Differential diagnostic value of 18F-FDG PET/CT for benign and malignant vertebral compression fractures / 中华核医学与分子影像杂志

Objective To investigate the differential diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT for benign and malignant vertebral compression fractures in patients with malignant tumor.Methods From August 2007 to July 2016,79 patients with vertebral compression fractures were enrolled.Patients were divided into 3 groups based on clinical follow-up or pathological results:osteoporosis group (n =40;13 males,27 females,median age:77 years),metastasis group (n=27;18 males,9 females,median age:64 years) and myeloma group (n=12;7 males,5 females,median age:67.5 years).Characteristics of 18 F-FDG PET/CT imaging and maximum standardized uptake value (SUVmax) of involved vertebrae were compared using x2 test,one-way analysis of variance and the least significant difference t test.SUVmax of normal L2 vertebral body was regarded as the control.Results (1) There were 53,41 and 16 compression fractures identified in osteoporosis group,metastasis group and myeloma group,respectively.No paravertebral soft tissue mass or spinal accessory involvement was found in osteoporosis group.In metastasis group,14(34.15％,14/41) paravertebral soft tissue masses and 28 spinal accessory involvements (68.29％,28/41) were detected,and the numbers were 2 (2/16) and 16 (16/16) for myeloma group respectively.There were significant differences for paravertebral soft tissue masses and spinal accessory involvements among 3 groups (x2 values:21.75,73.10,both P＜0.01).(2)In osteoporosis group,all lesions displayed strip-like (100％,53/53) 18F-FDG accumulation.In metastasis group,there were nodular accumulation (12.20％,5/41),bulk accumulation (43.90％,18/41),and irregular accumulation (43.90％,18/41).In myeloma group,the 18 F-FDG accumulation were strip-like (14/16) and irregular (2/16).The accumulation patterns among 3 groups were significantly different (x2=103.67,P＜0.01).(3)SUVmax of osteoporosis group,metastasis group,myeloma group and control group was 4.00±0.14,7.33±4.05,4.17±0.39 and 2.33±0.06,respectively (F=46.45,P＜0.01).The SUVmax between each 2 groups were significant (t values:12.38-29.51,all P＜0.05) except for that between osteoporosis group and myeloma group (t=0.26,P＞0.05).Conclusions Strip-like 18F-FDG accumulation,SUVmax of vertebral body,paravertebral soft tissue masses and spinal accessory involvements in 18F-FDG PET/CT imaging are important for differential diagnosis of benign and malignant compression fractures.

Prognostic value of the number of lesions with SUVmax>2.5 and metabolic tumor volume assessed by 18 F-FDG PET/CT imaging in patients with multiple myeloma / 中华核医学与分子影像杂志

Objective To investigate the effective indicators for the prognosis assessment in pa?tients with multiple myeloma (MM) by 18F?FDG PET/CT imaging. Methods A total of 36 patients(22 males, 14 females;median age 63.5 years) with MM confirmed by clinical or pathology from July 2007 to November 2014 were retrospectively reviewed. The number of lesions detected by PET/CT, the number of lesions with SUVmax>2.5, the SUVmax and MTV of each lesion were calculated. The correlation analysis was performed between the number of lesions detected by PET or CT,the number of lesions with SUVmax>2.5, the SUVmax , MTV and serumβ2?microglobulin (β2?M) , respectively. The patients were divided into differ?ent groups according to the development of lesions and the survival situation during the follow?up ( 4-92 months) . Kaplan?Meier analysis and multivariate Cox model were used to analyze the prognostic significance of the number of lesions detected by PET or CT and the number of lesions with SUVmax>2.5, the SUVmax and MTV. Results Both the number of lesions with SUVmax>2. 5 and MTV showed positive correlations with blood β2?M (r=0.776, 0.954, both P0.05) . The number of lesions with SUVmax>2.5 and MTV in the progressive group( n=14) were significantly higher than those in the regressive group(n=22):66.57±4.59 vs 31.95±4.75, t=4.95, P2.5 and MTV were significantly higher in the dead group(n=15) than those in the survival group(n=21):65.73±4.32 vs 30.90±4.87, t=5.10, P2. 5, and those were 114.74 and 105.48 cm3 for MTV, respectively. The progression?free survival rate was worse in the patients with higher index than those with lower value (χ2=18.20, 29.74, both P2.5 and MTV on 18 F?FDG PET/CT images could predict the progression?free survival and overall survival rates of patients with MM, which may provide accurate prognosis information.

