Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; diagnostic imaging ; drug therapy ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Female ; Fluorodeoxyglucose F18 ; Heart Neoplasms ; diagnostic imaging ; drug therapy ; Humans ; Lymph Nodes ; Lymphoma, Large B-Cell, Diffuse ; diagnostic imaging ; drug therapy ; Mediastinal Neoplasms ; diagnostic imaging ; drug therapy ; Peripheral Nervous System Neoplasms ; diagnostic imaging ; Positron Emission Tomography Computed Tomography ; Prednisone ; therapeutic use ; Radiopharmaceuticals ; Vincristine ; therapeutic use

No abstract available.
Adult ; Biological Markers/blood ; Female ; Humans ; Mouth Floor ; *Neck/radiography/radionuclide imaging/ultrasonography ; Predictive Value of Tests ; Radiopharmaceuticals/diagnostic use ; Sodium Pertechnetate Tc 99m/diagnostic use ; Thyroid Dysgenesis/blood/*diagnosis/drug therapy ; Thyroid Function Tests ; *Thyroid Gland/drug effects/metabolism/radiography/radionuclide imaging/ultrasonography ; Thyrotropin/blood ; Thyroxine/blood/therapeutic use ; Tomography, X-Ray Computed

Charcoal can be used for preoperative localization of metastatic lymph nodes in the neck. Charcoal remains stable without causing foreign body reactions during as hort period. However, foreign body reactions may develop if charcoal is left in situ for more than 6 months. We reported a case of charcoal granuloma mimicking local recurrence on fluorodeoxyglucose-positron emission tomography/computed tomography and ultrasonography in a 47-year-old woman who had cervical lymph node dissection due to metastatic invasive ductal carcinoma of the breast.
Breast Neoplasms/pathology/surgery/therapy ; Carcinoma/*pathology/surgery/therapy ; Cervix Uteri/pathology/ultrasonography ; Charcoal/toxicity ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Granuloma/*diagnosis/pathology ; Humans ; Lymph Nodes/*surgery/ultrasonography ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Recurrence, Local ; Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Tomography, X-Ray Computed

OBJECTIVE: The aim of this prospective study was to determine whether the additional use of the single photon emission computed tomography/CT (SPECT/CT) technique improves the diagnostic value of planar lymphoscintigraphy in patients presenting with primary lymph edema of the lower limb. MATERIALS AND METHODS: For a defined period of three years (April 2011-April 2014) a total of 34 consecutive patients (28 females; age range, 27-83 years) presenting with swelling of the leg(s) suspicious of (uni- or bilateral, proximal or distal) primary lymphedema were prospectively examined by planar lymphoscintigraphy (lower limbs, n = 67) and the tomographic SPECT/CT technique (anatomical sides, n = 65). RESULTS: In comparison to pathological planar scintigraphic findings, the addition of SPECT/CT provided relevant additional information regarding the presence of dermal backflow (86%), the anatomical extent of lymphatic disorders (64%), the presence or absence of lymph nodes (46%), and the visualization of lymph vessels (4%). CONCLUSION: As an adjunct to planar lymphoscintigraphy, SPECT/CT specifies the anatomical correlation of lymphatic disorders and thus improves assessment of the extent of pathology due to the particular advantages of tomographic separation of overlapping sources. The interpretation of scintigraphic data benefits not only in baseline diagnosis, but also in physiotherapeutical and microsurgical treatments of primary lymphedema.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lower Extremity/anatomy & histology/*radiography ; Lymphatic Vessels/radiography ; Lymphedema/*diagnosis/radiography ; Lymphoscintigraphy ; Middle Aged ; Radiopharmaceuticals/diagnostic use ; Retrospective Studies ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed

Whole body integrated magnetic resonance imaging (MR)/positron emission tomography (PET) imaging systems have recently become available for clinical use and are currently being used to explore whether the combined anatomic and functional capabilities of MR imaging and the metabolic information of PET provide new insight into disease phenotypes and biology, and provide a better assessment of oncologic diseases at a lower radiation dose than a CT. This review provides an overview of the technical background of combined MR/PET systems, a discussion of the potential advantages and technical challenges of hybrid MR/PET instrumentation, as well as collection of possible solutions. Various early clinical applications of integrated MR/PET are also addressed. Finally, the workflow issues of integrated MR/PET, including maximizing diagnostic information while minimizing acquisition time are discussed.
Coordination Complexes/chemistry/diagnostic use ; Heart/radiography ; Humans ; *Magnetic Resonance Imaging ; Neoplasm Metastasis ; Neoplasm Staging ; Neoplasms/pathology/radiography ; *Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Tomography, X-Ray Computed ; Whole Body Imaging/*standards/*trends

BACKGROUNDThe prognostic values of interim and post-therapy fluorine-18-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and PET/computed tomography (CT) scanning have been confirmed in several subtypes of lymphoma. However, its prognostic value in Burkitt's lymphoma has not been clearly defined. The aim of the present study was to assess the prognostic value of PET/CT scanning during different treatment processes of Burkitt's lymphoma.

