Application Of 18F-FDG Research Articles

Application of 18F-FDG PET/CT imaging radiomics in the differential diagnosis of single-nodule pulmonary metastases and second primary lung cancer in patients with colorectal cancer.

It is crucially essential to differentially diagnose single-nodule pulmonary metastases (SNPMs) and second primary lung cancer (SPLC) in patients with colorectal cancer (CRC), which has important clinical implications for treatment strategies. In this study, we aimed to establish a feasible differential diagnosis model by combining 18F-fluorodeoxyglucose positron-emission tomography (18F-FDG PET) radiomics, computed tomography (CT) radiomics, and clinical features. CRC patients with SNPM or SPLC who underwent 18F-FDG PET/CT from January 2013 to July 2022 were enrolled in this retrospective study. The radiomic features were extracted by manually outlining the lesions on PET/CT images, and the radiomic modeling was realized by various screening methods and classifiers. In addition, clinical features were analyzed by univariate analysis and logistic regression (LR) analysis to be included in the combined model. Finally, the diagnostic performances of these models were illustrated by the receiver operating characteristic (ROC) curves and the area under the curve (AUC). We studied data from 61 patients, including 36 SNPMs and 25 SPLCs, with an average age of 65.56 ± 10.355 years. Spicule sign and ground-glass opacity (GGO) were significant independent predictors of clinical features (P = 0.012 and P < 0.001, respectively) to build the clinical model. We achieved a PET radiomic model (AUC = 0.789), a CT radiomic model (AUC = 0.818), and a PET/CT radiomic model (AUC = 0.900). The PET/CT radiomic models were combined with the clinical model, and a well-performing model was established by LR analysis (AUC = 0.940). For CRC patients, the radiomic models we developed had good performance for the differential diagnosis of SNPM and SPLC. The combination of radiomic and clinical features had better diagnostic value than a single model.

The application of 18F-FDG PET/CT imaging for human hepatocellular carcinoma: a narrative review.

Primary hepatocellular carcinoma (HCC) poses a significant threat to human health. The mean overall survival (OS) of HCC is approximately 15.8 months whereas the 6-month and 1-year OS rates are only 71.6% and 49.7%, respectively. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) has been widely used for the management of several solid cancers; however, HCC frequently displays low 18F-FDG uptake; approximately 50% of HCC cases do not take up 18F-FDG. Therefore, 18F-FDG PET is not considered very useful for the visualization of HCC and is not currently a recommended standard imaging modality for HCC. Conversely, 18F-FDG PET/CT has been reported to be clinically important in the management, staging, and prognosis of HCC patients. Currently, reports relating to 18F-FDG uptake in HCC are unclear and controversial. There is an urgent need to clarify the efficacy of 18F-FDG PET for the management of HCC. The PubMed database was searched for all articles on the application of 18F-FDG PET/CT imaging for human HCC up to December 2021. The following search terms were used: 'Hepatocellular carcinoma', '[18F]FDG PET/CT', 'Hypoxia', '[11C]Choline'. In this review, we re-evaluate the potential hypoxia-dependent uptake mechanism of 18F-FDG in HCC and review the usefulness of 18F-FDG PET/CT for identifying, managing, and investigating the biological properties of HCC. 18F-FDG PET/CT is very useful for HCC visualization, management, and the evaluation of biological properties. A negative test for 18F-FDG uptake is not meaningless and may reflect a relatively better outcome. 18F-FDG-positive lesions indicate a significantly less favorable prognosis.

Advances in PET/CT Imaging for Breast Cancer.

One out of eight women will be affected by breast cancer during her lifetime. Imaging plays a key role in breast cancer detection and management, providing physicians with information about tumor location, heterogeneity, and dissemination. In this review, we describe the latest advances in PET/CT imaging of breast cancer, including novel applications of 18F-FDG PET/CT and the development and testing of new agents for primary and metastatic breast tumor imaging and therapy. Ultimately, these radiopharmaceuticals may guide personalized approaches to optimize treatment based on the patient's specific tumor profile, and may become a new standard of care. In addition, they may enhance the assessment of treatment efficacy and lead to improved outcomes for patients with a breast cancer diagnosis.

