Nicotine alleviates alcohol-induced memory and long-term potentiation impairment.

Alcohol and nicotine are routinely abused together. There is one plausible explanation that comorbidity can alleviate alcohol-induced cognitive impairment. However, the mechanism involved is not known. The aim of this report was to evaluate the interactive effects of alcohol coadministration with nicotine on hippocampal memory and long-term potentiation (LTP). C57BL/6 mice were distributed into 4 treatment groups: control, alcohol, nicotine, and alcohol plus nicotine. All mice received tap water or alcohol solution and saline or nicotine. In water maze test, the alcohol group showed significant decreases in hippocampus function and acquisition training than control, nicotine, and combined treatment groups. The alcohol group also showed a significantly shorter latency in entering the foot-shock compartment than control, nicotine, and combined treatment groups in a passive avoidance test. Theta burst stimulation was adopted to induce concrete LTP in CA1 field recording using hippocampal slice. Alcohol alone administration failed to maintain LTP. Nicotine alone administration did not alter hippocampal LTP. There were no negative effects of alcohol on hippocampal LTP in mice administrated with nicotine. The current study successfully demonstrated beneficial effects of nicotine on alcohol induced memory impairment accompanied by hippocampal LTP impairment after one week of co-administration and one-day withdrawal.

Incidental Detection of Ovarian Cancer as a Solitary Peridiaphragmatic Distant Lymph Node Metastasis without Pelvic Lesions on 18F-FDG PET/CT.

The spreading pattern of ovarian carcinoma is unique and unlike most other cancers, because exfoliated ovarian cancer cells primarily disseminate within the abdominal cavity, which are then transported throughout the peritoneum by physiological peritoneal fluid. An initial manifestation of a solitary peridiaphragmatic distant metastatic lymph node without peritoneal involvement is very rare. This study reports a case with an incidentally found single hypermetabolic mass in the peridiaphragmatic space without a pelvic lesion in the baseline staging 18 F-FDG PET/CT that histologically turned out to be metastatic serous papillary carcinoma due to ovarian cancer. 18F-FDG PET/CT may allow the identification of the initial manifestation of unexpected distant oligometastatic statuses of an unknown primary ovarian cancer.

Activation of matrix metalloproteinases and FoxO3a in HaCaT keratinocytes by radiofrequency electromagnetic field exposure.

As the skin is the largest body organ and critically serves as a barrier, it is frequently exposed and could be physiologically affected by radiofrequency electromagnetic field (RF-EMF) exposure. In this study, we found that 1760 MHz RF-EMF (4.0 W/kg specific absorption rate for 2 h/day during 4 days) exposure could induce intracellular reactive oxygen species (ROS) production in HaCaT human keratinocytes using 2',7'-dichlorofluorescin diacetate fluorescent probe analysis. However, cell growth and viability were unaffected by RF-EMF exposure. Since oxidative stress in the skin greatly influences the skin-aging process, we analyzed the skin senescence-related factors activated by ROS generation. Matrix metalloproteinases 1, 3, and 7 (MMP1, MMP3, and MMP7), the main skin wrinkle-related proteins, were significantly increased in HaCaT cells after RF-EMF exposure. Additionally, the gelatinolytic activities of secreted MMP2 and MMP9 were also increased by RF-EMF exposure. FoxO3a (Ser318/321) and ERK1/2 (Thr 202/Tyr 204) phosphorylation levels were significantly increased by RF-EMF exposure. However, Bcl2 and Bax expression levels were not significantly changed, indicating that the apoptotic pathway was not activated in keratinocytes following RF-EMF exposure. In summary, our findings show that exposure to 1760 MHz RF-EMF induces ROS generation, leading to MMP activation and FoxO3a and ERK1/2 phosphorylation. These data suggest that RF-EMF exposure induces cellular senescence of skin cells through ROS induction in HaCaT human keratinocytes.

The Feasibility of Serum Multiple Tumor Markers Test Between Patients with Primary Pancreatic Cancer and Those with Benign Pancreatic Cystic Disease.

