In conclusion, high FDG uptake in primary breast tumors is significantly correlated with clinicopathological factors, such as tumor size, histologic grade, TNM stage, negativity of the hormonal receptor, HER2 overexpression and triple negativity. Therefore, FDG PET/CT is a helpful prognostic tool to direct the further management of patients with breast cancer.
It is suggested that FDG PET/CT may play a role in the evaluation of early treatment response after interventional therapy for HCC. The results indicate that FDG PET/CT visual analysis may be more useful than quantitative analysis. Further prospective studies with a large number of patients and established protocol are needed to substantiate our results.
HighlightsFunctional imaging modalities may have an important role in diagnosing chondrosarcomas.PET is a sensitive and specific test for differentiating chondrosarcomas and benign chondroid tumours.Thallium-201 scintigraphy has a high positive predictive value for chondrosarcomas.DMSA (V) has a 100% negative predictive value and can be used to rule out chondrosarcomas.
The flare phenomenon (FP) on bone scintigraphy after the initiation of systemic treatment seriously complicates evaluations of therapeutic response in patients with bone metastases. The aim of this study was to evaluate whether serum alkaline phosphatase (ALP) can differentiate FP from disease progression on bone scintigraphy in these patients. Breast or prostate cancer patients with bone metastases who newly underwent systemic therapy were reviewed. Pretreatment baseline and follow-up data, including age, pathologic factors, type of systemic therapy, radiologic and bone scintigraphy findings, and ALP levels, were obtained. Univariate and multivariate analyses of these factors were performed to predict FP. An increased extent and/or new lesions were found in 160 patients on follow-up bone scintigraphy after therapy. Among the 160 patients, 80 (50%) had an improvement on subsequent bone scintigraphy (BS), while subsequent scintigraphy also showed an increased uptake in 80 (50%, progression). Multiple regression analysis revealed that stable or decreased ALP was an independent predictor for FP (p < 0.0001). ALP was an independent predictor for FP on subgroup analysis for breast and prostate cancer (p = 0.001 and p = 0.0223, respectively). Results of the study suggest that ALP is a useful serologic marker to differentiate FP from disease progression on bone scintigraphy in patients with bone metastasis. Clinical interpretation for scintigraphic aggravation can be further improved by the ALP data and it may prevent fruitless changes of therapeutic modality by misdiagnosis of disease progression in cases of FP.
A 69-year-old man with common bile duct cancer and deep jaundice had complained of abdominal pain after percutaneous transhepatic biliary drainage. The laboratory workup showed reduction of serum hemoglobin level after the procedure. A 99mTc-hydroxy diphosphonate bone scan was performed for further evaluation of common bile duct cancer, and there was no abnormality of the skeletal structures. However, diffuse and hazy increased radiotracer uptake was detected on the liver. Follow-up contrast-enhanced 99mCT revealed hematoma and subcapsular hemorrhage of the liver.
We present a case of catheter tract implantation metastasis of hilar cholangiocarcinoma after preoperative percutaneous transhepatic biliary drainage (PTBD) on F-18 FDG PET/CT. A 65-year-old woman had received preoperative PTBD before a left hemihepatectomy due to hilar cholangiocarcinoma 17 months ago. Recently, the patient complained of pain in the right flank. Serum CEA and CA 19-9 levels were within the normal range. Contrast-enhanced abdominal CT was done and interpreted as no definite abnormality, so F-18 FDG PET/CT was undertaken and showed metastatic implantation on the right flank. On a retrospective review of the previous CT, a small nodule was noted at the corresponding site of the lesion on FDG PET/CT ( Fig.
We describe the ¹⁸F-FDG PET/CT findings of 2 simultaneous metastatic gastric cancers to the colon and spleen with quite different FDG avidities. Longitudinal and weak FDG uptake was observed in the descending colon; therefore, it could not be distinguished from nonpathological functional uptake of normal colon. Meanwhile, the splenic mass showed intense uptake. Contrast-enhanced CT revealed a segmental wall thickening of the descending colon as well as a hypoattenuating splenic mass suggesting metastases. Splenectomy and left hemicolectomy were performed. Histological diagnosis disclosed metastatic gastric cancer. The differential diagnoses and review of the literature are presented.
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