William H Martin

Vanderbilt University, Нашвилл, Michigan, United States

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Publications (40)188.55 Total impact

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    ABSTRACT: The 2010 North American Consensus Guidelines (NACG) for pediatric administered doses and the European Association of Nuclear Medicine (EANM) dosage card recommend lower administered activities than those given at our institution. We compared the quality of the lower-activity images to the higher-activity images to determine if the reduction in counts affects overall image quality. Twenty patients presenting to our pediatric radiology department for bone scintigraphy were evaluated. Mean weight was 20 kg. Patients were referred for oncologic (n = 5), infectious/inflammatory (n = 5), and pain (n = 5) evaluation. Dynamic anterior and posterior images were acquired for 5 minutes for each patient. Data were subsampled to represent different administered activities corresponding to the activities recommended by the NACG and EANM dosage card. Images were evaluated for diagnostic quality and acceptability for daily clinical use. There was no statistically significant difference in the diagnostic quality of the images from any of the three protocols. Pathologic uptake was correctly identified independent of the administered activity , although there was one false-positive on an EANM image. When subjectively evaluating images as acceptable for daily clinical use, there was a slight preference for the higher activity images over the NACG (P = 0.04). The recommended administered activities of the NACG produce images of diagnostic quality, while reducing patient radiation exposure. Copyright © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
    No preview · Article · Jul 2015 · Journal of Nuclear Medicine
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    ABSTRACT: Purpose: High-speed (HS) single-photon emission computed tomography (SPECT) with a recently developed solid-state camera shows comparable myocardial perfusion abnormalities to those seen in conventional SPECT. We aimed to compare HS and conventional SPECT images from multiple centres with coronary angiographic findings. Methods: The study included 50 patients who had sequential conventional SPECT and HS SPECT myocardial perfusion studies and coronary angiography within 3 months. Stress and rest perfusion images were visually analysed and scored semiquantitatively using a 17-segment model by two experienced blinded readers. Global and coronary territorial summed stress scores (SSS) and summed rest scores (SRS) were calculated. Global SSS ≥3 or coronary territorial SSS ≥2 was considered abnormal. In addition the total perfusion deficit (TPD) was automatically derived. TPD >5% and coronary territorial TPD ≥3% were defined as abnormal. Coronary angiograms were analysed for site and severity of coronary stenosis; ≥50% was considered significant. Results: Of the 50 patients, 13 (26%) had no stenosis, 22 (44%) had single-vessel disease, 6 (12%) had double-vessel disease and 9 (18%) had triple-vessel disease. There was a good linear correlation between the visual global SSS and SRS (Spearman's ρ 0.897 and 0.866, respectively; p < 0.001). In relation to coronary angiography, the sensitivities, specificities and accuracies of HS SPECT and conventional SPECT by visual assessment were 92% (35/38), 83% (10/12) and 90% (45/50) vs. 84% (32/38), 50% (6/12) and 76% (38/50), respectively (p < 0.001). The sensitivities, specificities and accuracies of HS SPECT and conventional SPECT in relation to automated TPD assessment were 89% (31/35), 57% (8/14) and 80% (39/49) vs. 86% (31/36), 77% (10/13) and 84% (41/49), respectively. Conclusion: HS SPECT allows fast acquisition of myocardial perfusion images that correlate well with angiographic findings with overall accuracy by visual assessment better than conventional SPECT. Further assessment in a larger patient population may be needed to confirm this observation.