BACKGROUND: Although CA 19-9 is the primary marker used in the diagnosis and treatment of pancreatic cancer, other serum tumor markers have also been utilized in the follow-up of pancreatic cancer. We investigated the clinical utility of CYFRA 21-1, AFP, CEA, CA 19-9, CA 125, NSE, and combinations of these markers in patients with pancreatic cancer. METHODS: We enrolled patients with primary pancreatic cancer and benign pancreatic cystic disease (n = 163). We performed sensitivity tests for multiple tumor markers, plotted receiver operating characteristic curves, and conducted multivariate analysis using the Cox proportional hazard method. Survival data were evaluated using Kaplan-Meier analysis of overall survival. RESULTS: Among multiple tumor markers assessed in this study, CA 19-9 showed good diagnostic performance, with an area under the curve of 0.86 ± 0.04 in ROC analysis. Based on two different cutoff values, CYFRA 21-1 (≥ 2.0 and 1.83 ng/mL) had a respective sensitivity of 80.4% and 82.3% and was also more significant than the other tumor markers in a parallel test. There was a weak significant relationship between tumoral fluorodeoxyglucose uptake and CYFRA 21-1 or CA 19-9. Initial CA 125, CYFRA 21-1, and CEA could be utilized to categorize subgroups with different overall survival. In multivariate analyses, CA 125 (HR 18.8, p < 0.001) and CYFRA 21-1 levels (HR 0.962, p = 0.006) demonstrated independent prognostic significance for predicting overall survival. CONCLUSIONS: In addition to CA 19-9, the present study suggested that various tumor markers could be used in the diagnosis and prognosis of pancreatic cancer. Further studies are warranted to confirm the clinical usefulness of diverse biological markers in pancreatic cancer.

Feasibility of CYFRA 21-1 as a serum biomarker for the detection of colorectal adenoma and advanced colorectal adenoma in people over the age of 45.

BACKGROUND: Colon adenoma (CA) is a premalignant lesion of colorectal cancer, and its early removal is closely associated with more prolonged survival in the general population. In this study, we aimed to evaluate the relationship between diverse biologic markers and a newly diagnosed CA and to predict the clinical possibility of cytokeratin-19 soluble in serum fragment (CYFRA 21-1) as a screening tool in asymptomatic adults aged over 45 years. METHODS: Four hundred and seventy-nine patients with a histologically confirmed CA or benign colon polyp (BCP), 76 patients with only benign colorectal diseases and 223 negative controls with no CA or BCP detected on colonofibroscopy were investigated. Multiple tumor markers and biochemical markers were simultaneously checked by radioimmunoassay and enzyme immunoassay. RESULTS: The CYFRA 21-1 alone showed significant stepwise contrastive potential among the three groups (P<.001). Based on the receiver operating characteristic (ROC) analysis, Area under the curve (AUC) for CYFRA 21-1, with a value of 0.732 (95% confidence interval, 0.656-0.809, P<.001) for differentiating between negative controls and patients with advanced colon adenoma, was comparatively the highest among all analyzed factors. The sensitivity of CYFRA 21-1 was significantly higher than that of the other tumor markers in the diagnosis of CA and advanced CA, respectively (P<.001). CONCLUSIONS: Considering the results of our study, CYFRA 21-1 showed a significant diagnostic performance and significant stepwise comparative potential in differentiating patients with CA from benign controls. CYFRA 21-1 could be a simple and effective screening test for the diagnosis of CA.

Longitudinal Decline of Striatal Subregional [18F]FP-CIT Uptake in Parkinson's Disease.

