Effectiveness of the addition of the brain region to the FDG-PET/CT imaging area in patients with suspected or diagnosed lung cancer.

PURPOSE: We aimed to evaluate the effectiveness of the brain region imaging in FDG-PET/CT scanning of patients with suspected or diagnosed lung cancer. MATERIALS AND METHODS: We performed the study retrospectively on the medical charts of 427 patients. We divided the FDG-PET/CT field of view (FOV) into four major imaging regions: brain, head-neck, abdomen and pelvis. Metastatic findings on these regions were checked and determined the potential of these findings to affect the chemotherapy or radiotherapy protocol or surgical management. If metastatic findings had a potential to modify these parameters, we named this situation as "clinical contribution". Considering the number of bed positions of these regions, we calculated the clinical contribution of each region and named as "effective clinical contribution". Then, we calculated the metastatic findings, clinical contribution, and effective clinical contribution ratios. RESULTS: We found different brain metastasis ratios for lung cancer, solitary pulmonary mass (SPM), and solitary pulmonary nodule (SPN) groups (8.7, 2.8 and 0.9 %, respectively). In addition, the clinical contribution and effective clinical contribution ratios in the brain region for these three groups were 6.4, 2.8, 0.0 and 6.4, 2.8, 0.0 %, respectively. The highest metastatic findings (30.6 %) and clinical contribution (9.8 %) ratios were found in the abdomen region of the lung cancer group. However, the highest effective clinical contribution ratio (6.8 %) was found in the brain region within the same group. CONCLUSIONS: The addition of the brain region to the limited whole-body FOV in FDG-PET/CT scanning seems to be effective in the lung cancer and SPM groups, but not in the SPN group.

Is there any significance of lung cancer histology to compare the diagnostic accuracies of (18)F-FDG-PET/CT and (99m)Tc-MDP BS for the detection of bone metastases in advanced NSCLC?

AIM OF THE STUDY: Bone scintigraphy (BS) and fluorine-18 deoxyglucose positron emission tomography computed tomography ((18)F-FDG-PET/CT) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in histological subgroups of non-small cell lung cancer (NSCLC) remains ambiguous. The aim of this study was to compare the efficacy of (18)F-FDG-PET/C and 99mTc-methylene diphosphonate ((99m)Tc-MDP) BS in the detection of bone metastases of patients in NSCLC. Specifically, we compared the diagnostic accuracies of these imaging techniques evaluating bone metastasis in histological subgroups of NSCLC. MATERIAL AND METHODS: Fifty-three patients with advanced NSCLC, who had undergone both (18)F-FDG-PET/CT and BS and were eventually diagnosed as having bone metastasis, were enrolled in this retrospective study. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of (18)F-FDG-PET/CT and BS were 90.4%, 99.4%, 98.1%, 96.6%, 97.0% and 84.6%, 93.1%, 82.5%, 93.2, 90.8%, respectively. The κ statistics were calculated for (18)F-FDG-PET/CT and BS. The κ-value was 0.67 between (18)F-FDG-PET/CT and BS in all patients. On the other hand, the κ-value was 0.65 in adenocarcinoma, and 0.61 in squamous cell carcinoma between (18)F-FDG-PET/CT and BS. The κ-values suggested excellent agreement between all patients and histological subgroups of NSCLC. CONCLUSIONS: (18)F-FDG-PET/CT was more favorable than BS in the screening of metastatic bone lesions, but the trend did not reach statistical significance in all patients and histological subgroups of NSCLC. Our results need to be validated in prospective and larger study clinical trials to further clarify this topic.

Evaluation of the nasal mucociliary transport rate by rhinoscintigraphy in marble workshop workers.

Marble workers are occupationally exposed to intense environmental marble dust in their workplace. We aimed to investigate the effect of occupational marble dust exposure on nasal mucociliary transport rate (NMTR). Seventeen marble workers and 18 healthy controls were studied. In all subjects, NMTRs were measured by (99m)Tc-MAA rhinoscintigraphy. NMTRs of workers and control groups were compared by statistically. Mean NMTR was found as 9 ± 1.8 mm/min in marble workers whereas mean NMTR of healthy controls was 9.6 ± 2.2 mm/min. There was no statistically significant difference between NMTRs of workers and control groups (p > 0.05). This study has shown that occupationally exposured marble dusts may not cause functional impairment on NMTR in marble workshop workers.

Evaluation of the nasal mucociliary transport rate by rhinoscintigraphy before and after surgery in patients with deviated nasal septum.

