RESUMO
The authors describe the case of a 42-year-old woman presenting with significant knee pain and disability. Her imaging findings using contrast MR imaging and FDG PET/CT suggested adhesive capsulitis, which was confirmed by arthroscopy, histology, and the clinical outcome.
Assuntos
Bursite/diagnóstico , Articulação do Joelho , Adulto , Artroscopia , Bursite/cirurgia , Feminino , Humanos , Imageamento por Ressonância MagnéticaRESUMO
PURPOSE: A pilot study was performed in patients with recurrent back pain after spinal fusion surgery to evaluate the ability of (18)F-NaF PET/CT imaging to correctly identify those requiring surgical intervention and to locate a site amenable to surgical intervention. METHODS: In this prospective study 22 patients with recurrent back pain after spinal surgery and with equivocal findings on physical examination and CT were enrolled for evaluation with (18)F-NaF PET/CT. All PET/CT images were prospectively reviewed with the primary objective of identifying or ruling out the presence of lesions amenable to surgical intervention. The PET/CT results were then validated during surgical exploration or clinical follow-up of at least 15 months. RESULTS: Abnormal (18)F-NaF foci were found in 16 of the 22 patients, and surgical intervention was recommended. These foci were located at various sites: screws, cages, rods, fixation hardware, and bone grafts. In 6 of the 22 patients no foci requiring surgical intervention were found. Validation of the results by surgery (15 patients) or on clinical follow-up (7 patients) showed that (18)F-NaF PET/CT correctly predicted the presence of an abnormality requiring surgical intervention in 15 of 16 patients and was falsely positive in 1 of 16. CONCLUSION: In this initial investigation, (18)F-NaF PET/CT imaging showed potential utility for evaluation of recurrent symptoms after spinal fusion surgery by identifying those patients requiring surgical management.
Assuntos
Radioisótopos de Flúor , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Fusão Vertebral , Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Dor nas Costas/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fluoreto de Sódio , Coluna Vertebral/cirurgiaRESUMO
PURPOSE: To perform a systematic review of the effect of blood glucose levels on 2-Deoxy-2-[18F]fluoro-D-glucose (18F-FDG) uptake in normal organs. METHODS: We searched the MEDLINE, EMBASE and Cochrane databases through 22 April 2017 to identify all relevant studies using the keywords "PET/CT" (positron emission tomography/computed tomography), "standardized uptake value" (SUV), "glycemia," and "normal." Analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Maximum and mean SUVs and glycemia were the main parameters analyzed. To objectively measure the magnitude of the association between glycemia and 18F-FDG uptake in different organs, we calculated the effect size (ES) and the coefficient of determination (R2) whenever possible. RESULTS: The literature search yielded 225 results, and 14 articles met the inclusion criteria; studies included a total of 2714 (range, 51-557) participants. The brain SUV was related significantly and inversely to glycemia (ES = 1.26; R2 0.16-0.58). Although the liver and mediastinal blood pool were significantly affected by glycemia, the magnitudes of these associations were small (ES = 0.24-0.59, R2 = 0.01-0.08) and negligible (R2 = 0.02), respectively. Lung, bone marrow, tumor, spleen, fat, bowel, and stomach 18F-FDG uptakes were not influenced by glycemia. Individual factors other than glycemia can also affect 18F-FDG uptake in different organs, and body mass index appears to be the most important of these factors. CONCLUSION: The impact of glycemia on SUVs in most organs is either negligible or too small to be clinically significant. The brain SUV was the only value largely affected by glycemia.
Assuntos
Glicemia/análise , Fluordesoxiglucose F18/farmacocinética , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Compostos Radiofarmacêuticos/farmacocinética , Transporte Biológico , Encéfalo/diagnóstico por imagem , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , HumanosRESUMO
Our purpose was to evaluate the effect of glycemia on 18F-FDG uptake in normal organs of interest. The influences of other confounding factors, such as body mass index (BMI), diabetes, age, and sex, on the relationships between glycemia and organ-specific standardized uptake values (SUVs) were also investigated. We retrospectively identified 5623 consecutive patients who had undergone clinical PET/CT for oncological indications. Patients were stratified into groups based on glucose levels, measured immediately before 18F-FDG injection. Differences in mean SUVmax values among glycemic ranges were clinically significant only when >10% variation was observed. The brain was the only organ that presented a significant inverse relationship between SUVmax and glycemia (p < 0.001), even after controlling for diabetic status. No such difference was observed for the liver or lung. After adjustment for sex, age, and BMI, the association of glycemia with SUVmax was significant for the brain and liver, but not for the lung. In conclusion, the brain was the only organ analyzed showing a clinically significant relationship to glycemia after adjustment for potentially confounding variables. The lung was least affected by the variables in our model, and may serve as an alternative background tissue to the liver.
Assuntos
Glicemia/metabolismo , Encéfalo/metabolismo , Fluordesoxiglucose F18/metabolismo , Fígado/metabolismo , Pulmão/metabolismo , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Idoso , Encéfalo/diagnóstico por imagem , Feminino , Humanos , Fígado/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos/metabolismo , Estudos RetrospectivosAssuntos
Complexo AIDS Demência/diagnóstico por imagem , Terapia Antirretroviral de Alta Atividade , Tomografia Computadorizada de Emissão de Fóton Único , Complexo AIDS Demência/tratamento farmacológico , Adulto , Atlas como Assunto , Feminino , Humanos , Imageamento Tridimensional , Técnicas EstereotáxicasRESUMO
Foram selecionados 40 pacientes assintomáticos (45 quadris) pós-artroplastia total de quadril (ATQ) não-cimentada Bicontact e submetidos à cintilografia quantitativa com tecnécio, com objetivo de estabelecer um padrão normal de captação. Foram delimitadas regiões periprotéticas de interesse no acetábulo e fêmur, e utilizados como controle o fêmur contralateral e sacroilíacas, estabelecendo-se razões matemáticas. Houve queda da captação em todos os parâmetros junto à ATQ, à exceção da relação ponta da haste/terço médio, que permaneceu constante. Nas médias de captação para o acetábulo, houve queda significativa aos 12 meses, enquanto que o fêmur diminuiu sua captação por completo somente aos 18 meses, mantendo-se constante após. Este estudo pode servir de referência cintilográfica para acompanhamento de pacientes submetidos à ATQ não-cimentada.