ABSTRACT: PurposeTo determine the prognostic implications of pretreatment F-18 FDG PET/CT in patients with invasive ductal breast cancer (IDC),
we evaluated the relationship between FDG uptake of the primary tumor and known prognostic parameters of breast cancer. Prognostic
significance of tumoral FDG uptake for the prediction of progression-free survival (PFS) was also assessed.
Materials and MethodsFifty-five female patients with IDC who underwent pretreatment F-18 FDG PET/CT were enrolled. The maximum standardized uptake
value of the primary tumor (pSUVmax) was compared with clinicopathological parameters including tumor size, grade, estrogen
receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor2 (HER2), axillary lymph node (LN) metastasis,
and stage. The prognostic value of pSUVmax for PFS was assessed using the Kaplan-Meier method.
ResultsA high pSUVmax was significantly related to a higher stage of tumor size (P < 0.05), grade (P < 0.001), and stage (P < 0.001).
pSUVmax was significantly higher in ER-negative tumors (P < 0.001), PR-negative tumors (P < 0.001), and positive LN metastasis
(P < 0.01), but not different according to HER2 status. pSUVmax was significantly higher in patients with progression compared
to patients who were disease-free (10.6 ± 5.1 vs. 4.7 ± 3.5, P < 0.001). A receiver-operating characteristic curve demonstrated
a pSUVmax of 6.6 to be the optimal cutoff for predicting PFS (sensitivity; 86.7%, specificity; 82.5%). The patients with a
high pSUVmax (more than 6.6) had significantly shorter PFS compared to patients with a low pSUVmax (P < 0.0001).
ConclusionspSUVmax on pretreatment F-18 FDG PET/CT could be used as a good surrogate marker for the prediction of progression in patients
KeywordsF-18 FDG PET/CT–Invasive ductal breast cancer–SUVmax–Prognosis
ABSTRACT: Neurolymphomatosis is a rare manifestation of malignant lymphoma. A 74-year-old man, in complete remission from diffuse large
B cell lymphoma, presented with a loss of pain and temperature sensation in the left hemiface and left upper extremity, and
motor weakness in the left upper and both lower extremities. Cerebrospinal fluid analysis and brain magnetic resonance imaging
(MRI) findings were negative. Combined fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT)
revealed multiple linear hypermetabolic lesions along the mandibular branch of the left trigeminal nerve, left brachial plexus,
right axillary nerve, right suprarenal plexus, right adrenal gland, right femoral nerve, and both sciatic nerves, which corresponded
to the patient’s complex neurologic symptoms. C-spine and pelvic MRI revealed diffuse thickening with enhancement in the left
brachial plexus and in the proximal portion of the left sciatic nerve, but negative findings for other sites identified by
FDG-PET/CT. These findings suggest that FDG-PET/CT can detect peripheral nerve infiltration by malignant lymphoma earlier
than MRI. Thus, if a patient with a history of lymphoma presents with neurologic symptoms, FDG-PET/CT should be performed
to evaluate neurolymphomatosis.
ABSTRACT: Radioiodine (RI) such as (131)I or (124)I, can generate luminescent emission and be detected with an optical imaging (OI) device. To evaluate the possibility of a novel Cerenkov luminescence imaging (CLI) for application in thyroid research, we performed feasibility studies of CLI by RI in the thyroid gland and human anaplastic thyroid carcinoma cells expressing sodium iodide symporter gene (ARO-NIS). For in vitro study, FRTL-5 and ARO-NIS were incubated with RI, and the luminometric and CLI intensity was measured with luminometer and OI device. Luminescence intensity was compared with the radioactivity measured with γ-counter. In vivo CLI of the thyroid gland was performed in mice after intravenous injection of RI with and without thyroid blocking. Mice were implanted with ARO-NIS subcutaneously, and CLI was performed with injection of (124)I. Small animal PET or γ-camera imaging was also performed. CLI intensities of thyroid gland and ARO-NIS were quantified, and compared with the radioactivities measured from nuclear images (NI). Luminometric assay and OI confirmed RI uptake in the cells in a dose-dependent manner, and luminescence intensity was well correlated with radioactivity of the cells. CLI clearly demonstrated RI uptake in thyroid gland and xenografted ARO-NIS cells in mice, which was further confirmed by NI. A strong positive correlation was observed between CLI intensity and radioactivity assessed by NI. We successfully demonstrated dual molecular imaging of CLI and NI using RI both in vitro and in vivo. CLI can provide a new OI strategy in preclinical thyroid studies.
Endocrine Journal 05/2011; 58(7):575-83. · 2.03 Impact Factor
ABSTRACT: The purpose of this study was to determine the incidence of incidental pituitary uptake on whole-body 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and to investigate its clinical significance.
The files of 40,967 patients who underwent whole-body FDG PET/CT were retrospectively reviewed. Quantification of pituitary metabolic activity was obtained by using the maximum standardized uptake value (SUVmax). Hormone assays and pituitary MRIs were performed to assess pituitary lesions.
Focally increased pituitary FDG uptake on PET/CT was found in 30 of 40,967 patients, accounting for an incidence of 0.073%. The mean SUVmax of 30 patients was 8.9±6.6 (range: 3.2-32.6). Histological diagnosis was obtained in three patients and included two growth hormone-secreting adenomas and one non-functioning adenoma. Hormone assays were performed on serum samples from 11 patients, 2 of whom were shown to have hypersecretion of pituitary hormone. MRI was performed on 19 patients. Abnormal MRI findings suggesting a pituitary mass were found in 18 of 19 cases (94.7%). The mean SUV(max) calculated without correction for partial volume effect for macroadenomas was significantly higher than the SUVmax for microadenomas (11.5±8.4 vs 4.8±1.3; p<0.05). There were no cases diagnosed with metastasis to the pituitary gland during clinical follow-up.
Incidental pituitary FDG uptake was a very rare finding. Cases with incidental pituitary FDG uptake were diagnosed primarily with clinically non-functioning adenomas, and there were also a few functioning adenomas. Further evaluations, including hormone assays and pituitary MRI, are warranted when pituitary uptake is found on FDG PET/CT.
European Journal of Nuclear Medicine 12/2010; 37(12):2334-43. · 4.53 Impact Factor
Clinical nuclear medicine 08/2010; 35(8):601-3. · 3.92 Impact Factor
ABSTRACT: Facial muscle is a very rare site for distant metastasis of renal cell carcinoma (RCC). We present a 71-year-old man with isolated facial muscle metastasis 12 years after right nephrectomy for RCC. Magnetic resonance imaging showed a soft-tissue mass in the masticator space. F-18 fluorodeoxyglucose positron emission tomography/computed tomography showed a large hypermetabolic lesion in the right masticator space without other hypermetabolic lesion in the whole body. Subsequent biopsy and histologic study confirmed metastatic cancer from RCC.
Clinical nuclear medicine 04/2010; 35(4):263-4. · 3.92 Impact Factor