The role of 18F-FDG PET/CT in detecting small intestine adenocarcinoma / 中华核医学与分子影像杂志

Objective To evaluate the value of whole body 18F-FDG PET/CT in detecting small intestine adenocarcinoma (SIA).Methods A retrospective study of 18F-FDG PET/CT was performed on 29 cases (male 17,female 12) of SIA,21 cases of small intestine lymphoma (SIL) (male 15,female 6) and 10 cases of small intestine tuberculosis (SIT) (male 4,female 6).Visual and semi-quantitative methods (SUVmax) were used to summarize and analyse the 18F-FDG PET/CT resutls.One-way analysis of variance and x2 test were used to analyze the data.Results (1) 18F-FDG PET/CT for SIA showed a partially conglomerate pattern of hypermetabolic small bowel masses with nodular configurations.A typical SIL showed a partially annular abnormal growth with aggregated foci of radioactivity.SIT lesions were usually in form of stripes and/or nodules with high metabolic foci or lesions withskipped distribution.The SUVmax of SIA (8.44±3.82) was significantly lower than that of SIL (11.54±4.02; F=86.96,t=2.77,both P＜0.01),but not significantly different when compared with SIT (8.61±2.99; t=0.11,P＞0.05).(2) The incidence rates of peri-lesion lymph node enlargement in SIA,SIL and SIT were 72.41％ (21/29),85.71％ (18/21) and 70.00％ (7/10),respectively (x2 =1.50,P＞0.05).The SUVmax of peri-lesion lymph nodes in SIA (5.59±2.86) was significantly lower than that of SIL (11.10±5.72; F=56.56,t=3.85,both P＜0.01),but was not significantly different when compared with SIT (5.63± 3.36; t =0.30,P＞ 0.05).The detection rate of PET/CT on pefi-lesion lymph node enlargement of SIA was higher than CT (41.38％,12/29; x2 =5.69,P＜0.05).(3) The incidence rate of extra-intestinal metastases was 55.17％ (16/29) in SIA,and the most common metastatic sites were liver,bone and adrenal gland.The incidence rate of extra-intestinal lesions was 66.67％ (14/21) in SIL,most commonly presented as widespread multifocal nodal permeation.Extra abdominal tuberculous loci were found in 80.00％ (8/10) of SIT.The incidence rates of extra-intestinal involvement were not significantly different among SIA,SIL and SIT (x2=2.13,P＞0.05).(4) Among the 29 SIA cases,15 (51.72％) involved the ileum,8 (27.59％) jejunum,4 (13.79％) both jejunum and ileum,and 2 (6.90％) both jejunum and duodenum (x2 =18.16,P＜0.01).(5) Among the 29 SIA cases,primary SIA was found in 8 cases (27.59％),double primary in 7 cases (24.14％) and metastatic SIA in 14 eases (48.28％).(6) Based on the clinical data,pathological results and clinical follow-up,the diagnosis of SIA by 18F-FDG PET/CT had a sensitivity and specificity of 93.10％ (27/29) and 80.00％ (8/10),respectively.Conclusions 18F-FDG PET/CT is useful for the differential diagnosis of S1A and for supporting the diagnosis of single primary,multi-primary and metastatic SIA.

Diagnostic value of (18)F-FDG PET/CT in extrapulmonary tuberculosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the value of (18)F-FDG PET/CT in the diagnosis of extrapulmonary tuberculosis (ET).</p><p><b>METHODS</b>The imaging data from 88 cases of ET undergoing (18)F-FDG PET/CT examinations between August, 2005 and May, 2011 were analyzed retrospectively.</p><p><b>RESULTS</b>All the 88 cases showed high (18)F-FDG uptake on PET imaging with a SUVmax ranging from 1.3 to 23.2. In 19 of the 88 cases, the extrapulmonary lesions were misdiagnosed as malignant neoplasms. Twenty-two patients were found to have phthisis. According to locations, the lesions were classified into 4 basic types, namely membranous tuberculosis (36 cases) with soft tissue thickening as the main manifestation (only 6 cases did not present with obvious thickening), lymphatic tuberculosis (44 cases) with lymph node enlargement (ill-defined edge in 22 cases, central necrosis in 3 cases, and ring-like enhancement in enhanced CT scan in 6 cases), osteoarticular tuberculosis ( 28 cases) with the main findings of osteolytic destruction with or without osteosclerosis (tuberculosis of the spine was characterized by disc damage and paravertebral cold abscess; only one case showed high FDG uptake without bone destruction), and organ tuberculosis (25 cases) involving the liver, spleen, pancreas, kidney and brain, where lesions of low density were detected in CT scan (3 cases showed ring-like enhancement). In cases of organ tuberculosis, nasopharyngeal and laryngeal tuberculosis showed soft tissue thickening, and intestinal tuberculosis presented with slight intestinal wall thickening (involving multiple segments in 2 cases). Of the 88 cases, 30 had two or more than two lesion types.</p><p><b>CONCLUSION</b>PET/CT can accurately demonstrate the morphology, extent of involvement and uptake activity of the ET lesions to assist the early diagnosis and treatment of ET. Enhanced CT scan also helps in the differential diagnosis of the lesions.</p>

