[18F]FDG PET is more sensitive than SS for detecting bone metastasis in endemic NPC at initial staging, whereas SS can be considered as supplementary in this setting.

Fused T2-weighted and high-b-value DW images at 3 T can provide accurate information for preoperative evaluation of myometrial invasion.

The plasma concentration of Epstein-Barr virus (EBV) DNA is associated with tumor burden and prognosis in patients with nasopharyngeal carcinoma (NPC), but data on the relationship between viral load and 18 F-FDG PET functional parameters are lacking. We examined the association of 18 F-FDG PET functional parameters and EBV DNA load with the clinicopathologic characteristics and clinical outcomes of patients with NPC. Methods: One hundred eight patients with NPC who underwent 18 F-FDG PET before treatment were included in this study. We determined total lesion glycolysis (TLG) of the primary tumor, the cervical nodes, and their combination and the maximal standardized uptake value of the primary tumor and cervical lymph nodes. EBV DNA was measured by real-time polymerase chain reaction. Results: EBV DNA was significantly associated with total TLG (R 2 5 0.589). Total TLG values had the highest correlation with EBV DNA load and were significantly associated with tumor, nodal, and overall stages. However, tumor TLG greater than the median (.65 g) was the only parameter significantly associated with overall, local recurrence-free, disease-free, and distant metastasis-free survivals (P 5 0.033, 0.014, ,0.001, and 0.023, respectively). After allowance for potential confounders, tumor TLG retained its independent significance for overall and disease-free survival rates (P 5 0.045 and 0.006, respectively). Conclusion: Total TLG values are primarily associated with tumor burden and clinical stage, whereas tumor TLG is the best predictor of patient survival after treatment.

For prospective differentiation between uterine LMS/STUMP and benign leiomyoma, CE-MRI can provide accurate information and is preferable to DWI. Combination of DWI and ADC values can achieve a comparable diagnostic accuracy to CE-MRI.

Three-Tesla WB-MRI achieved a similar diagnostic capability to FDGPET-CT for the detection of residual/recurrent NPC. Both techniques have different advantages, and their combined interpretation can yield a slightly higher diagnostic capability. In clinical practice, 3-T WB-MRI can offer an accurate and comprehensive assessment of residual/recurrent NPC.

Conventional work-up (CWU) with chest radiography, abdominal ultrasonography, and skeletal scintigraphy has limited value in M staging of nonkeratinizing nasopharyngeal carcinoma (NPC). Our aim was to evaluate whether 18 F-FDG PET could replace CWU by comparing their diagnostic efficacies. Methods: Patients with histologically proven nonkeratinizing NPC and no prior treatment were prospectively enrolled. All study participants underwent CWU and 18 F-FDG PET for primary M staging. Distant metastasis was considered to be present if there was any reliable evidence identified within 1 y after diagnosis. The comparative diagnostic efficacies of 18 F-FDG PET, CWU, and the combination of 18 F-FDG PET and CWU (PET1CWU) were evaluated using the areas under the receiver-operating-characteristic (ROC) curves. Results: Sixty-one (20.3%) of 300 eligible patients were found to have distant metastases. On a patient-based analysis, 18 F-FDG PET was found to be more effective than CWU (P , 0.001), whereas it was equally effective with PET1CWU (P 5 0.130). On region-based analyses, 18 F-FDG PET was more effective than skeletal scintigraphy and chest radiography for detecting bone metastases (P , 0.001) and chest metastases (P , 0.001), respectively. 18 F-FDG PET and abdominal ultrasound were equally effective for detecting hepatic metastases (P 5 0.127). On region-based analyses, the combination of 18 F-FDG PET and CWU did not yield any noticeable increase in diagnostic efficacy. Conclusion: 18 F-FDG PET can replace CWU in primary M staging of nonkeratinizing NPC.

In this retrospective study, we sought to investigate the prevalence and the clinical significance of thyroid uptake discovered by FDG PET/CT within the thyroid gland during imaging investigation of non-thyroid disorders. This study included 5,877 subjects with no previous history of thyroid malignancy referred to our PET/CT center (1,596 for cancer screening and 4,281 for primary staging or restaging purposes) from June 2006 to April 2009. All of the patients had at least 12 months of follow-up or were censored on the date of the last follow-up. The disease status was analyzed for correlation with the maximum standardized uptake value (SUVmax). Receiver operating characteristics (ROC) curves were constructed to determine the optimal cutoff values for SUVmax. In the screening group (n=1,596), 55 patients (4%) had thyroid FDG uptake. Twenty-two subjects were referred for cytological or histological assessment and 4 (18%) were diagnosed with thyroid carcinoma. In the primary staging/restaging group (n=4,281), 165 patients (4%) had thyroid FDG-avid sites. Thirty-three patients were referred for cytological or histological assessment and 4 (12%) were found to have thyroid carcinoma. Of the 8 malignant lesions, 7 were papillary thyroid carcinoma, and 1 medullary thyroid carcinoma. Surgical resection was performed in seven out of eight patients. Three patients had lymph node metastasis (one case detected by preoperative PET/CT) and three bilateral malignant diseases (all false negative in PET/CT scans). Of the 47 benign lesions, 35 were nodular goiter or nodular hyperplasia, 6 multinodular goiter, and 6 autoimmune thyroid disease. The average value of SUVmax of malignant thyroid lesions was significantly higher than that of benign thyroid lesions (8.2±4.5 vs. 5.6±3.2, P=0.048). However, we were unable to identify an optimal SUVmax cutoff because the total area under the curve was small. The prevalence of thyroid uptake on FDG PET/CT in this study is 3.7%, which is consistent with previous observations. Of patients who received verification by cytology or histology, 14% (8/55) were found to have thyroid malignancies. However, we were unable to establish an optimal SUVmax cutoff value to differentiate benign from malignant lesions. FDG PET/CT scans were false negative in a significant proportion of patients with thyroid carcinoma and regional lymph node metastases or separate tumor nodule(s) in a contralateral lobe. Further diagnostic tests (thyroid ultrasound/fine needle aspiration) are recommended in presence of focal thyroid uptake detected by FDG PET/CT scans.

No abstract