Detection of unexpected emergency diseases using FDG-PET/CT in oncology patients

Toriihara, Akira; Yamaga, Emi; Nakadate, Masashi; Oyama, Jun; Tateishi, Ukihide

doi:10.1007/s11604-017-0664-5

Cited by 9 publications

(6 citation statements)

References 14 publications

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“…DFSP can also present high SUVmax [ 15 ]. Most reports about hematoma and lymph node metastasis focus on detection of lesions but not on differentiation with other diseases, so they did not list data of SUVmax [ 16 , 17 ]. SUVmax of hematoma and lymph node metastasis has been reported as 3.4 and 6.3, but we still need more evidence [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Use of 18F-FDG-PET/CT for Retroperitoneal/Intra-Abdominal Soft Tissue Sarcomas

Liu

Wang

et al. 2018

Contrast Media & Molecular Imaging

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Rationale To assess the diagnostic value of 18F-FDG-PET/CT for different retroperitoneal soft tissue sarcomas (STS) and other similar tumors. To analyze the predictive value of 18F-FDG-PET/CT for histological grade and main prognostic factors. Methods 195 patients with 44 different diseases have been included. Relationship between SUVmax, Clinical, pathological, and prognostic information has been analyzed. Results Malignant tumors do not show higher SUVmax than benign ones (P=0.443). We divided all 44 different diseases into two groups; SUVmax of group 1 is significantly higher than group 2 (P ≤ 0.001). The ROC curve suggests 4.35 is the cutoff value to distinguish groups 1 and 2 (sensitivity = 0.789; specificity = 0.736). SUVmax correlates with Ki-67 index, mitotic count, vascular resection, histological grade, and recurrent STS without considering pathological diagnosis (P=0.001, P=0.012, P=0.002, P ≤ 0.001, and P=0.037, resp.). Conclusion 18F-FDG-PET/CT cannot simply distinguish malignant and benign tumors in retroperitoneal/intra-abdominal cavity; however, the SUVmax of malignant tumors, inflammatory pseudotumor, and PPGL group is higher than the SUVmax of benign tumors, lymph node metastasis, hematoma, and low malignant STS group. Guidance of “SUVmax location” may be helpful for biopsy and pathology dissection.

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Section: Discussionmentioning

confidence: 99%

Use of 18F-FDG-PET/CT for Retroperitoneal/Intra-Abdominal Soft Tissue Sarcomas

Liu

Wang

et al. 2018

Contrast Media & Molecular Imaging

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“…Abdominal CT plays the most important role in the diagnosis of ileus. Abdominal CT can not only identify the site that causes ileus but also predict the pathophysiology of the ileus with the symbolic signs such as closed loop sign [5], beak sign [6], whirl sign [7], and dirty fat sign [8]. Contrast-enhanced CT can further depict the ischemic changes of the affected intestine.…”

Section: Discussionmentioning

confidence: 99%

Successful Surgical Intervention of Strangulated Ileus with a Simple Cut of the External Iliac Vein without Vein Reconstruction

Hishikawa

Oura

Tomita

2021

Case Rep Gastroenterol

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A 67-year-old woman with epigastralgia was referred to our hospital. The patient had undergone hysterectomy, bilateral oophorectomy, omentectomy, and radical pelvic and para-aortic lymph node dissection for her ovarian cancer 6 years before. Despite the gastrointestinal decompression therapy under the presumed diagnosis of adhesive ileus, computed tomography scans taken 3 days after the onset of epigastralgia showed marked dilatation of the small intestine and an oval high-density mass, that is, thrombi, in the right femoral vein. Aggravation of ileus with the thrombi in the femoral vein made us to treat the patient with surgery. Intraoperative findings showed that the terminal ileum was strangulated by a gap between the exposed right external iliac vein and artery presumably formed by pelvic lymph node dissection. Distal ileum strangulated by the gap, however, showed no ischemic change with no surgically available peritoneum left around the external iliac vein. To prevent the pulmonary embolism and the recurrence of this type of ileus due to both the thrombi and the persistent gap, we released the strangulated ileum with a simple cut of the external iliac vein without vein reconstruction. The patient recovered uneventfully and was discharged on the 13th day after operation. The patient has been well with nominal right leg edema. In this situation, that is, internal hernia caused by external iliac vessels with thrombi in the femoral vein and no leg edema, a simple cut of the external iliac vein without vein reconstruction is a feasible treatment option.

