Feasibility of Left Ventricle Ejection Fraction Calculation Using Electrocardiographically Gated SPECT Acquisition of 99m Tc-HDP Bone Scintigraphy in Cardiac Amyloidosis.

ABSTRACT: We performed bone scintigraphy in 6 patients with suspected cardiac amyloidosis. To evaluate feasibility of left ventricle function analysis, we additionally performed electrocardiographically gated SPECT acquisition. The cardiac-gated SPECT data confirmed adequate tracer uptake for automatic myocardial contour determination. LVEF estimations ranged between 24% and 54%. Comparison with LVEF estimations from prior echocardiography generally showed only small differences. In one patient, the LVEF measurements from both methods seemed discordant, probably reflecting actual LVEF worsening, which was confirmed at follow-up echocardiography. Therefore, our results may suggest that cardiac-gated SPECT acquisition at bone scintigraphy can provide meaningful estimates of LVEF.

Diabetes Mellitus-Related Fractional Glucose Uptake in Men and Women Imaged With 18F-FDG PET-CT.

CONTEXT: Cohort studies show that cognitive dysfunction and both vascular and Alzheimer's dementia are more common in patients with type 2 diabetes mellitus (T2DM). OBJECTIVE: To review and compare brain volume and 18F-fluorodeoxyglucose (FDG) uptake in brain of individuals age 60 to 70 years with or without type 2 diabetes. DESIGN: We searched 620 medical records for negative 18FDG PET-CT scans obtained during 33 months. Records showing history of cognitive impairment, Alzheimer's disease, neurologic disorders, any history of brain atrophy, or documented cerebral infarction on neuroimaging were excluded from the study. RESULTS: A total of 119 medical records met the inclusion criteria. Data from 63 women and 56 men (without T2DM, 86; with T2DM, 33) were analyzed. Brain volume was larger in men than women (mean ± SD, 1411 ± 225 cm3 vs 1325 ± 147 cm3, respectively; P = 0.02), but men had a significantly lower fractional glucose uptake (SUVgluc), calculated as fasting blood glucose × SUVmax. [median (minimum, maximum), 63.6 (34.6, 126.6) vs 70.0 (36.4, 134.3); P = 0.02]. Brain volume was also larger in persons without T2DM than in those with T2DM (1392 ± 172 cm3 vs 1269 ± 183 cm3; P < 0.001), but SUVgluc was similar between these groups. Brain volume correlated with SUVgluc in both men and women overall (P < 0.001) but not in men and women with T2DM (P = 0.20 and 0.36, respectively). CONCLUSION: In men without T2DM, median brain volume was larger and fractional glucose uptake was less than in women without T2DM. In men and women with T2DM, brain volume and fractional glucose uptake were similar. The findings support the hypothesis that fractional glucose uptake becomes impaired in men with T2DM.

FDG-PET/CT Limited to the Thorax and Upper Abdomen for Staging and Management of Lung Cancer.

PURPOSE: This study evaluates the diagnostic accuracy of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) of the chest/upper abdomen compared to the generally performed scan from head to upper thighs, for staging and management of (suspected) lung cancer in patients with no history of malignancy or complaints outside the thorax. METHODS: FDG-PET/CT scans of 1059 patients with suspected or recently proven lung cancer, with no history of malignancy or complaints outside the thorax, were analysed in a retrospective multi-centre trial. Suspect FDG-avid lesions in the chest and upper abdomen, the head and neck area above the shoulder line and in the abdomen and pelvis below the caudal tip of the liver were noted. The impact of lesions detected in the head and neck area and abdomen and pelvis on additional diagnostic procedures, staging and treatment decisions was evaluated. RESULTS: The head and neck area revealed additional suspect lesions in 7.2%, and the abdomen and pelvis in 15.8% of patients. Imaging of the head and neck area and the abdomen and pelvic area showed additional lesions in 19.5%, inducing additional diagnostic procedures in 7.8%. This resulted in discovery of additional lesions considered malignant in 10.7%, changing patient management for lung cancer in 1.2%. In (suspected) lung cancer, PET/CT limited to the chest and upper abdomen resulted in correct staging in 98.7% of patients, which led to the identical management as full field of view PET in 98.8% of patients. CONCLUSION: High value of FDG-PET/CT for staging and correct patient management is already achieved with chest and upper abdomen. Findings in head and neck area and abdomen and pelvis generally induce investigations with limited or no impact on staging and treatment of NSCLC, and can be interpreted accordingly.