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Objective: To explore the relationship of 18F-FDG PET/CT imaging and pulmonary function and laboratory inflammatory biomarkers in patients with idiopathic interstitial pneumonia (IIP). Methods PET/CT imaging of 20 patients with IIP (IIP group) and 20 patients without pulmonary lesions (control group) were retrospectively analyzed. The maximum standard uptake value (SUVmax) and mean SUV (SUVmean) of the whole lung were measured, and the maximum target-to-back ratio (TBRmax) and mean TBR (TBRmean) were calculated. SUV and TBR were compared between IIP group and control group, and the correlation of TBR and pulmonary function indexes and inflammatory biomarkers in IIP group were evaluated. Results SUVmax, SUVmean, TBRmax and TBRmean in IIP group were significantly higher than those in control group (all P0.05), nor between TBR and erythrocyte sedimentation rate and C-reaction protein (both P>0.05). Conclusion: The radioactive uptake increases in IIP patients, which has certain correlation with pulmonary function.
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Objective: To investigate the diagnostic value of 18F-FDG PET/CT combined with MR cholangiopancreatography (MRCP) multimodal imaging in diagnosis of malignant and benign obstructive jaundice. Methods Totally 57 biliary obstruction patients were enrolled and divided into malignant obstruction group (n=31) and benign obstruction group (n=26). The diagnostic efficacy of 18F-FDG PET/CT, MRCP and multimodal imaging of obstructive jaundice were analyzed and compared. Results In malignant obstruction group, moderate to severe biliary expansion accounted for 41.94% (13/31), while in the benign obstruction group, the rate was 3.85% (1/26), and the difference between the two groups was statistically significant (P=0.047). The maximum standard uptake value (SUVmax) of malignant obstruction group (10.54±6.69) was significantly higher than that of the benign obstruction group (3.78±1.68; P0.05), while compared with MRCP, the differences in sensitivity and accuracy were statistically significant (P=0.002, 0.002), the difference in specificity was not statistically significant (P=0.463). Compared with final results, the Kappa coefficients of multimodality imaging, 18F-FDG PET/CT and MRCP were 0.858, 0.752 and 0.375, respectively. Conclusion 18F-FDG PET/CT combined with MRCP multimodal imaging is helpful to improvement of the diagnostic accuracy of obstructive jaundice, which has important guiding significance for diagnosis and clinical treatment decision-making.
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Objective: To assess the changes of glucose metabolism in hypertrophic cardiomyopathy (HCM) patients with 18F-FDG PET in fasting and glucose-loading states. Methods Totally 36 patients with HCM underwent cardiac MRI (CMRI) and twice 18F-FDG PET, once in fasting state and once during glucose load state. Semiquantified assessment of metabolism score to PET images was analyzed. According to the delay enhancement (DE) on CMRI, HCM patients were divided into DE-positive group (n=24) and DE-negative group (n=12). Then the difference of semiquantified scores was compared. Results In fasting state, patients in DE-positive group had lower summed metabolism scores than those in DE-negative group (23.73±7.02 vs 36.24±14.18, P=0.015), while there was no significant difference in glucose-loading state (6.25±10.63 vs 4.38±7.41, P=0.099). Totally 11 patients had 42 myocardial segments which were normal or with improved uptake in fasting state, but defected or sparse during glucose load state. Compared with other 25 patients, these 11 patients had greater left ventricular wall thickness and greater left ventricular posterior wall thickness, more segments with DE and lower left ventricular ejection fraction (all P<0.05). Conclusion 18F-FDG PET myocardial glucose metabolism imaging in HCM patients in fasting state and during glucose load state shows obvious heterogeneity. Combined with CMRI, it may be used as an indicator of risk stratification in patients with HCM.
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Objective: To establish mathematical prediction models based on PET metabolic parameters, and to explore their value for differentiating benign and malignant solitary pulmonary lesions. Methods Data of 135 patients with solitary pulmonary lesions who underwent 18F-FDG PET/CT scan were retrospectively analyzed. PET metabolic parameters of the lesions were obtained, including metabolic tumor volume (MTV), maximum standardized uptake value (SUVmax), peak standardized uptake value (SUVpeak), mean standardized uptake value (SUVmean) and total lesion glycolysis of standardized uptake value (SUVtlg), as well as parameters of standardized uptake normalized to lean body mass (SUL), including SULmax, SULpeak, SULmean and SULtlg. The parameters above were used to establish support vector machine (SVM) models, which were selected according to the Akaike's information criterion (AIC). The diagnostic performances of the models were assessed with ROC curves. The permutation test was used for internal validation. Results: Two sets of optimization models were obtained and recorded as Mgroup A (include MTV, SUVpeak and SUVtlg) and Mgroup B (include MTV, SUVpeak and SULtlg). AUC of Mgroup A model was 0.865 (P=0.021), with the sensitivity of 82.72%, specificity of 83.33% and diagnostic accuracy of 82.96%, of Mgroup B model was 0.863 (P=0.030), with the sensitivity of 82.72%, specificity of 83.33% and diagnostic accuracy of 82.96%, respectively. There was no statistically significant difference of AUC between the two models (P=0.294). Both models were reliable evaluated with the permutation test. Conclusion: SVM models based on PET metabolic parameters can be used for differential diagnosis of benign and malignant solitary pulmonary lesions, whereas metabolic parameters corrected by lean body mass bring no remarkable improvement on diagnostic efficacy.
