Fluorine-18 fluorodeoxyglucose(F-18 FDG)positron emission tomography/computed tomography(PET/CT)has emerged as a cornerstone in cancer evaluation imaging,with a well-established history spanning several years.This ima...Fluorine-18 fluorodeoxyglucose(F-18 FDG)positron emission tomography/computed tomography(PET/CT)has emerged as a cornerstone in cancer evaluation imaging,with a well-established history spanning several years.This imaging modality,encompassing the examination of the body from the base of the skull to the upper thighs,comprehensively covers the chest and abdominopelvic regions in a singular scan,allowing for a holistic assessment of nearly the entire body,including areas of marginal interest.The inherent advantage of this expansive scan range lies in its potential to unveil unexpected incidental abnormal hypermetabolic areas.The identification of incidental focal FDG uptake within colorectal regions during PET/CT scans is not an uncommon occurrence,albeit fraught with challenges associated with non-specific FDG uptake.The presence of benign colorectal lesions or physiological uptake poses a particular obstacle,as these may manifest with FDG uptake levels that mimic malignancy.Consequently,physicians are confronted with a diagnostic dilemma when encountering abnormal FDG uptake in unexpected colorectal areas.Existing studies have presented divergent results concerning these uptakes.Standardized uptake value and its derivatives have served as pivotal metrics in quantifying FDG uptake in PET images.In this article,we aim to succinctly explore the distinctive characteristics of FDG,delve into imaging findings,and elucidate the clinical significance of incidental focal colorectal uptake.This discussion aims to contribute valuable insights into the nuanced interpretation of such findings,fostering a comprehensive understanding.展开更多
Since the inception of fluorine-18 fluorodeoxyglucose(F-18 FDG),positron emission tomography/computed tomography(PET/CT)utilizing F-18 FDG has become widely accepted as a valuable imaging modality in the field of onco...Since the inception of fluorine-18 fluorodeoxyglucose(F-18 FDG),positron emission tomography/computed tomography(PET/CT)utilizing F-18 FDG has become widely accepted as a valuable imaging modality in the field of oncology,with global prevalence in clinical practice.Given that a single Torso PET/CT scan encompasses the anatomical region from the skull base to the upper thigh,the detection of incidental abnormal focal hypermetabolism in areas of limited clinical interest is both feasible and not uncommon.Numerous investigations have been undertaken to delineate the distinctive features of these findings,yet the outcomes have proven inconclusive.The incongruent results of these studies present a challenge for physicians,leaving them uncertain about the appropriate course of action.This article provides a succinct overview of the characteristics of fluorodeoxyglucose,followed by a comprehensive discussion of the imaging findings and clinical significance associated with incidental focal abnormal F-18 FDG activity in several representative organs.In conclusion,while the prevalence of unrecognized malignancy varies across organs,malignancies account for a substantial proportion,ranging from approximately one-third to over half,of incidental focal uptake.In light of these rates,physicians are urged to exercise vigilance in not disregarding unexpected uptake,facilitating more assured clinical decisions,and advocating for further active evaluation.展开更多
Recently, several reports have demonstrated that fluorine-18 fluorodeoxyglucose positron emission tomography （FDG-PET） is useful in differentiating between benign and malignant lesions in the gallbladder. However, t...Recently, several reports have demonstrated that fluorine-18 fluorodeoxyglucose positron emission tomography （FDG-PET） is useful in differentiating between benign and malignant lesions in the gallbladder. However, there is a limitation in the ability of FDG-PET to differentiate between inflammatory and malignant lesions. We herein present a case of xanthogranulomatous cholecystitis misdiagnosed as gallbladder carcinoma by ultrasonography and computed tomography. FDG-PET also showed increased activity. In this case, FDG-PET findings resulted in a false-positive for the diagnosis of gallbladder carcinoma.展开更多