Relationship between the 18F-FDG PET/CT imaging characteristics and pathologic features of primary small intestine malignant neoplasms / 中国基层医药

Objective To study the relationship between the 18F-FDG PET/CT whole body imaging characteristics and pathologic features of small intestine primary malignant neoplasms.Methods A retrospective study was carried out on 18F-FDG PET/CT data of patients(n =44)with small intestine disease(25 malignant,19 benign).All results were proved by pathologiy,or diagnostic therapy and/or clinical follow-up.The intestinal wall thickness(IWT)and maxium standardized uptake value(SUVmax)were used to analyze the imaging features under different pathological conditions.Results(1)The incidence rate of local tumor formation for benign and malignant intestinal lesions was 31.6％ and 84.0％(x2 =10.40,P ＜ 0.01),respectively.The IWT was(0.75 ± 0.32)cm and(1.42 ± 0.20)cm(t =2.66,P ＜ 0.01),respectively.The S UVmax was(5.17 ± 3.04)and(9.65 ± 5.48)(t =2.88,P ＜ 0.01),respectively.The incidence rate of enlargement of mesenteric lymph nodes for benign and malignant intestinal lesions was 52.6％ and 72.0％(x2 =1.01,P ＞ 0.05),respectively.The SUVmax was(4.80 ± 1.91)and(7.00 ± 5.61)(t =1.11,P ＞ 0.05),respectively.(2)The metastasis incidence rate of other organs for intestinal malignant lesions was 44.0％.The most common metastasis organs were liver(28.0％),distant lymph nodes(20.0％)and bone (16.0％).The most pathological type of intestinal malignant lesions were malignant lymphoma(44.0％),adenocarcinoma(32.0％).The IWT was(1.41 ± 0.59)cm and(1.36 ± 0.62)cm(t =0.18,P ＞ 0.05),respectively.The SUVmax was(12.49 ± 7.00)and(7.93 ± 2.82)(t =7.55,P ＜ 0.01),respectively.The metastasis incidence rate was 9.1％ and 62.5 ％(x2 =3.89,P ＜ 0.05),respectively.(3)Taking the intestinal local tumor formation and SUVmax andnot less than 4.2 0 wall thickening,and / or metastasis as the main basis of the intestinal malignant lesions,the sensitivity,specificity and accuracy were 96.0％,94.7％ and 95.4％,respectively.The main pathological type of false positive for '8F-FDG PET/CT imaging was intestinal tuberculosis,and false negative was signet(f)ing cell carcinoma.Conclusion 18F-FDG PET/CT imaging has a higher clinical diagnosis value in differentiating small intestine primary malignant carcinoma from benign ones.The size and SUVmax of perifocus lymph nodes could not point out its malignant degree.The 18F-FDG uptake of the lesions is correlated with pathological type.The IWT is not correlated with pathological type.

Diagnostic Value of 18F-FDG PET/CT in Multiple Myeloma / 中国医学影像学杂志

Purpose To investigate the diagnostic value of ~(18)F-flurorodeoxyglucose (~(18)F-FDG) PET/CT (positron emission tomography/computed tomography) on multiple myeloma.Materials and Method ~(18)FDG PET/CT imaging findings were retrospectively analyzed in 31cases with multiple myeloma proved by bone marrow aspiration or biopsy from August 2005 to June 2009. Results The PET/CT imaging characteristics were categorized into three types: ① osseous destruction (n=28): Osseous destruction with active metabolism was found in this type combined with no extramedullary organs involvement. The SUV_(max) ranged from 2.5 to 15.4, and the SUV_(arg) ranged from 2.0 to 11.3. ② Extramedullary organ involvement (n=2): Besides osseous destruction, extramedullary organs involvement were detected in this type demonstrating active metabolism in varying degrees. The SUV_(max) ranged from 2.2 to 8.3 and the SUV_(avg) ranged from 1.7 to 6.5. ③ Diffuse bone marrow infiltration (n=1): Diffuse hypermetabolism without osseous destruction was found in the whole body bone marrow with the SUV_(max) of 13.4 and SUV_(avg) of 8.8.Conclusions ~(18)FDG PET/CT can accurately demonstrate the morphology, extent and activity of multiple myeloma, thus facilitating the clinical staging, whereas multiple osteolytic osseous metastases and osseous lymphoma should be excluded for certain cases.

CT and Angiography in Small Hepatocellular Carcinoma——Significance of Sequential Staining Sign from Interior to Exterior / 介入放射学杂志

The signs and results of 14 patients with small hepatocelular carcinoma HCC of a diameter less than 3 cm (in 10 of them the daignosis was proven by pathology after surgery) obtained by CT,angiography and CT angiography were described in this article. The value of the above imaging modalities in the detection and diagnosis of small HCC was discussed with emphasis on the significance of the sequential staining sign from interior to exterior in CT and angiography.