Clinical value of (18)F-FDGPET/CT in differentiation between benign lesions and lung cancer for large shadows in patients with pneumoconiosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of (18)F-FDG PET/CT in the differentiation between benign lesions and lung cancer for large shadows in patients with pneumoconiosis.</p><p><b>METHODS</b>A retrospective study was conducted in 21 patients with a confirmed diagnosis of pneumoconiosis who had a total of 37 large shadows in the lung fields as shown by whole-body (18)F-FDG PET/CT imaging, and (18)F-FDG uptake was evaluated using the maximum standardized uptake value (SUVmax). Twelve lesions were examined by CT-guided aspiration biopsy, and one case underwent fiberoptic bronchoscopy, as well as tests based on bronchoalveolar lavage fluid and sputum; the other cases were followed up for more than 2 years. The differences between pneumoconiosis nodules with high (18)F-FDG uptake and lung cancer were evaluated by t test.</p><p><b>RESULTS</b>Seventeen lung masses or nodules with high (18)F-FDG uptake were detected in 13 patients; among the 13 patients, 5 lesions of 5 cases were confirmed as non?small cell lung cancer (1 case of squamous cell carcinoma, 3 cases of adenocarcinoma, and 1 case of recurrent squamous cell carcinoma after operation), and 7 lesions of 7 cases were progressive massive fibrosis as shown by CT-guided aspiration biopsy; one case had no tumor cells detected by fiberoptic bronchoscopy, and 2.5-year follow-up revealed no changes in the lesions. The other 8 patients showed no increased (18)F-FDG uptake in their 20 lung nodules, which were confirmed as benign lesions by follow-up. The diameter range of lung cancer was 1.6∼6.8 cm, and the SUVmax range was 4.8∼14.0; the diameter range of pneumoconiosis nodules with high (18)F-FDG uptake was 1.5∼4.6 cm, and the SUVmax range was 2.6∼12.4. There were no significant differences in diameter and SUVmax between the lung cancer and pneumoconiosis nodules with high (18)F-FDG uptake (P > 0.05 for both). (18)F-FDG PET/CT had a specificity of 62.5% (20/32), an accuracy of 67.6% (25/37), a false-positive rate of 37.5% (12/32), and a negative predictive value of 100% (20/20) for the diagnosis of lung cancer. The lung cancer detection rate was 23.8% (5/21).</p><p><b>CONCLUSION</b>In (18)F-FDG PET/CT imaging for patients with pneumoconiosis, the lung lesions without (18)F-FDG uptake or symmetrical lesions with high (18)F-FDG uptake are considered as benign pneumoconiosis nodules; however, (18)F-FDG PET/CT might have a limited role in evaluating the solitary lung lesions in patients with pneumoconiosis and needs further study.</p>

Value of delayed PET/CT on diluted and filled bladder for the detection of bladder cancer / 中华核医学与分子影像杂志

Objective To evaluate the value of increased threshold of SUVmax and delayed imaging on diluted and filled bladder for improving the detection of bladder cancer with 18F-FDG PET/CT.Methods From July 2007 to October 2012,18 F-FDG PET/CT was performed on 63 suspected or treated (with bladder preserved) bladder cancer patients (55 males,8 females,average age 69.1 years).After routine imaging,all patients were given 1 500-2 000 ml of water orally three times and voided three times.Then they underwent delayed pelvic imaging at a full bladder status.The routine images were reanalyzed with increased SUVmax threshold (from 6-8 to 8-20).The final diagnosis was confirmed by pathology or follow-up (＞6 months).The differences of SUVmax in urine,18 F-FDG metabolism in lesions between routine and delayed imaging were compared.Paired t test was used to compare their differences.Results The SUVmax of urine on routine and delayed imaging was 15.11±11.11 and 4.73±2.00 respectively (t=4.15,P＜0.01).Among the 63 patients,there were 15 malignant and 3 benign cases confirmed by pathology,and 45 patients without obvious abnormality during follow-up.All 18 cases were detected by 18F-FDG PET/CT including the 3 benign false positive cases (2 were positive by CT though negative by PET,and 1 FDG-avid cystitis).All 15 true positive cases were confirmed as primary or recurrent bladder carcinoma and 1 false positive case as inflammation.The detection rates of early imaging with routine and increased display threshold of SUVmax were 18.8％(3/16) and 43.8％(7/16),respectively.Conclusion Increased SUVmax threshold for display and delayed imaging with diluted urine under full bladder status could effectively improve the detection rate of primary or recurrent bladder cancer with 18F-FDG PET/CT.

