المؤلفون: Klein R; University of Ottawa Heart Institute, Cardiac PET Centre, 40 Ruskin St., Ottawa, ON, K1Y 4W7, Canada, rklein@ottawaheart.ca., Hung GU, Wu TC, Huang WS, Li D, deKemp RA, Hsu B

المصدر: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2014 Dec; Vol. 21 (6), pp. 1075-88. Date of Electronic Publication: 2014 Oct 04.

نوع المنشور: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Elsevier Inc. on behalf of American Society of Nuclear Cardiology Country of Publication: United States NLM ID: 9423534 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-6551 (Electronic) Linking ISSN: 10713581 NLM ISO Abbreviation: J Nucl Cardiol Subsets: MEDLINE

مواضيع طبية MeSH: Fractional Flow Reserve, Myocardial* , Technetium Tc 99m Sestamibi*, Coronary Artery Disease/*diagnostic imaging , Image Interpretation, Computer-Assisted/*methods , Tomography, Emission-Computed, Single-Photon/*methods , Tomography, X-Ray Computed/*methods, Aged ; Coronary Artery Disease/physiopathology ; Coronary Circulation ; Feasibility Studies ; Female ; Humans ; Male ; Multimodal Imaging/methods ; Myocardial Perfusion Imaging/methods ; Observer Variation ; Radiopharmaceuticals ; Reproducibility of Results ; Sensitivity and Specificity

مستخلص: Purpose: Myocardial blood flow (MBF) quantification with dynamic SPECT could lead to widespread utilization of MBF imaging in clinical practice with little cost increase over current standard SPECT myocardial perfusion imaging. This work evaluates the feasibility and operator-dependent variability of MBF and flow reserve measurements with (99m)Tc-sestamibi (MIBI) dynamic SPECT imaging using a standard dual-head SPECT camera.
Methods: Twenty-eight patients underwent dipyridamole-stress and rest imaging with dynamic SPECT/CT acquisition. Quantitative images were iteratively reconstructed with all physical corrections and then myocardial and arterial blood regions of interest (ROI) were defined semi-automatically. A compartmental model was fitted to these ROI-sampled time-activity-curves, and flow-dependent MIBI extraction correction was applied to derive regional MBF values. Myocardial flow reserve (MFR) was estimated as stress/rest MBF ratio. MBF and MFR in low and high risk populations were evaluated for ability to detect disease. Images were each processed twice (≥7 days apart) by one expert and one novice operator to evaluate intra- and inter-operator variability of MBF and MFR measurement in the three coronary artery vascular territories.
Results: Mean rest flow, stress flow, and MFR values were 0.83, 1.82 mL·minute(-1)·g(-1), and 2.45, respectively. For stress/rest MFR, the inter-operator reproducibility was r(2) = 0.86 with RPC = 1.1. Stress MBF and MFR were significantly reduced (P < .05) in high risk (n = 9) vs low risk populations (n = 19), indicating ability to detect disease. For expert and novice operators very good intra-operator correlations of r(2) = 0.98 and 0.95 (n = 168, P < .001) were observed for combined rest and stress regional flow values. Bland-Altman reproducibility coefficients (RPC) were 0.25 and 0.47 mL·minute(-1)·g(-1) for the expert and novice operators, respectively (P < .001). Inter-operator correlation was r(2) = 0.91 and Bland-Altman RPC = 0.58 mL·minute(-1)·g(-1) (n = 336).
Conclusions: MBF and reserve measurements using (99m)Tc-sestamibi on a traditional, two-headed camera with fast rotation and with quantitative dynamic SPECT appears to be feasible, warranting further investigation.

المؤلفون: Huang WY; Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan., Kao CH, Huang WS, Chen CM, Chang LP, Lee MS, Chao HL, Chiu CH, Lo CH, Jen YM

المصدر: Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2013 Oct; Vol. 54 (10), pp. 1710-6. Date of Electronic Publication: 2013 Aug 22.

نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Society of Nuclear Medicine Country of Publication: United States NLM ID: 0217410 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-5667 (Electronic) Linking ISSN: 01615505 NLM ISO Abbreviation: J Nucl Med Subsets: MEDLINE

مواضيع طبية MeSH: Contrast Media* , Fluorodeoxyglucose F18* , Multimodal Imaging* , Positron-Emission Tomography* , Radiosurgery* , Tomography, X-Ray Computed*, Carcinoma, Hepatocellular/*surgery , Liver Neoplasms/*surgery, Adult ; Aged ; Carcinoma, Hepatocellular/diagnostic imaging ; Female ; Humans ; Liver Neoplasms/diagnostic imaging ; Male ; Middle Aged ; Prognosis ; Survival Analysis ; Treatment Outcome

مستخلص: Unlabelled: The application of stereotactic ablative radiotherapy (SABR) to hepatocellular carcinoma (HCC) is emerging. To identify pretreatment prognostic indicators is crucial for patient selection and optimal individual therapy. The aim of this study was to determine whether (18)F-FDG PET and a combined (18)F-FDG-contrast CT parameter could be useful tools to predict tumor control for patients with HCC treated by SABR.
Methods: We retrospectively identified 31 patients (41 tumors) who underwent (18)F-FDG PET before SABR between November 2007 and September 2011. (18)F-FDG PET parameters were collected as prognostic indicators, including visual PET scale (+/-), maximal standardized uptake value (SUV) of the tumor (T SUV max), ratio of T SUV max to maximal normal-liver SUV, ratio of T SUV max to mean normal-liver SUV, and score combining tumor volume and T SUV max (CT/(18)F-FDG PET score). They underwent SABR with a median dose of 42 Gy (ranging from 30 to 50 Gy) in 4-5 fractions. (18)F-FDG PET parameters and clinical factors were tested as predictors of tumor control and patient survival.
Results: The median follow-up time was 18 mo. Among the parameters examined, T SUV max and CT/(18)F-FDG PET score were significantly correlated with tumor control. T SUV max with a cutoff value of 3.2 was the most significant prognostic indicator. The 4-y control rate was 86.2% in tumors with a T SUV max of 3.2 or less but only 37.5% in those with a T SUV max of more than 3.2 (adjusted hazard ratio, 9.40; 95% confidence interval, 1.18-74.76; P = 0.034). CT/(18)F-FDG PET score (≤ 4 vs. >4) was also a significant predictor of tumor control after SABR. Tumors with a CT/(18)F-FDG PET score of more than 4 had a 5.23-fold risk of tumor failure. After adjustment for factors of sex, American Joint Committee on Cancer stage, Cancer of the Liver Italian Program score, and Child-Pugh classification, tumors with a score of more than 4 had a 4.96-fold risk of failure after SABR, compared with tumors with a score of 4 or less. For overall survival, none was statistically significant.
Conclusion: The use of (18)F FDG PET to predict tumor control is feasible. T SUV max with a cutoff value of 3.2 is the best prognostic indicator. We suggest that (18)F-FDG PET may be a reference for prognostic prediction, patient selection, and radiation dose adjustment for HCC patients treated with SABR.

المؤلفون: Chang MC; Nuclear Medicine Department, Changhua Christian Hospital, Changhua., Chen JH, Liang JA, Huang WS, Cheng KY, Kao CH

المصدر: Clinical nuclear medicine [Clin Nucl Med] 2013 Aug; Vol. 38 (8), pp. 623-9.

