ABSTRACT
The detection rates of whole-body combined [18 F]NaF/[18 F]FDG positron emission tomography combined with computed tomography (PET/CT), CT alone, whole-body magnetic resonance imaging (WB-MRI), and X-ray were prospectively studied in patients with treatment-requiring plasma cell disorders The detection rates of imaging techniques were compared, and focal lesions were classified according to their anatomic location. Twenty-six out of 30 initially included patients were assessable. The number of focal lesions detected in newly diagnosed patients (n = 13) and in relapsed patients (n = 13) were 296 and 234, respectively. The detection rate of PET/CT was significantly higher than those of WB-MRI (P < 0.05) and CT (P < 0.0001) both in patients with newly diagnosed and in those with relapsed multiple myeloma (MM). The X-ray detection rate was significantly lower than those of all other techniques, while CT detected more lesions compared with WB-MRI at diagnosis (P = 0.025). With regard to the infiltration patters, relapsed patients presented more diffuse patterns, and more focal lesions located in the limbs compared with newly diagnosed patients. In conclusion, the detection rate of [18 F]NaF/[18 F]FDG PET/CT was significantly higher than those of CT, MRI, and X-ray, while the detection rate of X-rays was significantly lower than those of all other imaging techniques except for focal lesions located in the skull.
Subject(s)
Fluorine Radioisotopes/administration & dosage , Glucose-6-Phosphate/analogs & derivatives , Magnetic Resonance Imaging , Multiple Myeloma/diagnostic imaging , Positron-Emission Tomography , Skull Neoplasms/diagnostic imaging , Sodium Fluoride/administration & dosage , Tomography, X-Ray Computed , Adult , Aged , Aged, 80 and over , Female , Glucose-6-Phosphate/administration & dosage , Humans , Male , Middle Aged , Neoplasm Metastasis , Prospective StudiesABSTRACT
OBJECTIVE: This work reports on musculoskeletal uptake of ¹8F-FPRGD2, targeting the integrin αvß3, in patients who had undergone ¹8F-FPRGD2 positron emission tomography combined with computed tomography (PET/CT) for oncologic purposes. METHODS: Whole-body ¹8F-FPRGD2 PET/CT images of 62 cancer patients were retrospectively reviewed to detect foci of musculoskeletal ¹8F-FPRGD2 uptake. For 37 patients, a FDG PET/CT performed in clinical settings was available. In each joint with an abnormal uptake, the maximum standardized uptake value (SUVmax) was estimated. RESULTS: A total of 260 musculoskeletal foci of ¹8F-FPRGD2 uptake were detected. Most common sites of uptake were joints and discs (n = 160; 61.5%), entheses (osteotendinous and osteoligamentous junctions; n = 55; 21.2%) and recent fractures (n = 18; 6.9%). In addition, 27 (10.4%) miscellaneous foci were detected. Out of the 146 lesions for which a FDG PET was available, 63% showed both ¹8F-FPRGD2 and FDG uptake, 33.6% did not show FDG avidity and 3.4% showed only FDG uptake. The uptake intensity of the 92 lesions positive with ¹8F-FPRGD2 and FDG was similar with both radiopharmaceuticals, but the target-to-background (blood pool or muscle) ratios were significantly higher with ¹8F-FPRGD2 than with FDG (p < 0.0001). CONCLUSION: The ¹8F-FPRGD2 uptake in joints, spine degenerative diseases and tendons was highly prevalent in our population. Up to one-third of ¹8F-FPRGD2 foci showed no FDG uptake suggesting that ¹8F-FPRGD2 signal may not be related to inflammatory angiogenesis only.
Subject(s)
Multimodal Imaging , Musculoskeletal Diseases/diagnostic imaging , Oligopeptides , Peptides, Cyclic , Positron-Emission Tomography , Tomography, X-Ray Computed , Adenocarcinoma/complications , Adult , Aged , Aged, 80 and over , Biological Transport , Cartilage/metabolism , Cell Dedifferentiation , Chondrocytes/metabolism , Cohort Studies , Female , Gene Expression Regulation, Neoplastic , Humans , Male , Middle Aged , Musculoskeletal Diseases/complications , Musculoskeletal Diseases/metabolism , Osteoarthritis/pathology , Radiation Dosage , Rectal Neoplasms/complications , Retrospective StudiesABSTRACT
OBJECTIVE: We sought to optimize the kilovoltage, tube current, and the radiation dose of computed tomographic arthrography of the hip joint using in vitro methods. MATERIALS AND METHODS: A phantom was prepared using a left femoral head harvested from a patient undergoing total hip arthroplasty and packed in a condom filled with iodinated contrast. The right hip joint of a cadaver was also injected with iodinated contrast. The phantom and the cadaver were scanned using different values of peak kilovoltage (kVp) and tube current (milliamp seconds, mAs). Three different regions of interest (ROI) were drawn in the cartilage, subchondral bone plate, and intraarticular contrast. The attenuation values, contrast/noise ratio (CNR), and effective dose were calculated. Two independent observers classified the quality of the contrast-cartilage interface and the cartilage-subchondral bone plate interface as (1) diagnostic quality or (2) nondiagnostic quality. RESULTS: Contrast, cartilage, and subchondral bone plate attenuation values decreased at higher kVp. CNR increased with both kVp and mAs. The qualitative analysis showed that in both phantom and cadaver, at 120 kVp and 50 mAs, the contrast-cartilage and cartilage-subchondral bone plate interfaces were of diagnostic quality, with an effective dose decreased to 0.5 MSv. CONCLUSIONS: The absolute effective dose is not directly related to the quality of images but to the specific combination of kVp and mAs used for image acquisition. The combination of 120 kVp and 50 mAs can be suggested to decrease the dose without adversely affect the visibility of cartilage and subchondral bone plate.
Subject(s)
Arthrography/methods , Cartilage, Articular/diagnostic imaging , Hip Joint/diagnostic imaging , Radiation Protection/methods , Radiographic Image Interpretation, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Algorithms , Cadaver , Humans , Middle Aged , Radiation Dosage , Radiographic Image Enhancement/methods , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
No disponible
Subject(s)
Humans , Female , Young Adult , Neutropenia/diagnosis , Turner Syndrome/complications , Fever/etiology , Obesity/complicationsSubject(s)
Coinfection/diagnosis , Fever/etiology , Herpesvirus 6, Human/isolation & purification , Invasive Pulmonary Aspergillosis/diagnosis , Neutropenia/etiology , Roseolovirus Infections/diagnosis , Coinfection/complications , Diagnosis, Differential , Fatal Outcome , Female , Humans , Invasive Pulmonary Aspergillosis/complications , Roseolovirus Infections/complications , Young AdultABSTRACT
No disponible
