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At least 19 recordsLinked to original sources
PubMed2000

Positron emission tomography with f18-fluorodeoxyglucose in the staging and preoperative evaluation of malignant pleural mesothelioma.

OBJECTIVES: The purpose of this study was to evaluate the utility of positron emission tomography with F18-fluorodeoxyglucose in the preoperative evaluation and staging of malignant mesothelioma in patients who were candidates for aggressive combined modality therapy. METHODS: Eighteen consecutive patients with biopsy-proven malignant mesothelioma underwent positron emission tomographic scanning. The results of positron emission tomographic imaging were compared with results obtained by computed tomography, mediastinoscopy, thoracoscopy, and pathologic examination of surgical specimens. All patients fasted and received an average of 14.5 +/- 2.7 mCi of F18-fluorodeoxyglucose for positron emission tomographic scanning. Attenuation-corrected whole-body and regional emission images of the chest and upper abdomen were acquired and formatted into transaxial, coronal, and sagittal images. RESULTS: All primary malignant mesotheliomas accumulated F18-fluorodeoxyglucose, and the mean standardized uptake value was 7. 6 (range, 3.33-14.85; n = 9). There were no false-negative results of positron emission tomography. Identification of occult extrathoracic metastases by positron emission tomography was the basis for excluding two patients from surgical therapy. There were two false-positive results of positron emission tomography: increased F18-fluorodeoxyglucose uptake in the contralateral chest that was negative by thoracoscopic biopsy (n = 1) and increased abdominal F18-fluorodeoxyglucose uptake after partial colectomy for diverticular disease (n = 1). CONCLUSIONS: Positron emission tomography can identify malignant pleural mesothelioma and appears to be a useful noninvasive staging modality for patients being considered for aggressive combined modality therapy.

Adult↗
PubMed1997

Metabolic imaging using F18-fluorodeoxyglucose to assess myocardial viability.

Over the past 10 years, F18-fluorodeoxyglucose (FDG) imaging with positron emission tomography (PET) has emerged as an important technique in the delineation of myocardial viability. Using this technique it has become possible to predict recovery of ventricular function after revascularization in patients with chronic coronary artery disease. Data from long-term (although retrospective) follow-up studies have demonstrated that patients with viable myocardium on FDG PET who do not undergo revascularization are prone to cardiac events, including cardiac death and non-fatal infarction. The same studies have pointed out that patients with viable tissue on FDG PET, who do undergo revascularization, improve substantially in symptoms related to congestive heart failure. To allow FDG imaging in centers without PET equipment, recent studies have evaluated the use of FDG imaging with single photon emission computed tomography (SPECT) and 511 keV collimators. Preliminary data using this alternative approach are promising, but need further confirmation. In this review the experience with FDG imaging (using either PET or SPECT) in the assessment of tissue viability in patients with coronary artery disease will be discussed.

Coronary Disease↗
PubMed1996

Course of impaired left ventricular function after acute myocardial infarction predicted with planar thallium-201 chloride and F18-fluorodeoxyglucose imaging.

