Literature DB >> 33452635

Whole-body parametric [18F]-FDG PET/CT improves interpretation of a distant lesion as venous embolus in a lung cancer patient.

Michael Messerli1, Fotis Kotasidis2, Daniela A Ferraro1, Ken Kudura1, Valerie Treyer1, Josephine Trinckauf1, Corina Weyermann1, Martin Hüllner1, Philipp Kaufmann1, Irene A Burger3,4.   

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Year:  2021        PMID: 33452635      PMCID: PMC8113174          DOI: 10.1007/s00259-020-05176-0

Source DB:  PubMed          Journal:  Eur J Nucl Med Mol Imaging        ISSN: 1619-7070            Impact factor:   9.236


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Despite well-known limitations of static analysis of FDG-PET images, the ease of its use leads to a widespread use of semi-quantitative indices, most commonly the standardized uptake value (SUV). In contrast to static imaging, dynamic imaging with kinetic modeling allows estimation of quantitative parameters, independent of uptake time, body weight, or injected dose, therefore potentially improving the interpretation of FDG-accumulation [1]. With improvements in scanner sensitivity and reconstruction algorithms, recently proposed multipass whole-body (WB) protocols in conjunction with image-derived input functions (IF) have made WB kinetic parameter estimation feasible [2]. Here we present a case of a patient with bronchial cancer and a venous thrombus in the left brachiocephalic vein (green arrows) with unclear FDG accumulation in the left axillary region (blue arrows) on SUV images (a). The patient was injected (134.1 MBq) and data over the heart were acquired for 7 min (blue insert: 155–180 s), followed by 10 WB passes (35 s/bed). The IF was extracted from the descending aorta and after appropriate corrections was used to estimate glucose influx (Ki) (b) and volume of distribution (Vd) (c) [3]. Note the high tumor uptake (red arrows) while missing accumulation in the axillar region on Ki (b), compared to high uptake in venous regions but low accumulation in the primary tumor on Vd (c). Standard static imaging was performed after the WB dynamic protocol (2.5 min/bed) (a), axial images are given for both areas of interest (a1/a2, scaled SUV 0-6). Only after review of the parametric images, the cause of FDG accumulation was linked to venous collaterals due to thrombosis.
  1 in total

1.  Case report: 18F-FDG PET confirmed pupil-sparing third nerve palsy heralding aseptic cavernous sinus embolism in patient with chest malignancy.

Authors:  Jianmei Xiong; Huanbo Liu; Jianyong Li; Jiajia Hou; Fang Cui
Journal:  Front Surg       Date:  2022-08-31
  1 in total

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