminal extension to the heart and mediastinum. FDG PET/CT revealed a mass lesion with intense FDG uptake in the main pulmonary artery and peripheral. There were lesions with intense FDG uptake in the middle mediastinum besides the ascending aorta. Malignant tumor was suspected. Later, he received tumor debulking excision. Pathology reports showed necrotizing granulomatous inflammation, positive interferon-gamma release assays, and positive Mycobacterium tuberculosis culture.


Assuntos
Fluordesoxiglucose F18 , Mycobacterium tuberculosis , Idoso , Humanos , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/patologia
8.
Clin Nucl Med ; 47(6): e455-e456, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35507437

RESUMO

ABSTRACT: Germ cell tumors of the basal ganglia are rare neoplasms that usually present with hemiparesis or other neurological symptoms. MR and PET/CT with different tracers have demonstrated their usefulness for the correct assessment of disease. Crossed cerebellar diaschisis refers to a depression in metabolism of a cerebellar hemisphere as a result of contralateral supratentorial lesions. We present a case in which MR and PET/CT were crucial for the assessment of left basal ganglia germ cell tumors with the presence of crossed cerebellar diaschisis.


Assuntos
Neoplasias Embrionárias de Células Germinativas , Gânglios da Base/diagnóstico por imagem , Cerebelo/diagnóstico por imagem , Cerebelo/patologia , Fluordesoxiglucose F18 , Humanos , Neoplasias Embrionárias de Células Germinativas/complicações , Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Neoplasias Embrionárias de Células Germinativas/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
9.
Clin Nucl Med ; 47(6): e470-e471, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35507439

RESUMO

ABSTRACT: Spindle cell sarcoma is a connective tissue tumor usually involving bone or muscle. Penis is an unusual and very rare site for the primary involvement of the tumor, especially mesenchymal tumor. We here present a case of a 27-year-old man diagnosed with spindle cell sarcoma of penile origin in which FDG PET/CT was done as part of workup.


Assuntos
Fluordesoxiglucose F18 , Sarcoma , Adulto , Humanos , Masculino , Pênis , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Sarcoma/diagnóstico por imagem , Sarcoma/patologia
10.
BMC Cancer ; 22(1): 495, 2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-35513804

RESUMO

BACKGROUND: To rethink the clinical significance of standardized uptake values (SUVs) of nasopharyngeal carcinoma (NPC) on 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET). METHODS: We retrospectively reviewed 369 NPC patients who underwent pretreatment 18F-FDG PET. The predictive value of the SUVmax of the primary tumor (SUVmax-t) and regional lymph nodes (SUVmax-n) was evaluated using probability density functions. Receiver operating characteristic curves were used to determine optimal cutoffs for the SUVmax-n/SUVmax-t ratio (NTR). Kaplan-Meier and Cox regression analyses were used to assess survival. RESULTS: The optimal SUVmax-t and SUVmax-n cutoffs were 7.5 and 6.9, respectively. High SUVmax-t and SUVmax-n were related to local and regional recurrence, respectively. Patients with low SUVmax had better 3-year overall survival (OS). To avoid cross-sensitization of cutoff points, we stratified patients with high SUVmax into the low and high NTR groups. The 3-year distant metastasis-free survival (DMFS; 92.3 vs. 80.6%, P = 0.009), progression-free survival (PFS; 84.0 vs. 67.7%, P = 0.011), and OS (95.9 vs. 89.2%, P = 0.002) significantly differed between the high vs. low NTR groups for patients with high SUVmax. Multivariable analysis showed that NTR was an independent prognostic factor for DMFS (hazard ratio [HR]: 2.037, 95% CI: 1.039-3.992, P = 0.038), PFS (HR: 1.636, 95% CI: 1.021-2.621, P = 0.041), and OS (HR: 2.543, 95% CI: 1.214-5.325, P = 0.013). CONCLUSION: High SUVmax was associated with NPC recurrence. NTR is a potential prognosticator for DMFS, suggesting that heterogeneity in the pretreatment 18F-FDG uptake between the primary tumor and lymph nodes is associated with high invasion and metastatic potential.