UNLABELLED: Planar reset myocardial thallium-201 chloride (201Tl)/F18-fluorodeoxyglucose (FDG) imaging has been shown to distinguish between viable and non-viable tissue. Twenty-five patients (60 +/- 9 years) with acute myocardial infarction were studied using this technique within 6 +/- 2 days (T1) after infarction and again after 42 +/- 4 days (T6). Serial assessment of wall motion with 2D-echocardiography was performed to determine the predictive value of radionuclide indices for the course of impaired regional left ventricular function. No revascularization procedure was performed. Segmental 201Tl and FDG uptake was evaluated using circumferential profiles. Echocardiographic wall motion was scored as normal, hypokinetic or akinetic. Myocardial segments were considered non-viable if a match between 201Tl and FDG uptake was present, which is a concordant reduction in 201 Tl and FDG uptake (Group A). Myocardial segments were considered viable if: a mismatch was present between 201Tl and FDG uptake which was defined as a segmental FDG uptake exceeding 201Tl uptake by > or = 20% in a segment with reduced 201Tl uptake (Group B); a normal FDG uptake (> or = 75%) was present without a mismatch pattern in a segment with reduced 201Tl uptake (201Tl < 75% of peak activity) (Group C); a normal 201Tl uptake was present in the area of wall motion abnormality (Group D). Corresponding scintigraphic images obtained at T1 and T6 were compared. RESULTS: 51 segments were normokinetic, 37 were hypokinetic and 6 were akinetic at T1. Of the 63 segments with wall motion abnormalities at T1, 18 regions showed a match (FDG-201Tl < 20%) (Group A). Regional function improved in only one (6%) of these segments. In 19 regions a mismatch was present (FDG-201Tl > 20%) (Group B) of which three (16%) showed spontaneous improvement in function (p = NS vs. matched segments), although recovery varied considerably among patients. Regional function in two segments deteriorated. In 14 regions with reduced 201Tl uptake, FDG uptake was normal (Group C) of which five (36%) were improved after 6 weeks (p < 0.05 vs. match; p = NS vs. mismatched segments). Of the 12 segments with normal 201Tl uptake (Group D), seven (58%) showed improvement in function, whereas five (42%) did not show improvement (p < 0.05 vs. match). In addition, all scintigraphically selected viable segments were grouped (Group B + C + D) and compared with the non-viable segments (Group A). The predictive value of a positive viability test for spontaneous functional improvement was 33%. The predictive value of a negative viability test for lack of functional improvement was 94%. CONCLUSIONS: absence of residual FDG uptake shortly after infarction is associated with irreversible injury, while preservation of metabolic activity identifies segments with variable outcome. Wall motion alone is not a good indicator for the presence of viable tissue. Planar 201Tl/FDG imaging allows early identification of viable but jeopardized tissue and may help select patients who will benefit from aggressive therapy to salvage endangered myocardium.

Deoxyglucose↗
PubMedDate not supplied

F18-fluorodeoxyglucose single-photon emission computed tomography predicts functional outcome of dyssynergic myocardium after surgical revascularization.

BACKGROUND: Prediction of functional recovery after revascularization is possible with positron emission tomography and F18-fluorodeoxyglucose (FDG). Recently, the use of FDG in combination with single-photon emission computed tomography (SPECT), with 511 keV collimators, has been proposed to allow more widespread use of FDG. In the current study we aimed to predict improvement of regional left ventricular function after surgical revascularization with FDG and SPECT. METHODS AND RESULTS: Twenty-seven patients with regional wall motion abnormalities (on echocardiography) underwent early thallium-201 (Tl-201) SPECT to assess perfusion and FDG SPECT to assess regional glucose uptake. The left ventricular myocardium was divided into 13 segments. For each segment, tracer uptake was evaluated visually (with the use of a 4-point scoring system) by consensus of two observers. Myocardial viability was determined in dyssynergic segments on echocardiography and defined as normal perfusion or increased FDG uptake in a perfusion defect (mismatch). Absence of viability was defined as a perfusion defect without increased FDG uptake (match). Improvement of regional wall motion was assessed 3 months after revascularization. In the group of segments that were viable on FDG/Tl-201 SPECT (n = 64), the segmental wall motion score decreased from 1.4 +/- 0.5 to 0.6 +/- 0.7 (p < 0.01), whereas the segmental wall motion score remained unchanged in nonviable segments (n = 72): 1.6 +/- 0.5 versus 1.5 +/- 0.6 (not significant). Forty-six (72%) of the 64 segments that were viable on FDG/Tl-201 SPECT demonstrated improved contractile function after coronary revascularization. In contrast, only 7 (10%) of 72 nonviable segments on FDG/Tl-201 SPECT showed improvement in function after revascularization (p < 0.01 versus viable segments). The sensitivity, specificity, and positive and negative predictive values were 87%, 78%, 72%, and 90%, respectively. CONCLUSION: This study shows that FDG/Tl-201 SPECT can identify patients who improve in regional ventricular function after revascularization.

Aged↗
PubMed1986

Myocardial glucose utilization in ischaemic heart disease: preliminary results with F18-fluorodeoxyglucose and positron emission tomography.

