ABSTRACT
A 53-year-old patient underwent a positron emission tomography/computed tomography with 2-fluoro-2-deoxy-d-glucose (18F-FDG PET/CT) in the suspicious of gastric tumor recurrence (mediastinal and abdominal lymph nodes). PET/CT identified only an area of 18F-FDGuptake in the twelfth thoracic vertebrae. Unexpectedly, a bone scintigraphy revealed many "hot" spots changing the diagnosis (single metastasis versus plurimetastatic disease) and impacting on patient's management (AU)
Un paciente de 53 años fue sometido a una tomografía por emisión de positrones-tomografía computarizada con 18F-2-fluoro-2 deoxi-d-glucosa (18F-FDG PET/TC) ante la sospecha de recidiva de cáncer de estómago (nódulos linfáticos en mediastino y abdomen). El PET/TC identificó únicamente una zona de captación de 18F-FDG en la duodécima vértebra torácica. Sorpresivamente, la gammagrafía ósea reveló muchas imágenes hipercaptantes que modificaron el diagnóstico (metástasis única en lugar de metástasis múltiples) con el consiguiente impacto en el tratamiento del paciente (AU)
Subject(s)
Humans , Male , Middle Aged , Stomach Neoplasms , Fluorodeoxyglucose F18 , Tomography, Emission-Computed/methods , Biomarkers, Tumor/analysis , Follow-Up Studies , Radionuclide Imaging/methods , Radionuclide Imaging/standards , Radionuclide Imaging , Nuclear Medicine/methodsABSTRACT
A 53-year-old patient underwent a positron emission tomography/computed tomography with 2-fluoro-2-deoxy-d-glucose ((18)F-FDG PET/CT) in the suspicious of gastric tumor recurrence (mediastinal and abdominal lymph nodes). PET/CT identified only an area of (18)F-FDGuptake in the twelfth thoracic vertebrae. Unexpectedly, a bone scintigraphy revealed many "hot" spots changing the diagnosis (single metastasis versus plurimetastatic disease) and impacting on patient's management.
Subject(s)
Bone Neoplasms/diagnostic imaging , Fluorodeoxyglucose F18 , Neoplasm Recurrence, Local/diagnostic imaging , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Stomach Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Follow-Up Studies , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: The goal of this study was to evaluate the usefulness of positron emission tomography with [(18)F]fluorodeoxyglucose ([(18)F]FDG-PET) in detecting metastases in patients with gestational trophoblastic tumor (GTTs). METHODS: A retrospective study was conducted on three patients with GTTs who had been studied with [(18)F]FDG-PET and computed tomography (CT) after an increase in human chorionic beta-gonadotropin (betahCG) serum levels. PET scans were performed with a multiring whole-body positron emission tomograph 45 min after an intravenous bolus injection of [(18)F]FDG ( approximately 5.2 MBq/kg). CT studies were obtained on a spiral scanner prior and after administration of intravenous iodinated contrast material. Within a week of CT and [(18)F]FDG-PET studies, the patients underwent surgical procedures for histological diagnosis. RESULTS: In one patient, a lung lesion positive for neoplastic tissue with [(18)F]FDG-PET and negative with CT was confirmed to be a GTT metastasis at histology. In another patient, [(18)F]FDG-PET was negative, while CT was positive for the presence of lung metastasis; no viable tumor tissue was found at histological analysis. The remaining patient had a positive [(18)F]FDG-PET and CT study for lung metastasis; this was confirmed at histological analysis. In the same patient, both [(18)F]FDG-PET and CT depicted the presence of a liver lesion. Necrotic lesion regression after treatment was clearly documented with [(18)F]FDG-PET only. CONCLUSIONS: Our preliminary results suggest that [(18)F]FDG-PET may be useful for the assessment of metastatic disease in patients with GTTs.
Subject(s)
Fluorodeoxyglucose F18 , Gestational Trophoblastic Disease/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/secondary , Radiopharmaceuticals , Adult , Female , Gestational Trophoblastic Disease/pathology , Humans , Middle Aged , Pregnancy , Retrospective Studies , Tomography, Emission-Computed/methodsABSTRACT
AIM: To determine the additional value of [(18)F]FDG-PET in combination with computed tomography (CT) over CT used alone, for evaluating ovarian cancer patients after primary treatment. METHODS: Twenty-five women (mean age: 53.6 years) had primary debulking surgery followed by chemotherapy for histologically proven ovarian carcinoma. At initial diagnosis, the tumor types were papillary serous adenocarcinoma (n=20), endometroid carcinoma (n=3), mixed mullerian tumor (n=1), and granulosa cell tumor (n=1). All patients underwent [(18)F]FDG-PET and contrast enhanced CT examinations, within 30 days of the completion of chemotherapic treatment. [(18)F]FDG-PET images were interpreted with the knowledge of CT findings (PET+CT); conversely, CT images were evaluated with no knowledge of the [(18)F]FDG-PET results. Within 7 day of imaging studies, 2(nd)-look laparoscopy (n=7) or laparotomy (n=18) was performed for histological confirmation. In all cases, imaging findings were then correlated with results of histopathologic examination. RESULTS: Of the 23 neoplastic viable lesions, all histologically confirmed, 16 could be detected by CT alone and 19 by PET+CT. An inflammatory lymph-node was misdiagnosed as viable tumor with both PET+CT and CT alone; an area of scar tissue in the presacral region was also misinterpreted as malignant tissue with CT alone. Overall lesion-based sensitivity, specificity and accuracy in assessing focal areas of residual tumor were as follows: 69.56%, 83.33%, 74.28% for CT, and 82.60%, 91.67%, 85.71% for PET+CT. The negative predictive value of PET+CT was markedly higher (73.33%), compared to that of CT alone (58.82%). CONCLUSION: PET used in combination with CT allows to accurately assess tumor response. A major advantage of PET+CT over CT alone is in excluding the presence of residual viable lesions after treatment.
