Associations among bronchioloalveolar carcinoma components, positron emission tomographic and computed tomographic findings, and malignant behavior in small lung adenocarcinomas
Morihito OkadaShunsuke TauchiKoichiro IwanagaTakeshi MimuraYoshitaka KitamuraHirokazu WatanabeShuji AdachiToshiko SakumaChiho Ohbayashi
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A 65-year-old patient with acute lymphoblastic leukemia presented for an 18fluoro-2-deoxy-d-glucose positron emission tomography computed tomography (18FDG PET) after several courses of chemotherapy for metastatic evaluation. Unexpectedly, on 18FDG PET scan, no discernible uptake was observed in the visceral organs, but instead, the skeleton/bone marrow showed homogenously intense metabolic activity. The distribution of 18FDG observed on the scan was remarkably similar to that on the NaF PET scan, indicating a superscan appearance.
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Regional cerebral glucose metabolism was studied in a 73-year-old woman with autopsy-confirmed Creutzfeldt-Jakob disease, using positron emission tomography of 2-(18F)fluorodeoxyglucose. Regional absolute values were analyzed in 14 partially overlapping slices. Clinically, the patient was in an advanced stage of disease when positron emission tomographic scans revealed severe, diffuse hypometabolism, and neuropathological findings showed diffuse spongiform changes throughout the brain, with neuronal cell loss being obvious only in the cerebellum. Computed tomography was unremarkable for age, whereas the positron emission tomographic results were in accordance with histological findings and the patient's clinical condition. This article suggests that positron emission tomography depicts neuronal dysfunction rather than neuronal cell loss.
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Clinical Positron Emission Tomography (PET)Correlation with Morphological Cross-Sectional ImagingLamk M. LamkiAudio Available | Share
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Positron emission tomography-computed tomography with fluorine-18 fluorodeoxy-D-glucose has a major role in the investigation of head and neck cancers. Fluorine-18 fluorodeoxy-D-glucose is not a tumour-specific tracer and can also accumulate in benign pathology. Therefore, positron emission tomography-computed tomography scan interpretation difficulties are common in the head and neck, which can produce false-positive results. This study aimed to investigate patients detected as having abnormal vocal fold uptake on fluorine-18 fluorodeoxy-D-glucose positron emission tomography-computed tomography.Positron emission tomography-computed tomography scans were identified over a 15-month period where reports contained evidence of unilateral vocal fold uptake or vocal fold pathology. Patients' notes and laryngoscopy results were analysed.Forty-six patients were identified as having abnormal vocal fold uptake on positron emission tomography-computed tomography. Twenty-three patients underwent positron emission tomography-computed tomography and flexible laryngoscopy: 61 per cent of patients had true-positive positron emission tomography-computed tomography scans and 39 per cent had false-positive scan results.Most patients referred to ENT for abnormal findings on positron emission tomography-computed tomography scans had true-positive findings. Asymmetrical fluorine-18 fluorodeoxy-D-glucose uptake should raise suspicion of vocal fold pathology, accepting a false-positive rate of approximately 40 per cent.
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Abstract Introduction This study aims to evaluate discrepant findings between positron emission tomography/magnetic resonance imaging (PET/MRI) and positron emission tomography/computed tomography (PET/CT) in a cohort of oncological patients and to undertake a phantom study to assess the potential for extended PET acquisitions to lead to false‐positive findings on PET/MRI. Methods Discrepant findings from a series of 106 patients undergoing same‐day 18 F‐fluorodeoxyglucose (FDG)‐PET/CT and PET/MRI were reviewed. Phantom studies explored the potential for PET acquisition time to contribute to discrepancy. Results There were 14 discrepant cases, 5 (35.7%) of which related to PET/MRI acquisitions that had been extended to 10 min. Three of these five cases proved to be falsely positive. Phantom studies showed greater contrast recovery and signal to noise ratio for 10‐min PET/MRI acquisitions compared to 2‐min acquisitions using PET/CT. There were no discrepancies when PET/CT showed disseminated disease ( P = 0.036). Conclusions Extended PET/MRI acquisitions used to accommodate multiple MRI sequences may be associated with false‐positive findings compared to PET/CT. PET/MRI is more likely to have incremental value when the prior probability for disseminated disease is low.
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Positron emission tomography (PET) is a powerful quantitative molecular imaging technique that is complementary to structural imaging techniques for purposes of disease detection and characterization. This review article provides a brief overview of PET, hybrid PET instrumentation, and PET quantification.
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