Fat necrosis after abdominal surgery: A pitfall in interpretation of FDG-PET/CT

Davidson, Tima; Lotan, Eyal; Klang, Eyal; Nissan, Johnatan; Goldstein, Jeffrey; Goshen, Elinor; Ben‐Haim, Simona; Apter, Sara; Chikman, Bar

doi:10.1007/s00330-017-5201-5

Cited by 17 publications

(17 citation statements)

References 32 publications

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“…The trans-axial field of view and pixel size of the PET images reconstructed for fusion were 57.6 cm and 4 mm, respectively, with a matrix size of 144 × 144. The technical parameters used for CT imaging were pitch 0.8, gantry rotation speed 0.5 s/rotation, 120 kVp, 250 mAs, 3 mm slice thickness, and specific breath-holding instructions [ 14 , 15 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…CT images were fused with the PET data and were used to generate a map for attenuation correction. PET images were reconstructed using a line of response protocol with CT attenuation correction, and the reconstructed images were generated for review on a computer workstation (Extended Brilliance Workstation, Philips Medical Systems, Cleveland OH, US [ 14 , 15 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

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The Utility of 18FDG-PET/CT in Diagnosing Fever of Unknown Origin: The Experience of a Large Tertiary Medical Center

Mahajna

Vaknin

Shimol

et al. 2021

IJERPH

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Fever of unknown origin (FUO) poses a diagnostic challenge, and 18-fluorodexoyglucose positron emission tomography with computed tomography (18FDG-PET/CT) may identify the source. We aimed to evaluate the diagnostic yield of 18FDG-PET/CT in the work-up of FUO. The records of patients admitted to Sheba Medical Center between January 2013 and January 2018 who underwent 18FDG-PET/CT for the evaluation of FUO were reviewed. Following examination of available medical test results, 18FDG-PET/CT findings were assessed to determine whether lesions identified proved diagnostic. Of 225 patients who underwent 18FDG-PET/CT for FUO work-up, 128 (57%) met inclusion criteria. Eighty (62.5%) were males; mean age was 59 ± 20.3 (range: 18–93). A final diagnosis was made in 95 (74%) patients. Of the 128 18FDG-PET/CT tests conducted for the workup of FUO, 61 (48%) were true positive, 26 (20%) false positive, 26 (20%) true negative, and 15 (12%) false negative. In a multivariate analysis, weight loss and anemia were independently associated with having a contributary results of 18FDG-PET/CT. The test yielded a sensitivity of 70%, specificity of 37%, positive predictive value of 70%, and negative predictive value of 37%. 18FDG-PET/CT is a valuable tool in the diagnostic workup of FUO. It proved effective in diagnosing almost half the patients, especially in those with anemia and weight loss.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The Utility of 18FDG-PET/CT in Diagnosing Fever of Unknown Origin: The Experience of a Large Tertiary Medical Center

Mahajna

Vaknin

Shimol

et al. 2021

IJERPH

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“…The protocol of the PET CT scans was similar to those described in previously reported studies [11,12].…”

Section: Image Assessmentmentioning

confidence: 99%

The Usefulness of PET/CT In Detecting and Managing Cancers With Unknown Primary Site Depends on Histological Subtype

Nissan

Amit

Baron

et al. 2021

Preprint

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Introduction: We assessed the role of PET/CT in identifying and managing cancer of unknown primary site (CUP). Methods: We reviewed 64 patients' PET/CT scans with CUP performed during 2012–2019. Results: The median age was 65 years. Of 138-FDG-avid lesions, the mean SUVmax was10.6±6.0. Primary tumors (PT) were detected in 28(44%) patients. Detection was positive in only one(10%) patient with squamous cell carcinoma (SCC) histology, compared to 4/14(29%) with poorly differentiated carcinoma, 4/9(44%) with adenocarcinoma, 18/30(60%) of those for whom the origin could be presumed (p= 0.034 for SCC compared to other histologies). The mean age, mean SUVmax, and the distribution of organ involvement were similar between patients with and without discovered PTs, and also between patients with SCC and with the other histologies combined. However, those with SCC were less likely than the others to present with multi-lesion involvement, p<0.001. PET/CT interpretations apparently affected treatment of 8/28(29%) patients with PT detected and in none of the 35 whose PT was not discovered, p<0.001. Conclusion: PET/CT detected PT in almost half of CUP. However, it did not appear beneficial in those with SCC histology. PET/CT showed limited overall value in guiding clinical management but benefited a subgroup with discovered PT.

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“…The CT component was performed in accordance with the hospital's standard protocol, with routine use of both oral and intravenous contrast media unless either was contraindicated. The following technical parameters were used for CT imaging: pitch 0.8, gantry rotation speed 0.5, 120 kVp, 250 mAs, 3-mm slice thickness, and specific breath-holding instructions [18][19][20] .…”

mentioning

confidence: 99%

“…The diagnostic CT images were used for fusion with the PET data and to produce a map for attenuation correction. PET images were generated with CT attenuation correction utilizing a line of response protocol, and the reconstructed images were constructed for review (EWB, Extended Brilliance Workstation, Philips Medical Systems, Cleveland OH, USA) [18][19][20] .…”

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confidence: 99%

Penile secondary lesions: a rare entity detected by PET/CT

Davidson

Domachevsky

Giladi

et al. 2021

Sci Rep

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While penile metastases are rare, PET/CT has facilitated their detection. We aimed to describe penile secondary lesions (PSL) identified by PET/CT. We reviewed 18F-FDG and Ga68-PSMA PET/CT records performed in a single center during May 2012-March 2020, for PSL. Of 16,774 18F-FDG and 1,963 Ga68-PSMA-PET scans, PSL were found in 24(0.13%) men with a mean age of 74. PSMA detected PSL in 12 with prostate cancer; FDG identified PSL in 4 with lymphoma, 3 with colorectal cancer, 2 with lung cancer, and one each with bladder cancer, pelvic sarcoma, and leukemia. Mean SUVmax of PSL was 7.9 ± 4.2 with focal uptake in 13(54%). Mean lesion size was 16.5 ± 6.8 mm; 8 at the penile root, 4 along the shaft, and 1 at the glans. CT detected loss of the penile texture in 15(63%). PSL were observed only during relapse or follow-up of disseminated disease. Among those with prostate cancer, PSA varied widely. Fifteen (62.5%) died, at a mean 13.3 ± 15.9 months following PSL demonstration, nine had non-prostate malignancies. PET/CT identified and characterized PSL in a fraction of cancer patients, most commonly those with prostate cancer. PSL universally surfaced in advanced disease, and signaled high mortality, especially in non-prostate cancers.

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Fat necrosis after abdominal surgery: A pitfall in interpretation of FDG-PET/CT

Abstract: • Postsurgical fat necrosis may mimic cancer in FDG-PET/CT. • Follow-up of fat necrosis showed no increase in FDG intensity. • CT follow-up showed a decrease in lesion size. • FDG uptake did not correlate with time lapsed from surgery.

Cited by 17 publications

References 32 publications

The Utility of 18FDG-PET/CT in Diagnosing Fever of Unknown Origin: The Experience of a Large Tertiary Medical Center

The Utility of 18FDG-PET/CT in Diagnosing Fever of Unknown Origin: The Experience of a Large Tertiary Medical Center

The Usefulness of PET/CT In Detecting and Managing Cancers With Unknown Primary Site Depends on Histological Subtype

Penile secondary lesions: a rare entity detected by PET/CT

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