Regional myocardial utilization of glucose can be assessed non-invasively in man with the sugar analogue F18-2-fluoro-2-deoxyglucose (FDG) and positron emission tomography (PET). The preliminary observations made in patients with different clinical forms of ischaemic heart disease using FDG and PET are reported. In patients with stable angina pectoris at rest, regional myocardial glucose utilization was comparable to that in normal volunteers whilst an increased utilization of glucose was found in the recovery from exercise-induced ischaemia in the regions that showed an abnormal perfusion during the stress test. These metabolic changes persisted in the recovery phase when all the parameters that were altered during the exercise, including myocardial perfusion, had normalized. In patients with unstable angina, characterized by repeated episodes of spontaneous ST depression, myocardial glucose utilization was regionally or globally increased already at rest in the absence of symptoms or signs of ischaemia at the time of study and most often without evident perfusion abnormalities. In patients with a recent infarction, two different patterns of glucose utilization in the infarcted area have been described: a concordant decrease of myocardial perfusion and glucose utilization; a disproportionately increased glucose utilization relative to perfusion interpreted as an index of the presence of ischaemic, but still viable myocardium.

Angina Pectoris↗
PubMed2000

Positron emission tomography is a useful tool in differentiating idiopathic from ischemic dilated cardiomyopathy.

We evaluated the utility of positron emission tomography in differentiating patients with idiopathic dilated cardiomyopathy from those with ischemic cardiomyopathy. Twenty consecutive non-diabetic patients with dilatation (end-diastolic volume > or = 120 cc/m2) and reduced systolic function (ejection fraction < or = 40%) of the left ventricle on cineangiography, underwent coronary angiography, F18 fluorodeoxyglucose (F18-FDG) (glucose load technique) and N13-ammonia (N13-NH3) positron emission tomography. A semiquantitative score based on the extension and the severity of the uptake defects was calculated. Endomyocardial biopsy was performed in patients with normal coronary arteries. Ten patients (group A) had normal coronary arteries and histologic features of the endomyocardium fitting with the diagnosis of idiopathic dilated cardiomyopathy. Cineangiography showed critical stenosis of at least one major coronary artery in the other 10 patients (group B). The two groups were similar in age. left ventricular end-diastolic volume and ejection fraction. Both N13-NH3, positron emission tomography and F18-FDG positron emission tomography scores were lower in group A than in group B: 0.1 +/- 0.3 vs. 10.6 +/- 5.1 (P<0.0001) and 2.4 +/- 4.4 vs. 9.9 +/- 4.1 (P<0.0001) respectively. but only N13-NH3 positron emission tomography allowed a complete separation of the two groups (score range 0-1 group A vs. 4-12 group B). The F18-FDG score value showed some overlapping between the two groups (score range 0-12 in the group A vs. 2-17 in the group B). All three idiopathic dilated cardiomyopathy patients with a F18-FDG score value >2 had left bundle branch block on standard ECG. Positron emission tomography imaging with N13-NH3 and F18-FDG provided a complete differentiation between idiopathic dilated cardiomyopathy and ischemic cardiomyopathy patients. However patients with left bundle branch block on ECG could present defects in FDG uptake even if affected by idiopathic dilated cardiomyopathy.

Adult↗
PubMed1990

Temporoparietal cortex in aphasia. Evidence from positron emission tomography.

Forty-four aphasic patients were examined with (F18)-fluorodeoxyglucose positron emission tomography in a resting state to determine whether consistent glucose metabolic abnormalities were present. Ninety-seven percent of subjects showed metabolic abnormalities in the angular gyrus, 89% in the supramarginal gyrus, and 87% in the lateral and transverse superior temporal gyrus. Pearson product moment correlations were calculated between regional metabolic measures and performance on the Western Aphasia Battery. No significant correlations were found between the Western Aphasia Battery scores and right hemisphere metabolic measures. Most left hemisphere regions correlated with more than one score from the Western Aphasia Battery. Temporal but not frontal regions had significant correlations to the comprehension score. The left temporoparietal region was consistently affected in these subjects, suggesting that common features in the aphasias were caused by left temporoparietal dysfunction, while behavioral differences resulted from (1) the extent of temporoparietal changes, and (2) dysfunction elsewhere in the brain, particularly the left frontal and subcortical areas.