Research Advances on Application of 18F-FDG PET/CT in Clinical Diagnosis and Treatment of Hepatocellular Carcinoma

Research Advances on Application of 18F-FDG PET/CT in Clinical Diagnosis and Treatment of Hepatocellular Carcinoma

18F-fluorodeoxyglucose positron emission tomography\u2013computed tomography for assessing organ distribution of stressed red blood cells in mice

Red blood cells (RBCs) stressed by high temperature are similar to senescent or damaged RBCs in pathological conditions. RBCs can be efficiently labelled with 18F-fluorodeoxyglucose (FDG). The aim of this study was to assess stressed RBCs erythrophagocytosis and organ distribution in vivo with the application of 18F-FDG PET/CT. RBCs were induced under high temperature (48 °C) to prepare stressed RBCs. Fluorescence-activated cell sorting (FACS) was used to analyse reactive oxygen species (ROS) generation, intracellular Ca2+ concentration and membrane phosphatidylserine (PS) externalization of RBCs. 18F-FDG was used to label RBCs and assess the erythrophagocytosis. Finally, 18F-FDG PET/CT was applied to reveal and measure the organ distribution of stressed RBCs in mice. Compared with untreated RBCs, stressed RBCs decreased in cell volume and increased in ROS level, intracellular Ca2+ concentration, and PS exposure. RBCs could be labelled by 18F-FDG. Stressed RBCs tended to be phagocytosed by macrophages via assessment of FACS and radioactivity. 18F-FDG PET/CT imaging showed that stressed RBCs were mainly trapped in spleen, while untreated RBCs remained in circulation system. Thus, stressed RBCs can be effectively labelled by 18F-FDG and tend to be trapped in spleen of mice as assessed by PET/CT.

Application of 18F-FDG PET/CT in evaluation of curative effect and prognosis for small cell lung cancer.

Small cell lung cancer belongs to neuroendocrine tumors and is the most malignant one in lung cancer. It possesses clinical features such as rapid growth, easy early metastasis, and poor prognosis. PET/CT is a molecular imaging technique that combines morphological and metabolic imaging. It has been widely used in the diagnosis, staging, treatment planning, efficacy and prognosis evaluation of tumors. This article reviews the efficacy, prognostic parameters, evaluation criteria, possible influencial factors, clinical application and value of 18F-fluorodeoxyglucose (18F-FDG) PET/CT in small cell lung cancer. The accuracy and sensitivity of 18F-FDG PET/CT in small cell lung cancer stage, efficacy and prognosis evaluation are significantly higher than those of traditional imaging methods. Maximal standardized uptake, metabolic tumor volume, and total lesion glycolysis have been applied in efficacy and prognosis prediction, which have important value in developing the personalized treatment and improving the survival for small cell lung cancer patient.

Application of 18F-FDG PET/CT in necrobiotic xanthogranuloma involving multiple organs.

Application of 18F-FDG PET/CT in necrobiotic xanthogranuloma involving multiple organs.

Clinical application of 18F-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography for cancer cells in lung cancer

Purpose: One of the most important tools used in the diagnosis and treatment of lung cancer in patients with or suspected of having lung cancer is positron emission tomography-computed tomography XS(PET-CT). The popularity of this method is rapidly increasing. Material and Review Method: We searched papers on the topic of the recognition of cancer cells in lung cancer using18F-fluoro-2-deoxy-D-glucose (FDG) PET-CT using keywords such as18F-FDG PET-CT and lung cancer, 18F-FDG PET-CT imaging in oncology, cancer and nuclear medicine, diagnosis of lung cancer and imaging, molecular imaging in cancer, false-positive18F-FDG PET-CT scans and oncology, application of18F-FDG PET-CT in staging and metabolic activity assessment of cancer, and PET-CT imaging method. Results: In this review, we found the following results: 1.Due to the high diagnostic sensitivity of PET-CT scans, it is possible to reject malignancy in pulmonary cells using this method 2. PET-CT scans decrease the number of unnecessary procedures. 3. According to the findings of this review study, high sensitivity in PET-CT is the major advantage compared to other methods used to rule out the possibility of malignancy of lung cells; it is necessary but not sufficient. Conclusions: Regarding the imaging of abnormal pulmonary cells using PET-CT, except for a few exceptions, if the result of a PET-CT scan is negative, these abnormalities can confidently be considered to be benign. These exceptions include nonsolid and small (

