A PET study of 18 FDG uptake in soft tissue masses

Lodge, Martin A.; Lucas, Jonathan; Marsden, Paul; Cronin, B.; O’Doherty, Michael; Smith, Michael A.

doi:10.1007/s002590050355

Cited by 271 publications

(132 citation statements)

References 8 publications

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“…Uptake time is important in sarcomas (Lodge et al, 1999) and possibly testicular cancer (Hain et al, 2000). The optimal time allowed for FDG uptake in squamous cell carcinoma of the head and neck is unknown.…”

Section: Discussionmentioning

confidence: 99%

FDG–PET. A possible prognostic factor in head and neck cancer

et al. 2002

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Previous studies have shown that high uptake of 18 F-fluoro-2-deoxy-glucose in head and neck cancer, as determined by the standardized uptake value on positron emission tomography scan, was associated with poor survival. The aim of this study was to confirm the association and to establish whether a high standardized uptake value had prognostic significance. Seventythree consecutive patients with newly diagnosed squamous cell carcinoma of the head and neck underwent a positron emission tomography study before treatment. Age, gender, performance status tumour grade, stage, maximal tumour diameter and standardized uptake value were analyzed for their possible association with survival. The median standardized uptake value for all primary tumours was 7.16 (90% range 2.30 to 18.60). In univariate survival analysis the cumulative survival was decreased as the stage, tumour diameter and standardized uptake value increased. An standardized uptake value of 10 was taken as a cut-off for high and low uptake tumours. When these two groups were compared, an standardized uptake value 410 predicted for significantly worse outcome (P=0.003). Multivariate analysis demonstrated that an standardized uptake value 410 provided prognostic information independent of the tumour stage and diameter (P=0.002). We conclude that high FDG uptake (standardized uptake value410) on positron emission tomography is an important marker for poor outcome in primary squamous cell carcinoma of the head and neck. Standardized uptake value may be useful in distinguishing those tumours with a more aggressive biological nature and hence identifying patients that require intensive treatment protocols including hyperfractionated radiotherapy and/or chemotherapy.

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Section: Discussionmentioning

confidence: 99%

FDG–PET. A possible prognostic factor in head and neck cancer

et al. 2002

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“…This suggestion is especially relevant for cases of locally advanced or metastatic disease, conditions for which standard staging studies are equivocal, or suspicious findings [1]. Uptake of 18 F-FDG, a commonly used radiopharmaceutical in PET/CT scans, increases distinctly in malignant cells after periods longer than 1 h [4]. Therefore, using delayed PET scans or dual-time 18 F-FDG PET/CT imaging in oncological imaging has been suggested by some researchers.…”

Section: Introductionmentioning

confidence: 99%

Dual-Time 18F-FDG PET/CT Imaging in Initial Locoregional Staging of Breast Carcinoma: Comparison with Conventional Imaging and Pathological Prognostic Factors

et al. 2016

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The aims of this retrospective study were to consider the diagnostic role of dual-time 18 F-fluorodeoxyglucose positron emission tomography and computed tomography ( 18 F-FDG PET/CT) in detection of breast carcinoma and axillary lymph node (ALN) status and to evaluate the primary tumor 18 F-FDG uptake pattern. Preoperative staging was performed by 18 F-FDG PET/CT in 78 female patients with breast carcinoma. Conventional imaging results were evaluated by breast magnetic resonance imaging (MRI) of 79 lesions in 78 patients, bilateral mammography (MMG) of 40 lesions in 40 patients, and breast ultrasonography (USG) of 47 lesions in 46 patients. The primary tumor detection rate using 18 F-FDG PET/CT was higher than those using MRI, USG, and MMG. The sensitivity and specificity of 18 F-FDG PET/CT scans for detecting multifocality were higher than those of MRI. The specificity of ALN metastasis detection with MRI was higher than that with 18 F-FDG PET/CT, but 18 F-FDG PET/CT had higher sensitivity. Higher 18 F-FDG uptake levels were detected in patients with ALN metastasis, histologic grade 3, estrogen-progesterone-negative receptor status, lymphatic invasion, and moderate to poor prognostic groups. There was no statistical difference for the retention index in categorical pathological parameters except for progesterone-negative status.In conclusion, 18 F-FDG PET/CT scans may be a valuable imaging technique for evaluating primary tumor and axillary status in staging breast carcinoma and 18 F-FDG uptake may be a prognostic factor that indicates aggressive tumor biology and poor prognosis. Dual-time imaging in breast carcinoma staging may not be used for predicting pathological criteria and the aggressiveness of primary lesions.