    No preview · Article · Apr 2013 · European Journal of Nuclear Medicine

  • No preview · Article · Jul 2012 · Journal of Nuclear Medicine
  • Dominique Delbeke · William H Martin
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    ABSTRACT: The evaluation of patients with known or suspected recurrent colorectal carcinoma is now an accepted indication for positron emission tomography using (18)F-fluorodeoxyglucose (FDG-PET) imaging. PET and CT are complimentary, and therefore, integrated PET/CT imaging should be performed where available. FDG-PET/CT is indicated as the initial test for diagnosis and staging of recurrence, and for preoperative staging (N and M) of known recurrence that is considered to be resectable. FDG-PET imaging is valuable for the differentiation of posttreatment changes from recurrent tumor, differentiation of benign from malignant lesions (indeterminate lymph nodes, hepatic, and pulmonary lesions), and the evaluation of patients with rising tumor markers in the absence of a known source. The addition of FDG-PET/CT to the evaluation of these patients reduces overall treatment costs by accurately identifying patients who will and will not benefit from surgical procedures. This new powerful technology provides more accurate interpretation of both CT and FDG-PET images and therefore more optimal patient care. PET/CT fusion images affect the clinical management by guiding further procedures (biopsy, surgery, and radiation therapy), excluding the need for additional procedures, and changing both inter- and intramodality therapy.
    No preview · Article · Jan 2011 · Methods in molecular biology (Clifton, N.J.)

  • No preview · Conference Paper · Nov 2010
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    ABSTRACT: This prospective, multicenter trial compared quantitative results of myocardial perfusion imaging and function using a high-speed single-photon emission computed tomography (SPECT) system with those obtained with conventional SPECT. A novel SPECT camera was shown in a pilot study to detect a similar amount of myocardial perfusion abnormality compared with conventional SPECT in one-seventh of the acquisition time. A total of 238 patients underwent myocardial perfusion imaging with conventional and high-speed SPECT at 4 U.S. centers. An additional 63 patients with a low pre-test likelihood of coronary artery disease underwent myocardial perfusion imaging with both technologies to develop method- and sex-specific normal limits. Rest/stress acquisition times were, respectively, 20/15 min and 4/2 min for conventional and high-speed SPECT. Stress and rest quantitative total perfusion deficit, post-stress left ventricular end-diastolic volume, and ejection fraction were derived for the 238 patients by the 2 methods. High-speed stress and rest total perfusion deficit correlated linearly with conventional SPECT total perfusion deficit (r = 0.95 and 0.97, respectively, p < 0.0001), with good concordance in the 3 vascular territories (kappa statistics for the left anterior descending coronary artery, left circumflex coronary artery, and right coronary artery were 0.73, 0.73, and 0.70, respectively; >90% agreement). The percentage of ischemic myocardium by both imaging modalities was significantly larger in patients with a high coronary artery disease likelihood than in those with a low and intermediate likelihood (p < 0.001). The average amount of ischemia was slightly but significantly larger by high-speed SPECT compared with conventional SPECT in high-likelihood patients (4.6 +/- 4.6% vs. 3.9 +/- 4.0%, respectively; p < 0.05). Post-stress ejection fraction and end-diastolic volume by the 2 methods were linearly correlated (r = 0.89 and 0.97, respectively). The high-speed SPECT technology provides quantitative measures of myocardial perfusion and function comparable to those with conventional SPECT in one-seventh of the acquisition time.
    Full-text · Article · May 2010 · Journal of the American College of Cardiology
  • Dominique Delbeke · William H Martin
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    ABSTRACT: FDG PET imaging is useful for preoperative diagnosis of pancreatic carcinoma in patients with suspected pancreatic cancer in whom CT fails to identify a discrete tumor mass or in whom FNAs are nondiagnostic. FDG PET imaging is useful for M staging and restaging by detecting CT occult metastatic disease, allowing noncurative resection to be avoided in this group of patients. FDG PET can differentiate post-therapy changes from recurrence and holds promise for monitoring neoadjuvant chemoradiation therapy. The technique is less useful in periampullary carcinoma and marginally helpful in staging except for M staging. As with other malignancies, FDG PET is complementary to morphologic imaging with CT, therefore, integrated PET/CT imaging provides optimal images for interpretation and thus more optimal patient care.