Subtype-Guided 18 F-FDG PET/CT in Tailoring Axillary Surgery Among Patients with Node-Positive Breast Cancer Treated with Neoadjuvant Chemotherapy: A Feasibility Study.

The purpose of this study was to investigate the value of 18 [F]-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) in tailoring axillary surgery by predicting nodal response among patients with node-positive breast cancer after neoadjuvant chemotherapy (NAC). One hundred thirty-three patients with breast cancer with biopsy-confirmed nodal metastasis were prospectively enrolled. 18 F-FDG PET/CT scan was performed before NAC (a second one after two cycles with baseline maximum standardized uptake value [SUVmax ] ≥2.5), and a subset of patients underwent targeted axillary dissection (TAD). All the patients underwent axillary lymph node dissection (ALND). The accuracy was calculated by a comparison with the final pathologic results. With the cutoff value of 2.5 for baseline SUVmax and 78.4% for change in SUVmax , sequential 18 F-FDG PET/CT scans demonstrated a sensitivity of 79.0% and specificity of 71.4% in predicting axillary pathologic complete response with an area under curve (AUC) of 0.75 (95% confidence interval, 0.65-0.84). Explorative subgroup analyses indicated little value for estrogen receptor (ER)-negative, human epidermal growth factor receptor 2 (HER2)-positive patients (AUC, 0.55; sensitivity, 56.5%; specificity, 50.0%). Application of 18 F-FDG PET/CT could spare 19 patients from supplementary ALNDs and reduce one of three false-negative cases in TAD among the remaining patients without ER-negative/HER2-positive subtype. Application of the subtype-guided 18 F-FDG PET/CT could accurately predict nodal response and aid in tailoring axillary surgery among patients with node-positive breast cancer after NAC, which includes identifying candidates appropriate for TAD or directly proceeding to ALND. This approach might help to avoid false-negative events in TAD. This feasibility study showed that 18 [F]-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) could accurately predict nodal response after neoadjuvant chemotherapy (NAC) among patients with breast cancer with initial nodal metastasis except in estrogen receptor-negative, human epidermal growth factor receptor 2-positive subtype. Furthermore, the incorporation of 18 F-FDG PET/CT can tailor subsequent axillary surgery by identifying patients with residual nodal disease, thus sparing those patients supplementary axillary lymph node dissection. Finally, we have proposed a possibly feasible flowchart involving 18 F-FDG PET/CT that might be applied in post-NAC axillary evaluation.

P119 - Application of 18F-FDG PET/CT in preoperative evaluation of axillary lymph node metastasis of breast cancer

P119 - Application of 18F-FDG PET/CT in preoperative evaluation of axillary lymph node metastasis of breast cancer

Application of 18F-FDG PET/CT in IgG4-related disease

Immunoglobulin (Ig)G4-related disease (IgG4-RD) is a new multi-organ immune-mediated disease, which was characterized by multiple organs involvement, high serum IgG4 concentrations and IgG4+ plasma cells infiltration. Early diagnosis is helpful for the treatment and prognosis evaluation. Imaging can provide important diagnostic bases for IgG4-RD, but conventional imaging methods are difficult to determine the overall involvement of the patient. 18F-fluorodeoxyglucose (FDG) PET/CT can display the changes of morphology and metabolism in involved organs, and can be used in the diagnosis, guidance of biopsy, therapeutic response monitoring and recurrence of IgG4-RD. This review summarizes the applications of 18F-FDG PET/CT in patients with IgG4-RD. Key words: Autoimmune diseases; Immunoglobulin G; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose; Trends