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“…Currently, there is no ideal diagnostic tool that can be used alone to provide a definite and accurate diagnosis before surgery. Research efforts to find and introduce non-invasive, inexpensive and practically usable laboratory methodologies that do not depend on the user's experience in the diagnosis of AA are still ongoing [13]. AA is a well-known infection and inflammation.…”

Section: Gallium-68 Citrate Pet/ct Findings In An Experimental Model mentioning

confidence: 99%

“…Previous studies have reported the use of Indium-111 and 99m Tc-HMPAO-labelled leukocyte scintigraphy, 99m Tc-labelled human immune globulin and anti-granulocyte antibodies in AA cases [10,11]. In recent years, incidental cases of AA have been identified during 18 F-FDG PET/CT scans for oncologic screening [12][13][14][15]. One of the most popular agents used for infection and inflammation nuclear imaging is Gallium-67 ( 67 Ga), which has been used for imaging purposes for the past 40 years [16].…”

Section: Gallium-68 Citrate Pet/ct Findings In An Experimental Model mentioning

confidence: 99%

Gallium-68 citrate PET/CT findings in an experimental model of acute appendicitis in rabbits

Gültekin¹,

Uzunlu²,

Uğur³

et al. 2020

Preprint

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Objective Acute appendicitis (AA) is the most common abdominal surgical emergency worldwide. Several infection and inflammation imaging methods have been used in a limited number of cases. Gallium-68 ( 68 Ga) has recently been investigated as an infection and inflammation imaging agent. The aim of our study was to produce 68 Ga-citrate in an automated synthesis unit and perform 68 Ga-citrate PET/CT imaging in rabbits with experimentally induced AA. Furthermore, this study aimed to investigate and correlate PET/CT findings with those of histopathological and biochemical examinations. Methods 68 Ga-citrate was synthesized using the cationic method in an automatic synthesis unit. Twelve rabbits of the New Zealand strain ( Oryctolagus cuniculus ) were divided into two groups. In the AA group (n = 6), the appendices of the rabbits were surgically ligated. In the sham group (n = 6), the abdomen was surgically opened and closed. All rabbits were imaged using 68 Ga-citrate PET/CT at 12, 24 and 36 h following the establishment of the experimental models, and at 36 h, all rabbits were appendectomised. Appendices were examined histopathologically and blood samples were drawn from all rabbits at the beginning and end of the experimental process. Interleukin-6 (IL-6) and procalcitonin (Pct) levels were measured. PET/CT results were compared statistically with histopathological and biochemical references. Results The labelling efficiency of 68 Ga-citrate was more than 98%. The sensitivity, specificity and accuracy of 68 Ga-citrate PET/CT in AA were 100%, 83.3% and 81.7%, respectively. IL-6 and Pct levels at 36 h in the AA group were significantly higher than those in the sham group and at baseline (p < 0.05). Conclusions 68 Ga-citrate was synthesized in an automatic synthesis unit for the first time, and 68 Ga-citrate uptake was shown using PET/CT in a histopathologically and biochemically confirmed experimental AA rabbit model.

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Detection of unexpected emergency diseases using FDG-PET/CT in oncology patients

Abstract: Although rare, an unexpected emergency disease requiring urgent management can be detected using FDG-PET/CT in oncology patients.

Cited by 9 publications

References 14 publications

Use of 18F-FDG-PET/CT for Retroperitoneal/Intra-Abdominal Soft Tissue Sarcomas

Use of 18F-FDG-PET/CT for Retroperitoneal/Intra-Abdominal Soft Tissue Sarcomas

Successful Surgical Intervention of Strangulated Ileus with a Simple Cut of the External Iliac Vein without Vein Reconstruction

Gallium-68 citrate PET/CT findings in an experimental model of acute appendicitis in rabbits

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