    No preview · Article · Apr 2010 · Surgical Oncology Clinics of North America
  • Dominique Delbeke · Heiko Schöder · William H Martin · Richard L Wahl
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    ABSTRACT: The incremental diagnostic value of integrated positron emission tomography-computed tomography (PET/CT) or single-photon emission computed tomography (SPECT)/CT images compared with PET or SPECT alone, or PET or SPECT correlated with a CT obtained at a different time includes the following: (1) improvement in lesion detection on both CT and PET or SPECT images, (2) improvement in the localization of foci of uptake resulting in better differentiation of physiological from pathologic uptake, (3) precise localization of the malignant foci, for example, in the skeleton vs soft tissue or liver vs adjacent bowel or node (4) characterization of serendipitous lesions, and (5) confirmation of small, subtle, or unusual lesions. The use of these techniques can occur at the time of initial diagnosis, in assessing the early response of disease to treatment, at the conclusion of treatment, and in continuing follow-up of patients. PET/CT and SPECT/CT fusion images affect the clinical management in a significant proportion of patients with a wide range of diseases by (1) guiding further procedures, (2) excluding the need of further procedures, (3) changing both inter- and intramodality therapy, including soon after treatment has been initiated, and (4) by providing prognostic information. PET/CT fusion images have the potential to provide important information to guide the biopsy of a mass to active regions of the tumor and to provide better maps than CT alone to modulate field and dose of radiation therapy. It is expected that the role of PET/CT and SPECT/CT in changing management will continue to evolve in the future and that these tools will be fundamental components of the truly "personalized medicine" we are striving to deliver.
    No preview · Article · Oct 2009 · Seminars in nuclear medicine
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    ABSTRACT: The purpose of this study was to compare stress supine single photon emission computed tomography (SPECT) imaging with attenuation correction (AC) via computed tomography-based attenuation maps with stress prone SPECT imaging with regard to the rate of equivocal interpretation of rest/stress myocardial perfusion imaging. Interpretations for 324 consecutive patients referred for rest/stress myocardial perfusion imaging were performed by use of the following sets of poststress SPECT images: supine with no AC (NC), supine NC/AC, supine NC/prone, and all images. The number of equivocal studies decreased with additional imaging: supine NC, 40%; supine NC/prone, 18%; supine NC/AC, 11%; and all images, 8%. The supine NC/AC sets of images reduced the number of defects to a greater extent than the supine NC/prone images for all patients (P = .01), men (P = .002), and women (P = .425). For the inferior (but not the anterior) wall, the percent decrease in defects with supine NC/AC images was lower as compared with supine NC/prone images. Interpretation with all images resulted in the fewest equivocal studies. The supine NC/AC images reduced the number of equivocal studies to a greater extent than the supine NC/prone images. AC and prone imaging were more helpful in men than women and were more helpful to resolve inferior than anterior wall defects. Adding prone imaging to supine imaging without and with AC does not significantly alter the number of equivocal interpretations.
    No preview · Article · May 2007 · Journal of Nuclear Cardiology
  • William H. Martin · Martin P. Sandler · Milton D. Gross
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    ABSTRACT: The thyroid is a bilobed structure evolving from the fourth and fifth branchial pouches. It is initially attached to the ventral floor of the pharynx by the thyroglossal duct. Thyroid tissue may be found anywhere between the base of the tongue and the retrosternal anterior mediastinum (Figure 13.1). The fetal thyroid gland begins to concentrate iodine and synthesize thyroid hormones by approximately 10.5 weeks, which is pertinent when the administration of 131I to fertile women is contemplated. The two ellipsoid lobes of the adult thyroid are joined by a thin isthmus. Each lobe is approximately 2 cm in thickness and width and averages 4–4.5 cm in length. The thyroid gland, averaging approximately 20 grams in weight, resides in the neck at the level of the cricoid cartilage. A pyramidal lobe is present in approximately 30–50%, arising fromeither the isthmus or the superomedial aspect of either lobe; it undergoes progressive atrophy in adulthood but may be prominent in patients with Graves' disease. Although the right lobe tends to be somewhat larger than the left lobe, there is a great deal of variability in both size and shape of the normal gland.
