• The Korean Journal of Nuclear Medicine Technology
• /
• v.20 no.2
• /
• pp.9-13
• /
• 2016

Purpose PET-CT examinations using $^{18}F-FDG$ to treat urinary system cancer are limited in terms of anatomical structure and excretion route of $^{18}F-FDG$. But one of the ongoing examinations utilizing $^{11}C-Acetate$ can compensate for such defects. We would like to introduce a clinical application of $^{11}C-Acetate$ PET-CT in urinary cancer patients. Materials and Methods We conducted a clinical survey of 22 patients diagnosed with urinary cancer at our hospital, 10 prostate cancer patients, 10 renal cell carcinoma patients, and 2 bladder cancer patients. All patients were performed $^{18}F-FDG$ PET-CT examinations, $^{11}C-Acetate$ examinations were performed after two weeks on average. The equipment used to D-710 PET-CT in GE Company and we performed PET-CT procedures 15 minutes after injecting $^{11}C-Acetate$, and a medical doctor from the department of nuclear medicine appraised and compared images between $^{18}F-FDG$ and $^{11}C-Acetate$. Results According to our survey, prostate cancer patients generally had lower uptake of $^{18}F-FDG$ than other cancer patients did. In 2 out of 10 prostate cancer patients, metastasized cancer showed greater uptake in $^{11}C-Acetate$ than $^{18}F-FDG$. In renal cell carcinoma cases, 8 out of 10 patients displayed evidently greater uptake in $^{11}C-Acetate$ than $^{18}F-FDG$. We excluded bladder cancer cases in this study because uptake of $^{18}F-FDG$ in the bladder was too hot, the number of patients was insufficient, and the cases did not meet criteria such as the use of diuretics. Conclusion It is too premature to draw solid conclusions from the survey, since it involved only a small number of participants. However, there are a number of studies conducted abroad that prove the effectiveness of the $^{11}C-Acetate$ PET-CT examinations in treating urinary system cancer, and this study is still ongoing at our hospital. If the tests were to be conducted on a larger number of participants, this study could lead to numerous other potential research topics, such as the correlation between Prostatic specific antigen (PSA) values and $^{11}C-Acetate$ PET-CT, Gleason sum values from biopsy before surgery, Specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) between $^{18}F-FDG$ PET-CT examinations and $^{11}C-Acetate$ PET-CT examinations in other urinary system cancers.

• Nuclear Medicine and Molecular Imaging
• /
• v.41 no.3
• /
• pp.185-193
• /
• 2007

This review focuses on the use of $^{18}F-FDG$ PET/CT to evaluate second primary cancers. The emergence of a second primary cancer is an important prognostic factor in cancer patients. The early detection of a second primary cancer and the appropriate treatment are essential for reducing the morbidity and mortality associated with these tumors. Integrated $^{18}F-FDG$ PET/CT, which can provide both the metabolic and anatomic information of a cancer, has been shown to have a better accuracy in oncology than either CT or conventional PET. The whole body coverage and high sensitivity of $^{18}F-FDG$ PET/CT along with its ability to provide both metabolic and anatomic information of a cancer make it suitable for evaluating a second primary cancer in oncology. Whole body $^{18}F-FDG$ PET/CT is useful for screening second primary cancers with a high sensitivity and good positive predictive value. In order to rule out the presence of a second primary cancer or an unexpected metastasis, further diagnostic work-up is essential when abnormal findings indicative of a second primary cancer are found on the PET/CT images. PET/CT is better in detecting a second primary tumor than conventional PET.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.3
• /
• pp.218-228
• /
• 2008

Purpose: Our purpose was to evaluate spinal bony metastasis which could be missed on an F-18 FDG PET/CT (FDG PET/CT) alone, and to characterize discordant metastatic lesions between FDG PET/CT and bone scan. Material and Methods: FDG PET/CT and bone scans of 43 patients with spinal bony metastasis were analyzed retrospectively. A McNemar test was performed comparing the FDG PET/CT alone to the FDG PET/CT plus bone scan in the spinal bony metastases. A one-way chi-square test was performed to characterize the metastases that were missed on the FDG PET/CT alone. To evaluate discordant lesions between FDG PET/CT and bone scan, we performed logistic regression analyses. The independent variables were sites (cervical, thoracic, and lumbar), size (large and small), and maximum SUVs, and the dependant variable was bone scan uptake (positive and negative MDP uptake). Results: A significant difference was found between the FDG PET/CT alone and the FDG PET/CT combined with the bone scan (p < 0.01). Using the FDG PET/CT only, diffuse osteoblastic metastasis was missed with a significantly higher frequency (p = 0.04). In the univariate analysis, cervical vertebra and small size were related to negative MDP uptake, and thoracic vertebra and large size were related to positive MDP uptake. However, in the multivariate analysis, only the large size was related to positive MDP uptake. Conclusion: A bone scan in addition to the FDG PET/CT increased the ability to evaluate spinal bony metastases, especially for diffuse osteoblastic metastasis. Large metastasis was related to positive bone scan uptake in spinal bony metastasis.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.7
• /
• pp.3569-3573
• /
• 2016