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“…These results suggest a different trend between malignant and benign/inflammatory lesions with regard to FDG accumulation: the first ones show an increase with time, whereas the second ones a decrease. Based on this logic, Lodge et al 16 performed a study of FDG uptake in soft tissue masses to investigate some of the methodological factors potentially affecting the ability of PET in assessing tumor malignancy. Twenty-nine patients with soft tissue masses were evaluated using a 6-hour scanning protocol, consisting of a 2-hour dynamic acquisition, which commenced immediately after tracer injection, followed by 2 further static scans, which started 4 and 6 hours after FDG administration.…”

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confidence: 99%

Use of Dual-Point Fluorodeoxyglucose Imaging to Enhance Sensitivity and Specificity

Schillaci

2012

Seminars in Nuclear Medicine

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Positron emission tomography (PET) and positron emission tomography/computed tomography imaging with fluorodeoxyglucose (FDG) are widely used as a powerful evaluation modality in oncological nuclear medicine not only for detecting tumors but also for staging and for therapy monitoring. Nevertheless, there are numerous causes of FDG uptake in benign processes seen on PET images. In fact, the degree of FDG uptake is related to the cellular metabolic rate and the number of glucose transporters. FDG accumulation in tumors is due, in part, to an increased number of glucose transporters in malignant cells. However, FDG is not specific for neoplasms: a similar situation exists in inflammation; activated inflammatory cells demonstrate increased expression of glucose transporters. Therefore, there is growing interest in improving the specificity of FDG-PET in patients with cancer. Preliminary studies showed that in several neoplasms, the uptake of FDG continues to increase for hours after radiopharmaceutical injection, and this difference in the time course of FDG uptake could be useful to improve the accuracy of PET to distinguish benign lesions from malignant ones. Also in experimental cultures, dual-point acquisition (early at 40-60 minutes postinjection and delayed at 90-270 minutes) demonstrated that it is able to differentiate inflammatory from neoplastic tissue. In general, inflammatory tissue is expected to reduce FDG uptake as the time goes by, whereas the uptake in the neoplastic lesions is supposed to be increasing. There is evidence in the recent literature of the clinical usefulness of dual-time-point FDG-PET imaging in a wide variety of malignancies, including those of head and neck, lung, breast, gallbladder, cervix, liver, and in brain tumors. A lesion is likely to be malignant if the standard uptake value increases over time, whereas it is likely to be benign if the standard uptake value is stable or decreases. It is worth noting that in many of these studies, dual-time-point PET improved not only the specificity but also the sensitivity in assessing breast, pulmonary, liver, and other tumors because of increased lesion-to-background ratio, as a consequence of FDG washout from the surrounding normal tissues and increasing neoplastic uptake. Semin Nucl Med 42:267-280

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A PET study of 18 FDG uptake in soft tissue masses

Cited by 271 publications

References 8 publications

FDG–PET. A possible prognostic factor in head and neck cancer

FDG–PET. A possible prognostic factor in head and neck cancer

Dual-Time 18F-FDG PET/CT Imaging in Initial Locoregional Staging of Breast Carcinoma: Comparison with Conventional Imaging and Pathological Prognostic Factors

Use of Dual-Point Fluorodeoxyglucose Imaging to Enhance Sensitivity and Specificity

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