Adult↗
PubMed1999

The detection of small carcinoma with 18F-FDG using a dual head coincidence camera.

Tumour imaging with F18-fluorodeoxyglucose (18F-FDG) has yielded promising results for the detection of a variety of tumours. Owing to the high costs and limited availability of dedicated Positron emission tomography (PET) scanners, alternative methods of imaging the 511-KeV photons of positron emitters have been sought. With a dual head coincidence camera PET scanning of FDG is possible. The system parameters, such as sensitivity and spatial resolution, are already measured, but the clinical experience of this alternative imaging method is very limited. Two cases are described in which tumours with a diameter of 4 and 5 mm, respectively, were detected using a dual head coincidence camera. The presented cases support the use of this converted gamma camera in head and neck oncology.

Adult↗
PubMedDate not supplied

PET scanning and measuring the impact of treatment.

Positron emission tomography (PET) scanning with F18-fluorodeoxyglucose or FDG is a becoming a standard method for tumor staging. The prediction and evaluation of therapy response are newer applications of FDG-PET. PET often offers an early readout of treatment efficacy and is an attractive alternative to conventional anatomic assessments of treatment response. This article reviews the methods available with PET to monitor therapy response. Disease specific applications of PET imaging are then reviewed. While FDG is the most commonly used radiotracer for PET, many other radioligands could be applied in the future.

Fluorodeoxyglucose F18↗
PubMed1999

[Cardiac hypertrophy and coronary reserve in endurance athletes].

Impaired coronary reserve (CR) with angiographic coronary arteries has been demonstrated in patients with left ventricular hypertrophy (LVH) in response to valvular heart disease or hypertension. To determine if adaptive LVH induced by intensive training may alter myocardial blood flow (MBF) and CR, 8 highly trained endurance tri- athletes (29.6 +/- 4.0 yrs, with echographic LVH) were compared with 6 control subjects (33.0 +/- 7.9 yrs, with a normal echographic examination). Triathletes entered the study if they had a left ventricular mass >120 g/m2 at 2-D echocardiographic measurements (mean = 148.6 +/- 19.8 g/m2). MBF was assessed using positron emission tomography (PET) with H2O15. Subjects underwent an intravenous bolus of 17- 25 mCi of H2)15 at baseline and after intravenous infusion of 0.80 mg/kg of dipyridimole; H2O15 examination was followed by an F18-fluorodeoxyglucose (FDG) myocardial imaging. CR was determined as the ration of maximal to basal myocardial blood flow. In comparison with controls, triathletes with LVH showed normal MBF values (0.74 +/- 0.1 vs 0.8 +/- 0.2 ml/ml/min, p = 0.2), but an increased CR (3.8 +/- 0.7 vs 6.1 +/-1.9, p < 0.05). In contrast with other forms of LVH, CR is not altered in LVH due intense physical training. These results suggest that LVH due to intensive physical training is associated with an increase in coronary blood flow capacity.

Adult↗
PubMedDate not supplied

[Decrease in the frontal-superobasal metabolic ratio in unipolar depression].

Cerebral frontal glucose metabolism was investigated in 12 unipolar depressed patients and compared to these of 12 healthy volunteers using Positron Emission Tomography (PET) and (F18) fluorodeoxyglucose. The PET investigation was made in a quiet room with a dimly light and each subject remained in a resting state with closed eyes. Results show a decreased in a frontal superobasal calculated ratio in depressed patients compared to control subjects for left and for right values. This reduction indicates an imbalance between the frontal and the superobasal region. This imbalance could relate to some particular depressive symptom profile.

Adult↗
PubMed1998

Relation between the kinetics of thallium-201 in myocardial scintigraphy and myocardial metabolism in patients with acute myocardial infarction.