Hepatocellular carcinoma(HCC) is one of major causes of cancer mortality worldwide. For decades, ^(18)F-fluorodeoxyglucose(FDG) positron emission tomography(PET) has been widely used for staging, predicting prognosis,...Hepatocellular carcinoma(HCC) is one of major causes of cancer mortality worldwide. For decades, ^(18)F-fluorodeoxyglucose(FDG) positron emission tomography(PET) has been widely used for staging, predicting prognosis, and detecting cancer recurrence in various types of malignant diseases. Due to low sensitivity of FDG PET for detecting intrahepatic HCC lesions, the clinical value of FDG PET in HCC patients has been limited. However, recent studies with diverse analytic methods have shown that FDG PET has promising role in aiding management of HCC patients. In this review, we will discuss the clinical role of FDG PET for staging, predicting prognosis, and evaluating treatment response in HCC. Further, we will focus on recent clinical studies regarding implication of volumetric FDG PET parameters, the significance of FDG uptake in HCC for selecting treatment and predicting treatment response, and the use of radiomics of FDG PET in HCC.展开更多
AIM： To investigate the correlations of pre-treatmentpositron emission tomography-computer tomography（PET-CT） metabolic quantifiers with clinical data ofunstratified gastric cancer （GC） patients.METHODS： Forty P...AIM： To investigate the correlations of pre-treatmentpositron emission tomography-computer tomography（PET-CT） metabolic quantifiers with clinical data ofunstratified gastric cancer （GC） patients.METHODS： Forty PET-CT scans utilising 18-fluorodeoxyglucosein patients who received no prior treatmentwere analysed. Analysis involved measurements ofmaximum and mean standardised uptake volumes（SUV）, coefficient of variation （COV）, metabolictumour volumes and total lesion glycolysis of differentthresholds above which the tumor volumes wereidentified. The threshold values were： SUV absolutevalue of 2.5, 30% of SUVmax, 40% of SUVmax,and liver uptake-based （marked 2.5, 30, 40 and liv,respectively）. Clinical variables such as age, sex,clinical stage, performance index, weight loss, tumorhistological type and grade, and CEA and CA19.9 levelswere included in survival analysis. Patients receivedvarious treatment modalities appropriate to theirdisease stage and the outcome was defined by time tometastasis （TTM） and overall survival （OS）. Clinical andmetabolic parameters were evaluated by analysis of variance, receiver operating characteristics, univariateKaplan-Meier, and multivariate Cox models. P 〈 0.05was considered statistically significant.RESULTS： Significant differences were observedbetween initially disseminated and non-disseminatedpatients in mean SUV （6.05 vs 4.13, P = 0.008）, TLG2.5（802 cm3 vs 226 cm3; P = 0.031）, and TLG30 （436 cm3vs 247 cm3, P = 0.018）. Higher COV was associatedwith poor tumour differentiation （0.47 for G3 vs0.28 for G1 and G2; P = 0.03）. MTV2.5 was positivelycorrelated to patient weight loss （〈 5%, 5%-10%and 〉 10%： 40.4 cm3 vs 123.6 cm3 vs 181.8 cm3,respectively, P = 0.003）. In multivariate Cox analysis,TLG30 was prognostic for OS （HR = 1.001, 95%CI：1.0009-1.0017; P = 0.047） for the whole group ofpatients. In the same model yet only including patientswithout initial disease dissemination TLG30 （HR = 1.009,95%CI： 1.003-1.014; P = 0.004） and MTV2.5 （HR = 1.02,95%CI： 1.002-1.036; P = 0.025） were prognostic forOS; for TTM TLG30 was the only significant prognosticvariable （HR = 1.006, 95%CI： 1.001-1.012; P = 0.02）.CONCLUSION： PET-CT in GC may represent a valuablediagnostic and prognostic tool that requires furtherevaluation in highly standardised environments such asrandomised clinical trials.展开更多
AIM： To evaluate the role of positron emission tomography using 18F-fluorodeoxyglucose （FDG-PET） in the surgical management of patients with pancreatic cancer, including the diagnosis, staging, and selection of pat...AIM： To evaluate the role of positron emission tomography using 18F-fluorodeoxyglucose （FDG-PET） in the surgical management of patients with pancreatic cancer, including the diagnosis, staging, and selection of patients for the subsequent surgical treatment. METHODS： This study involved 53 patients with proven primary pancreatic cancer. The sensitivity of diagnosing the primary cancer was examined for FDG-PET CT, cytological examination of the bile or pancreatic juice, and the serum levels of carcinoembrionic antigens （CEA） and carbohydrate antigen 