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Objective: To investigate the impact of saline flush for syringe after 18F-FDG injection on the residual dose of 18F-FDG and the standardized uptake value (SUV) of liver during PET/CT examination. Methods: A total of 50 patients who underwent PET/CT examination were enrolled and divided into control group (n=25) and experimental group (n=25) according to different injection methods. Device system of the vein passage was established with 23 gauge scalp needle. In control group, the intravenous line was directly flushed with 5 ml physiological saline after 18F-FDG injection, while in experimental group, firstly the intravenous line was flushed with 1 ml saline, then the syringe was flushed with 2 ml saline, finally the intravenous line was flushed again with the residual 2 ml saline. The residual dose of 18F-FDG and SUVmean and SUVmax of liver were compared between the two groups. Results: The total residual dose ([0.22±0.08]mCi), syringe residual dose ([0.19±0.07]mCi) and intravenous channel residual dose ([0.03±0.02]mCi) in the experimental group were all lower than those in control group (all P0.05). Conclusion: Flushing the syringe can reduce residual dose of 18F-FDG injection. A small amount of radiopharmaceuticals retention in the syringe may not affect SUV for liver, but further standardization of the operation process of 18F-FDG injection is still necessary.
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Parkinson disease (PD) is a common neurodegenerative disease. PET has special advantages in early identification, diagnosis and evaluation of PD. The main PET tracers contain 18F-FDG and dopaminergic neuron function targeting imaging tracers. The research status and progresses of 18F-FDG PET brain imaging and dopaminergic neuron function targeting imaging on evaluation of PD were reviewed in this article.
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Objective@#To evaluate the clinical value of preoperative 18F-Fludeoxyglucose (18F-FDG PET-CT) in lymphatic metastasis diagnosis of cutaneous melanoma on extremities and trunk.@*Methods@#112 patients with cutaneous melanoma pathologically of extremities and trunk from January 2006 to December 2016, who received 18F-FDG PET-CT examination preoperatively, were retrospectively reviewed. The correlations between the maximal diameters of lymph nodes, the maximal standard uptake value (SUV) and the diagnostic impression grades of PET-CT examination, and the final pathological diagnosis were analyzed. The correlations between Breslow thickness of primary lesions and the diagnostic impression of PET-CT examination were also analyzed. All the above were analyzed with Receiver Operating Characteristic (ROC) curve to get the cut-off value. Based on the final results of pathological diagnosis of lymph nodes as the golden standard, the statistically significant indicators of ROC curve analysis were used to evaluate the diagnostic effect, as well as to calculate the sensitivity, specificity and accuracy. With gender, age, maximal diameter of lymph nodes, maximal SUV, diagnosis impressions, and Breslow thickness as the independent variables and pathological diagnosis results of lymph nodes as the dependent variable, two-class stepwise Logistic regression analysis was used to determine the independence of diagnostic indicators. ROC curve analysis and log rank test were used to analyze the relationship between Breslow thickness and patient survival.@*Results@#To evaluate melanoma patients′ lymph node status, the results of ROC curve analysis showed that the area under the curve of lymph node maximal diameter, maximal SUV, diagnosis impression of PET-CT examinations were 0.789, 0.786 and 0.816, respectively (all P<0.05). The cut-off values were 0.85 cm, 1.45 and 2.5, respectively. The sensitivity of the cut-off values to determine the status of lymph nodes in melanoma patients were 71.4%, 64.9% and 72.1% respectively, and the specificities were 85.2%, 88.7% and 87.0% respectively. Multivariate Logistic regression analysis showed that PET-CT diagnosis impressions had independent diagnostic significance for the lymph node status of melanoma patients (OR=11.296, 95%CI: 2.550~50.033). The area under the curve of Breslow thickness evaluating PET-CT diagnostic impression is 0.664 (P=0.042) and the cut-off value was 4.25 mm. The survival rate of the patients with Breslow thickness ≥ 4.25 mm was lower than that in the group <4.25 mm (P=0.006).@*Conclusions@#18F-FDG PET-CT can help to evaluate metastases and make treatment decisions for cutaneous melanoma of extremities and trunk, especially for patients whose primary lesion′s Breslow thickness has reached more than 4.25 mm. For the patients whose maximal SUV of regional lymph node is higher than 1.45 and short diameter of the largest lymph node is larger than 0.85cm, the possibility of metastases should be considered.