    No preview · Chapter · Oct 2006
  • Dominique Delbeke · William H. Martin
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    ABSTRACT: FDG-PET imaging appears helpful in differentiating malignant from benign hepatic lesions, with the exception of false-negative HCC, false-negative infiltrating cholangiocarcinoma, and false-positive inflammatory lesions. It is not helpful to identify HCC in patients with cirrhosis and regenerating nodules. In patients with primary malignant hepatic tumors that accumulate FDG, PET imaging does identify unexpected distant metastases (although miliary carcinomatosis is often false negative) and can help in monitoring response to therapy. FDG-PET imaging seems promising for monitoring patient response to therapy, including regional therapy to the liver, but larger studies are necessary. FDG-PET imaging is especially helpful for the preoperative diagnosis of pancreatic carcinoma in patients with suspected pancreatic cancer in whom CT fails to identify a discrete tumor mass or in whom biopsy is nondiagnostic. By providing scintigraphic preoperative documentation of pancreatic malignancy in these patients, laparotomy may be undertaken with a curative intent, and the risk of aborting resection because of diagnostic uncertainty is minimized. FDG-PET imaging is also useful for M staging and restaging by detecting CT-occult metastatic disease and allowing nontherapeutic resection to be avoided altogether in this group of patients. As is true with other neoplasms, FDG-PET can accurately differentiate posttherapy changes from recurrence and holds promise for monitoring neoadjuvant chemoradiation therapy. FDG-PET imaging is complementary to morphologic imaging with CT; therefore, integrated PET/CT imaging provides optimal images for interpretation.
    No preview · Chapter · Oct 2006
  • Christopher D Roman · William H Martin · Dominique Delbeke
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    ABSTRACT: The purpose of this study was to assess the incremental value of integrated F-18 FDG PET-CT imaging compared with either alone for evaluation of patients with body malignancies. Images from 173 consecutive patients with body malignancies referred for integrated PET-CT imaging were reviewed. A CT with contrast performed within 2 months of PET-CT was available for 74 patients. There was agreement between the transmission CT (TrCT) and PET interpreted separately in 65% (112 of 173) of patients. Interpretation of integrated PET-CT had an incremental diagnostic value in 17.9% (31 of 173) of the total patient population. Data was analyzed further excluding patients for whom further analysis was not relevant: 1) 20% (34 of 173) of patients with normal TrCT and PET and 2) 11% (19 of 173) of patients with disseminated metastases (too numerous to count) on both TrCT and PET. Among the 120 other patients, PET interpreted alone was positive in 195 body regions and CT-positive in 178 body regions with agreement for all regions in 49% (59 of 120) of patients and discordance or equivocal lesions in 51% (61 of 120) of patients. Integrated PET-CT had an incremental diagnostic value in 27% (31 of 120) of patients. Contrasted CT scan demonstrated hepatic lesions in 5 and extrahepatic lesions in 3 patients overlooked on TrCT; all 8 of these lesions were PET-positive. There was incremental impact on the management of 12.5% (15 of 120) of patients. After excluding patients with a normal PET-CT or disseminated disease, there was an incremental diagnostic value of integrated PET-CT imaging in 27% (31 of 120) and incremental impact on management in 12.5% (15 of 120) of patients. CT with contrast did not demonstrate lesions not appreciated by PET-CT.
    No preview · Article · Aug 2005 · Clinical Nuclear Medicine
  • Christopher D Roman · M Reza Habibian · William H Martin
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    ABSTRACT: The purpose of this case report is to demonstrate the utility of multimodality imaging in the diagnosis of infection within a retained prosthetic device in the posttransplant setting. Autologous leukocytes were labeled in vitro with indium-111 oxine and were reinjected. Whole-body and SPECT images were acquired at 24 hours and correlated with contemporary CT images. Through the use of combined indium-labeled WBC scintigraphy and CT we were able to identify infection within retained left ventricular assist device tubing status postcardiac transplantation in a patient with a diagnosis of fever of unknown origin. Localization of possible infectious etiologies within the transplant population is of utmost concern. Multimodality imaging, often utilizing scintigraphic techniques, is recommended.