19-9 （CA29-9）. Next, the accuracy of staging was compared between FDG-PET and CT. Finally, FDG-PET was analyzed semiquantitatively using the standard uptake value （SUV）. The impact of the SUV on patient management was evaluated by examining the correlations between the SUV and the histological findings of cancer. RESULTS： The sensitivity of FDG-PET, CT, cytological examination of the bile or pancreatic juice, and the serum levels of CEA and CA19-9 were 92.5%, 88.7%, 46.4%, 37.7% and 69.8%, respectively. In staging, FDG-PET was superior to CT only in diagnosing distant disease （bone metastasis）. For local staging, the sensitivity of CT was better than that of FDG-PEr. The SUV did not correlate with the pTNM stage, grades, invasions to the vessels and nerve, or with the size of the tumor. However, there was a statistically significant difference （4.6 ± 2.9 vs 7.8 ± 4.5, P = 0.024） in the SUV between patients with respectable and unresectable disease. CONCLUSION： FDG-PET is thus considered to be useful in the diagnosis of pancreatic cancer. However, regarding the staging of the disease, FDG-PET is not considered to be a sufficiently accurate diagnostic modality. Although the SUV does not correlate with the patho-histological prognostic factors, it may be useful in selecting patients who should undergo subsequent surgical treatment.展开更多
The purpose of this article is to provide a pictorial review of the findings and interpretative pitfalls about focal fluorodeoxyglucose(FDG)uptake in the absence of corresponding computer tomography(CT)lesion or abnor...The purpose of this article is to provide a pictorial review of the findings and interpretative pitfalls about focal fluorodeoxyglucose(FDG)uptake in the absence of corresponding computer tomography(CT)lesion or abnormality on an integrated positron emission tomography(PET)-CT.The integrated CT images in the PET-CT scanner allow correct co-registration and fused imaging of anatomical and functional data.On FDG PET-CT imaging,a real pathologic process often demonstrates abnormal uptake associated with a visible corresponding CT lesion or abnormality.When focal uptake is seen on PET imaging but no corresponding anatomic abnormality is visualized on the integrated CT,one should always be aware of possible mis-registration or mismatch of the PET and CT images due to the patient’s respiratory or body motion.While most of the hot spots in the absence of corresponding anatomic abnormalities are artefactual or secondary to benign etiologies,some may represent small sized or early staged neoplasm or metastases,especially in the gastrointestinal tract and skeletons.Caution should be exercised to simply diagnose a pathology based on the presence of the uptake only,or exclude the disease based on the absence of anatomic abnormality.展开更多
AIM To determine the significance and need for investigation of incidental prostatic uptake in men undergoing ^(18)F-labelled fluorodeoxyglucose(^(18)F-FDG) positron emission tomography/computed tomography(PET/CT) for...AIM To determine the significance and need for investigation of incidental prostatic uptake in men undergoing ^(18)F-labelled fluorodeoxyglucose(^(18)F-FDG) positron emission tomography/computed tomography(PET/CT) for other indications.METHODS Hospital databases were searched over a 5-year period for patients undergoing both PET/CT and prostate magnetic resonance imaging(MRI). For the initial analysis, the prostate was divided into six sectors and suspicious or malignant sectors were identified using MRI and histopathology reports respectively. Maximum and mean ^(18)F-FDG standardised uptake values were measured in each sector by an investigator blinded to the MRI and histopathology findings. Two agematched controls were selected per case. Results were analysed using a paired t-test and one-way ANOVA. For the second analysis, PET/CT reports were searched for prostatic uptake reported incidentally and these patients were followed up. RESULTS Over a 5-year period, 15 patients underwent both PET/CT and MRI and had biopsy-proven prostate cancer.Malignant prostatic sectors had a trend to higher ^(18)F-FDG uptake than benign sectors, however this was neither clinically nor statistically significant(3.13 ±0.58 vs 2.86 ± 0.68, P > 0.05). ^(18)F-FDG uptake showed no correlation with the presence or histopathological grade of tumour. ^(18)F-FDG uptake in cases with prostate cancer was comparable to that from age-matched controls. Forty-six(1.6%) of 2846 PET/CTs over a 5-year period reported incidental prostatic uptake. Of these, 18(0.6%) were investigated by PSA, 9(0.3%)were referred to urology, with 3(0.1%) undergoing MRI and/or biopsy. No cases of prostate cancer were diagnosed in patients with incidental ^(18)F-FDG uptake in our institute over a 5-year period.CONCLUSION ^(18)F-FDG uptake overlaps significantly between malignant and benign prostatic conditions. Subsequent patient management was not affected by the reporting of incidental focal prostatic uptake in this cohort.展开更多
