Nuclear medicine in SARS-CoV-2 pandemia: 18F-FDG-PET/CT to visualize COVID-19

AbstractThe current outbreak of coronavirus SARS-CoV-2 has reached multiple countries worldwide. While the number of newly diagnosed cases and fatalities is rising quickly, far-reaching measures were enacted to prevent further spread. Diagnosis relies on clinical presentation, exposure history, PCR using specimens from the respiratory tract together with computed tomography (CT) imaging. One of the hallmarks of a critical course of COVID-19 is the development of severe acute respiratory distress syndrome (ARDS). As management of COVID-19 can be considered a multi-disciplinary approach involving various medical specialties, we here review the first 18F-FDG-PET/CT scans of COVID-19 to discuss how Nuclear Medicine could contribute to management of this disease.

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P-013: Development of a new risk stratification system for patients with newly diagnosed multiple myeloma using R-ISS and 18F-FDG PET/CT

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/s2152-2650(21)02147-9 ◽

2021 ◽

Vol 21 ◽

pp. S46

Author(s):

Juhyung Kim ◽

Jung Min Lee ◽

Hee Jeong Cho ◽

Sung-Hoon Jung ◽

Ho-Jin Shin ◽

...

Keyword(s):

Multiple Myeloma ◽

Risk Stratification ◽

Fdg Pet ◽

Newly Diagnosed ◽

Pet Ct ◽

18F Fdg ◽

Stratification System ◽

Fdg Pet Ct ◽

Risk Stratification System

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Clinical Impact of 18f-FDG PET/CT As a Valuable Prognostic Tool for the Newly Diagnosed Multiple Myeloma with Extramedullary Disease

Blood ◽

10.1182/blood-2019-129831 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 3142-3142

Author(s):

Dong Won Baek ◽

Hee Jeong Cho ◽

Sang Kyun Sohn ◽

Sung-Hoon Jung ◽

Hong chae Moon ◽

...

Keyword(s):

Multiple Myeloma ◽

Fdg Pet ◽

Survival Outcomes ◽

Newly Diagnosed ◽

Prognostic Tool ◽

Pet Ct ◽

National University ◽

18F Fdg ◽

Fdg Pet Ct

Purpose 18F-FDG PET/CT (PET/CT) could be a valuable tool to predict long-term survival outcomes in patients with newly diagnosed multiple myeloma (MM). It has ability to distinguish metabolically active sites such as extramedullary disease (EMD) as well as bone damage with relatively high sensitivity and specificity. In this study, we attempted to evaluate the role of PET-CT as a novel prognostic tool for patients with newly diagnosed MM who have EMD. Patients and Methods This study included 211 patients who were newly diagnosed with multiple myeloma from Kyunpook National University Hospital and Chonnam National University Hwasun Hospital. We retrospectively analyzed the medical records of enrolled patients. PET/CT was performed at the diagnosis and EMD was identified in 36 patients (17.1%). Results With a median follow-up duration of 21.5 months (range 1.4-67.7), the estimated 2-year PFS and OS rates were 46.1% and 79.6%, respectively. The presence of PET/CT positive EMD and high maximum standardized uptake value (SUVmax) on baseline PET/CT were significantly associated with inferior long-term survivals in terms of PFS (p=0.013, p=0.007) and OS (p=0.002, p=0.004). In addition, patients who underwent autologous stem cell transplantation (auto-SCT) showed superior PFS (p=0.005) and OS (p=0.022) in PET/CT positive EMD group. Meanwhile, Revised-International Staging System (R-ISS) successfully predicted the prognosis in this study. When we modified R-ISS with the presence of EMD, survival outcomes of the R-ISS stage III patients who didn't have EMD were similar to R-ISS II, while patients with PET/CT positive EMD showed even worse prognosis than the R-ISS stage III group. In the multivariate survival analysis, the presence of EMD (hazard ratio (HR), 2.397; 95% confidence internal (CI), 1.281-4.483; p=0.006) and auto-SCT (HR, 0.326; 95% CI, 0.194-0.549; p<0.001) were related to PFS, while LDH (HR, 2.56; 95% CI, 1.221-5.366; p=0.013) level and auto-SCT (HR, 0.398; 95% CI, 0.167-0.953; p=0.039) were independent prognostic factors of OS. Conclusion In conclusion, PET/CT positive EMD was a poor prognostic factor in patients with newly diagnosed MM. In addition, PET/CT could be a valuable tool to make better risk-adapted treatment strategies with R-ISS in EMD positive MM patients. Above all, patients with PET/CT positive EMD should be considered auto-SCT to improve long-term survivals. Figure Disclosures No relevant conflicts of interest to declare.

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99mTc-sestamibi SPECT/CT and 18F-FDG-PET/CT have similar performance but different imaging patterns in newly diagnosed multiple myeloma

Nuclear Medicine Communications ◽

10.1097/mnm.0000000000001259 ◽

2020 ◽

Vol 41 (10) ◽

pp. 1081-1088

Author(s):

Camila Mosci ◽

Fernando V. Pericole ◽

Gislaine B. Oliveira ◽

Marcia T. Delamain ◽

Maria E.S. Takahashi ◽

...

Keyword(s):

Multiple Myeloma ◽

Fdg Pet ◽

Newly Diagnosed ◽

Similar Performance ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

99Mtc Sestamibi

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Prevalence of Newly Diagnosed Malignancies in Patients with Polymyalgia Rheumatica and Giant Cell Arteritis, Comparison of 18F-FDG PET/CT Scan with Chest X-ray and Abdominal Ultrasound: Data from a 40 Week Prospective, Exploratory, Single Centre Study

Journal of Clinical Medicine ◽

10.3390/jcm9123940 ◽

2020 ◽

Vol 9 (12) ◽

pp. 3940

Author(s):

Amir Emamifar ◽

Søren Hess ◽

Torkell Ellingsen ◽

Susan Due Kay ◽

Jacob Christian Bang ◽

...