PURPOSE: Dopamine transporter imaging is suggested to be a useful imaging biomarker for Parkinson's disease (PD) progression and monitoring drug effects. We investigated the longitudinal decline characteristics of striatal [18F]FP-CIT uptake in PD. METHODS: We retrospectively reviewed 35 PD patients and 9 non-PD patients. All patients underwent [18F]FP-CIT PET at the initial diagnosis and follow-up. PET images were spatially normalized and analyzed with eight striatal and one occipital VOI templates. We measured the specific to non-specific binding ratio (SNBR) of the striatal subregions and calculated the absolute annual reduction (AAR) and relative annual reduction (%RAR) of the SNBRs. RESULTS: Total striatal SNBRs in PD patients were significantly lower than those in non-PD patients, with the most significant difference in the posterior putamen. Both AAR (0.26 ± 0.14 vs. 0.09 ± 0.19, p < 0.05) and %RAR (6.9 ± 3.5 vs. 1.2 ± 2.7, p < 0.001) of total striatal SNBRs were significantly greater in PD than non-PD patients. There were no significant differences in the AAR and %RAR of total striatal SNBRs between elderly and young onset PD. The AARs of the posterior putamen were higher in early PD than in advanced PD. Conversely, the %RARs were not significantly different between early and more advanced PD. The disease duration was significantly negatively correlated with the AAR but not with the %RAR of the posterior putamen. CONCLUSIONS: The longitudinal decline of striatal [18F]FP-CIT uptake in PD was nonlinear and significantly faster than that in non-PD, with a different rate of decline among the striatal subregions.

Relationship Between Dual Time Point FDG PET/CT and Clinical Prognostic Indexes in Patients with High Grade Lymphoma: a Pilot Study.

PURPOSE: This study investigated the correlative relationship between metabolic parameters estimated from dual time point 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG) positron emission tomography/computerized tomography (PET/CT) and the clinical tools predicting the outcome of a lymphoma. We also measured metabolic and volumetric alterations between early and delayed 18F-FDG PET/CT in patients with high grade lymphoma (HGL). METHODS: The samples were 122 lymph nodes and extralymphatic lesions from 26 patients diagnosed with HGL. All patients were applied to the International Prognostic Index (IPI), Ann Arbor stage, and revised IPI as clinical prognostic parameters. 18F-FDG dual time point PET/CT (DTPFP) consisted of an early scan 1 h after 18F-FDG injection and a delayed scan 2 h after the early scan. Based on an analysis of DTPFP, we estimated the standardized uptake value (SUV) of tumors from the early and delayed scans, retention index (RI) representing the percentage change between early and delayed SUV, and metabolic volume different index (MVDI) calculated using metabolic tumor volumes (MTV). RESULTS: RImax showed a multiple positive correlative relationship with stage and IPI in lesion-by-lesion analysis (p < 0.01). In the case of IPI, the high risk group exhibited higher RImax than the low risk group (p = 0.004). In the case of revised IPI, the RImax of the low risk group were significantly lower than the intermediate and high risk groups, respectively (p < 0.01). The MVDIs of the best outcome group were decreased in comparison to the moderate outcome group (p = 0.029). There was a significant negative correlative relationship between RImax and MVDI, and the inclinations for decreased MVDIs were slightly associated with increased RIs. CONCLUSIONS: RImax extracted from DTPFP had a significant relationship to extranodal involvement, staging, IPI, and revised IPI. MVDI showed significant negative correlation with RImax. Further large scale studies are warranted to support and extend these preliminary results.

[18F]fluorothymidine PET Informs the Synergistic Efficacy of Capecitabine and Trifluridine/Tipiracil in Colon Cancer.