    No preview · Article · Feb 2005 · Clinical Nuclear Medicine
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    Dominique Delbeke · William H Martin
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    ABSTRACT: Evaluation of patients with known or suspected recurrent colorectal carcinoma is now an accepted indication for FDG PET imaging. FDG PET does not replace imaging modalities such as CT for preoperative anatomic evaluation, but is indicated as the initial test for diagnosis and staging of recurrence, and for preoperative staging (N and M) of known recurrence that is considered to be resectable. FDG PET imaging is valuable for differentiation of post-treatment changes from recurrent tumor, differentiation of benign from malignant lesions (indeterminate lymph nodes, hepatic and pulmonary lesions) and evaluation of patients with rising tumor markers in the absence of a known source. FDG PET has an impact on the treatment of 25%-30% of patients. Addition of FDG PET to the evaluation of these patients reduces overall treatment costs by accurately identifying patients who will and will not benefit from surgical procedures. FDG PET imaging seems promising for monitoring patient response to therapy, including regional therapy to the liver, but larger studies are necessary. FDG PET imaging appears helpful to differentiate malignant from benign hepatic lesions, with the exception of false negative HCC, false negative infiltrating cholangiocarcinoma, and false positive inflammatory lesions. It is not helpful to identify HCC in patients with cirrhosis and regenerating nodules. In patients with hepatic primary malignant tumors trapping FDG, FDG PET imaging does identify unexpected distant metastases (although military carcinomatosis is often false negative) and can help in monitoring therapy. FDG PET imaging is especially helpful for the preoperative diagnosis of pancreatic carcinoma in patients with suspected pancreatic cancer in whom CT fails to identify a discrete tumor mass or in whom FNAs are non-diagnostic. By providing preoperative documentation of pancreatic malignancy in these patients, laparotomy may be undertaken with a curative intent, and the risk of aborting resection due to diagnostic uncertainty is minimized. FDG PET imaging is also useful for M staging and restaging by detecting CT-occult metastatic disease, and allowing non-therapeutic resection to be avoided altogether in this group of patients. As is true with other neoplasms, FDG PET can differentiate post-therapy changes from recurrence and holds promise for monitoring neo-adjuvant chemoradiation therapy. FDG PET imaging is complementary to morphological imaging with CT; therefore, integrated PET/CT imaging provides optimal images for interpretation. The diagnostic implications of integrated PET/CT imaging include improved detection of lesions on both the CT and FDG PET images, better differentiation of physiologic from pathologic foci of metabolism, and better localization of the pathologic foci. This new powerful technology provides more accurate interpretation of both CT and FDG PET images and therefore more optimal patient care. PET/CT fusion images affect the clinical management by guiding further procedures (biopsy, surgery, radiation therapy), excluding the need for additional procedures, and changing both inter- and intra-modality therapy.
    Preview · Article · Feb 2005 · HPB
  • Dominique Delbeke · William H Martin
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    ABSTRACT: The evaluation of patients with known or suspected recurrent colorectal carcinoma is now an accepted indication for positron emission tomography using (18)F-fluorodeoxyglucose (FDG-PET) imaging. FDG-PET does not replace imaging modalities such as computed tomography (CT) for preoperative anatomic evaluation but is indicated as the initial test for diagnosis and staging of recurrence and for preoperative staging (N and M) of known recurrence that is considered to be resectable. FDG-PET imaging is valuable for the differentiation of posttreatment changes from recurrent tumor, differentiation of benign from malignant lesions (indeterminate lymph nodes, hepatic and pulmonary lesions), and the evaluation of patients with rising tumor markers in the absence of a known source. The addition of FDG-PET to the evaluation of these patients reduces overall treatment costs by accurately identifying patients who will and will not benefit from surgical procedures. Although initial staging at the time of diagnosis is often performed during colectomy, FDG-PET imaging is recommended for a subgroup of patients at high risk (with elevated CEA levels) and normal CT and for whom surgery can be avoided if FDG-PET shows metastases. Screening for recurrence in patients at high risk has also been advocated. FDG-PET imaging seems promising for monitoring patient response to therapy but larger studies are necessary. The diagnostic implications of integrated PET-CT imaging include improved detection of lesions on both the CT and FDG-PET images, better differentiation of physiologic from pathologic foci of metabolism, and better localization of the pathologic foci. This new powerful technology provides more accurate interpretation of both CT and FDG-PET images and therefore more optimal patient care. PET-CT fusion images affect the clinical management by guiding further procedures (biopsy, surgery, radiation therapy), excluding the need for additional procedures, and changing both inter- and intramodality therapy.