In this study, we have investigated the effect of nasal septal deviation (NSD) on nasal mucociliary activity and how does a septoplasty operation affects the nasal mucociliary transport rate in the first and third months during the post-operative period. Twenty-two patients who were diagnosed with NSD and 22 healthy controls were studied using rhinoscintigraphy with Tc-99m-macroaggregated albumin (Tc-99m-MAA). On each case, the nasal mucociliary transport rate (NMTR) was measured pre-operatively only on five cases, on the first and third months of post-operative period. The NMTRs of patients with a deviated septum were significantly lower than the NMTRs of the healthy controls on both the convex and concave sides. Significant improvement was observed in the first post-operative month. On the concave and convex sides, the average postop third month post-operative NMTR value was higher than the first month post-operative NMTR values. It was concluded that the septoplasty operation improves reduced NMTRs after surgery. The effect of nasal surgery on nasal mucociliary activity may be more accurately evaluated in the third month than the first month of post-operative period.

Effect of R-CHOP chemotherapy on liver and mediastinal blood pool (18)F-FDG standardized uptake values in patients with non-Hodgkin's lymphoma.

AIM: We aimed to investigate the impact of chemotherapy on (18)F-FDG uptake in the liver and mediastinal blood pool (MBP) among patients with non-Hodgkin's lymphoma. METHODS: Twenty-three patients with NHL underwent baseline, interim, and postchemotherapy (18)F-FDG PET/CT. SUVmax and SUVmean values of the liver and MBP at imaging time were compared statistically. RESULTS: We did not find any significant differences between the liver and mediastinum SUVmean and SUVmax values (P>.05). CONCLUSIONS: Our study demonstrates that the (18)F-FDG uptake in the liver and MBP are not significantly affected by R-CHOP chemotherapy in patients with NHL.

A comparison of acoustic radiation force impulse imaging and scintigraphy in the functional evaluation of the major salivary glands.

PURPOSE: This study aimed to determine the efficacy of acoustic radiation force impulse (ARFI) imaging for the functional assessment of salivary glands by comparing ARFI with salivary gland scintigraphy. MATERIALS AND METHODS: We prospectively evaluated 60 parotid (P) glands and 60 submandibular (SM) glands of 30 patients using salivary gland scintigraphy and ARFI elastography. The average pixel uptake and the excretion fraction (EF) in the P and SM glands were determined scintigraphically. The degree of stiffness in the P and SM glands at prelemon and postlemon stimulation periods were measured elastographically with ARFI. Changes in the degree of stiffness of the P and SM glands were also calculated with lemon stimulation. The scintigraphic and elastographic parameters were then compared statistically. RESULTS: We found a moderate linear correlation between the excretion function and the changes in the degree of stiffness of the P and SM glands induced by lemon stimulation (P<0.001, r=0.661; P<0.001, r=0.530, respectively). We also found a weak positive correlation between the EF and the degree of stiffness of the P and SM glands in the prelemon stimulation period (P=0.001, r=0.405; P<0.001, r=0.480, respectively). However, we did not find any significant correlation between other scintigraphic and elastographic parameters. CONCLUSION: ARFI imaging may play a role in the determination of the EF of P and SM glands by measuring tissue elasticity changes with lemon stimulation. However, ARFI does not seem to be a suitable substitute for scintigraphy in the evaluation of the parenchymal function of P and SM glands.

Assessment of technetium-99m labeled macroaggregated albumin rhinoscintigraphy for the measurement of nasal mucociliary transport rate: intratest, interobserver, and intraobserver reproducibility.

Objectives. The measurement of mucociliary transport velocity by rhinoscintigraphy with Tc-99m-macroaggregated albumin ((99m)Tc-MAA) is reliable measure of mucociliary clearance. The aim of this study is to assess the intratest, interobserver, and intraobserver reproducibility of nasal mucociliary transport rate (NMTR) measurement. Materials and Methods. Twenty-two subjects were evaluated to determine intratest reproducibility and a group of 35 subjects was examined to determine inter- and intraobserver reproducibility. Rhinoscintigraphy with (99m)Tc-MAA was used to measure NMTR in all study subjects. Paired NMTR measurements were compared using a range of statistical methodologies. Intraclass correlation coefficients (ICC) and repeatability coefficients and Bland-Altman plots were applied to assess the degree of intratest, interobserver, and intraobserver variation. Results. Statistical analysis of test and retest experiments demonstrated the statistical equivalence of intratest NMTR measurements, interobserver NMTR measurements, and intraobserver NMTR measurements. The intratest ICC, interobserver ICC, and intraobserver ICC were 0.96, 0.83, and 0.91, respectively, indicating that intratest and intraobserver reproducibility are excellent and interobserver reproducibility is good. Conclusions. Rhinoscintigraphy using (99m)Tc-MAA results in highly reproducible measurement of NMTR. The use of radionuclide imaging in measuring NMTR results in excellent intratest and intraobserver reproducibility and good interobserver reliability.