Assuntos
Fluordesoxiglucose F18 , Neoplasias Nasofaríngeas , Humanos , Carcinoma Nasofaríngeo/diagnóstico por imagem , Neoplasias Nasofaríngeas/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons/métodos , Prognóstico , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
11.
Mol Imaging ; 2022: 9222331, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35517712

RESUMO

Purpose: Bacterial cancer therapy (BCT) research using engineered Salmonella typhimurium has increased in recent years. 2-Deoxy-2[18F] fluoro-D-glucose positron emission tomography (FDG PET) is widely used in cancer patients to detect cancer, monitor treatment responses, and predict prognoses. The aim of this pilot study was to investigate FDG uptake patterns in a mouse tumor model after BCT. Procedures. BCT was performed via the intravenous injection of attenuated S. typhimurium (SLΔppGpp/lux) into female mice bearing a tumor (derived from CT26 murine colon cancer cells) in the right thigh. 18F-FDG PET images acquired before BCT and at different time points after BCT. In vivo bioluminescence imaging confirmed bacterial presence in the tumor. The tumor volume, standardized uptake value (SUV) of FDG (SUVmax and SUVmean), early SUV reduction%, and normalized tumor volume change were analyzed. Results: Early after BCT (1 or 2 days post-injection (dpi)), FDG tumor uptake decreased in 10 out of 11 mice and then increased at later stages. FDG uptake before BCT was correlated with normalized tumor volume change after BCT. Early FDG reduction% after BCT was correlated with normalized volume change after BCT. Conclusions: Early after BCT, FDG tumor uptake decreased and then increased at later stages. The higher the FDG tumor uptake before BCT, the better the BCT response. FDG uptake patterns were related to tumor volume change after BCT. Therefore, FDG uptake was a good candidate for evaluating BCT.


Assuntos
Neoplasias do Colo , Fluordesoxiglucose F18 , Animais , Neoplasias do Colo/diagnóstico por imagem , Neoplasias do Colo/terapia , Feminino , Glucose , Humanos , Camundongos , Projetos Piloto , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Salmonella typhimurium
12.
Sci Rep ; 12(1): 7148, 2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35504955

RESUMO

Aim of this study was to validate the prognostic impact of clinical parameters and baseline 18F-FDG-PET/CT derived textural features to predict histopathologic response and survival in patients with esophageal squamous cell carcinoma undergoing neoadjuvant chemoradiation (nCRT) and surgery. Between 2005 and 2014, 38 ESCC were treated with nCRT and surgery. For all patients, the 18F-FDG-PET-derived parameters metabolic tumor volume (MTV), SUVmax, contrast and busyness were calculated for the primary tumor using a SUV-threshold of 3. The parameter uniformity was calculated using contrast-enhanced computed tomography. Based on histopathological response to nCRT, patients were classified as good responders (< 10% residual tumor) (R) or non-responders (≥ 10% residual tumor) (NR). Regression analyses were used to analyse the association of clinical parameters and imaging parameters with treatment response and overall survival (OS). Good response to nCRT was seen in 27 patients (71.1%) and non-response was seen in 11 patients (28.9%). Grading was the only parameter predicting response to nCRT (Odds Ratio (OR) = 0.188, 95% CI: 0.040-0.883; p = 0.034). No association with histopathologic treatment response was seen for any of the evaluated imaging parameters including SUVmax, MTV, busyness, contrast and uniformity. Using multivariate Cox-regression analysis, the heterogeneity parameters busyness (Hazard Ratio (HR) = 1.424, 95% CI: 1.044-1.943; p = 0.026) and contrast (HR = 6.678, 95% CI: 1.969-22.643; p = 0.002) were independently associated with OS, while no independent association with OS was seen for SUVmax and MTV. In patients with ESCC undergoing nCRT and surgery, baseline 18F-FDG-PET/CT derived parameters could not predict histopathologic response to nCRT. However, the PET/CT derived features busyness and contrast were independently associated with OS and should be further investigated.


Assuntos
Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/terapia , Carcinoma de Células Escamosas do Esôfago/diagnóstico por imagem , Carcinoma de Células Escamosas do Esôfago/terapia , Fluordesoxiglucose F18/metabolismo , Humanos , Imagem Multimodal/métodos , Terapia Neoadjuvante , Neoplasia Residual , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Compostos Radiofarmacêuticos/metabolismo
14.
Contrast Media Mol Imaging ; 2022: 9614678, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35494209