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Objective: To evaluate the application value of fluorine-18-fludeoxyglucose (18F-FDG) PET/CT maximal standard uptake (SUVmax) in the diagnosis of lymphoma. Methods: A total of 103 patients with lymphoma which confirmed by pathological diagnosis in Gansu Provincial Hospital from January 2011 to December 2016 were collected. All patients underwent a whole body simultaneous18F-FDG PET/CT and had complete clinical data. The possible relationships of SUVmax with the different pathological subtypes, clinical stages and risk grades of lymphoma were analyzed. The correlations of SUVmax value with Ki-67 index, lactate dehydrogenase (LDH) and erythrocyte sedimentation rate (ESR) were analyzed. Results: There was no significant difference in SUVmax between Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) (P > 0.05). The SUVmax in patients with strongly invasive diffuse large B-cell lymphoma (DLBCL), T-lymphoblastic lymphoma (T-LBL), anaplastic large cell lymphoma (ALCL) and natural killer (NK)/T cell lymphoma was higher than that in patients with relatively weakly invasive mantle cell lymphoma (MCL), peripheral T-cell lymphoma (PTCL), small lymphocytic lymphoma (SLL), follicular lymphoma (FL) (grade 1-2) and marginal zone lymphoma (MZL) (P 0.05). The SUVmax had no significant difference between stage -Ⅱ and III- in the patients with lymphoma (P > 0.05). The SUVmax in the patients with high-risk NHL was higher than that in the patients with intermediate- and low-risk NHL (both P 0.05). Conclusion:18F-FDG PET/CT SUVmax can be used as a reference indicator for evaluating the invasive degree of lymphoma, predicting Ki-67 index, and judging the risk classification of NHL.
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Objective To investigate the value of 18 F-fluorodeoxyglucose FDG) positron emission tomography (PET)-computed tomography (CT) in predicting the progression-free survival (PFS)and overall survival (OS) of patients with esophageal squamous cell carcinoma (ESCC) after threedimensional (3D) radiotherapy.Methods A retrospective analysis was performed on 98 ESCC patients,who underwent FDG PET-CT before 3D radiotherapy from 2004 to 2010,to investigate their 1-,3-,and 5-year PFS and OS rates.The relationship of maximum standard uptake value (SUVmax),mean SUV (SUVmean),metabolic target volume (MTV),length of primary tumor on PET-CT before radiotherapy,and number of tumors on PET with PFS and OS were analyzed.The SUVs and clinical data were analysed by independent samples t-test or Hotelling T2 test; the Kaplan-Meier method was used for calculating PFS and OS rates,and the Logrank test was used for survival difference analysis;the prognostic factors were analysed using the Cox proportional hazard model.Results The follow-up rate was 100％ ;56 patients were followed up for at least 3 years,and 27 for at 5 years.The SUVmax SUVmean and MTV of primary tumor,length of primary tumor on PET-CT before radiotherapy,and number of tumors on PET were correlated with PFS and OS (x2 =8.99-41.82,all P ＜ 0.01).The Cox regression analysis showed that PFS could be well predicted based on SUVmean (x2 =4.41,P =0.036,RR =1.398) and number of tumors on PET (x2 =6.79,P =0.009,RR =3.650) and that OS could be well predicted based on number of tumors on PET (x2 =5.03,P =0.025,RR =3.740).Conclusions When estimating the long-term response to precise radiotherapy in patients with ESCC,SUV mean and number of tumors on PET may be used to predict PFS,and number of tumors on PET may be used to predict OS.
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OBJECTIVE: To analyze 18F-fludeoxyglucose injection by Silica Gel TLC method.METHODS: TLC was adopted in which 18F-fludeoxyglucose injection(A) and mixture solution of 18F-FDG injection-acetonitrile(5∶95,V/V)(B) were used as testing solution.GF silica plate and G silica plate were used as stationary phase,and the mobile phase was acetonitrile: water(95∶5,V/V).RESULTS: The main peak Rf of testing solution A had a great fluctuation;The main peak Rf of testing solution B was 0.38～0.40.Radiochemical purity of 18F-fludeoxyglucose was more than 98%,and the Rf of radioimpurity 18F-and the by-product 18F-fludeoxymannose stood at 0.0 and 0.78 respectively.CONCLUSION: When testing solution B,the process of silica gel thin-layer chromatographic analysis is stable and reproducible,and the results meets the requirements specified in USP and are independent of the category of silica plate.
