AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography (18F-FDG PET/CT) in detection of gastric cancer recurrence after initial surgical resection. METHODS: In the peri...AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography (18F-FDG PET/CT) in detection of gastric cancer recurrence after initial surgical resection. METHODS: In the period from January 2007 to May 2008, 23 patients who had previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 18F-FDG PET/CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for at least 5 mo after PET/CT examinations. RESULTS: PET/CT was positive in 14 patients (61%) and negative in 9 (39%). When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients (35%) and by clinical follow-up in 15 (65%), PET/CT was true positive in 12 patients, false positive in 2, true negative in 8 and false negative in 2. Overall, the accuracy of PET/CT was 82.6%, the negative predictive value (NPV) was 77.7%, and the positive predictive value (PPV) was 85.7%. The 2 false positive PET/CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negativePET/CT, the f inal diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly, PET/CT revealed true-positive findings in 11 (47.8%) patients who had negative or no definite findings by CT. PET/CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in one patient. Clinical treatment decisions were changed in 7 (30.4%) patients after introducing PET/CT into their conventional post-operative follow-up program. CONCLUSION: Whole body 18F-FDG PET/CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important impacts on clinical decisions in a considerable portion of patients.展开更多
AIM: To demonstrate the 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) findings in patients with non-Hodgkin's lymphoma (NHL) involving the gastrointestinal (GI) tract and the clinical utility o...AIM: To demonstrate the 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) findings in patients with non-Hodgkin's lymphoma (NHL) involving the gastrointestinal (GI) tract and the clinical utility of modality despite of the known normal uptake of FDG in the GI tract.METHODS: Thirty-three patients with biopsy-proven gastrointestinal NHL who had undergone FDG-PET scan were included. All the patients were injected with 10-15 mCi FDG and scanned approximately 60 min later with a CTI/Siemens HR (+) PET scanner. PET scans were reviewed and the maximum standard uptake value (SUVmax) of the lesions was measured before and after the treatment,if data were available and compared with histologic diagnoses.RESULTS: Twenty-five patients had a high-grade lymphoma and eight had a low-grade lymphoma. The stomach was the most common site of the involvement (20 patients). In high-grade lymphoma, PET showed focal nodular or diffuse hypermetabolic activity. The average SUVmax±SD was 11.58±5.83. After the therapy,the patients whose biopsies showed no evidence of lymphoma had a lower uptake without focal lesions.The SUVmax±SD decreased from 11.58±5.83 to 2.21±0.78. In patients whose post-treatment biopsies showed lymphoma, the SUVmax±SD was 9.42±6.27. Low-grade follicular lymphomas of the colon and stomach showed diffuse hypermetabolic activity in the bowel wall (SUVmax 8.2 and 10.3, respectively). The SUVmax was 2.02-3.8 (mean 3.02) in the stomach lesions of patients with MALT lymphoma.CONCLUSION: 18F-FDG PET contributes to the diagnosis of high-grade gastrointestinal non-Hodgkin's lymphoma,even when there is the normal background FDG activity. Furthermore, the SUV plays a role in evaluating treatment response. Low-grade NHL demonstrates FDG uptake but at a lesser intensity than seen in high-grade NHL.展开更多
OBJECTIVE To evaluate the role of whole-body{ 18 F}fluro-2-dexoxyglucose(FDG)positron emission tomography(PET)scans in the detection of recurrent cervical cancer. METHODS Between June,2000 and January,2006,25 patients...OBJECTIVE To evaluate the role of whole-body{ 18 F}fluro-2-dexoxyglucose(FDG)positron emission tomography(PET)scans in the detection of recurrent cervical cancer. METHODS Between June,2000 and January,2006,25 patients had undergone a PET scan at the Peking Union Medical College Hospital to evaluate possible recurrent cervical cancer.All the PET findings were reviewed and compared to available clinical data to classify each PET scan result as a true positive,true negative,false positive,or false negative. RESULTS A total of 38 PET scans were conducted on the 25 patients whose median age was 46 years.The Stage distributions were IA(n=1),IB(n=11),IIA(n=5),IIB(n=4),IIIB(n=2),IVB(n =1),and unknown Stage(n=1).There were 22 cases of squamous cell carcinoma and 3 cases of adenocarcinoma resulting in 9 true positive PET scans,27 true negatives,2 false positives and no false negatives.The sensitivity of the FDG PET scans for detecting recurrent cervical cancer was 100%,specificity 93.1%,positive predictive value 81.8%,and negative predictive value 100%. CONCLUSION The whole body FDG PET scans are a sensitive and specific imaging modality for the detection of recurrent cervical cancer.However the cost of PET scans is too high at this time.A large prospective study will determine whether this modality should be used routinely and take the place of other imaging methods in the early detection of recurrent cervical展开更多