    No preview · Article · Aug 2004 · Seminars in Nuclear Medicine
  • Dominique Delbeke · William H. Martin
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    ABSTRACT: The rapid advances in imaging technologies are a challenge for both radiologists and clinicians who must integrate these technologies for optimal patient care and outcomes at minimal cost. Multiple indications for functional imaging using fluorodeoxyglucose (FDG) are now well accepted in the fields of neurology, cardiology, and oncology, including differentiation of benign from malignant lesions, staging of malignant lesions, detection of malignant recurrence, and monitoring of therapy. The fusion of anatomic and molecular images (computed tomography [CT] and FDG) obtained with integrated positron emission tomography (PET)-CT systems, sequentially in time but without moving the patient from the imaging table, allows optimal co-registration of anatomic and molecular images, leading to accurate attenuation correction and precise anatomic localization of lesions with increased metabolism. This powerful technology provides a valuable new tool for diagnostic and therapeutic applications. The diagnostic accuracy is improved in approximately 50% of patients because of improvement of lesion detection on both CT and FDG PET images, better differentiation between physiologic and pathological foci of FDG uptake, and better localization of malignant foci of FDG uptake. This new technology affects the management of 10%-20% of cases by guiding further therapy. Promising clinical applications include guiding biopsy to the metabolically active sites of tumors, guiding surgery, and planning intensity-modulated radiation therapy. In addition, new PET radiopharmaceuticals are emerging for indications for which FDG has limitations. Some of the new PET tracers are labeled with 18F, which has a practical half-life for commercial distribution. In the past few years, the clinical indications for FDG have broadened dramatically, and the rapid technical developments of integrated multimodality imaging systems and new PET tracers further extend the horizon.
    No preview · Article · Jul 2004 · The Cancer Journal
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    ABSTRACT: The aim of this investigation was to evaluate the influence and accuracy of (18)F-FDG PET in target volume definition as a complementary modality to CT for patients with head and neck cancer (HNC) using dedicated PET and CT scanners. Six HNC patients were custom fitted with head and neck and upper body immobilization devices, and conventional radiotherapy CT simulation was performed together with (18)F-FDG PET imaging. Gross target volume (GTV) and pathologic nodal volumes were first defined in the conventional manner based on CT. A segmentation and surface-rendering registration technique was then used to coregister the (18)F-FDG PET and CT planning image datasets. (18)F-FDG PET GTVs were determined and displayed simultaneously with the CT contours. CT GTVs were then modified based on the PET data to form final PET/CT treatment volumes. Five-field intensity-modulated radiation therapy (IMRT) was then used to demonstrate dose targeting to the CT GTV or the PET/CT GTV. One patient was PET-negative after induction chemotherapy. The CT GTV was modified in all remaining patients based on (18)F-FDG PET data. The resulting PET/CT GTV was larger than the original CT volume by an average of 15%. In 5 cases, (18)F-FDG PET identified active lymph nodes that corresponded to lymph nodes contoured on CT. The pathologically enlarged CT lymph nodes were modified to create final lymph node volumes in 3 of 5 cases. In 1 of 6 patients, (18)F-FDG-avid lymph nodes were not identified as pathologic on CT. In 2 of 6 patients, registration of the independently acquired PET and CT data using segmentation and surface rendering resulted in a suboptimal alignment and, therefore, had to be repeated. Radiotherapy planning using IMRT demonstrated the capability of this technique to target anatomic or anatomic/physiologic target volumes. In this manner, metabolically active sites can be intensified to greater daily doses. Inclusion of (18)F-FDG PET data resulted in modified target volumes in radiotherapy planning for HNC. PET and CT data acquired on separate, dedicated scanners may be coregistered for therapy planning; however, dual-acquisition PET/CT systems may be considered to reduce the need for reregistrations. It is possible to use IMRT to target dose to metabolically active sites based on coregistered PET/CT data.