RESUMO

Objective: To evaluate 18F-fluorodeoxyglucose positron emission tomography (18FDG PET) and clinical parameters to differentiate rheumatoid arthritis (RA) and polymyalgia rheumatic (PMR). Patients and Methods. This retrospective study evaluated 54 patients with suspected RA (n = 23) and PMR (n = 31) who underwent 18F-FDG PET/CT before treatment. The complete diagnosis was based on each classification criterion and at least followed up for 6 months. Demographic and clinical data were also collected. Semiquantitative analysis (maximum standardized uptake value, SUVmax) of abnormal 18F-FDG uptake was undertaken at 17 musculoskeletal sites, and two scoring systems (mean reference (liver/control) scores) were evaluated. The differential diagnostic efficacy of each independent parameter was evaluated using the receiver operating characteristic (ROC) curve. Integrated discriminatory improvement (IDI) and bootstrap tests were used to evaluate the improvement in diagnostic efficacy using a combination of multiple parameters. Results: The ROC curve analysis of SUVmax indicated that the interspinous ligament showed the highest discriminative diagnostic value (sensitivity, 64.5%; specificity, 78.3%; area under the curve (AUC), 0.764; positive predictive value, 0.800; negative predictive value, 0.621). The combined model with the rheumatoid factor (RF) and metabolic parameters of 18F-FDG PET resulted in the highest AUC of 0.892 and showed significant reclassification by IDI (IDI, 9.51%; 95% confidence interval: 0.021-0.175; P = 0.013). According to the bootstrap test, compared with RF alone, the combination of RF and metabolic parameters showed an improvement in ROC and was statistically significant (P = 0.017). Conclusions: The combination of 18F-FDG PET metabolic and clinical parameters can further improve the differential diagnosis of RA and PMR.


Assuntos
Artrite Reumatoide , Fluordesoxiglucose F18 , Artrite Reumatoide/diagnóstico por imagem , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Estudos Retrospectivos
15.
Contrast Media Mol Imaging ; 2022: 5975338, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35494210

RESUMO

Purpose: Our study aims to compare the diagnostic value of 18F-NaF positron emission tomography-computed tomography (PET/CT), 18F-NaF PET, and planar 99mTc-MDP bone scintigraphy for detection of bone metastases in patients with newly diagnosed nasopharyngeal carcinoma (NPC). Methods: Our study retrospectively analyzed 58 patients with pathologically proven NPC. They all underwent both 18F-NaF PET/CT and planar 99mTc-MDP bone scintigraphy within a 7-day interval. Bone metastases were confirmed by follow-up using PET/CT, contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI). These three examinations were compared using per-patient-based analysis and per-lesion-based analysis. Results: 19 patients (32.7%) were classified as having bone metastatic disease in their final diagnosis. The patient-based diagnostic performances (sensitivity, specificity, and overall accuracy) were as follows: 18F-NaF PET/CT (100%, 92.3%, and 94.8%), 18F-NaF PET (100%, 53.8%, and 69.0%), and planar 99mTc-MDP bone scintigraphy (78.9%, 74.4%, and 75.9%). The overall accuracy of 18F-NaF PET/CT was significantly more favorable compared to 18F-NaF PET (p=0.002) and to planar 99mTc-MDP bone scintigraphy (p=0.044). The lesion-based diagnostic performances (sensitivity, specificity, and overall accuracy) were as follows: 18F-NaF PET/CT (98.5%, 93.9%, and 96.6%), 18F-NaF PET (98.5%, 57.1%, and 81.1%), and planar 99mTc-MDP bone scintigraphy (69.9%, 85.7%, and 76.4%). Conclusion: 18F-NaF PET/CT outperforms 18F-NaF PET or planar 99mTc-MDP bone scintigraphy in detecting bone metastases with newly diagnosed NPC on a patient-based and lesion-based analysis.


Assuntos
Neoplasias Ósseas , Neoplasias Nasofaríngeas , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Fluordesoxiglucose F18 , Humanos , Imagem Multimodal/métodos , Carcinoma Nasofaríngeo/diagnóstico por imagem , Neoplasias Nasofaríngeas/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons/métodos , Estudos Retrospectivos , Medronato de Tecnécio Tc 99m
16.
Contrast Media Mol Imaging ; 2022: 4849081, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35510179