Keyword(s):

Ct Scan ◽

Fdg Pet ◽

Abdominal Ultrasound ◽

Newly Diagnosed ◽

X Ray ◽

Pet Ct ◽

Chest X Ray ◽

18F Fdg ◽

Fdg Pet Ct ◽

Pet Ct Scan

The aim of the study was to identify the prevalence of newly diagnosed malignancies in patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), with the aid of 18F-FDG PET/CT scan compared to conventional imaging techniques: Chest X-ray (CXR) and abdominal ultrasound (US). Secondarily, to examine the relative diagnostic accuracy of these two imaging modalities for the detection of cancer. Eighty consecutive patients with newly diagnosed PMR, GCA, or concomitant PMR and GCA, were included and followed up for 40 weeks. All patients underwent an 18F-FDG PET/CT scan, CXR, and abdominal US at diagnosis. Imaging findings were dichotomously categorized into malignant or benign. Among 80 patients, three patients were diagnosed with seronegative rheumatoid arthritis and were excluded from the analysis. Of the remaining 77, 64 (83.1%) patients were diagnosed with pure PMR, 3 (3.9%) with pure GCA, and 10 (13.0%) with concomitant PMR and GCA. Five types of cancer that were more prevalent than the one-year prevalence of 1.2% among the background population were found in four (5.2%; 95%CI: 1.4–12.8%) patients. CXR/abdominal US could detect the solid cancer in one patient, whereas 18F-FDG PET/CT could identify all four solid cancers. Furthermore, four (5.2%; 95%CI: 1.4–12.8%) cases of monoclonal gammopathy of undetermined significance (MGUS) were found. An increase in C reactive protein (CRP) implicated an increased risk for cancer of 2.4% (OR: 1.024, 95%CI: 1.001–1.047; p = 0.041). 18F-FDG PET/CT can reveal occult cancers at an early stage with a high negative predictive value, and it is specifically beneficial in PMR/GCA patients with nonspecific symptoms.

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18F-FDG PET/CT Scan Can Predate Clinical Presentation in Acute Appendicitis

Clinical Nuclear Medicine ◽

10.1097/rlu.0000000000001750 ◽

2017 ◽

Vol 42 (9) ◽

pp. e409-e411 ◽

Cited By ~ 1

Author(s):

Syed Zama Ali ◽

Loi Hoi Yin ◽

Khor Lih Kin ◽

Arvind Kumar Sinha ◽

Li Mei Poon

Keyword(s):

Acute Appendicitis ◽

Ct Scan ◽

Fdg Pet ◽

Clinical Presentation ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Pet Ct Scan

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18f-FDG PET/CT and the Revised International Staging System Are More Discriminating of Survival Outcomes in Newly Diagnosed Multiple Myeloma

Blood ◽

10.1182/blood-2018-99-112354 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 4483-4483

Author(s):

Sung-Hoon Jung ◽

Seong Young Kwon ◽

Jung-Joon Min ◽

Hee Seung Bom ◽

Seo-Yeon Ahn ◽

...

Keyword(s):

Fdg Pet ◽

Conflicts Of Interest ◽

Independent Predictor ◽

Staging System ◽

Survival Outcomes ◽

Newly Diagnosed ◽

Pet Ct ◽

International Staging System ◽

18F Fdg ◽

Fdg Pet Ct

Abstract Purpose : This study evaluated the prognostic role of 18F-FDG PET/CT at baseline in patients with newly diagnosed multiple myeloa (MM) and evaluated the prognostic relevance of 18F-FDG PET/CT for each stage according to the Revised International Staging System (R-ISS). Method: We retrospectively analyzed the records of 167 patients with newly diagnosed MM. 18F-FDG PET/CT was performed prior to induction therapy in patients with newly diagnosed MM. A Focal lesions (FL) at diagnosis was defined as focally increased FDG uptake greater than the physiologic bone marrow or liver uptake, with or without any underlying lesion. Extramedullary disease (EMD) was defined as FDG-avid soft tissue that was not contiguous to bone. Results: A total of 102 patients (61.1%) had at least one FL at diagnosis, and 44.9% had more than three FLs. EMD was present in 13.2% of all patients. In the total cohort, the presence of more than three hypermetabolic FLs or EMD on baseline PET/CT was associated with significantly inferior progression free survival (PFS) and overall survival (OS) than other patients. Because most patients (91%) with EMD had more than three FLs, PET/CT positivity was defined as the presence of more than three FLs or the presence of EMD. The C-reactive protein level was higher (0.550 vs. 0.245 mg/L, P = 0.004) and the serum albumin level was lower in the PET/CT-positive group (3.5 vs. 3.6 g/dL, P = 0.040). Patients who were PET/CT-positive had a significantly lower complete response rate after first-line therapy compared with those who were PET/CT-negative (15.6% vs. 34.4%, P = 0.007). In multivariate analyses, PET/CT positivity was an independent predictor of PFS and OS in all patients. Fifty-five patients (46.1%) with R-ISS II were PET/CT-positive at baseline and had significantly shorter PFS and OS. PET/CT positivity was also correlated with poor PFS and OS in patients with R-ISS III. Conclusion : 18F-FDG PET/CT was an independent predictor of survival outcomes in patients with newly diagnosed MM. In addition, performing 18F- FDG PET/CT at diagnosis may be useful for determining the survival outcomes of MM patients with R-ISS II and III. Figure. Figure. Disclosures No relevant conflicts of interest to declare.

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