In cancer therapy, enhanced thymidine uptake by the salvage pathway can bypass dTMP depletion, thereby conferring resistance to thymidylate synthase inhibition. We investigated whether sequential combination therapy of capecitabine and trifluridine/tipiracil (TAS-102) could synergistically enhance antitumor efficacy in colon cancer xenograft models. We also examined 3'-deoxy-3'-[18F]fluorothymidine ([18F]FLT) PET as a means to predict therapeutic response to a sequential combination of capecitabine and trifluridine/tipiracil. [3H]FLT uptake after 5-fluorouracil treatment in vitro and [18F]FLT uptake after capecitabine (360 mg/kg/day) in athymic nude mice (Balb/c-nu) with xenografts (n = 10-12 per group) were measured using eight human colon cancer cell lines. We determined the synergistic effects of sequential combinations of 5-fluorouracil and trifluridine in vitro as well as the sequential combination of oral capecitabine (30-360 mg/kg) and trifluridine/tipiracil (trifluridine 75 or 150 mg/kg with tipiracil) in six xenograft models (n = 6-10 per group). We observed significant increases in [3H]FLT uptake in all cell lines and [18F]FLT uptake in five xenograft models after 5-fluorouracil and capecitabine treatment, respectively. Increased [18F]FLT uptake after capecitabine followed by extinction of uptake correlated strongly with tumor growth inhibition (ρ = -0.81, P = 0.02). The effects of these combinations were synergistic in vitro A synergy for sequential capecitabine and trifluridine/tipiracil was found only in mouse xenograft models showing increased [18F]FLT uptake after capecitabine. Our results suggest that the sequential combination of capecitabine and trifluridine/tipiracil is synergistic in tumors with an activated salvage pathway after capecitabine treatment in mice, and [18F]FLT PET imaging may predict the response to capecitabine and the synergistic antitumor efficacy of a sequential combination of capecitabine and trifluridine/tipiracil. Cancer Res; 77(24); 7120-30. ©2017 AACR.

Clinical significance of incidental prostatic fluorine-18-fluorodeoxyglucose uptake in the diagnosis of infectious prostatitis in adult males.

BACKGROUND: We performed a work-up study of cancer patients with incidentally found uncharacterized prostatic fluorine-18-fluorodeoxyglucose (F-FDG) uptake in F-FDG PET/CT results. Then, we evaluated the clinical significance of the incidental prostate F-FDG uptake (IPU) in nonmalignant prostate tissues. PATIENTS AND METHODS: Overall, 51 men agreed to a physical prostate examination and an expressed prostatic secretion (EPS) test within 2 weeks after torso F-FDG PET/CT scans. We then reviewed the F-FDG PET/CT scans of the enrolled patients and evaluated the relationship between the F-FDG PET/CT, prostate-specific antigen, and prostatic laboratory findings. RESULTS: The pathological diagnosis of five men indicated the presence of prostate cancer, and of the remaining 46 men, 27 cases showed IPU in the F-FDG PET/CT whereas 19 did not. The characteristics of the enrolled patients were as follows: mean age of 61.15±13.79 years (range: 30-83 years), maximum standardized uptake value of 2.64±1.33 (range: 1.2-7.1), and prostate-specific antigen of 3.10±3.50 ng/ml (range: 0.16-13.55 ng/ml). Ten of the 27 (37%) patients with IPU in the PET/CT scan showed bacterial infections in their prostate. A multivariate analysis indicated that the bacterial presence in the EPS increased the risk of IPU (adjusted odds ratio: 9.167; P=0.019). CONCLUSION: Bacterial presence in the prostate tends to increase the likelihood of IPU in F-FDG PET/CT scans. Therefore, men with incidental prostate F-FDG uptake should be considered for a possible prostate infection in addition to a concomitant malignancy.

Preliminary evaluation of clinical utility of CYFRA 21-1, CA 72-4, NSE, CA19-9 and CEA in stomach cancer.

BACKGROUND: Although various tumor markers have been utilized in management of stomach cancer (SC), only a few reports have described relevance of examples such as CYFRA 21-1 and neuron-specific enolase (NSE). The purpose of this study was to evaluate the potential diagnostic performance of carcinoembryonic antigen (CEA), CA 19-9, CA72-4, CYFRA 21-1 and NSE in patients with SC. MATERIALS AND METHODS: Ninety-six SC patients with pathologic confirmation between 2012 and 2013 were enrolled. Serum levels of five tumor markers were analyzed using a solid-phase immunoradiometric assay. Receiver operating characteristic (ROC) curves were plotted for the five tumor markers to investigate their diagnostic powers and adjusted cutoff values derived from analysis of ROC curves were evaluated to calculate the sensitivity of each for SC with recommended cutoff values. RESULTS: Based on two different cutoff values (recommended and adjusted), CYFRA 21-1 (≥2.0 and 1.2 ng/ml) had a respective sensitivity of 50% and 78.1%, compared with 8.3% and 18.8% for CEA (≥7.0 and 3.9 ng/ml), 15.6% and 18.8% for CA 19-9 (≥37 and 26.7 ng/ml), 28.1% and 9.6% for CA 72-4 (≥4.0 and 13 ng/ml) and 7.3% and 7.3% for NSE (≥14.7 and 15.0 ng/ml) in the initial staging of primary SC. The area under the curve (AUC) for CYFRA 21-1, with a value of 0.978 (95% confidence interval, 0.964-0.991) was comparatively the highest. Univariate analysis revealed significant relationships between tumor marker level and lymph node involvement, metastasis and staging with CYFRA 21-1, CA 72-4 and NSE. CONCLUSIONS: CYFRA 21-1 was the most sensitive tumor marker and showed the most powerful diagnostic performance among the five SC tumor markers. NSE and CA 72-4 are significantly related to lymph node involvement, metastasis or stage. Further evaluations are warranted to clarify the clinical usefulness and prognostic prediction of these markers in SC.