RESUMO

Hemophagocytic lymphohistiocytosis (HLH) is a rare, potentially fatal illness, which can be divided into primary HLH (pHLH) and secondary HLH (sHLH). pHLH can be driven by genetic defections. Moreover, the sHLH is usually be triggered by malignancy or non-malignancy diseases. Sixty-two newly diagnosed sHLH patients with known etiology and those who underwent 18F-FDG PET/CT examination from July 2018 to December 2020 were retrospectively analyzed. They were divided into malignancy-associated HLH (M-HLH, n = 13) and non-malignancy-associated HLH (NM-HLH, n = 49). The metabolic parameters of the liver (Li), spleen (Sp), bone marrow (BM), lymph nodes (LN), and their ratios to the liver background (LiBG) and mediastinum (M) were compared between two groups. These metabolic parameters were evaluated for correlation with laboratory parameters and prognostic parameters. We found that the SUVmax-LN/Sp/Li and SUVmean-Sp in M-HLH were significantly higher than those in NM-HLH (P=0.031, 0.035, 0.016, and 0.032). The malignant disease should be considered when SUVmax-LN was higher than 4.41 (sensitivity 61.5%, specificity 81.6%). Hypermetabolic lesions in extranodal organs were more likely to occur in M-HLH than in NM-HLH (P=0.011). IFN- γ was positively correlated with SUVmax-BM/Li/Sp and SUVmean-BM/Li/Sp (P < 0.05). Ferritin, sCD25, IL-6, and IL-10 were positively correlated with SUVmax-Sp and SUVmean-Sp (P < 0.05). In Epstein-Barr virus-associated HLH (EBV-HLH), the SUV parameters of bone marrow were significantly correlated with a poor 2-week treatment response, overall survival, and event-free survival (P < 0.05). We conclude that some 18F-FDG PET/CT metabolic parameters can help identify the etiology of sHLH in children and provide directions for further inspection. The malignant disease should be considered when the SUVmax-LN is higher than 4.41 and hypermetabolic lesions occur in extranodal organs. In EBV-HLH, a higher SUV of bone marrow is associated with a poorer prognosis.


Assuntos
Infecções por Vírus Epstein-Barr , Linfo-Histiocitose Hemofagocítica , Neoplasias , Criança , Infecções por Vírus Epstein-Barr/complicações , Fluordesoxiglucose F18 , Herpesvirus Humano 4 , Humanos , Linfo-Histiocitose Hemofagocítica/diagnóstico por imagem , Linfo-Histiocitose Hemofagocítica/etiologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Prognóstico , Estudos Retrospectivos
17.
In Vivo ; 36(3): 1519-1522, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35478156

RESUMO

BACKGROUND/AIM: Pulmonary arterial intimal sarcoma (PAIS) is a rare malignant soft tissue tumor that is difficult to differentiate from pulmonary thromboembolism (PTE). Therefore, pre-operative diagnosis is often difficult. However, recent advances in fluorodeoxyglucose positron emission tomography (FDG-PET) have enabled the use of standardized uptake values (SUVs) for the differential diagnosis of PAIS from PTE, and the frequency of diagnosis of PAIS has increased. Here, we report a case of PAIS that was difficult to differentiate from PTE despite using FDG-PET. CASE REPORT: A 40-year-old woman presented with gradually worsening exertional dyspnea. Contrast-enhanced computed tomography (CT) revealed lesions with poor enhancement in the right lateral basal pulmonary artery. FDG-PET/CT did not reveal any tumor or thrombosis in other areas. Cytological evaluation using a right ventricular catheter did not lead to a definitive diagnosis. Because the patient did not respond to anticoagulation, we performed pulmonary artery endarterectomy. Pathological examination of the pulmonary artery tumor revealed a mucinous tumor with an edematous stroma and spindle-shaped tumor-cell proliferation, which confirmed the diagnosis of PAIS. However, FDG/PET demonstrated a low SUV of 3.4. CONCLUSION: Some PAISs with low cellular densities and high mucous tissue proportions have SUVs similar to those in PTE. In patients with low FDG uptake, if PAIS is suspected based on other objective findings, additional exploration using highly invasive tests or surgical procedures specific to PAIS is warranted.