نوع المنشور: Journal Article; Meta-Analysis

بيانات الدورية: Publisher: Lippincott Country of Publication: United States NLM ID: 7611109 Publication Model: Print Cited Medium: Internet ISSN: 1536-0229 (Electronic) Linking ISSN: 03639762 NLM ISO Abbreviation: Clin Nucl Med Subsets: MEDLINE

مواضيع طبية MeSH: Multimodal Imaging/*methods , Peritoneal Neoplasms/*diagnostic imaging , Positron-Emission Tomography/*methods , Tomography, X-Ray Computed/*methods, Animals ; Humans

مستخلص: Unlabelled: The present study assessed the diagnostic performances of (18)F-FDG PET or PET/CT in detecting peritoneal carcinomatosis in patients with cancer.
Methods: Through a search of MEDLINE (January 1998 to September 2012), an overall weighted average for sensitivity and specificity was calculated using the weighted averages of the sample sizes in each relevant study. Pooled estimates of positive and negative likelihood ratios were calculated using fixed and random effects models, respectively, according to the heterogeneity among studies. A summary receiver operating characteristics (sROC) curve was constructed and the area under the sROC curve (AUC) was calculated. To explore heterogeneity, due to sources other than threshold effects, I-square was calculated.
Results: The present study included analyses of patients (n = 513) from 7 studies. Results indicated a significant heterogeneity for sensitivity and specificity (I(2) > 50% and P < 0.05). The overall pooled estimates for sensitivity and specificity of FDG PET or PET/CT scans in the detection of peritoneal carcinomatosis were 72.4% (95% CI, 64.4%-79.5%) and 96.7% (95% CI, 94.4%-98.3%), respectively. The positive likelihood ratio was 10.414 (95% CI, 6.195-17.506) and the negative likelihood ratio 0.312 (95% CI, 0.159-0.612). The AUC was 0.9404. The overall diagnostic accuracy (Q* index) was 87.8%.
Conclusion: The high specificity may provide the reliability of a positive FDG PET or PET/CT to detect peritoneal carcinomatosis in patients with cancer. FDG PET or PET/CT has only weak power to exclude the presence of peritoneal carcinomatosis. By a good overall diagnostic accuracy, FDG PET or PET/CT may prove beneficial to surgeons when selecting appropriate patients on whom to perform laparoscopy or laparotomy.

المؤلفون: Chang CY; Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, 325 Section 2 Cheng-Kung Road, Taipei, Taiwan., Tzao C, Lee SC, Cheng CY, Liu CH, Huang WS, Ku CH, Lee JK, Oliver Wong CY

المصدر: Molecular imaging and biology [Mol Imaging Biol] 2010 Apr; Vol. 12 (2), pp. 204-9. Date of Electronic Publication: 2009 Jun 20.

نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Springer Country of Publication: United States NLM ID: 101125610 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1860-2002 (Electronic) Linking ISSN: 15361632 NLM ISO Abbreviation: Mol Imaging Biol Subsets: MEDLINE

مواضيع طبية MeSH: Fluorodeoxyglucose F18* , Positron-Emission Tomography* , Tomography, X-Ray Computed*, Lung Neoplasms/*diagnostic imaging , Solitary Pulmonary Nodule/*diagnostic imaging, Adult ; Aged ; Aged, 80 and over ; Demography ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results

مستخلص: Objectives: The objective of this study was to evaluate the increased diagnostic benefit of integrated positron emission tomography/computed tomography (PET/CT) interpretation in evaluating solitary pulmonary nodules for malignancy.
Methods: One hundred seventeen patients (67 men and 50 women; mean age +/- SD, 61.7 +/- 13.6 years, range, 31-86 years) with indeterminate solitary pulmonary nodules and no previous history of malignancy were analyzed. PET/CT was performed with an integrated PET/CT scanner (Siemens Biograph BGO duo) 1 h after an intravenous injection of 370 MBq (10 mCi) (18)F-fluorodeoxyglucose. Patients fasted for 6 h before imaging. PET was interpreted alone or combined with CT and was graded according to a five-point scale. A malignant diagnosis was based on histological findings or a clinical and radiological follow-up after at least 24 months. The diagnostic performances of PET alone and integrated PET/CT interpretation were evaluated using discriminant analysis.
Results: PET alone correctly classified 85% of nodules and integrated PET/CT interpretation increased the correct classification to 89%, with similar sensitivity and specificity of 88% and 89%, respectively. False-positive PET results mainly resulted from granulomatous disorders. Four (50%) of the eight cases deemed indeterminate on PET alone were resolved with combined PET/CT interpretation.
Conclusions: Although the benefit attributable to the CT component was limited when integrated PET/CT was used, PET and CT acted synergistically to significantly increase the diagnostic veracity for PET-indeterminate nodules.