An unusual case of superior vena cava syndrome caused by the intravascular invasion of an invasive thymoma.

Superior vena cava syndrome (SVCS) is usually caused by extrinsic compression or invasion of the superior vena cava (SVC) by malignant tumors involving mediastinal structures. Although thymomas are well-known causes of SVCS, cases of SVCS caused by malignant thymomas protruding into adjacent vessels draining the SVC with thrombosis have been very rarely reported worldwide. We experienced a 39-year-old female patient with SVCS that developed after the direct invasion of the left brachiocephalic vein (LBCV) and SVC by an anterior mediastinal mass with a high maximum standardized uptake value on the chest computed tomography (CT) and positron emission tomography-CT. Based on these results, she underwent en bloc resection of the tumor, including removal of the involved vessels, and was eventually diagnosed as having a type B2 thymoma permeating into the LBCV and SVC. We present this case as a very rare form of SVCS caused by an invasive thymoma.

Clinical Usefulness of Serum CYFRA 21-1 in Patients with Colorectal Cancer.

PURPOSE: Among diverse tumor markers, pretreatment evaluation and follow-up detection of recurrence in colorectal cancer are generally evaluated by serum carcinoembryonic antigen (CEA) levels. However, there have been some reports about the low accuracy and high false-positive results of CEA in colorectal cancer. We investigated the clinical utilities of CYFRA 21-1 by comparing CEA and cancer antigen 19-9 (CA 19-9) in pretreatment and recurrent colorectal cancer. METHODS: Using a solid-phase immunoradiometric assay, serum levels of CYFRA 21-1, CEA and CA 19-9 were analyzed in 132 patients with primary colorectal cancer, 124 healthy controls, 104 patients with benign colorectal disease and 19 patients with recurrent colorectal cancer. We determined three different cutoff values to evaluate the sensitivity of diagnostic performance in pretreatment and recurrent colorectal cancer. RESULTS: CYFRA 21-1 (≥ 1.13 ng/ml) had a sensitivity of 47 %, compared with 37 % for CEA (≥ 3.05 ng/ml) and 32.6 % for CA 19-9 (≥ 23.1 ng/ml) in the initial staging of primary colorectal cancer. Using different cutoff values, CYFRA 21-1 showed higher sensitivity for pretreatment colorectal cancer than CEA and CA 19-9 in adenocarcinoma and adenosquamous carcinoma of this study. A mildly significant correlative relationship was noted between Dukes' stages and three tumor markers (p < 0.01). The areas under the receiver operating characteristic curves of CYFRA 21-1, CEA and CA 19-9 were 0.81 ± 0.03, 0.74 ± 0.03 and 0.62 ± 0.04, respectively, for discriminating colorectal cancer patients from patients with benign colorectal disease. In addition, CYFRA 21-1 was determined as the most sensitive tumor marker for evaluating recurrent colorectal cancer for all cutoff values. CONCLUSION: This study showed that CYFRA 21-1 could be a useful and dependable tumor marker for pretreatment and recurrent colorectal cancer. Further prospective studies on its usefulness with respect to the prognosis and utility of combined tumor markers are needed.