Assuntos
Hipertensão Pulmonar , Neoplasias Pulmonares , Embolia Pulmonar , Sarcoma , Adulto , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/diagnóstico , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons/métodos , Embolia Pulmonar/diagnóstico por imagem , Sarcoma/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
18.
BMC Cancer ; 22(1): 403, 2022 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-35418080

RESUMO

BACKGROUND: R-CHOP with or without radiotherapy is the standard treatment for limited-stage diffuse large B-cell lymphoma (DLBCL). To prevent overtreatment, we assessed whether four cycles of CHOP plus six applications of rituximab was adequate with negative interim PET/CT and the role of consolidation radiotherapy specifically for patients with Waldeyer's ring DLBCL. One hundred and twenty-nine patients with limited-stage DLBCL were enrolled in this open-label, nonrandomized, single-arm, phase 2 clinical trial (NCT01804127). METHODS: All patients were initially treated with 4 cycles of R-CHOP and underwent interim PET/CT. Patients with negative PET/CT (Deauville scores 1-2) received 2 additional cycles of rituximab monotherapy, unless they had any risk factors (primary mediastinal large B-cell lymphoma, extranodal primary or bulky disease). Otherwise, patients received another 2 cycles of R-CHOP. Patients with partial response on interim PET/CT received another 4 cycles of R-CHOP. No radiotherapy was conducted in Waldeyer's ring DLBCL patients with negative PET/CT. The primary endpoint was 3-year progression-free survival (PFS). Overall survival (OS) in this study was compared with those from a historical study (NCT 00854568159). RESULTS: One hundred fifteen interim PET/CT scans (89.1%) were negative after 4 cycles of R-CHOP. An elevated lactate dehydrogenase level was significantly associated with positive interim PET/CT (P < 0.05). A trend of inferior outcome was observed in patients with positive interim PET/CT in terms of 3-year PFS (78.6% vs. 91.9%, P = 0.24) and 3-year OS (85.7% vs. 95.6%, P = 0.16). There were no PFS or OS differences found between patients treated with 4R-CHOP+2R and those treated with 6R-CHOP from a historical control study. Patients with Waldeyer's ring DLBCL and negative interim PET/CT achieved a 3-year PFS of 87.2% and a 3-year OS of 89.7%. CONCLUSIONS: Our results suggested that for interim PET/CT-negative patients without risk factors, the extra 2 cycles of CHOP might be omitted, and radiotherapy might also be omitted in patients with Waldeyer's ring DLBCL without compromising the efficacy. These results need to be confirmed in a randomized study. TRIAL REGISTRATION: clinicaltrials.gov , NCT01804127 . Date of first registration: 05/03/2013.


Assuntos
Linfoma Difuso de Grandes Células B , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Fluordesoxiglucose F18/uso terapêutico , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/radioterapia , Prednisona/uso terapêutico , Estudos Prospectivos , Rituximab , Vincristina/uso terapêutico
19.
Hell J Nucl Med ; 25(1): 103-105, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35388807

RESUMO

Peritoneal lymphomatosis (PL) is a rare extranodal involvement of non-Hodgkin's lymphoma (NHL) and is associated with a poor prognosis. It is confused with the more common peritoneal carcinomatosis and may be misdiagnosed. Early diagnosis is the most important step of effective treatment. In patients with NHL, fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is a valuable imaging modality in guiding biopsy, determining extent of the disease, and evaluating metabolic response to therapy. It also provides important information in the differential diagnosis. We report a case of a 40-year-old male patient who presented with abdominal distention and pain, with diffuse thickening of the peritoneum suggestive of peritoneal carcinomatosis on a computed tomography scan. Biopsy from the thickened peritoneum confirmed the diagnosis of diffuse large B cell lymphoma (DLBCL). Fluorine-18-FDG PET/CT performed for staging showed thickening and increased 18F-FDG uptake in almost the entire peritoneum as well as lymph node involvement in supra- and infra-diaphragmatic areas, and a mass in the spleen. Post-treatment 18F-FDG PET/CT revealed a complete metabolic response.


Assuntos
Linfoma Difuso de Grandes Células B , Linfoma não Hodgkin , Neoplasias Peritoneais , Adulto , Fluordesoxiglucose F18 , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/patologia , Masculino , Neoplasias Peritoneais/diagnóstico por imagem , Peritônio/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos
20.
Hell J Nucl Med ; 25(1): 106-107, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35388808

RESUMO

Pseudomyogenic hemangioendothelioma (PMH) presenting with right ventricle and pancreas involvement is very rare. Herein, we reported a 46-year-old man who presented multiple subcutaneous nodules throughout the body for eight months.Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) revealed multiplehypermetabolic lesions including in the soft tissues, right ventricle and pancreas. Fine needle aspiration of subcutaneous nodule revealed a PMH.


Assuntos
Fluordesoxiglucose F18 , Hemangioendotelioma , Ventrículos do Coração , Hemangioendotelioma/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos
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