METHODSA total of 29 adult patients with newly diagnosed Burkitt's lymphoma were retrospectively involved in this study; of them, 23 patients underwent baseline PET/CT, 15 patients underwent mid-therapy PET/CT after 1-4 cycles of chemotherapy, and 17 patients underwent post-therapy PET/CT after all planned first-line chemotherapy cycles. Mid-therapy and post-therapy PET/CT results (positive vs. negative) were visually interpreted according to the criteria of the International Harmonization Project. The reduction in the maximum standardizes uptake values (∆SUVmax) of 25%, 50%, and 75% were regarded as cutoff points. Overall survival (OS) and progression-free survival (PFS) were regarded as the major endpoints.

RESULTSThe median OS and PFS were 27.6 months (range 6.5-78.3 months) and 27.2 months (range 3.0-78.3 months), respectively. The median SUVmax of the baseline PET/CT was 18.3 (range 1.6-35.9), whereas the median SUVmax of the mid-therapy and post-therapy PET/CT decreased to 4.0 (range 0-17.6) and 3.0 (range 0-14.5), respectively. The patients' Eastern Cooperative Oncology Group (ECOG) scores (<2 vs. ≥2) were significantly associated with the baseline PET/CT SUVmax. The mid-therapy and post-therapy PET/CT results (positive vs. negative) showed no significant association with OS or PFS. The optimal cutoff ∆SUVmax from the baseline to the post-therapy PET/CT that could predict a change in OS in patients with Burkitt's lymphoma was 50% (P = 0.019).

CONCLUSIONS(18)F-FDG uptake was intense in Burkitt's lymphoma, and there was a significant reduction in SUVmax during the interim and post-therapy PET/CT procedures. A ∆SUVmax of greater than 50% was a favorable cutoff point to predict the OS of Burkitt's lymphoma patients.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Burkitt Lymphoma ; diagnostic imaging ; drug therapy ; Female ; Fluorodeoxyglucose F18 ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Positron Emission Tomography Computed Tomography ; methods ; Prognosis ; Radiopharmaceuticals ; Retrospective Studies ; Treatment Outcome

We report a rare case of distant subcutaneous parathyroid carcinoma recurrence. A 50-year-old woman was referred to our hospital because of sustained hypercalcemia despite surgical removal of a parathyroid carcinoma. A focal uptake in the upper mediastinal area was detected in a 99mTc-sestamibi scan, and 18F-fluorodeoxyglucose (FDG) positron-emission tomography (PET)/computed tomography (CT) imaging demonstrated a subcutaneous mass. She underwent tumor resection, and the pathological findings were consistent with a parathyroid carcinoma. The postoperative serum parathyroid hormone (PTH) level remained within normal limits. However, a new palpable solitary mass was identified in the upper portion of the left breast 1 year postoperatively. Both a 99mTc-sestamibi scan and 18F-FDG PET/CT imaging revealed an abnormal lesion in the upper breast, and subsequent pathology reports confirmed parathyroid carcinoma metastasis. Serum PTH and calcium levels fell within normal ranges after tumor resection. Two subcutaneous recurrent lesions appeared likely due to tumor seeding during the previous endoscopic operation at a local hospital.
Biological Markers/blood ; Breast Neoplasms/blood/radiography/*radionuclide imaging/*secondary/surgery ; Carcinoma/blood/radiography/*radionuclide imaging/*secondary/surgery ; Female ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Middle Aged ; Multimodal Imaging ; Parathyroid Hormone/blood ; Parathyroid Neoplasms/blood/*pathology/surgery ; *Positron-Emission Tomography ; Predictive Value of Tests ; Radiopharmaceuticals/*diagnostic use ; Technetium Tc 99m Sestamibi/*diagnostic use ; Time Factors ; *Tomography, X-Ray Computed ; Treatment Outcome