OBJECTIVE: To investigate the relations between myocardial metabolism and the kinetics of thallium-201 in myocardial scintigraphy. METHODS: 46 patients within six weeks after the onset of acute myocardial infarction underwent resting myocardial dual isotope, single acquisition, single photon emission computed tomography (SPECT) using radioiodinated 15-iodophenyl 3-methyl pentadecaenoic acid (BMIPP) and thallium-201, exercise thallium-201 SPECT, and positron emission tomography (PET) using nitrogen-13 ammonia (NH3) and [F18]fluorodeoxyglucose (FDG) under fasting conditions. The left ventricle was divided into nine segments, and the severity of defects was assessed visually. RESULTS: In the resting SPECT, less BMIPP uptake than thallium-201 uptake was observed in all of 40 segments with reverse redistribution of thallium-201, and in 21 of 88 segments with a fixed defect of thallium-201 (p < 0.0001); and more FDG uptake than NH3 uptake (NH3-FDG mismatch) was observed in 35 of 40 segments with reverse redistribution and in 38 of 88 segments with fixed defect (p < 0.0001). Less BMIPP uptake in the resting SPECT was observed in 49 of 54 segments with slow stress redistribution in exercise SPECT, and in nine of 17 segments with rapid stress redistribution (p < 0.0005); NH3-FDG mismatch was observed in 42 of 54 segments with slow stress redistribution and in five of 17 segments with rapid stress redistribution (p < 0.0005). CONCLUSIONS: Thallium-201 myocardial scintigraphy provides information about not only myocardial perfusion and viability but also about myocardial metabolism in patients with acute myocardial infarction.

Adult↗
PubMed2000

Doppler tissue velocity sampling improves diagnostic accuracy during dobutamine stress echocardiography for the assessment of viable myocardium in patients with severe left ventricular dysfunction.

BACKGROUND: Both nuclear imaging with F18-fluorodeoxyglucose and dobutamine stress echocardiography have been used to identify viable myocardium, although dobutamine-stress echocardiography has been demonstrated to be the less sensitive of the two. AIM: To compare the accuracy of pulsed-wave Doppler tissue sampling with dobutamine-stress echocardiography for the detection of viable myocardium, using F18-fluorodeoxyglucose imaging as a reference. Methods Forty patients with chronic coronary artery disease and left ventricular dysfunction (mean ejection fraction 33+/-11%), underwent F18-fluorodeoxyglucose imaging, dobutamine-stress echocardiography and pulsed-wave Doppler tissue sampling. Evaluation was performed using a six-segment model. RESULTS: Visual assessment by resting echo was feasible in 230 out of 240 segments (96%); 177 (77%) segments showed severe dyssynergy at rest. F18-fluorodeoxyglucose imaging showed viability in 95 (54%) segments while 82 (46%) were non-viable. Ejection phase velocity at rest was not significantly different; ejection velocities during low-dose and peak-dose dobutamine, however, were significantly higher in viable myocardium (8.6+/-2.9 vs 6.0+/-1.8 and 9.3+/-3.1 vs 6.2+/-2.1 cm x s(-1)). Using receiver operating characteristic curves the optimal cut-off value for viability assessment was an increase in the ejection phase velocity low-dose of 1+/-0.5 cm x s(-1), while 0+/-0.5 cm x s(-1)predicted non-viability. The sensitivity and specificity (95%CI) of pulsed-wave Doppler tissue sampling and dobutamine-stress echocardiography for the prediction of viability was respectively 87% (82-92) vs 75% (67-81) (P<0.05) and 52% (44-59) vs 51% (45-59) (P=ns). CONCLUSIONS: The sensitivity of pulsed-wave Doppler tissue sampling is superior to dobutamine-stress echocardiography for the assessment of myocardial viability.

Dobutamine↗
PubMedDate not supplied

Agreement and disagreement between "metabolic viability" and "contractile reserve" in akinetic myocardium.