BACKGROUND Lymph node(LN)metastasis is an important prognostic factor in patients with gastric cancer(GC).However,the evaluation of LN metastasis status in the preoperative setting is not accurate.Therefore,precise pr...BACKGROUND Lymph node(LN)metastasis is an important prognostic factor in patients with gastric cancer(GC).However,the evaluation of LN metastasis status in the preoperative setting is not accurate.Therefore,precise preoperative prediction of LN metastasis status is crucial for optimal treatment in patients with GC.AIM To develop a preoperative nomogram for LN metastasis using F-18 fluorodeoxyglucose(F-18 FDG)positron emission tomography/computed tomography(PET/CT)and preoperative laboratory test findings in GC.METHODS In this study,the data of 566 GC patients who underwent preoperative F-18 FDG PET/CT and subsequent surgical resection were analyzed.The LN metastasis prediction model was developed in the training cohort and validated in the internal validation cohort.Routine preoperative laboratory tests,including albumin and carbohydrate antigen(CA)19-9 were performed in all patients.Univariate and multivariable logistic regression was performed to validate the preoperative predictive indicators for LN metastasis.RESULTS Of the 566 patients,232(41%)had confirmed histopathologic LN metastasis.Univariate logistic regression revealed that the tumor location,blood hemoglobin,serum albumin levels,neutrophil to lymphocyte ratio,platelet to lymphocyte ratio,CA 19-9,maximum standardized uptake value(SUVmax)of the primary tumor(T_SUVmax),and SUVmax of LN(N_SUVmax)were significantly associated with LN metastasis.In multivariate analysis,T_SUVmax(OR=1.08;95%CI:1.02–1.15;P=0.011)and N_SUVmax(OR=1.49;95%CI:1.19–1.97;P=0.002)were found to be significant predictive factors for LNmetastasis.The LN metastasis prediction model using T_SUVmax,N_SUVmax,serum albumin,and CA 19-9 yielded an area under the curve(AUC)of 0.733(95%CI:0.683–0.784,P=0.025)in the training cohort and AUC of 0.756(95%CI:0.678–0.833,P<0.001)in the test cohort.CONCLUSION T_SUVmax and N_SUVmax measured by preoperative F-18 FDG PET/CT are independent predictive factors for LN metastasis in GC.展开更多
文摘Fluorine-18 fluorodeoxyglucose(F-18 FDG)positron emission tomography/computed tomography(PET/CT)has emerged as a cornerstone in cancer evaluation imaging,with a well-established history spanning several years.This imaging modality,encompassing the examination of the body from the base of the skull to the upper thighs,comprehensively covers the chest and abdominopelvic regions in a singular scan,allowing for a holistic assessment of nearly the entire body,including areas of marginal interest.The inherent advantage of this expansive scan range lies in its potential to unveil unexpected incidental abnormal hypermetabolic areas.The identification of incidental focal FDG uptake within colorectal regions during PET/CT scans is not an uncommon occurrence,albeit fraught with challenges associated with non-specific FDG uptake.The presence of benign colorectal lesions or physiological uptake poses a particular obstacle,as these may manifest with FDG uptake levels that mimic malignancy.Consequently,physicians are confronted with a diagnostic dilemma when encountering abnormal FDG uptake in unexpected colorectal areas.Existing studies have presented divergent results concerning these uptakes.Standardized uptake value and its derivatives have served as pivotal metrics in quantifying FDG uptake in PET images.In this article,we aim to succinctly explore the distinctive characteristics of FDG,delve into imaging findings,and elucidate the clinical significance of incidental focal colorectal uptake.This discussion aims to contribute valuable insights into the nuanced interpretation of such findings,fostering a comprehensive understanding.