Application of 18F-FDG PET/CT in the diagnosis of extrapulmonary tuberculosis

ObjectiveThis study aimed to evaluate the diagnostic value of positron emission tomography/computed tomography(PET/CT) for detecting the infective lesions in patients with extrapulmonary tuberculosis (EPTB). MethodsThe PET/CT imaging findings of 46 patients with extrapulmonary tuberculosis were analyzed retrospectively. Of the 46 patients, the standard uptake value (SUV) was calculated, and the maximum SUV (SUVmax) was measured. Characteristic imaging findings and SUV of EPTB in PET/CT were summarized. ResultsPET/CT demonstrated different degrees of increased 18F-FDG uptake in EPTB patients, with the SUVmax ranging from 1.3 to 30.0. Based on the involved organ and tissue, there were 4 types of lesions, including lymph node tuberculosis (25 cases), membranous tuberculosis (13 cases), organ tuberculosis (13 cases) and osteoarticular tuberculosis (8 cases). Of the 46 cases, 11 had two or more than two types of lesions. In the 25 cases of lymph node tuberculosis, slight or moderate lymphadenopathy were revealed by CT, and nodular or mass-like increased 18F-FDG uptake were found by PET, with SUVmax ranged from 3.0 to 30.0. In the 13 cases of membranous tuberculosis, the lesions involved meninx, pericardium, pleura and peritoneum. And PET/CT demonstrated different degrees of membranous thickening, with the SUVmax ranging from 1.3 to 14.5. In the 13 cases of organ tuberculosis, the lesion involved liver, spleen, pancreas, colon, prostate, seminal vesicle and ovary, with the SUVmax ranging from 2.5 to 15.6. In the 8 cases of osteoarticular tuberculosis, osteolytic bone destruction was found. The lesions showed increased 18F-FDG uptake on the PET/CT, with SUVmax ranging from 3.5 to 19.2. ConclusionThere were some imaging characteristics of EPTB by PET/CT. PET/CT can accurately demonstrate the pathological morphology, extent of involvement and uptake activity of EPTB, and provided information in accurate diagnosis, differential diagnosis and assessment of treatment response of EPTB.

Application of 18F-FDG microPET/CT in the screening of cerebral ischemia reperfusion models

Objective To investigate the feasibility of 18F-fluorodeoxyglucose (FDG) microPET/CT in the screening of cerebral ischemia reperfusion (CIR) models. Methods The suture-occluded method was used to establish CIR rat models with reversible middle cerebral artery embolism. After that only awake rats whose Zea-Longa scores were 1-4 were selected for the following experiments, and 18 male SD rats were selected. Garcia scale with 18 points was used to evaluate the neurological function of rats at 2 and 24 h post-operation. At the same time points, 18F-FDG was injected into caudal vein after anesthesia and microPET/CT scan was conducted at 40 min post-injection. Visual and semi-quantitative analyses were adopted to analyze the images. The autopsy and HE staining were performed on accidentally dead rats. The other alive rats were sacrificed after microPET/CT scan at 24 h post-operation, and their brain tissues were taken out quickly to detect the infarction by triphenyl tetrazolium chloride (TTC) staining. The pathological results were taken as the gold criteria. Fisher exact test was used to compare the difference of accuracy for diagnosing CIR models between neurological function score (NFS) and microPET/CT. Results According to the pathology, there were 11 CIR models, 4 with subarachnoid hemorrhage (SAH), 3 with SAH and cerebral hemorrhage. Between 8-12 h post-operation, 4 rats died accidentally. At 2 h post-operation, the diagnostic accuracies of NFS and microPET/CT were 11/18 and 15/18 (P 0.05). Conclusion 18F-FDG microPET/CT is better than NFS in screening CIR models in early stage. Key words: Brain ischemia; Reperfusion; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose; Rats

Application of 18F-FDG PET/CT in patients with synchronous multiple primary carcinoma