المؤلفون: Wong CY; Department of Nuclear Medicine, William Beaumont Hospital, 3601 W. Thirteen Mile Road, Royal Oak, MI 48073-6769, USA. owong@beaumont.edu, Noujaim D, Fu HF, Huang WS, Cheng CY, Thie J, Dalal I, Chang CY, Nagle C

المصدر: Molecular imaging and biology [Mol Imaging Biol] 2009 Jul-Aug; Vol. 11 (4), pp. 283-90. Date of Electronic Publication: 2009 Mar 27.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Springer Country of Publication: United States NLM ID: 101125610 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1860-2002 (Electronic) Linking ISSN: 15361632 NLM ISO Abbreviation: Mol Imaging Biol Subsets: MEDLINE

مواضيع طبية MeSH: Tomography, X-Ray Computed*, Fluorodeoxyglucose F18/*pharmacokinetics , Head and Neck Neoplasms/*diagnostic imaging , Head and Neck Neoplasms/*metabolism , Radiopharmaceuticals/*pharmacokinetics, Adult ; Aged ; Algorithms ; Blood Glucose ; Female ; Humans ; Linear Models ; Male ; Middle Aged ; Positron-Emission Tomography ; Time Factors

مستخلص: Objectives: The aim of this study was to define and investigate the time sensitivity of tumors by variable dual-time fluorodeoxyglucose positron emission tomography (FDG PET).
Methods: Variable dual-time (t) protocol (P) FDG PET-computed tomography (CT) scans from 40 patients with pathologically proven head and neck tumors without brain metastasis were analyzed. The first protocol (P.I) consisted of 26 patients with early (E) and delayed (D) PET-CT obtained at 106 +/- 15 and 135 +/- 16 min after injection of 16.3 +/- 1.9 mCi FDG. The second protocol (P.II) recruited 14 patients with E- and D-PET performed at 54 +/- 13 and 151 +/- 28 min after injection of 9.6 +/- 1.7 mCi FDG. The maximum standardized uptake values (SUVs) were measured in the primary tumor (CA1) and the cerebellum (CBL). The time sensitivity (S) was defined as d{ln(SUV)}/d{ln(t)} and its value was obtained by linear regression of ln(D-SUV/E-SUV) vs ln(t (D)/t (E)). Patients with cerebellar variations greater than 30% in SUV between E- and D-PET was excluded from the analysis.
Results: Two patients from P.I were excluded due to wide cerebellar SUV variations. D-SUV were significantly higher than E-SUV in CA1 for both P.I (18.9 +/- 6.9 vs 14.8 +/- 5.6, p < 0.0005) and P.II (11.5 +/- 7.9 vs 9.7 +/- 6.9, p = 0.013). The S values for CA1 in P.I and P.II were 0.67 and 0.17, respectively. The D-SUV were also higher than E-SUV in CBL for both P.I (12.5 +/- 1.6 vs 11.6 +/- 1.6, p < 0.0005) and P.II (7.6 +/- 1.6 vs 7.0 +/- 1.6, p = 0.008). The S values for CBL in P.I and P.II were 0.47 and 0.04, respectively, which were over 1.4-fold smaller than that of CA1, suggesting fundamental kinetic differences between CA1 and CBL.
Conclusions: The time sensitivity factor reflects another kinetic parameter of tumor metabolism besides SUV when using variable dual-time FDG PET. It offers another useful diagnostic tool in optimizing choices of dual-time protocols for oncologic PET-CT and in reducing SUV variations due to time interval differences with corrections using S.

