A new method for detecting urinary bladder cancer by using FDG PET/CT.

To evaluate the accuracy of a new fluorine-18-2-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) method when applying an increased upper limit of the image threshold (IULIT) to detect bladder cancer. All patients with an unknown history of bladder tumors were retrospectively included for analysis. Applying an IULIT in PET showed a hypermetabolic focus. (18)F-FDG accumulation in the bladder that was higher or lower than the urinary level of (18)F-FDG was considered an abnormal focus. In 12 of the 28,767 patients with bladder cancer, applying an IULIT in PET allowed the visualization of the contrast between lesion and urinary activity. The proposed method could increase the accuracy of detection of bladder cancer.

Direct injection of (188)Re-microspheres in the treatment of hepatocellular carcinoma: compared with traditional percutaneous ethanol injection: an animal study.

UNLABELLED: The AIM of this study was to compare the therapeutic efficacies of direct intratumoural injection of (188)Re microspheres (DIRM) and direct intratumoural injection of ethanol (DIE) in rabbits bearing liver tumours. MATERIALS AND METHODS: Fifteen rabbits bearing liver tumours were divided into three groups: group 1 received DIE, group 2 received DIRM, and group 3 (control) received saline. Tumour size was measured by liver sonography before injection, as well as 2, 4, 8, and 12 weeks after injection. Survival time was calculated from the day of treatment to three months after treatment by Kaplan-Meier survival analysis. RESULTS: The mean survival time was 68 +/- 9.8 days for the rabbits in the DIRM group, 55.8 +/- 11.8 days for the DIE group, and 38.8 +/- 6.2 days for the control group. CONCLUSION: The rabbits survived longer in the DIRM group than in the DIE group although there is no statistical significance. We believe the DIRM method has a good potential to be an alternative to DIE for the treatment of liver tumours.

A high-fibre diet in combination with bisacodyl for bowel preparation in gallium renal scintigraphy.

Bowel accumulation of gallium-67 frequently complicates the interpretation of gallium-67 scintigrams. This is a drawback, especially when reading gallium renal images. In this study, we evaluated the value of a high-fibre diet in bowel preparation for improving the quality of gallium renal imaging in lupus nephritis. Group A, consisting of 86 patients, was on a regular diet and received bisacodyl the night before imaging. Group B, consisting of 77 patients, was on a high-fibre diet for three consecutive days before imaging and received bisacodyl the night before imaging. Gallium bowel activity was rated on a scale of 0 to III on the basis of anterior and posterior views of delayed 48 h images. Our data revealed that there was a significant difference in image quality between groups A and B. Fifty per cent of group A patients had obvious bowel activity. The percentage decreased significantly to 25% in group B. In conclusion, the application of a high-fibre diet significantly improves the efficacy of bowel preparation for gallium renal scintigraphy in the evaluation of lupus nephritis.

Value of 18F-fluoro-2-deoxyglucose positron emission tomography in the evaluation of recurrent colorectal cancer.

To evaluate the clinical value of positron emission tomography (PET) with 18F-fluoro-2-deoxyglucose (FDG) in recurrent colorectal cancer, the records of 33 patients who underwent 34 FDG-PET scans were reviewed and compared with computed tomography (CT) and carcinoembryonic antigen (CEA). The final diagnosis was based on operative, histopathological findings or clinical follow-up > 1 year. FDG-PET detected all 15 patients with recurrent diseases (9 local recurrences, 4 lymphatic metastases, 2 hepatic metastases and 8 pulmonary metastases) and 1 primary lung cancer. However, there were 3 false positive cases. The overall sensitivity and specificity of FDG-PET were 100% and 83%, respectively. The sensitivity and specificity of CEA were 33% and 86%, respectively, for detecting recurrent colorectal cancer. Abdominal CT had a sensitivity and specificity of 78% and 61% for detecting local recurrence and detected one lymphatic and one hepatic metastasis. In conclusion, the FDG-PET was more accurate than CT and CEA for the detection of recurrent colorectal cancer. In addition, it accurately detected distant metastases or occult secondary malignancy and may affect clinical management.

Differentiation of radiographically indeterminate solitary pulmonary nodules with.

BACKGROUND: The purpose of this preliminary study was to evaluate the efficacy of positron emission tomography (PET) with [18F]fluoro-2-deoxyglucose (FDG) for differentiating benign from malignant solitary pulmonary nodules. METHODS: Twenty-six patients (12 females, 14 males, age 27-79 years) with radiographically indeterminate solitary pulmonary nodules underwent FDG-PET and the findings were compared with the results of pathological examination of biopsy samples. FDG activity in the lesion was expressed as the ratio of lesion-to-background counts (L/B ratio) for semiquantitative analysis. RESULTS: The mean L/B ratio of malignant lesions (8.81+/-3.71, n = 20) was not significantly higher than that of benign lesions (4.71+/-3.00, n = 6) (p = 1.00). Using a cut-off L/B ratio of 5.0 for malignancy, FDG-PET correctly detected 19 true positive and three true negative cases, but failed to detect three false positive (two abscesses and one cryptococcus) cases and one false negative (adenocarcinoma) case. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 95, 50, 86, 75 and 85%, respectively. CONCLUSIONS: FDG-PET is a sensitive modality for detecting malignancy, but is not specific enough. Benign lung lesion with active inflammation could demonstrate high FDG uptake, making it difficult to differentiate from malignancy. In the future, we will increase the case numbers to evaluate further the utility of FDG-PET for differentiating radiographically indeterminate solitary pulmonary nodules.

Recurrent hyperfunctioning parathyroid gland demonstrated on radionuclide imaging and an intraoperative gamma probe.

Radionuclide imaging with Tc-99m MIBI is the preferred mode of parathyroid localization in current practice. It also successfully identifies hyperfunctioning autotransplanted parathyroid tissue. The authors report a case with recurrent hyperparathyroidism after total parathyroidectomy and autotransplantation in the forearm. Double-phase Tc-99m MIBI imaging successfully localized the hyperfunctioning parathyroid tissue, which was missed by magnetic resonance imaging and ultrasonography. In addition, the parathyroid tissue was localized using an intraoperative probe at subsequent surgery.

Focal cerebral hyper-perfusion in phantom limbs: assessed by Tc-99m HMPAO SPECT.

Phantom limb pain is a common experience for patients who have received amputation. However, the definite mechanism is still not clear. Here, we describe a patient who suffered from phantom limb pain after left above-elbow amputation. The Tc-99m hexamethylpropylene amine oxime (HMPAO) brain single photon emission computed tomography (SPECT) study revealed increased regional cerebral blood flow in the right parietal cortex. This finding may imply the involvement of cerebral cortex in the development of phantom limb pain. Further study is worthwhile to elucidate the utility of SPECT and the role of cortex in phantom limb pain.

Multiple skeletal metastases of Ewing's sarcoma demonstrated on FDG-PET and compared with bone and gallium scans.

Bone and gallium scans have been shown to be useful in imaging Ewing's sarcoma. Here we report on a case of recurrent Ewing's sarcoma with multiple skeletal metastases demonstrated by the FDG-PET whole body scan, while the bone scan revealed fewer lesions and a non-remarkable finding was found on the gallium scan. The following pathologic examination showed bone marrow involvement. This case demonstrated that the FDG-PET could detect more lesions of metastatic Ewing's sarcoma than bone and gallium scans, especially for those with bone marrow involvement.