Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography: A Novel Approach for the Diagnosis of Cholecystitis for Equivocal Diagnoses after Ultrasound Imaging

2012 ◽  
Vol 78 (10) ◽  
pp. 1109-1113
Author(s):  
Yosef Nasseri ◽  
Ariel J. Ourian ◽  
Alan Waxman ◽  
Alessandro D'Angolo ◽  
Louise E. Thomson ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Hida Scan ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Fluorodeoxyglucose Positron Emission

Although hepatobiliary iminodiacetic acid (HIDA) scan is often used when the diagnosis of cholecystitis remains questionable after ultrasound, it carries a high false-positive rate and has other limitations. Fluorodeoxyglucose positron emission tomography–computed tomography (18FDG PET-CT) has recently gained enthusiasm for its ability to detect infection and inflammation. In this study, we evaluate the accuracy of 18FDG PET-CT in diagnosing cholecystitis. Nineteen patients with suspected cholecystitis (Group S) underwent PET-CT and 10 had positive PET-CT findings. Of these 10, nine underwent cholecystectomies, and pathology confirmed cholecystitis in all nine. One patient was managed nonoperatively as a result of multiple comorbidities. Of the nine patients with negative PET-CT, six were managed nonoperatively, safely discharged, and had no readmissions at 3-month follow-up. The other three patients with negative PET-CT underwent cholecystectomies, and two showed no cholecystitis on pathology. The third had mild to moderate cholecystitis with focal mucosal erosion/ulceration without gallbladder wall thickening on pathology. 18FDG PET-CT detected gallbladder inflammation in all but one patient with pathology-proven cholecystitis with a sensitivity and specificity of 0.90 and 1.00, respectively. 18FDG-PET-CT appears to be a promising, rapid, direct, and accurate test in diagnosing cholecystitis and could replace HIDA scan in cases that remain equivocal after ultrasound.

scholarly journals Potential and Clinical Significance of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Evaluating Liver Cancer Response to Lenvatinib Treatment

Oncology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Daiki Yamashige ◽  
Yusuke Kawamura ◽  
Masahiro Kobayashi ◽  
Junichi Shindoh ◽  
Yuta Kobayashi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Recist 1.1 ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Fluorodeoxyglucose Positron Emission

<b><i>Background:</i></b> The sensitivity of <sup>18</sup>F-fluorodeoxyglucose positron emission tomography/computed tomography (<sup>18</sup>F-FDG-PET/CT) in hepatocellular carcinoma (HCC) is low; however, clinical evidence demonstrating its prognostic value in patients with HCC has recently been reported. This study aimed to assess the value of <sup>18</sup>F-FDG-PET/CT as a tool for evaluating the response of HCC to lenvatinib treatment. <b><i>Methods:</i></b> We evaluated 11 consecutive patients with HCC diagnosed by dynamic CT or magnetic resonance imaging combined with <sup>18</sup>F-FDG-PET/CT from April 2018 to December 2019. The tumor-to-normal liver ratio (TLR) of the target tumor was measured before and during the course of lenvatinib treatment with <sup>18</sup>F-FDG-PET/CT (pre and post analysis, respectively), with a TLR ≥2 classified as PET-positive HCC. At the time of each evaluation, we also used the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, the modified RECIST (mRECIST), and the tumor marker alfa-fetoprotein (AFP). <b><i>Results:</i></b> Of 11 patients, 3 (27%) and 8 (73%) had an objective response to lenvatinib treatment at the time of post-analysis by RECIST 1.1 and mRECIST, respectively. There were 3 (27%) and 7 (64%) patients with PET-positive HCC at the time of pre- and post-analysis, respectively. There was a significant correlation between the rates of change in AFP and TLR during lenvatinib treatment (<i>r</i> = 0.69, <i>p</i> = 0.019). Based on these results, we were able to perform liver resection on 4 patients with PET-positive HCC as conversion therapy. Three samples from these patients showed poorly differentiated tumors. <b><i>Conclusion:</i></b> <sup>18</sup>F-FDG-PET/CT has potential as an evaluation tool for describing biological tumor behavior and reflecting disease progression, location, and treatment response. This modality may provide useful information for considering prognosis and subsequent therapy.

scholarly journals RELEVANCE OF 18F-FLUORODEOXYGLUCOSE-POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF ATYPICAL TEMPORAL ARTERITIS

2017 ◽  
pp. 1-2
Author(s):  
M. Leclercq ◽  
L. Goodrich ◽  
C. Le Guillou ◽  
X. Gbaguidi
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Inflammatory Syndrome ◽  
Fluorodeoxyglucose Positron Emission

Atypical form of Giant cell arteritis (GCA), involving the absence of American College of Rheumatology (ACR) criteria, should be suspected before fever or inflammatory syndrome of unknown origin in the elderly. In that case, the diagnosis may be complex insofar as there are many possible infectious, inflammatory or tumorous etiologies. Completion of multiple and / or invasive clinical investigations can be questionable in a frail elderly population. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is a non-invasive examination of high sensitivity and specificity in the diagnosis of GCA which may reveal abnormal fixation of the wall of the aorta and its branches. Its negative predictive value close to 90 % is also a strength to exclude the diagnosis. FDG-PET/CT is also effective in the search for differential diagnoses. On the other hand, FDG-PET/CT should not be prescribed in front of typical form of GCA in which ACR criteria are met. This clinical case illustrate the place of FDG-PET/CT in the diagnostic strategy of an inflammatory syndrome in an elderly patient for whom GCA is suspected.

scholarly journals 18F-Fluorodeoxyglucose positron emission tomography-computed tomography imaging in HIV-infected patients with lymphadenopathy, with or without fever and/or splenomegaly

2017 ◽  
Vol 29 (7) ◽  
pp. 691-694
Author(s):  
L Jain ◽  
S Mackenzie ◽  
JB Bomanji ◽  
R Shortman ◽  
M Noursadeghi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Ct Imaging ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Fluorodeoxyglucose Positron Emission

We audited whether 18F-Fluorodeoxyglucose positron emission tomography-computed tomography (18FDG PET-CT) imaging could discriminate between different diagnoses in HIV-infected patients presenting with lymphadenopathy, with or without fever and/or splenomegaly. Maximum standardised uptake (SUVmax) values were similar in lymphoma and mycobacterial and fungal infections and were lower but similar in those with human herpesvirus (HHV) 8-associated disease and HIV-associated reactive lymphadenopathy. Nodal 18FDG avidity, with SUVmax ≥10, excluded diagnoses of HHV 8-associated disease and miscellaneous conditions, and HIV-associated reactive lymphadenopathy was additionally excluded in those who had undetectable plasma HIV viral loads. This audit suggests 18FDG PET-CT imaging did not permit discrimination between specific diagnoses but has utility in identifying lymph nodes with increased avidity that could be targeted for biopsy and in ruling out significant pathology.

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