المؤلفون: Chundru S; Department of Nuclear Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073-6769, USA., Wong CY, Wu D, Balon H, Palka J, Chang CY, Gaskill M, Cheng CY, Huang WS, Fink-Bennett D

المصدر: Nuclear medicine communications [Nucl Med Commun] 2008 Jul; Vol. 29 (7), pp. 623-7.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: England NLM ID: 8201017 Publication Model: Print Cited Medium: Print ISSN: 0143-3636 (Print) Linking ISSN: 01433636 NLM ISO Abbreviation: Nucl Med Commun Subsets: MEDLINE

مواضيع طبية MeSH: Granulomatous Disease, Chronic/*diagnosis , Positron-Emission Tomography/*methods , Solitary Pulmonary Nodule/*diagnosis , Tomography, X-Ray Computed/*methods, Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms/diagnosis ; Male ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Subtraction Technique

مستخلص: Objectives: To evaluate combined PET-computed tomography (CT) criteria for differentiating between granulomatous disease (GD) and malignancy (CA) in oncologic PET-CT studies.
Methods: Sixty-two patients who were referred for fluoro-2-deoxyglucose (FDG) PET-CT evaluation of pulmonary lesion(s) without a history of concurrent infection were studied. PET-CT was performed 1.5 h after intravenous administration of 555 MBq 18F-FDG in the fasting state with oral contrast. Combined PET-CT criteria including (i) calcifications (Ca2+) within lymph nodes, (ii) Ca2+ in lung nodules, (iii) liver and/or spleen Ca2+, (iv) locations of lung lesion(s), (v) hilar FDG uptake, (vi) comparison of lung versus maximum mediastinal FDG uptake, (vii) lymph node uptake not in the most probable lymphatic drainage pathway from a particular lung lesion, and (viii) extra pulmonary abnormal FDG uptake were each assigned a numerical score (0-3) with progressively higher score and sum of scores toward the increasing likelihood of GD. These patients either had pathological confirmation by biopsy/resection or were followed radiographically for a period of 2 years (CA=13; GD=49). Discriminant analysis was performed on all the above criteria with this gold standard. Simple t-test and box plot analysis were also performed on the summation of the scores (from 0 in CA to 13 in GD).
Results: When all eight criteria were entered into discriminant analysis, the combined PET-CT criteria classified correctly 71% of patients with a sensitivity of 65% and specificity of 92% for GD. The most significant discriminating criterion was FDG uptake in the lung lesion(s) less than maximum mediastinal uptake (P=0.01). The sum scores in GD and CA were significantly different (4.9+/-2.4 vs. 3.2+/-1.5, respectively, P=0.014). Box plots showed a clear separation at a cut-off value of around 3.5.
Conclusion: Results show that the set of combined PET-CT criteria are highly specific for GD, which is not necessarily a nuisance during oncologic evaluation. Knowledge of these criteria may attribute some of the abnormal PET findings to GD, which is a useful asset for quick recognition and clinical interpretation.

المؤلفون: Chang CY; Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Republic of China)., Tsai CS, Peng YJ, Huang WS

المصدر: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2007 Sep-Oct; Vol. 14 (5), pp. 754-7.

نوع المنشور: Case Reports; Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Elsevier Inc. on behalf of American Society of Nuclear Cardiology Country of Publication: United States NLM ID: 9423534 Publication Model: Print Cited Medium: Internet ISSN: 1532-6551 (Electronic) Linking ISSN: 10713581 NLM ISO Abbreviation: J Nucl Cardiol Subsets: MEDLINE

مواضيع طبية MeSH: Fluorodeoxyglucose F18*, Lymphoma, B-Cell/*diagnosis , Positron-Emission Tomography/*methods , Tomography, X-Ray Computed/*methods, Diagnosis, Differential ; Heart Transplantation/adverse effects ; Heart Transplantation/diagnostic imaging ; Humans ; Male ; Middle Aged ; Myocardial Ischemia/diagnosis ; Myocardial Ischemia/etiology ; Radiopharmaceuticals ; Subtraction Technique

المؤلفون: Chang CY; Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China., Lin LF, Lin YS, Peng YJ, Huang WS, Cherng SC

المصدر: Clinical nuclear medicine [Clin Nucl Med] 2007 May; Vol. 32 (5), pp. 390-2.