The value of 18F-FDG PET/CT in transcatheter hepatic arterial chemoembolization therapy of primary hepatocellular carcinoma with high FDG uptake / 中华核医学与分子影像杂志

Objective To evaluate the therapeutic response of transcatheter hepatic arterial chemoembolization (TACE) for primary HCC using 18 F-FDG PET/CT.Methods Twenty-four HCC patients (21males,3 females; age range:40 to 75 years,mean age:58.1 years) with high uptake of 18F-FDG on pretreatment PET/CT and with follow-up 18F-FDG PET/CT 1-2 months post TACE were retrospectively analyzed.A lesion was regarded as positive for HCC if it had higher FDG uptake than the surrounding liver parenchyma.All patients were followed for 3 months by clinical symptoms,AFP and 18F-FDG PET/CT.x2 test was used to analyze the difference between the diagnostic value of 18F-FDG PET/CT and AFP.Results On follow-up 18F-FDG PET/CT,9 patients had lower 18F-FDG uptake than the surrounding liver parenchyma,indicating no residual tumor; while 11 patients with residual tumor showed higher uptake of FDG than the liver background though the uptake was lower than that of baseline PET/CT.Two patients with isometabolic FDG uptake were confirmed of having residual tumor during follow-up.One case showed increased 18F-FDG uptake more than that of baseline,indicating disease progression.One case was false positive for residual tumor due to over attenuation correction in the presence of lipiodol.The sensitivity and accuracy for the detection of residual tumor by 18F-FDG PET/CT and AFP were 100％ (14/14) vs 71.4％ (10/14),and 95.8％(23/24) vs 70.8％(17/24) (x2 =6.56 and 4.18,both P＜0.05),respectively.Conclusion 18F-FDG PET/CT is useful to evaluate the efficacy of TACE for 18F-FDG-avid HCC and it may provide important information for further treatment planning.

18F-FDG PET/CT and contrast-enhanced CT in diagnosis of pulmonary sclerosing hemangioma / 中华核医学与分子影像杂志

Objective To evaluate the value and characteristics of 18F-FDG PET/CT and contrastenhanced CT in pulmonary sclerosing hemangioma (PSH).Methods A retrospective study involving 5 patients confirmed as PSH by pathology from June 2007 to June 2011 was performed.The cases consisted of four women and one man with age ranged from 39 to 66 (mean 51.6) years.All patients received dualphase 18 F-FDG PET/CT,high resolution (HR) CT and multi-phase contrast-enhanced CT (Siemens Biograph 16 PET/CT).Lesion SUVmaon early and delayed PET/CT images,retention index,increased HU value,washout time from peak on contrast-enhanced CT and peritumor vessel sign were studied.Results PSH lesions showed patchy increased 18F-FDG uptake with mean SUVmax on early and delayed PET/CT of 3.3 ± 1.1 and 3.4 ± 1.4,respectively.The mean retention index was (2.1 ± 20.8) ％.The morphological features of PSH on HRCT included findings such as a round/oval nodule or mass with well-defined margins and air meniscus sign.On muhi-phase contrast-enhanced CT,PSH showed moderate to high enhancement (the increased value:35 to 59 HU) with washout times from peak of 140 to 260 s,and 1 to 4 peritumor vessel signs.Conclusions A patchy pattern of high 18F-FDG uptake on PET/CT is suggestive of benign entity.Contrast-enhanced CT findings are very useful to increase the confidence for the diagnosis of PSH.

Clinical Application of 3D-CT Reconstruction Using Spiral CT in the Diagnosis of Surface-involved Lesions of Bone-Compared with Plain Film and 2D-CT / 实用放射学杂志

Objective To study the value of 3D-CT reconstruction in the diagnosis of surface involved lesions of bone for its nature and location,comparing with plain film and 2D-CT.Methods Surface-involved lesions of bone revealed by plain-film were performed spiral CT examination.Multi-planar reconstruction(MPR)and surface shading display(SSD)were performed among 20 cases which had pathologic results.The diagnosing correct rate of nature and location in all the techniques were compared.Results The correct rate of nature diagnosing of plain film,2D-CT,MPR and SSD was 75%,80%,65%,60% respectively;correct rate of location diagnosing was 90%,75%,85%,95% respectively.The highest nature diagnostic correct rate was found in 2D-CT.The highest location diagnostic correct rate was found in SSD.Conclusion Spiral CT stereoscopic reconstruction is of great value in the location diagnosing of surface-involved bone lesion.

To Obtain Radiology Literature From the Internet / 实用放射学杂志

Objective To collect the URL of Chinese and English periodicals and medical seraching engines,sum up the methods and procedures of getting radiolgical literature from the Internet.Methods To search URL with a computer connected to the Internet,by software of Internet Explorer and searching engines known.Results The URL of 21 English and 11 Chinese radiological perodicals,14 searching engines,4 medical databases were obtained,which can be used to find the abstract and full text of the articles we want from the internet.Conclusion To obtain radiological literature from the internet can be easy,convenient,rapid and economical.

The Clinical Significance of Bone Destruction of Maxillary Sinus / 实用放射学杂志

0.05).84.58%(28/33)of the expanding bone destruction were resulted from benign and 84.62%(33/39) of the aggressive bone destruction were resulted from malignant.The form of bone destruction of maxillary sinus in the benign and the malignant was different(? 2=34.61,?