Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

Gotthardt, Martin; Bleeker‐Rovers, Chantal P.; Boerman, Otto C.; Oyen, Wim J.G.

doi:10.2967/jnumed.110.076232

Cited by 232 publications

(197 citation statements)

References 75 publications

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“…Therefore, scheduling was problematic in some cases; however, given increasing evidence of the usefulness of PET/CT in patients with infectious diseases, we expect this situation to change. Third, PET/CT is a highly sensitive test for localizing abnormalities, since the results are a measure of inflammatory cell activity (19); therefore, the results could increase the risk of false-positive findings. To minimize this effect, we performed a discrepancy analysis and compared PET/CT results with clinical and microbiologic data and the results of conventional imaging techniques.…”

Section: Discussionmentioning

confidence: 99%

Role of ¹⁸F-FDG PET in Patients with Infectious Endocarditis

et al. 2014

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It was our purpose to evaluate the clinical impact of systematic PET/CT for the diagnosis of infectious embolisms in patients with infectious endocarditis (IE) in comparison with a historic cohort of IE patients managed without this technique. Detection of extracardiac lesions is an essential component of the management and outcome of IE. Studies using PET/CT for the evaluation of patients with IE are scarce, lack a control group, evaluate a small number of patients, or consist of case reports. Methods: We performed a prospective cohort study (47 patients with definite IE undergoing PET/ CT) with matched controls (94 patients with definite IE not undergoing PET/CT) from January 2012 to July 2013 in a tertiary hospital. The results were compared with those of conventional diagnostic techniques and clinical follow-up. Results: PET/CT revealed at least 1 lesion in 35 patients (74.5%): 18 showed an embolic complication, 8 showed pathologic uptake on the valves or cardiac devices, 1 showed both, 5 had incidental noninfectious findings, and the findings for 3 were considered false-positive. The validity values for the efficacy of PET/CT in the diagnosis of septic lesions were as follows: sensitivity, 100%; specificity, 80%; positive predictive value, 90%; and negative predictive value, 100%. PET/CT was the only initially positive imaging technique in 15 true-positive cases (55.5%). The systematic use of PET/CT was associated with a 2-fold reduction in the number of relapses (9.6% vs. 4.2%, P 5 0.25) and enabled significantly more infectious complications to be diagnosed (18% vs. 57.4%, P 5 0.0001). Conclusion: PET/CT enables the extent of IE to be assessed using a single test. It is fast (,2 h) and comfortable for the patient, gathers whole-body data, and detects significantly more infectious complications.

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Section: Discussionmentioning

confidence: 99%

Role of ¹⁸F-FDG PET in Patients with Infectious Endocarditis

et al. 2014

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“…Fluorine-18-l-3,4-dihydroxyphenylalanine ( 18 F-DOPA) PET/CT showed the highest sensitivity (98%) as compared with SRS and 11 C-5-hydroxy-l-tryptophan (11C-5-HTP) PET for the detection of GI-NETs, but not pNETs (Van Essen et al 2014). 11 C-5-HTP is a radiolabelled precursor in the serotonin synthesis: 11 C-5-HTP PET showed the highest sensitivity (96%) for the detection of pNETs as compared with CT, SRS or 18 F-DOPA PET (Gotthardt et al 2010) (Froberg et al 2009). Another radiopeptide used for targeting the GLP1R is (Lys(40)(Ahx-HYNIC-99m Tc/EDDA) NH2)-exendin-4, GLP1R imaging using this compound has been studied in MTCs (Pach et al 2013).…”

Section: Diagnostic Methods For Detecting Endocrine Pnsmentioning

confidence: 99%

Paraneoplastic endocrine syndromes

Dimitriadis

Angelousi

Weickert

et al. 2017

Endocrine-Related Cancer

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The majority of neoplasms are responsible for symptoms caused by mass effects to surrounding tissues and/or through the development of metastases. However, occasionally neoplasms, with or without endocrine differentiation, acquire the ability to secrete a variety of bioactive substances or induce immune cross-reactivity with the normal tissues that can lead to the development of characteristic clinical syndromes. These syndromes are named endocrine paraneoplastic syndromes when the specific secretory components (hormones, peptides or cytokines) are unrelated to the anticipated tissue or organ of origin. Endocrine paraneoplastic syndromes can complicate the patient's clinical course, response to treatment, impact prognosis and even be confused as metastatic spread. These syndromes can precede, occur concomitantly or present at a later stage of tumour development, and along with the secreted substances constitute the biological 'fingerprint' of the tumour. Their detection can facilitate early diagnosis of the underlying neoplasia, monitor response to treatment and/or detect early recurrences following successful initial management. Although when associated with tumours of low malignant potential they usually do not affect long-term outcome, in cases of highly malignant tumours, endocrine paraneoplastic syndromes are usually associated with poorer survival outcomes. Recent medical advances have not only improved our understanding of paraneoplastic syndrome pathogenesis in general but also enhanced their diagnosis and treatment. Yet, given the rarity of endocrine paraneoplastic syndromes, there is a paucity of prospective clinical trials to guide management. The development of well-designed prospective multicentre trials remains a priority in the field in order to fully characterise these syndromes and provide evidence-based diagnostic and therapeutic protocols.

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“…18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET) could also be used for detecting joint inflammation, infection and degenerative changes, owing to its very good sensitivity (up to 95% for osteomyelitis) [15].…”

Section: Other Imaging Studiesmentioning

confidence: 99%

Investigating persistent bilateral ankle swelling

Ciurtin

Pitiyage²,

Villiers³

et al. 2015

Int Arch Med

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This paper presents a case-report of a young female reporting sudden onset ankle swelling and pain, subcutaneous inflammation and progressive bilateral pes planus, in the context of no associated co-morbidities or risk factors for autoimmune and infective conditions. We discussed the appropriate imaging techniques which facilitated the diagnosis, which included Xrays, ultrasound and MRI scans used to rule out soft tissue injuries, stress fractures, inflammatory arthritis, and other causes of peripheral nerve entrapment and tendon pathology. The patient was diagnosed with polyarteritis nodosa based on deep skin biopsy. This is the first case ever reported showing significant peripheral nerve enlargement in the context of small vessel vasculitis.The imaging step-up approach is discussed in relation to the sensitivity and specificity of different imaging techniques for assessing joint, bone, tendon, ligament and nerve-related pathology. The rarity of this diagnosis in the context of a very common presentation emphasised the need for specialist referral and has significant educational value.

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Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

Cited by 232 publications

References 75 publications

Role of ¹⁸F-FDG PET in Patients with Infectious Endocarditis

Role of ¹⁸F-FDG PET in Patients with Infectious Endocarditis

Paraneoplastic endocrine syndromes

Investigating persistent bilateral ankle swelling

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Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

Cited by 232 publications

References 75 publications

Role of 18F-FDG PET in Patients with Infectious Endocarditis

Role of 18F-FDG PET in Patients with Infectious Endocarditis

Paraneoplastic endocrine syndromes

Investigating persistent bilateral ankle swelling

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Product

Resources

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Role of ¹⁸F-FDG PET in Patients with Infectious Endocarditis

Role of ¹⁸F-FDG PET in Patients with Infectious Endocarditis