Objective: To investigate the value of 18F-fluorodeoxyglucose (18F-FDG) PET/CT in detection of synchronous multiple primary carcinoma (MPC) before treatment. Methods: The pre-treatment whole body PET/CT images of seventy-two patients with synchronous MPC confirmed by postoperative and biopsy pathology were analyzed. The pathological results were used as gold standard, and the detection rates of tumor lesions by 18F-FDG PET/CT and plain CT were compared, and the metabolism of 18F-FDG in tumor lesion was analyzed. Results: There were 151 lesions confirmed by pathology in 72 patients with synchronous MPC. The detection rate of tumor lesions by 18F-FDG-PET/CT was 88.1% (133/151), which was significantly higher than that of integrated CT (78.8%, 119/151) (P < 0.05). In patients with first primary cancer in digestive tract and second primary cancer in lung, the maximal standardized uptake value (SUVmax) of first primary cancer in digestive tract was higher than that of second primary cancer in lung (P = 0.042). There was no significant difference in SUVmax between synchronous MPCs in digestive tract (P = 0.345), but there was significant difference in SUVmax between synchronous MPCs in lung (P = 0.046). There were differences in SUVmax among tumor tissue lesions (P < 0.001), and the SUVmax of digestive tract cancer was higher than that of lung cancer (P = 0.01). Conclusion: The whole body 18F-FDG PET/CT imaging can effectively detect and diagnose the synchronous MPC. DOI:10.3781/j.issn.1000-7431.2018.44.731

Application of 18F-FDG PET/CT and other conventional imaging technologies in carcinoma of unknown primary site

Carcinoma of unknown primary (CUP) is a diagnostic and therapeutic challenge in oncology. The early and correct detection of the primary tumors of CUP is very important to its diagnosis, treatment, therapeutic response evaluation and prognosis prediction. This review summarizes the implications and development of the imaging technologies, especially 18F-FDG PET/CT scan, in the diagnosis, treatment and prognosis prediction of CUP patients. Key words: Neoplasms, unknown primary; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose; Trends

Research and application of 18F-fluorodeoxyglucose positron emission tomography/ computed tomography for the diagnosis and treatment of primary hepatocellular carcinoma

Primary hepatocellular carcinoma is a common cancer. Many patients are found with intermediate-advanced stage, rapid development, poor treatment and high mortality. 18F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) can discover the early lesions and therefore plays an important role in diagnosis, treatment and prognosis of patients with hepatocellular carcinoma. It especially has obvious advantages in detecting metastasis and monitoring recurrence. However, 18F-FDG PET/CT imaging has poor quality and low diagnosis rate. Understanding the advantages and limitations of 18F-FDG PET/CT can provide better basis for clinical diagnosis and treatment for hepatocellular carcinoma patients. This article briefly introduces the research and application of 18F-FDG PET/CT in the diagnosis and treatment of hepatocellular carcinoma.

Positron Emission Tomography for the Development and Characterization of Corneal Permanence of Ophthalmic Pharmaceutical Formulations.

This work is aimed at describing the utility of positron emission tomography/computed tomography (PET/CT) as a noninvasive tool for pharmacokinetic studies of biopermanence of topical ocular formulations. The corneal biopermanence of a topical ophthalmic formulation containing gellan gum and kappa carragenan (0.82% wt/vol) labeled with 18Fluorine (18F) radiotracers (18F-FDG and 18F-NaF) was evaluated by using a dedicated small-animal PET/CT, and compared with the biopermanence of an aqueous solution labeled with the same compounds. Regions of interest (ROIs) were manually drawn on the reconstructed PET images for quantifying the radioactivity concentration in the eye. The biopermanence of the formulations was determined by measuring the radioactivity concentration at different times after topical application. Additionally, cellular and ex vivo safety assays were performed to assess the safety of the performed procedures. Differences were observed in the ocular pharmacokinetics of the two formulations. After 1.5 hours of contact, 90% of the hydrogel remained in the ocular surface, while only 69% of the control solution remained. Furthermore, it was observed that flickering had a very important role in the approach of the trial. The application of 18F-FDG in the eye was neither irritating nor cytotoxic for human corneal epithelial cells. The use of small-animal PET and 18F radiotracers in ocular pharmacokinetics of ophthalmic formulations is feasible and could be a safe method for future ocular pharmacokinetic studies in humans.