文摘AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography (18F-FDG PET/CT) in detection of gastric cancer recurrence after initial surgical resection. METHODS: In the period from January 2007 to May 2008, 23 patients who had previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 18F-FDG PET/CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for at least 5 mo after PET/CT examinations. RESULTS: PET/CT was positive in 14 patients (61%) and negative in 9 (39%). When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients (35%) and by clinical follow-up in 15 (65%), PET/CT was true positive in 12 patients, false positive in 2, true negative in 8 and false negative in 2. Overall, the accuracy of PET/CT was 82.6%, the negative predictive value (NPV) was 77.7%, and the positive predictive value (PPV) was 85.7%. The 2 false positive PET/CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negativePET/CT, the f inal diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly, PET/CT revealed true-positive findings in 11 (47.8%) patients who had negative or no definite findings by CT. PET/CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in one patient. Clinical treatment decisions were changed in 7 (30.4%) patients after introducing PET/CT into their conventional post-operative follow-up program. CONCLUSION: Whole body 18F-FDG PET/CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important impacts on clinical decisions in a considerable portion of patients.
文摘AIM: To demonstrate the 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) findings in patients with non-Hodgkin's lymphoma (NHL) involving the gastrointestinal (GI) tract and the clinical utility of modality despite of the known normal uptake of FDG in the GI tract.METHODS: Thirty-three patients with biopsy-proven gastrointestinal NHL who had undergone FDG-PET scan were included. All the patients were injected with 10-15 mCi FDG and scanned approximately 60 min later with a CTI/Siemens HR (+) PET scanner. PET scans were reviewed and the maximum standard uptake value (SUVmax) of the lesions was measured before and after the treatment,if data were available and compared with histologic diagnoses.RESULTS: Twenty-five patients had a high-grade lymphoma and eight had a low-grade lymphoma. The stomach was the most common site of the involvement (20 patients). In high-grade lymphoma, PET showed focal nodular or diffuse hypermetabolic activity. The average SUVmax±SD was 11.58±5.83. After the therapy,the patients whose biopsies showed no evidence of lymphoma had a lower uptake without focal lesions.The SUVmax±SD decreased from 11.58±5.83 to 2.21±0.78. In patients whose post-treatment biopsies showed lymphoma, the SUVmax±SD was 9.42±6.27. Low-grade follicular lymphomas of the colon and stomach showed diffuse hypermetabolic activity in the bowel wall (SUVmax 8.2 and 10.3, respectively). The SUVmax was 2.02-3.8 (mean 3.02) in the stomach lesions of patients with MALT lymphoma.CONCLUSION: 18F-FDG PET contributes to the diagnosis of high-grade gastrointestinal non-Hodgkin's lymphoma,even when there is the normal background FDG activity. Furthermore, the SUV plays a role in evaluating treatment response. Low-grade NHL demonstrates FDG uptake but at a lesser intensity than seen in high-grade NHL.
文摘OBJECTIVE To evaluate the role of whole-body{ 18 F}fluro-2-dexoxyglucose(FDG)positron emission tomography(PET)scans in the detection of recurrent cervical cancer. METHODS Between June,2000 and January,2006,25 patients had undergone a PET scan at the Peking Union Medical College Hospital to evaluate possible recurrent cervical cancer.All the PET findings were reviewed and compared to available clinical data to classify each PET scan result as a true positive,true negative,false positive,or false negative. RESULTS A total of 38 PET scans were conducted on the 25 patients whose median age was 46 years.The Stage distributions were IA(n=1),IB(n=11),IIA(n=5),IIB(n=4),IIIB(n=2),IVB(n =1),and unknown Stage(n=1).There were 22 cases of squamous cell carcinoma and 3 cases of adenocarcinoma resulting in 9 true positive PET scans,27 true negatives,2 false positives and no false negatives.The sensitivity of the FDG PET scans for detecting recurrent cervical cancer was 100%,specificity 93.1%,positive predictive value 81.8%,and negative predictive value 100%. CONCLUSION The whole body FDG PET scans are a sensitive and specific imaging modality for the detection of recurrent cervical cancer.However the cost of PET scans is too high at this time.A large prospective study will determine whether this modality should be used routinely and take the place of other imaging methods in the early detection of recurrent cervical