Evaluation of clinical contributions provided by addition of the brain, calvarium, and scalp to the limited whole body imaging area in FDG-PET/CT tumor imaging.

PURPOSE: The aim of this study was to detect additional findings in whole body FDG-PET/CT scan including the brain, calvarium, and scalp (compared to starting from the base of the skull) in cancer patients and to determine contributions of these results to tumor staging and treatment protocols. MATERIALS AND METHODS: We noted whether the findings related to the brain, calvarium, and scalp in 1359 patients had a potential to modify staging of the disease, chemotherapy protocol, radiotherapy protocol, and surgical management. We identified rates of metastatic findings on the brain, calvarium, and scalp according to the tumor types on FDG-PET/CT scanning. RESULTS: We found FDG-PET/CT findings for malignancy above the base of the skull in 42 patients (3.1%), one of whom was a patient with an unknown primary tumor. Twenty-two of the metastatic findings were in the brain, 16 were in the calvarium, and two were in the scalp. CONCLUSION: This study has demonstrated that addition of the brain to the limited whole body FDG-PET/CT scanning may provide important contributions to the patient's clinical management especially in patients with lung cancer, bladder cancer, malignant melanoma, breast cancer, stomach cancer, and unknown primary tumor.

Evaluation of Nasal Mucociliary Transport Rate byTc-Macroaggregated Albumin Rhinoscintigraphy in Woodworkers.

Woodworkers in the furniture industry are exposed to wood dust in their workplaces. The aim of this study is to investigate the effect of occupational wood dust exposure on the nasal mucociliary transport rates (NMTRs) in woodworkers. Twenty five woodworkers and 30 healthy controls were included in this study. Wood dust concentration in workplaces was measured using the sampling device. (99m) Tc-macroaggregated albumin ((99m)Tc-MAA) rhinoscintigraphy was performed, and NMTR was calculated in all cases. In statistical analysis, an independent samples t-test was used to compare NMTR of woodworkers and control subjects. We found that the mean NMTR of the woodworkers was lower than that of the healthy controls. However, there was not a statistically significant difference between them (P = 0.066). In conclusion, our findings suggested that wood dust exposure may not impair nasal mucociliary transport rate in woodworkers employed in joinery workshops.

Comparison of left ventricular functional parameters obtained from three different commercial automated software cardiac quantification program packages and their intraobserver reproducibility.

OBJECTIVE: ECG-gated myocardial perfusion scintigraphy (MPS) can be used to determine several cardiac functional parameters (e.g., left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV)). In this study, we aimed to compare these cardiac functional parameters calculated by the following cardiac quantification programs: Emory Cardiac Toolbox (ECTb), Quantitative Gated SPECT (QGS), and Myometrix. We also evaluated reproducibility of the cardiac programs. METHODS: Fifty-seven patients (27 male, 30 female) at Elazig Research and Training Hospital from 2008 to 2009 were included in this study. In all patients, (99m)Tc-MIBI ECG-Gated (8-bin frame mode) myocardial perfusion scintigraphies were performed. By using 3 different cardiac quantification programs (ECTb, QGS, and Myometrix); LVEF, EDV, and ESV were calculated. The same raw data of MPS images were reprocessed at different time periods, and these 3 parameters were recalculated. LVEF, EDV, and ESV yielded by 3 different programs were compared for interprogram variability assessment, and parameters calculated at two different time periods were compared to evaluate intraprogram reproducibility. RESULTS: There were statistically significant differences between ECTb, QGS, and Myometrix programs for LVEF, EDV, and ESV (p < 0.001). There was also a statistically significant correlation between LVEF and EDV (p < 0.001, r = 0.546; p < 0.001, r = 0.45, respectively), but no statistically significant correlation was present between the ESV values (p > 0.05, r = 0.09). Statistically significant differences were not found between the values of LVEF, EDV, and ESV obtained from the first and second reconstruction analysis of 3 cardiac quantification programs. DISCUSSION: Different MPS cardiac software programs give variable (but correlated) LVEF and left ventricular volumetric measures. Those obtained from different cardiac softwares cannot be used interchangeably. Our findings have shown that ECTb, QGS, and Myometrix programs are reproducible, with respect to LVEF, EDV, and ESV.