Biologic correlation between glucose transporters, hexokinase-II, Ki-67 and FDG uptake in malignant melanoma.

INTRODUCTION: The purpose of this study was to investigate the correlative association between tumoral 2-deoxy-2-[(18)F]-fluoro-D-glucose (FDG) uptake, and the expressions of glucose transporter 1 (GLUT-1), glucose transporter 3 (GLUT-3), hexokinase II (HK-2), and Ki-67 expression in malignant melanoma. METHODS: Nineteen patients with histologically proven malignant melanoma and pretreatment FDG PET/CT performance were involved in this preliminary study. For semi-quantitative analysis of FDG PET/CT, maximal standardized uptake values (SUVmax) were estimated. Immunohistochemical staining of tumor sections was performed for GLUT-1, GLUT-3, and HK-2, and for the cell proliferation maker Ki-67. Especially, by combining proportions and intensity of immunochemical staining, we evaluated modified immunohistologic scores of GLUT-1 and GLUT-3. RESULTS: The SUVmax of malignant melanoma lesions ranged from 2 to 18.7 (average; 9.1±5.4). Comparison between nodal and extranodal lesions revealed no significant difference of SUVmax (p=0.97). GLUT-1 staining showed the most positive expression level (89.5%, 17/19) among the diverse immunohistochemical markers. There were significant relationships between FDG uptake of malignant melanoma and GLUT-1 proportion (p<0.0001), GLUT-1 intensity (p<0.0001), GLUT-3 proportion (p=0.031), GLUT-3 intensity (p=0.009), GLUT-1 immunohistologic scores (p<0.0001), and GLUT-3 immunohistologic scores (p=0.028). HK-2 was not expressed in all melanoma samples. Although Ki-67 expression showed a high grade in all staining, there was no significant link between FDG uptake and Ki-67 grades (p=0.38). CONCLUSIONS: The data in this preliminary study indicate that FDG uptake in malignant melanoma is determined by GLUT-1 and GLUT-3, whereas HK-2 and Ki-67 play no role in FDG uptake of malignant melanoma.

A case of rectal cancer in a patient with neurofibromatosis type 1.

A rectal cancer was found in a 67-year-old man with a history of neurofibromatosis type 1. A low anterior resection was performed, and he received concurrent chemoradiation for 6 months. Twelve months after the surgery, a tumor was found at the anastomotic site by positron emission tomography-computed tomography and colonoscopy and was mistaken as anastomotic site recurrence. The tumor was confirmed as an inflammatory myofibroblastic tumor through transanal excision.

Relationship Between Dual-Time Point FDG PET and Immunohistochemical Parameters in Preoperative Colorectal Cancer: Preliminary Study.

PURPOSE: The clinical availability of 2-deoxy-2-[18F] fluoro-D-glucose (FDG) dual-time point positron emission tomography/computerized tomography (DTPP) has been investigated in diverse oncologic fields. The aim of this preliminary study was to evaluate the relationship between various immunohistopathologic markers reflecting disease progression of colorectal cancer and parameters extracted from FDG DTPP in colorectal cancer patients. MATERIALS AND METHODS: Forty-seven patients with histologically confirmed colorectal cancer were analyzed in this preliminary study. FDG DTPP consisted of an early scan 1 h after FDG injection and a delayed scan 1.5 h after the early scan. Based on an analysis of FDG DTPP, we estimated the maximum standardized uptake value (SUV) of tumors on the early and delayed scans (SUVearly and SUVdelayed, respectively). The retention index (RI) was calculated as follows: (SUVdelayed - SUVearly) × 100/ SUVearly. The clinicopathological findings (size and T and N stages) and immunohistochemical factors [glucose transporter 1 (GLUT-1), hexokinase 2 (HK-2), p53, P504S, and ß-catenin] were analyzed by visual analysis. RESULTS: The RIs calculated from the SUVs ranged from -1.8 to 73.4 (31.8 ± 15.5). The RIs were significantly higher in patients with high T stages (T3 and T4) than with low T stages (T1 and T2; p < 0.05). Among the immunohistochemical analytic markers, GLUT-1 had the highest positive staining rate (93.6%) compared to other markers. Based on univariable analysis, it was shown that the RI of high-level GLUT-1 expression was significantly higher than low-level GLUT-1 expression (p = 0.01), and the RI of high-level p53 expression was slightly higher than low-level p53 expression (p = 0.08). Multivariate analysis to investigate a link between RI and clinicopathologic parameters of colorectal carcinoma showed that GLUT-1, p53, and T staging were independently connected with increased RIs (p < 0.05, total) using backward selection methods. There was no significant statistical relationship between SUVearly and SUVdelayed and clinicopathologic parameters in this study. CONCLUSION: The RIs obtained from preoperative colorectal cancers had a significant relationship to tumor size, T staging, GLUT-1, and p53, in contrast to SUVearly or SUVdelayed. Compared with previous reports, our results showed that RI can better predict GLUT-1 expression than HK-2 and other immunohistochemical markers. This study demonstrated that the RI might have the potential to be applied as a prognostic marker in preoperative colorectal cancer.