F-18-fluorodeoxyglucose (FDG) positron emission tomography/CT is an important whole-body imaging tool in the oncology and widely utilized to stage and restage various malignancies. The findings of significant focal accumulation of FDG in the lung parenchyma in the absence of corresponding CT abnormalities are related to the lung microembolism and known as hot-clot artifacts. Herein we present two cases with focal FDG uptake in the lung parenchyma with no structural lesions on the CT scan and discuss the possible mechanisms.
*Artifacts ; False Positive Reactions ; Female ; Fluorodeoxyglucose F18/*administration & dosage/diagnostic use/pharmacokinetics ; Humans ; Lung/metabolism/radiography/*radionuclide imaging ; Male ; Middle Aged ; Multimodal Imaging/methods ; Positron-Emission Tomography/*methods ; Pulmonary Embolism/radiography/*radionuclide imaging ; Radiopharmaceuticals/*administration & dosage/diagnostic use/pharmacokinetics ; Tomography, X-Ray Computed/methods ; Young Adult

The role of integrated 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography computed tomography (PET-CT) is uncertain in gallbladder cancer. The aim of this study was to show the role of PET-CT in gallbladder cancer patients. Fifty-three patients with gallbladder cancer underwent preoperative computed tomography (CT) and PET-CT scans. Their medical records were retrospectively reviewed. Twenty-six patients underwent resection. Based on the final outcomes, PET-CT was in good agreement (0.61 to 0.80) with resectability whereas CT was in acceptable agreement (0.41 to 0.60) with resectability. When the diagnostic accuracy of the predictions for resectability was calculated with the ROC curve, the accuracy of PET-CT was higher than that of CT in patients who underwent surgical resection (P=0.03), however, there was no difference with all patients (P=0.12). CT and PET-CT had a discrepancy in assessing curative resection in nine patients. These consisted of two false negative and four false positive CT results (11.3%) and three false negative PET-CT results (5.1%). PET-CT was in good agreement with the final outcomes compared to CT. As a complementary role of PEC-CT to CT, PET-CT tended to show better prediction about resectability than CT, especially due to unexpected distant metastasis.
Adult ; Aged ; Aged, 80 and over ; *Cholecystography ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Gallbladder/pathology/surgery ; Gallbladder Neoplasms/*diagnosis/*surgery ; Humans ; Lymphatic Metastasis/diagnosis ; Male ; Middle Aged ; Neoplasm Staging ; *Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Retrospective Studies ; Sensitivity and Specificity ; *Tomography, X-Ray Computed ; Treatment Outcome

PURPOSE: We investigated the prognostic role of volume-based parameters measured on 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) scans in patients with locally advanced pancreatic cancer (LAPC) treated with chemoradiation therapy (CRT). MATERIALS AND METHODS: We enrolled 60 patients with LAPC who underwent FDG PET/CT before CRT. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of primary pancreatic cancers were measured on FDG PET/CT scans. Treatment response was evaluated according to the Response Evaluation Criteria in Solid Tumors. Survival analysis was performed using the Kaplan-Meier method, and Cox proportional hazard models were used to determine independent prognostic factors. RESULTS: The progression-free survival (PFS), locoregional progression-free survival (LRFPS), and overall survival (OS) for this population were 6.2, 10.9, and 13.2 months, respectively. The overall treatment response rate was 16.7% at 4 weeks after CRT, and the disease control rate (DCR) was 80.0%. DCR was significantly higher in patients with low SUVmax, MTV, or TLG, and showed strong correlation with longer survival times. On univariate analysis, MTV and TLG were significant prognostic factors for PFS, LRPFS, and OS, together with pre-CRT and post-CRT CA19-9 levels. Multivariate analyses demonstrated that MTV together with the pre-CRT CA19-9 level were independent prognostic factors for PFS, LRPFS, and OS, as was TLG for LRPFS and OS. CONCLUSION: MTV and the pre-CRT CA19-9 level provided independent prognostic information in patients with LAPC treated with CRT. Volume-based PET/CT parameters may be useful in identifying which subgroup of patients would benefit from radiation therapy as a part of CRT.
Adult ; Aged ; Aged, 80 and over ; *Chemoradiotherapy ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18/*diagnostic use ; Glycolysis ; Humans ; Male ; Middle Aged ; Multimodal Imaging ; Multivariate Analysis ; Neoplasm Staging ; Pancreatic Neoplasms/*diagnosis/*therapy ; *Positron-Emission Tomography ; Prognosis ; Proportional Hazards Models ; Radiopharmaceuticals ; Retrospective Studies ; Severity of Illness Index ; Survival Analysis ; *Tomography, X-Ray Computed ; Tumor Burden