    Full-text · Article · May 2004 · Journal of Nuclear Medicine
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    Article: Corrections

    Full-text · Article · Mar 2004 · Journal of Nuclear Cardiology
  • Daniel R Scanga · William H Martin · Dominique Delbeke
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    ABSTRACT: The purpose of this study was to evaluate the value and impact on management of FDG PET imaging in patients with biopsy-proved neuroendocrine and neural crest tumors, as well as thyroid carcinoma of various types. This is a retrospective review of imaging and clinical data of 60 consecutive patients presenting for evaluation of suspected recurrence who underwent FDG PET imaging between August 1993 and February 2002. All patients were referred for PET because of equivocal findings on conventional evaluation (most often increasing tumor markers and negative conventional workup) or for restaging. The final diagnosis was established with pathology (n = 19) or at least 6 months of follow-up (n = 41). The FDG images were acquired 1 hour after the intravenous administration of 10 mCi FDG with 1 of 2 dedicated PET tomographs (Siemens ECAT 933, CTI, Knoxville, TN; and GE Advance, General Electric Medical Systems, Milwaukee, WI). Thirty-four patients had recurrent disease and 26 had no evidence of recurrence. FDG PET imaging revealed at least as many focal abnormalities as concurrent CT, magnetic resonance, or other nuclear imaging modalities in 46 of 60 patients (77%). There were 17 patients (28%) in whom FDG PET found abnormalities not seen with other modalities. In the small group (n = 18) of cases of carcinoid, pheochromocytoma, Merkel cell tumor, and neuroblastoma, all cases were true positive (T+) or true negative (T-). In the group of 42 cases of thyroid carcinoma, the sensitivity was 67%. There were 16 T+, 18 T-, and 8 false-negative (F-) cases. Six F- cases presented with increasing thyroglobulin levels and negative whole-body I-131 scans. Four of these 6 F- cases were proved by surgery, 1 by a positive post I-131 therapy scan, and 1 by normalization of thyroglobulin levels after I-131 therapy. Two of the 8 F- PET cases had a positive I-131 scan. FDG PET imaging had an impact on the management of 13 of 60 of these patients (22%) by demonstrating extensive metastases and cancelling surgery (n = 2), and by detecting recurrence and guiding surgery (n = 5) or radiation therapy (n = 6). FDG PET is helpful in the evaluation of thyroid, neuroendocrine, and neural crest tumors. Although the sensitivity was only 76%, there were no false-positive findings, and FDG PET findings changed the management of 22% of the patients.
    No preview · Article · Mar 2004 · Clinical Nuclear Medicine
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    ABSTRACT: Erdheim-Chester disease (ECD) is a disseminated xanthogranulomatous infiltrative disease of unknown etiology due to infiltration of different organs and bones by foamy histiocytes. A 37-year-old male with cerebral and periorbital lesions was diagnosed with this rare disease and was evaluated with magnetic resonance imaging (MRI) and 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) with positron emission tomography/computed tomography (PET/CT) imaging at baseline and following therapy. FDG-PET imaging allowed accurate evaluation of the extent of the disease at baseline, as well as assessment of response to therapy.
    No preview · Article · Feb 2004 · Molecular Imaging & Biology