文摘Since the inception of fluorine-18 fluorodeoxyglucose(F-18 FDG),positron emission tomography/computed tomography(PET/CT)utilizing F-18 FDG has become widely accepted as a valuable imaging modality in the field of oncology,with global prevalence in clinical practice.Given that a single Torso PET/CT scan encompasses the anatomical region from the skull base to the upper thigh,the detection of incidental abnormal focal hypermetabolism in areas of limited clinical interest is both feasible and not uncommon.Numerous investigations have been undertaken to delineate the distinctive features of these findings,yet the outcomes have proven inconclusive.The incongruent results of these studies present a challenge for physicians,leaving them uncertain about the appropriate course of action.This article provides a succinct overview of the characteristics of fluorodeoxyglucose,followed by a comprehensive discussion of the imaging findings and clinical significance associated with incidental focal abnormal F-18 FDG activity in several representative organs.In conclusion,while the prevalence of unrecognized malignancy varies across organs,malignancies account for a substantial proportion,ranging from approximately one-third to over half,of incidental focal uptake.In light of these rates,physicians are urged to exercise vigilance in not disregarding unexpected uptake,facilitating more assured clinical decisions,and advocating for further active evaluation.
文摘Recently, several reports have demonstrated that fluorine-18 fluorodeoxyglucose positron emission tomography （FDG-PET） is useful in differentiating between benign and malignant lesions in the gallbladder. However, there is a limitation in the ability of FDG-PET to differentiate between inflammatory and malignant lesions. We herein present a case of xanthogranulomatous cholecystitis misdiagnosed as gallbladder carcinoma by ultrasonography and computed tomography. FDG-PET also showed increased activity. In this case, FDG-PET findings resulted in a false-positive for the diagnosis of gallbladder carcinoma.
文摘Hepatocellular carcinoma(HCC) is one of major causes of cancer mortality worldwide. For decades, ^(18)F-fluorodeoxyglucose(FDG) positron emission tomography(PET) has been widely used for staging, predicting prognosis, and detecting cancer recurrence in various types of malignant diseases. Due to low sensitivity of FDG PET for detecting intrahepatic HCC lesions, the clinical value of FDG PET in HCC patients has been limited. However, recent studies with diverse analytic methods have shown that FDG PET has promising role in aiding management of HCC patients. In this review, we will discuss the clinical role of FDG PET for staging, predicting prognosis, and evaluating treatment response in HCC. Further, we will focus on recent clinical studies regarding implication of volumetric FDG PET parameters, the significance of FDG uptake in HCC for selecting treatment and predicting treatment response, and the use of radiomics of FDG PET in HCC.
基金Supported by National Polish Science Centre,No.403238140
文摘AIM： To investigate the correlations of pre-treatmentpositron emission tomography-computer tomography（PET-CT） metabolic quantifiers with clinical data ofunstratified gastric cancer （GC） patients.METHODS： Forty PET-CT scans utilising 18-fluorodeoxyglucosein patients who received no prior treatmentwere analysed. Analysis involved measurements ofmaximum and mean standardised uptake volumes（SUV）, coefficient of variation （COV）, metabolictumour volumes and total lesion glycolysis of differentthresholds above which the tumor volumes wereidentified. The threshold values were： SUV absolutevalue of 2.5, 30% of SUVmax, 40% of SUVmax,and liver uptake-based （marked 2.5, 30, 40 and liv,respectively）. Clinical variables such as age, sex,clinical stage, performance index, weight loss, tumorhistological type and grade, and CEA and CA19.9 levelswere included in survival analysis. Patients receivedvarious treatment modalities appropriate to theirdisease stage and the outcome was defined by time tometastasis （TTM） and overall survival （OS）. Clinical andmetabolic parameters were evaluated by analysis of variance, receiver operating characteristics, univariateKaplan-Meier, and multivariate Cox models. P 