F-18 FDG PET/CT imaging of solitary genital tuberculosis mimicking recurrent lymphoma.

A 65-year-old man who had multiple lymph nodes swelling was pathologically diagnosed with diffuse large B cell lymphoma. After initiation of induction chemotherapy, F-18 FDG PET/CT showed a significantly decreased extent of previous lymphomatous lesions except for 2 newly developed focal hypermetabolic lesions in the prostate and left epididymis. The specimens from the prostate and orchiectomy revealed tuberculosis lesions. After a 3-month antituberculosis regimen, there was definitively decreased glucose uptake in the prostate on F-18 FDG PET. F-18 FDG PET may be helpful for characterizing genitourinary tuberculosis and monitoring antituberculosis treatment.

Performance of FDG PET/CT in postoperative colorectal cancer patients with a suspected recurrence and a normal CEA level.

PURPOSE: The performance of 2-deoxy-2-[(18)F]fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) has been not established for the evaluation of recurrent colorectal cancer. The aim of this study was to evaluate the diagnostic value of FDG PET/CT in postoperative colorectal cancer patients with normal carcinoembryonic antigen (CEA) levels. METHODS: This retrospective study was conducted on 63 FDG PET/CT cases, involving postoperative colorectal cancer patients suspected of having recurrent or metastatic lesions with normal CEA levels. The diagnostic performance of FDG PET/CT was evaluated based on diverse suspected conditions, using physical examination, a conventional imaging work-up, and endoscopy. Histopathology, a clinical imaging work-up (including an FDG PET/CT examination), and determination of tumor marker levels during the follow-up served as the reference standard. RESULTS: The sensitivity, specificity, and accuracy for FDG PET/CT were 95, 76.6, and 88.8% for a lesion-by-lesion analysis, and 96.3, 86.1, and 90.5% for a case-by-case analysis, respectively. Three false-negative lesions among 107 suspected recurrent findings were identified as compared with nine false-positive lesions. For radiologically suspected recurrent or metastatic conditions, FDG PET/CT diagnostic performance was superior to radiological image modalities, for both lesion-by-lesion and case-by-case analyses. On follow-up of patients with normal CEA levels, but high CA19-9 levels, the use of FDG PET/CT detected true-positive findings in 63.3% of cases. CONCLUSION: FDG PET/CT is a valuable tool to distinguish recurrence or metachronous tumor from postoperative changes or other benign lesions in postoperative colorectal cancer patients with normal CEA levels and radiologically or clinically suspicious lesions.

F-18 FDG PET/CT imaging of a Leydig cell tumor.

We report the F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings of a patient with a testicular Leydig cell tumor. A 43-year-old man was referred for whole body FDG PET/CT imaging for health care screening. FDG PET/CT imaging demonstrated the presence of a focal hypermetabolic lesion in the right testicle and no specific findings in other areas. Based on the preoperative impression, right testis-sparing surgery was attempted. The tumor was pathologically confirmed as a Leydig cell tumor.