BACKGROUND: In patients with chronic coronary artery disease and depressed left ventricular function, assessment of residual viability in akinetic myocardium is important for therapeutic management. Intact perfusion, preserved metabolism, and presence of contractile reserve are different aspects of cellular viability. However, not all viable cells exhibit all characteristics; it is thought that contractile reserve is less often preserved compared with metabolic activity or intact perfusion. In this study we performed a direct comparison between perfusion imaging with thallium-201 single photon emission computed tomography (SPECT), metabolic imaging with F18-fluorodeoxyglucose SPECT, and assessment of contractile reserve with low-dose dobutamine echocardiography in akinetic myocardium. METHODS AND RESULTS: Forty patients with depressed left ventricular function (mean left ventricular ejection fraction 31% +/- 16%) were studied. Resting echocardiography showed akinesis in 165 (32%) segments. Most (n = 154, 93%) of these segments demonstrated resting hypoperfusion. F18-fluorodeoxyglucose imaging revealed a perfusion-metabolism mismatch in 41 segments and a match in 113 segments. Contractile reserve was present in 33 (80%) of the segments with a perfusion-metabolism mismatch and in 7 (6%) segments with a match (P < .0005). Of the 11 segments with normal perfusion, only 5 (45%) showed contractile reserve. The agreement between SPECT and dobutamine echocardiography was 87%. Although 94% of the segments that were nonviable on scintigraphy did not show contractile reserve, the disagreement between SPECT and dobutamine echocardiography was caused mainly by the absence of contractile reserve in 27% of the segments that were viable on scintigraphy. CONCLUSION: This study shows a good agreement between SPECT and dobutamine echocardiography, although a substantial number of segments with preserved viability on SPECT do not exhibit contractile reserve, indicating underestimation of viability by dobutamine echocardiography compared with F18-fluorodeoxyglucose imaging.

Coronary Disease↗
PubMed1998

[Value of (F18)-2-fluorodeoxyglucose PET scanning in staging mouth cavity carcinoma. Comparative evaluation of PET findings before and after preoperative radiochemotherapy with histological and computerized tomography findings].

OBJECTIVE: The lack of sensitivity and specificity of conventional imaging techniques based on morphological critera is responsible for considerable limitations in the staging and surveillance of oral cancer. Therefore, this study investigates the contribution of [F18]-2-fluordesoxyglucose (FDG) positron emission tomography (PET) to tumor management with special regard to lymphnode involvement and therapeutic monitoring after radiotherapy. DESIGN: Prospective observational study. PATIENTS: Twenty-one patients with advanced oral cancer, predominantly T3/T4. INTERVENTION: FDG-PET scans before and after preoperative radio(chemo)therapy. Standardized uptake values (SUV) were determined for the tumor site and lymphnode areas. PET scans were correlated to histological findings after ablative tumor surgery. RESULTS: FDG-PET yielded superior sensitivity and specificity for tumor and lymphnode assessment. The effect of radiotherapy was reflected by the metabolic activity of the tumor, which shows a close correlation between the decrease of FDG uptake and histologic tumor regression. PET detected distant metastases and simultaneous tumors. CONCLUSION: FDG-PET is a challenging imaging technique with the potential to improve staging procedures for oral cancer. In the monitoring of metabolic activity of the tumor in the course of radio(chemo)therapy, FDG-PET allows objective measurement of the treatment response.

Aged↗
PubMed2002

[Diagnosis of metastasis of malignant melanoma in the thyroid gland with f18-FDG PET scan].

Metastases in the thyroid gland are very rare. When they occur, long-term survival is dismal; thus an early diagnosis is critical. Malignant melanoma is one of the tumors which may metastasize to the thyroid gland. Therefore we wanted to demonstrate F18-Fluorodeoxyglucose-Positron emission tomography (F18-FDG-PET) is a sensitive and reliable method to identify such metastases. We report about a 51-year-old man, who had an inguinal lymph node metastasis of a malignant melanoma with unknown primary tumor site. He came to us for an a follow-up F18-FDG-PET investigation. In the PET there was a pathologic FDG-uptake in the left lobe of the thyroid gland. The nodule was removed and showed a malignant melanoma metastasis. This unusual scenario underscores the value of the PET in the oncologic follow-up of patients with malignant melanoma.

Diagnosis, Differential↗