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

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

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

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

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

BACKGROUND/AIMS: The aim of this study was to evaluate the influence of recent chemotherapy on the patterns of the maximum-standardized uptake value (M-SUV) and sensitivity of 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in colorectal cancer. METHODS: We retrospectively analyzed the FDG-PET/CT of 509 patients who underwent surgery for colorectal cancer. Subgroup analysis was performed according to chemotherapy status; 401 patients were not treated with chemotherapy and 108 patients were treated with chemotherapy within 6 months prior to surgery. Pathologic analysis of the surgical specimen was used as the gold standard. RESULTS: The M-SUV was significantly lower in patients treated with chemotherapy than in those not treated with chemotherapy in pathologically confirmed same stages of disease. The difference in the sensitivity of the M-SUV according to chemotherapy status was greatest using a cutoff M-SUV value of 6.4 (p<0.001). The longest diameter of the primary tumor was the most important factor that correlated with M-SUV of the primary tumor irrespective of the chemotherapy effect (p<0.001). The M-SUV of the primary tumor was not an independent predictor of lymph node metastasis in colorectal cancer. CONCLUSIONS: The results indicate that the M-SUV of FDG-PET/CT should be interpreted in the context of concurrent chemotherapy.
Aged ; Antineoplastic Agents/*adverse effects ; Chemoradiotherapy, Adjuvant/adverse effects ; Chemotherapy, Adjuvant/adverse effects ; Colorectal Neoplasms/drug therapy/pathology/*radionuclide imaging ; Female ; Fluorodeoxyglucose F18/diagnostic use/*pharmacology ; Humans ; Male ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Positron-Emission Tomography/methods ; Radiopharmaceuticals/diagnostic use/*pharmacology ; Retrospective Studies

Cases of metastases to the thyroid gland seem to be increasing in recent years. The clinical and ultrasonographic findings of diffuse metastases have been sparsely reported. Thirteen cases of diffuse metastases to the thyroid gland were documented by thyroid ultrasonography-guided fine needle aspiration cytology between 2004 and 2013. We retrospectively reviewed the patients with diffuse thyroid metastases. The most common primary site was the lung (n=9), followed by unknown origin cancers (n=2), cholangiocarcinoma (n=1), and penile cancer (n=1). Eleven patients were incidentally found to have thyroid metastases via surveillance or staging FDG-PET. Other 2 patients were diagnosed during work-up for hypothyroidism and palpable cervical lymph nodes. On ultrasonography, the echogenicity of the enlarged thyroid gland was heterogeneously hypoechoic or isoechoic, and reticular pattern internal hypoechoic lines were observed without increased vascularity found by power Doppler ultrasonography (3 right lobe, 2 left lobe, and 8 both lobes). In the 8 patients who had involvement of both lobes, 3 had hypothyroidism. In conclusion, ultrasonographic finding of diffuse metastasis is a diffusely enlarged heterogeneous thyroid with reticular pattern internal hypoechoic lines. Thyroid function testing should be performed in all patients with diffuse thyroid metastases, especially those with bilateral lobe involvement.
Aged ; Bile Duct Neoplasms/pathology ; Biopsy, Fine-Needle ; Cholangiocarcinoma/pathology ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Hypothyroidism/complications ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Penile Neoplasms/pathology ; Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Thyroid Function Tests ; Thyroid Gland/pathology/*ultrasonography ; Thyroid Neoplasms/pathology/secondary/*ultrasonography

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