〈 0.05was considered statistically significant.RESULTS： Significant differences were observedbetween initially disseminated and non-disseminatedpatients in mean SUV （6.05 vs 4.13, P = 0.008）, TLG2.5（802 cm3 vs 226 cm3; P = 0.031）, and TLG30 （436 cm3vs 247 cm3, P = 0.018）. Higher COV was associatedwith poor tumour differentiation （0.47 for G3 vs0.28 for G1 and G2; P = 0.03）. MTV2.5 was positivelycorrelated to patient weight loss （〈 5%, 5%-10%and 〉 10%： 40.4 cm3 vs 123.6 cm3 vs 181.8 cm3,respectively, P = 0.003）. In multivariate Cox analysis,TLG30 was prognostic for OS （HR = 1.001, 95%CI：1.0009-1.0017; P = 0.047） for the whole group ofpatients. In the same model yet only including patientswithout initial disease dissemination TLG30 （HR = 1.009,95%CI： 1.003-1.014; P = 0.004） and MTV2.5 （HR = 1.02,95%CI： 1.002-1.036; P = 0.025） were prognostic forOS; for TTM TLG30 was the only significant prognosticvariable （HR = 1.006, 95%CI： 1.001-1.012; P = 0.02）.CONCLUSION： PET-CT in GC may represent a valuablediagnostic and prognostic tool that requires furtherevaluation in highly standardised environments such asrandomised clinical trials.
文摘AIM： To evaluate the role of positron emission tomography using 18F-fluorodeoxyglucose （FDG-PET） in the surgical management of patients with pancreatic cancer, including the diagnosis, staging, and selection of patients for the subsequent surgical treatment. METHODS： This study involved 53 patients with proven primary pancreatic cancer. The sensitivity of diagnosing the primary cancer was examined for FDG-PET CT, cytological examination of the bile or pancreatic juice, and the serum levels of carcinoembrionic antigens （CEA） and carbohydrate antigen 19-9 （CA29-9）. Next, the accuracy of staging was compared between FDG-PET and CT. Finally, FDG-PET was analyzed semiquantitatively using the standard uptake value （SUV）. The impact of the SUV on patient management was evaluated by examining the correlations between the SUV and the histological findings of cancer. RESULTS： The sensitivity of FDG-PET, CT, cytological examination of the bile or pancreatic juice, and the serum levels of CEA and CA19-9 were 92.5%, 88.7%, 46.4%, 37.7% and 69.8%, respectively. In staging, FDG-PET was superior to CT only in diagnosing distant disease （bone metastasis）. For local staging, the sensitivity of CT was better than that of FDG-PEr. The SUV did not correlate with the pTNM stage, grades, invasions to the vessels and nerve, or with the size of the tumor. However, there was a statistically significant difference （4.6 ± 2.9 vs 7.8 ± 4.5, P = 0.024） in the SUV between patients with respectable and unresectable disease. CONCLUSION： FDG-PET is thus considered to be useful in the diagnosis of pancreatic cancer. However, regarding the staging of the disease, FDG-PET is not considered to be a sufficiently accurate diagnostic modality. Although the SUV does not correlate with the patho-histological prognostic factors, it may be useful in selecting patients who should undergo subsequent surgical treatment.
文摘The purpose of this article is to provide a pictorial review of the findings and interpretative pitfalls about focal fluorodeoxyglucose(FDG)uptake in the absence of corresponding computer tomography(CT)lesion or abnormality on an integrated positron emission tomography(PET)-CT.The integrated CT images in the PET-CT scanner allow correct co-registration and fused imaging of anatomical and functional data.On FDG PET-CT imaging,a real pathologic process often demonstrates abnormal uptake associated with a visible corresponding CT lesion or abnormality.When focal uptake is seen on PET imaging but no corresponding anatomic abnormality is visualized on the integrated CT,one should always be aware of possible mis-registration or mismatch of the PET and CT images due to the patient’s respiratory or body motion.While most of the hot spots in the absence of corresponding anatomic abnormalities are artefactual or secondary to benign etiologies,some may represent small sized or early staged neoplasm or metastases,especially in the gastrointestinal tract and skeletons.Caution should be exercised to simply diagnose a pathology based on the presence of the uptake only,or exclude the disease based on the absence of anatomic abnormality.