Purpose: The aim of this study was to compare C-11 choline and F-18 FDG PET/CT, gadoxetic-enhanced 3-T MRI and contrast-enhanced CT for diagnosis of hepatocellular carcinoma (HCC). Materials and Methods: Twelve chronic hepatitis B patients suspected of having HCC by abdominal ultrasonography received all diagnostic modalities performed within a one-week timeslot. PET/CT results were analyzed visually by two independent nuclear medicine physicians and quantitatively by tumor to background ratio (T/B). Nine patients then had histopathological confirmation. Results: Six patients had well differentiated HCC, while two and one patient(s) were noted with moderately and poorly differentiated HCC, respectively. All were detected by both CT and MRI with an average tumor size of $5.7{\pm}3.8cm$. Five patients had positive C-11 choline and F-18 FDG uptake. Of the remaining four patients, three with well differentiated HCC showed negative F-FDG uptake (one of which showed negative results by both tracers) and one patient with moderately differentiated HCC demonstrated no C-11 choline uptake despite intense F-18 FDG avidity. The overall HCC detection rates with C-11 choline and F-18 FDG were 78% and 67%, respectively, while the sensitivity of F-18 FDG for non-well differentiated HCC was 100%, compared with 83% of C-11 choline. The average T/B of C-11 choline in well-differentiated HCC patients was higher than in moderately and poorly differentiated cases (p=0.5) and vice versa with statistical significance for T/B of F-18 FDG (p = 0.02). Conclusions: Our results suggested better detection rate in C-11 choline for well differentiated HCC than F-18 FDG PET. However, the overall detection rate of PET/CT with both tracers could not compare with contrast-enhanced CT and MRI.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.6
• /
• pp.482-484
• /
• 2008

It is well known that F18-FDG PET/CT is a highly sensitive diagnostic modality for cancer patients. However, false positive cases resulting from benign disease such as tuberculosis in the endemic area often compromise the diagnostic accuracy of F18-FDG PET/CT. Nasopharyngeal tuberculosis is a rare disease although extrapulmonary tuberculosis can involve any region in the body. We report one case of nasopharyngeal tuberculosis incidentally detected on F18-FDG PET/CT.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.6
• /
• pp.456-463
• /
• 2008

Purpose: We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by $^{18}F-FDG$ PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. Materials & Methods: The subjects were 3,768 consecutive $^{18}F-FDG$ PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal $^{18}F-FDG$ uptake or a focal nodular lesion on CT image irrespective of $^{18}F-FDG$ uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. Results: The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value>75 HU or <30HU; standard deviation of mean attenuation > 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone ($0.680{\pm}0.093$ vs. $0.786{\pm}0.076$, p<0.05). Conclusion: The malignant risk of focal breast lesions incidentally found on $^{18}F-FDG$ PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both $^{18}F-FDG$ uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion.

• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.6
• /
• pp.577-581
• /
• 2009

Solid pseudo-papillary tumor (SPT) is a rare pancreatic neoplasm with low malignant potential, which tends to occur predominantly in younger females. Only a few cases of SPT seen on F-18 FDG PET scan have been reported, and the findings are not fully evaluated. A 33 year-old woman underwent F-18 FDG PET/CT study for staging of renal cell carcinoma. She was diagnosed with SPT of the pancreas 6 years ago, and has not had any treatment so far. Recent PET/CT showed marked F-18 FDG uptake in the peripheral solid portion and relatively less F-18 FDG uptake to the central calcified portion of SPT. We report one case of SPT of the pancreas on F-18 FDG PET/CT.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.sup1
• /
• pp.17-28
• /
• 2008

This review focuses on the clinical use of $^{18}F-FDG$ PET to evaluate solitary pulmonary nodule (SPN) and non-small cell lung cancer (NSCLC). When SPN or mass without calcification is found on chest X-ray or CT, $^{18}F-FDG$ PET is an effective modality to differentiate benign from malignant lesions. For initial staging of NSCLC, $^{18}F-FDG$ PET is useful, and proved to be cost-effective in several countries. $^{18}F-FDG$ is useful for detecting recurrence, restaging and evaluating residual tumor after curative therapy in NSCLC. For therapy response assessment, $^{18}F-FDG$ PET may be effective after chemotherapy or radiation therapy. $^{18}F-FDG$ PET is useful to predict pathological response after neoadjuvant therapy in NSCLC. For radiation therapy planning, $^{18}F-FDG$ PET may be helpful, but requires further investigations. PET/CT is better for evaluating NSCLC than conventional PET.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.sup1
• /
• pp.32-38
• /
• 2008

This review focuses on the clinical use of $^{18}F-FDG$ PET in esophageal cancer. For initial staging of esophageal cancer, $^{18}F-FDG$ PET is better than chest CT and is complementary to endoscopic ultrasound. Due to its good results for detecting distant metastasis, $^{18}F-FDG$ PET evades unnecessary curative surgery. Also, PET findings are associated with prognosis in esophageal cancer. $^{18}F-FDG$ PET seems to be useful for detecting recurrence and restaging in esophageal cancer. For therapy response assessment, $^{18}F-FDG$ PET is effective after chemotherapy or radiation therapy. $^{18}F-FDG$ PET is useful to predict pathological response after neoadjuvant therapy in esophageal cancer, which is better than chest CT and endoscopic ultrasound. For radiation therapy planning, $^{18}F-FDG$ PET may be helpful, but requires further investigations.

• Nuclear Medicine and Molecular Imaging
• /
• v.41 no.6
• /
• pp.570-573
• /
• 2007

We present a case of infected abdominal aortic aneurysm due to salmonella enteritidis. F-18 FDG PET/CT was performed to diagnosis and during follow-up after antibiotic treatment. Computed tomography (CT) is considered to be the best diagnostic imaging modality in infected aortic lesions. In this case, a combination of CT and FDG PET/CT provided accurate information for the diagnosis of infected abdominal aortic aneurysm. Moreover, FDG PET/CT made an important contribution to monitoring disease activity during antibiotic treatment.