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Objective To evaluate the clinical value of 18FDG PET/CT in the diagnosis of lymph node metastasis and evaluation of node staging for esophageal carcinoma. Methods A prospective study was performed to access whether 18F FDG PET/CT can improve the diagnostic accuracy in lymph node metastasis for patients with esophageal carcinoma, 30 patients underwent esophagectomy with extensive dissection of lymph nodes. PET/CT findings were compared with that of CT. Results The pathological examination confirmed metastasis in 22 patients and 49 out of 243 excised lymph nodes. In PET/CT analysis, the sensitivity in the detection of lymph node metastasis was 93.9%, specificity was 91.2%, with a diagnostic accuracy of 91.8%. The positive and negative predictive value was 73.0% and 98.3%, respectively. CT resulted in a sensitivity of 40.8%, specificity of 96.9%, accuracy of 85.6%, the PPV was 76.9% and NPV 86.6%, respectively. The difference of sensitivity (P
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Objective To investigate the glucose metabolism changes of cerebral ischemic area after middle cerebral artery occlusion (MCAO) in cat on 18 *"FDG-PET scans.Methods A permanent focal cerebral ischemia model of cat was established by electrocoagulating the terminal of left middle cerebral artery via a transorbital approach. 15 minutes before MCAO, 0.5 mCi 18 *"FDG were intravenous bolus injection.15 minutes, 1 h, 3 h, and 6 h after ischemia, 18 *"FDG-PET were performed and the SUV were measured. After neurological examination, the cats were killed for performing TTC stainnig.Results The SUV of ischemic area were highter than that of contralateral and control area(P
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Objective To evaluate the correlation between changes in regional cerebral glucose metabolism and reduced body mass index (BMI) in patients with mild to moderate Alzheimer's disease(AD). Methods Regional cerebral glucose metabolism in many regions of interest of 27 AD patients were measured by positron emission tomography (PET) through 18 F fluro deoxyglucose (FDG) and their correlation with low BMI was analysed. Results The analysis using simple and multiple regression correlation showed that the metabolic ratio had a positive correlation with low BMI only in anterior cingulate cortex. Conclusions Anterior cingulate cortex may preferably involve in the regulation of food intake and body weight.
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Objective To assess the val ue of 18-fluorodeoxy glucose (~18F-FDG) positron emission tomography( PE T)-CT in the detection of malignant bone metastases. Methods Thirty-five out of 332 patients, 89 lesions were detected on ~18 F-FDG PET-CT and were interpreted separately on PET, combined CT, and fused PE T-CT images. Results Of the 89 lesions detected on PET- CT images, 68 were malignant and 21 were benign lesions. PET alone identified 62 malignant lesions and 17 benign lesions. The diagnostic sensitivity, specificit y, and accuracy of PET alone for diagnosis of bone metastases were 91.2% (62/68) , 81.0% (17/21), and 88.8% (79/89), respectively. The combined CT alone identifi ed 55 malignant lesions and 16 benign lesions. The diagnostic sensitivity, s pecificity, and accuracy of combined CT alone were 80.9% (55/68), 76.2% (16/21), and 79.8% (71/89), respectively. The fused PET-CT images identified 64 maligna nt and 19 benign lesions. The diagnostic sensitivity, specificity, and accuracy of the fused PET-CT were 94.1% (64/68), 90.5% (19/21), and 93.2% (83/89), respe ctively. Conclusion In the diagnosis of bone metastases, ~18F-FDG PET-CT imaging reduces the false positive rate and increases the specificity. ~18F-FDG PET-CT imaging is helpful in the differentiation o f bone metastases from benign lesions.
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Bone scintigraphy is a very sensitive and cost-effective diagnostic method for detecting bony metastases of malignant neoplasm. However it has been reported that bone scan is less sensitive for early bony metastases, especially vertebral metastases. PET is a non-invasive clinical imaging methodology that can be used to assess such biochemical disturbance in tissue in vivo quantitatively with high resolution.We experienced two cases of small cell lung cancer with multiple bony metastases which were detected on PET imaging but not on planar bone scan. This case report suggests that FDG-PET will be a very effective diagnostic tool for bony metastases especially in clinically suspected case despite a normal planar bone scan.