The clinical value of 18F-FDG detection with a dual-head coincidence camera: a review

Abstract

Positron emission tomography (PET) has evolved into a technique that can accurately determine the distribution of positron-emitting radionuclides. The addition of a coincidence detection mode to a standard dual-head detector system has resulted in the option of single-photon and annihilation coincidence detection. This new device for imaging fluorine-18 2-fluoro-2-deoxy-D-glucose (18F-FDG) accumulation in neoplasms became commercially available in 1994. Besides conventional low-energy imaging in the collimated single-photon mode, it offers a relatively inexpensive opportunity to perform uncollimated PET by switching to the coincidence acquisition mode. This review summarises the clinical value of 18F-FDG detection with a dual-head coincidence camera in oncology. The results are compared with the overall results obtained using dedicated PET scanners. With respect to head and neck tumours, 18F-FDG coincidence mode gamma camera imaging (CGI) yields results that are in agreement with those obtained with dedicated PET scanners. With regard to other malignancies, such as lung cancer, lymphoma and brain tumours, data in the literature are too scarce to draw any definite conclusions. In general, the results of 18F-FDG CGI in tumours >15 mm seem to be comparable to those obtained with dedicated PET scanners, whereas in tumours <15 mm, the relative sensitivity of 18F-FDG CGI is approximately 80%. Using attenuation correction, the diagnostic yield of 18F-FDG CGI may increase. However, further clinical investigation is required to definitely establish its value in staging primary disease, therapy monitoring and assessment of tumour recurrence in clinical oncology.

Glucose Availability Regulates IFN-γ Production and p70S6 Kinase Activation in CD8+ Effector T Cells

“…Furthermore, growth factor deprivation leads to a drop in glycolysis, Glut1 expression, and intracellular ATP, all of which contribute to cell death (11,12). However, although these pathways have been studied in tumor cell lines, and the aerobic glycolysis phenotype has been shown to contribute to the malignant state (13), little is known regarding the particular requirement for glucose-dependent metabolism for TCR signaling and effector functions in normal T lymphocytes.…”

Glycolysis as a metabolic marker in orthotopic breast cancer, monitored by in vivo 13C MRS

“…FDG-PET has also been used for prognostic evaluation, for monitoring tumor therapy, and for early detection of recurrent cancer growth (2,29,33). 13 C magnetic resonance spectroscopy (MRS) with use of enriched [ 13 C]glucose can also serve to monitor in vivo glucose metabolism.…”

“…Furthermore, quantitative studies of biopsies from human cancers have indicated a positive correlation between tumor lactate concentration and incidence of metastasis (5,26,34,35). Increased glycolysis is associated with higher glucose uptake and metabolism, and it is now utilized as an indicator of malignancy by applying positron emission tomography (PET) with the glucose analog 2-[ 18 F]fluoro-2-deoxy-D-glucose (FDG) (2,23,29,33). FDG-PET has also been used for prognostic evaluation, for monitoring tumor therapy, and for early detection of recurrent cancer growth (2, 29, 33).…”

18F-FDG dual-headed gamma camera PET in detection of axillary nodal disease in patients with large or locally advanced breast cancer: Possible alternative staging of axilla

“…In the 2 patients with false negative results, histopathological examination demonstrated solitary involved nodes, the tumour deposits measuring 5 and 4 mm, respectively. Such small lesions are below the resolution of GCPET, which is limited by partial volume effects (29). The results also highlighted the efficacy of GCPET, sited in a district general hospital, to detect axillary lymph node metastases with high specificity in women with large and LABCs.…”