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1.
Clin Radiol ; 75(8): 643.e1-643.e10, 2020 08.
Article in English | MEDLINE | ID: mdl-32299619

ABSTRACT

AIM: To analyse the relationship between 18F-labelled sodium fluoride (NaF) uptake and lumbar back pain in patients with lumbosacral transitional vertebra (LSTV) a congenital malformation of the lumbosacral spine. MATERIALS AND METHODS: The study population comprised 55 patients (mean age, 51.42 years; median age 52 years) with LSTV. All patients underwent integrated positron-emission tomography (PET)/computed tomography (CT) by injecting 0.06 mCi/kg of 18F-NaF. A three-point grading system was used to evaluate 18F-NaF uptake (grade 0, no uptake; grade 1, mild uptake; and grade 2, marked increase uptake. RESULTS: In total, 55 cases of LSTV (34 symptomatic and 21 asymptomatic) were included. Asymptomatic patients had no uptake in the majority of cases, i.e., grade 0 (n=18) and grade 1 (n=3), whereas symptomatic patients demonstrated focal increase tracer uptake of grade 2 (n=24), grade 1 (n=4), and grade 0 (n=6). There is a strong linear trend between the intensity of 18F-NaF uptake and presence of symptoms (p<0.0001). The sensitivity and specificity of 18F-NaF uptake at LSTV as a cause of pain were 82% (95% confidence interval [CI]: 65-93%) and 86% (95% CI: 64-97%). The positive and negative predictive values were 90% (95% CI: 74-98%) and 75% (95% CI: 53-90%). CONCLUSIONS: 18F-NaF PET/CT can be useful in evaluating back pain and 18F-NaF may be used as an adjunctive biological maker for assessing LSTV as a potential cause of pain.


Subject(s)
Low Back Pain/diagnosis , Lumbar Vertebrae/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Sacrum/diagnostic imaging , Sodium Fluoride/pharmacology , Female , Fluorine Radioisotopes , Humans , Male , Middle Aged
2.
Clin Radiol ; 74(2): 95-110, 2019 02.
Article in English | MEDLINE | ID: mdl-30340750

ABSTRACT

18F-sodium fluoride (NaF) is a PET bone imaging agent and is commonly used in imaging patients with cancer; however, similar to technetium-99m medronic acid (99mTc-MDP), it can be useful in the evaluation of benign bone and joint conditions. NaF is an excellent bone-seeking agent with high bone uptake due to rapid single-pass extraction. It has negligible plasma protein binding, rapid blood, renal clearance, high bone uptake and almost all NaF delivered is retained by bone after a single pass of blood; however, uptake of NaF can be observed in non-osseous structures such as the arterial vasculature, gastrointestinal tract, genitourinary tract, and viscera. In this article, we present a spectrum of clinical cases with non-osseous NaF uptake in patients referred for cancer staging.


Subject(s)
Bone Neoplasms/diagnostic imaging , Fluorine Radioisotopes/pharmacokinetics , Organs at Risk/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Sodium Fluoride/pharmacokinetics , Humans
3.
Gulf J Oncolog ; 1(19): 7-13, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26499823

ABSTRACT

Metastases of differentiated thyroid cancer (DTC) can lose affinity to radioiodine with the passage of time, with resultant difficulty in management. Thyroid tumors are known to express somatostatin receptors and therefore 111In-pentetreotide, somatostatin analogue, can visualize tumors with high concentration of somatostatin receptors. We report a case of I-131 whole body scan (WBS) negative recurrent metastatic papillary thyroid carcinoma with positive 18F FDG PET-CT and 111In-pentetreotide scan. Somatostatin receptor scintigraphy (SRS) with 111In-pentetreotide may be useful both in the staging and monitoring of patients with non-iodine avid carcinoma of the thyroid. 111In-pentetreotide scan positive patients are potential candidates for somatostatin receptor-targeted therapy.

4.
Br J Radiol ; 83(995): 934-9, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20965904

ABSTRACT

The aim of this study was to compare the usefulness of (99)Tc(m)-methoxy-isobutyl-isonitrile (MIBI) scintimammography and ultrasonography, alone and in combination, for the detection of chest wall recurrence in the post-mastectomy breast. A total of 41 consecutive post-mastectomy patients (mean age 46.6 years; median age 45 years) with clinical suspicion of breast cancer recurrence were evaluated. For scintimammography all patients received a 740-900 MBq iv injection of (99)Tc(m)-MIBI; planar images were taken 5-10 min post-injection followed by supine single photon emission CT. Breast ultrasonography was performed in each patient using a 7.5 MHz transducer. Both MIBI uptake and ultrasound findings were documented using standard protocols. All patients had fine needle aspiration cytology biopsy (FNAC), core biopsy or excision biopsy for final tissue diagnosis. Of the 41 patients, 24 had true positive signs of local breast cancer recurrence upon ultrasonography, 10 were diagnosed as true negatives, a sensitivity of 86%, specificity 77%, positive predictive value (PPV) 89%, negative predictive value (NPV) 71% and accuracy 83% (p = 0.001). By comparison, scintimammography findings were found to be true positive in 25 patients and true negative in 12 patients - sensitivity 89%, specificity 92%, PPV 96%, NPV 80% and accuracy 90% (p = 0.001). Using a combination of these two modalities, the combined sensitivity was 100%, specificity 77%, PPV 90%, NPV 100% and accuracy 93%. The high NPV of the two studies in combination implies a potential use of this approach to exclude recurrent disease in patients with a low initial index of suspicion and/or when histology is indeterminate.


Subject(s)
Breast Neoplasms , Neoplasm Recurrence, Local , Radiopharmaceuticals , Technetium Tc 99m Sestamibi , Thoracic Wall , Ultrasonography, Mammary/methods , Adult , Aged , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/surgery , Female , Humans , Mastectomy, Radical/methods , Middle Aged , Neoplasm Recurrence, Local/diagnostic imaging , Radionuclide Imaging , Sensitivity and Specificity , Thoracic Wall/diagnostic imaging , Young Adult
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