نوع المنشور: Case Reports; Journal Article

بيانات الدورية: Publisher: Lippincott Country of Publication: United States NLM ID: 7611109 Publication Model: Print Cited Medium: Print ISSN: 0363-9762 (Print) Linking ISSN: 03639762 NLM ISO Abbreviation: Clin Nucl Med Subsets: MEDLINE

مواضيع طبية MeSH: Giant Cell Tumors/*diagnosis , Laryngeal Neoplasms/*diagnosis , Leydig Cell Tumor/*diagnosis , Positron-Emission Tomography/*methods , Thyroid Neoplasms/*diagnosis , Tomography, X-Ray Computed/*methods, Diagnosis, Differential ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Radiopharmaceuticals ; Thyroid Gland/diagnostic imaging ; Thyroid Gland/pathology

المؤلفون: Lee JK; Department of Nuclear Medicine, Chung Shan University Hospital, Taichung, Taiwan. jklee4528@yahoo.com.tw, Tyan YS, Huang WS

المصدر: European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2004 Apr; Vol. 31 (4), pp. 528-31. Date of Electronic Publication: 2004 Jan 14.

نوع المنشور: Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Validation Study

بيانات الدورية: Publisher: Springer-Verlag Berlin Country of Publication: Germany NLM ID: 101140988 Publication Model: Print-Electronic Cited Medium: Print ISSN: 1619-7070 (Print) Linking ISSN: 16197070 NLM ISO Abbreviation: Eur J Nucl Med Mol Imaging Subsets: MEDLINE

مواضيع طبية MeSH: Thallium*, Carcinoma, Squamous Cell/*diagnosis , Mouth Neoplasms/*diagnosis , Neoplasm Recurrence, Local/*diagnosis , Tomography, Emission-Computed, Single-Photon/*methods , Tomography, X-Ray Computed/*methods, Adult ; Aged ; Carcinoma, Squamous Cell/diagnostic imaging ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Mouth Neoplasms/diagnostic imaging ; Neoplasm Recurrence, Local/diagnostic imaging ; Radiopharmaceuticals ; Reproducibility of Results ; Sensitivity and Specificity ; Subtraction Technique

مستخلص: This study was designed to compare the effectiveness of thallium-201 single-photon emission tomography (SPET) and conventional imaging, comprising computed tomography (CT) and magnetic resonance imaging (MRI), in the detection of residual/recurrent squamous cell carcinoma (SCC) of the oral cavity. Thirty-two patients with clinically suspected recurrent SCC of the oral cavity were recruited. All patients underwent (201)Tl SPET and CT or MRI within 2 weeks. The final diagnoses were based on the histology of the biopsy specimen. (201)Tl SPET and CT/MRI both accurately detected 17 of 18 residual/recurrent tumours. CT/MRI yielded eight false-positive studies, whereas (201)Tl SPET successfully excluded all tumours. The sensitivity, specificity, positive and negative predictive values and accuracy of (201)Tl SPET for the detection of recurrent oral SCC were 94%, 100%, 100%, 93% and 97%, respectively. The sensitivity, specificity, positive and negative predictive values and accuracy of CT/MRI for the detection of recurrent oral SCC were 94%, 43%, 68%, 86% and 72%, respectively. Thallium-201 SPET is more accurate than conventional imaging (CT or MRI) in differentiating residual/recurrent oral SCC from post-therapy changes.