文摘AIM To determine the significance and need for investigation of incidental prostatic uptake in men undergoing ^(18)F-labelled fluorodeoxyglucose(^(18)F-FDG) positron emission tomography/computed tomography(PET/CT) for other indications.METHODS Hospital databases were searched over a 5-year period for patients undergoing both PET/CT and prostate magnetic resonance imaging(MRI). For the initial analysis, the prostate was divided into six sectors and suspicious or malignant sectors were identified using MRI and histopathology reports respectively. Maximum and mean ^(18)F-FDG standardised uptake values were measured in each sector by an investigator blinded to the MRI and histopathology findings. Two agematched controls were selected per case. Results were analysed using a paired t-test and one-way ANOVA. For the second analysis, PET/CT reports were searched for prostatic uptake reported incidentally and these patients were followed up. RESULTS Over a 5-year period, 15 patients underwent both PET/CT and MRI and had biopsy-proven prostate cancer.Malignant prostatic sectors had a trend to higher ^(18)F-FDG uptake than benign sectors, however this was neither clinically nor statistically significant(3.13 ±0.58 vs 2.86 ± 0.68, P > 0.05). ^(18)F-FDG uptake showed no correlation with the presence or histopathological grade of tumour. ^(18)F-FDG uptake in cases with prostate cancer was comparable to that from age-matched controls. Forty-six(1.6%) of 2846 PET/CTs over a 5-year period reported incidental prostatic uptake. Of these, 18(0.6%) were investigated by PSA, 9(0.3%)were referred to urology, with 3(0.1%) undergoing MRI and/or biopsy. No cases of prostate cancer were diagnosed in patients with incidental ^(18)F-FDG uptake in our institute over a 5-year period.CONCLUSION ^(18)F-FDG uptake overlaps significantly between malignant and benign prostatic conditions. Subsequent patient management was not affected by the reporting of incidental focal prostatic uptake in this cohort.
基金Supported by National Research Foundation of Korea,No.2017R1C1B5076640.
文摘BACKGROUND Lymph node(LN)metastasis is an important prognostic factor in patients with gastric cancer(GC).However,the evaluation of LN metastasis status in the preoperative setting is not accurate.Therefore,precise preoperative prediction of LN metastasis status is crucial for optimal treatment in patients with GC.AIM To develop a preoperative nomogram for LN metastasis using F-18 fluorodeoxyglucose(F-18 FDG)positron emission tomography/computed tomography(PET/CT)and preoperative laboratory test findings in GC.METHODS In this study,the data of 566 GC patients who underwent preoperative F-18 FDG PET/CT and subsequent surgical resection were analyzed.The LN metastasis prediction model was developed in the training cohort and validated in the internal validation cohort.Routine preoperative laboratory tests,including albumin and carbohydrate antigen(CA)19-9 were performed in all patients.Univariate and multivariable logistic regression was performed to validate the preoperative predictive indicators for LN metastasis.RESULTS Of the 566 patients,232(41%)had confirmed histopathologic LN metastasis.Univariate logistic regression revealed that the tumor location,blood hemoglobin,serum albumin levels,neutrophil to lymphocyte ratio,platelet to lymphocyte ratio,CA 19-9,maximum standardized uptake value(SUVmax)of the primary tumor(T_SUVmax),and SUVmax of LN(N_SUVmax)were significantly associated with LN metastasis.In multivariate analysis,T_SUVmax(OR=1.08;95%CI:1.02–1.15;P=0.011)and N_SUVmax(OR=1.49;95%CI:1.19–1.97;P=0.002)were found to be significant predictive factors for LNmetastasis.The LN metastasis prediction model using T_SUVmax,N_SUVmax,serum albumin,and CA 19-9 yielded an area under the curve(AUC)of 0.733(95%CI:0.683–0.784,P=0.025)in the training cohort and AUC of 0.756(95%CI:0.678–0.833,P<0.001)in the test cohort.CONCLUSION T_SUVmax and N_SUVmax measured by preoperative F-18 FDG PET/CT are independent predictive factors for LN metastasis in GC.