Application of 18F-FDG PET/CT combined with carbohydrate antigen 19-9 for differentiating pancreatic carcinoma from chronic mass-forming pancreatitis in Chinese elderly.

ObjectiveThe current study was designed to analyze the value of 18F-FDG positron emission tomography/computed tomography (PET/CT) combined with carbohydrate antigen 19-9 (CA19-9) in differentiating pancreatic carcinoma (PC) from chronic mass-forming pancreatitis (CMFP) in Chinese elderly.MethodsAs it is impossible to differentially diagnose PC from CMFP, 60 participants older than 65 years with focal pancreatic lesions were scanned by 18F-FDG PET/CT and their CA19-9 levels were tested. Diagnoses of all participants were confirmed by comprehensive methods including aspiration biopsy, surgical pathology, and clinical follow-up of 12 months. Twenty participants with CMFP were included in CMFP group and 40 participants with PC in PC group.ResultsIn CMFP and PC groups, 46 participants showed increased 18F-FDG uptake, 43 had elevated CA19-9 levels, and 38 participants had both increased 18F-FDG uptake and elevated CA19-9 levels. Standardized uptake value maximum of PC group (5.98±2.27) was significantly different from CMFP group (2.58±1.81, P<0.05). Sensitivity, specificity, and accuracy of 18F-FDG PET/CT in differentiating PC from CMFP were 95%, 60%, and 83.3%, respectively. CA19-9 levels of PC group (917.44±1,088.24) were significantly different from CMFP group (19.09±19.54, P<0.05). Sensitivity, specificity, and accuracy of CA19-9 levels in differentiating PC from CMFP were 87.5%, 60%, and 78.3%, respectively. Sensitivity, specificity, and accuracy of 18F-FDG PET/CT combined with CA19-9 levels in differentiating PC from CMFP were 90%, 90%, and 90%, respectively.Conclusion18F-FDG PET/CT had reliable sensitivity, specificity, and accuracy in differentiating PC from CMFP, and CA19-9 levels could be helpful in 18F-FDG PET/CT for differentiating PC from CMFP in Chinese elderly. Moreover, 18F-FDG PET/CT combined with CA19-9 levels was found to be an effective method to differentially diagnose PC from CMFP and has paved the way for the timely and safe treatment of PC and CMFP in Chinese elderly.

Clinical application of 18F-FDG PET/CT in Takayasu arteritis

Objective To investigate the characteristics of 18F-FDG PET/CT imaging in Takayasu arteritis (TA) and its clinical value. Methods Five male patients with TA in active phase (age range: 65-82 years; mean age: (72.8±6.6) years) from November 2011 to August 2014 were retrospectively analyzed. All patients underwent 18F-FDG PET/CT imaging, and one of them who was in stable phase after one year′s treatment underwent follow-up PET/CT imaging. The characteristics of the abnormal 18F-FDG uptake and SUVmax of lesions were analyzed. Another 5 age- and gender-matched patients with slightly elevated tumor markers and normal results of 18F-FDG PET/CT imaging in the same period were selected as the control group. Arteries were divided into 18 segments, including the ascending aorta, the aortic arch, the descending aorta, the abdominal aorta, the brachiocephalic trunk, the left/right common carotid, the left/right subclavian, the left/right brachial, the superior mesenteric, the left/right common iliac, the left/right renal, and the left/right femoral, and their SUVmax were measured respectively. Paired t test was used to analyze the difference of SUVmax between TA group and the control group. Results (1) 18F-FDG PET/CT imaging displayed diffused increase of radioactivity in the wall of aorta and its major branches in TA group, and CT showed multiple irregular thickening, punctate and banding calcification in arterial walls of those patients. The ascending aorta, the aortic arch, the descending aorta, the abdominal aorta, the brachiocephalic trunk, the left/right subclavian, the left/right common carotid, and the left/right common iliac artery were all involved in 5 patients; the left/right brachial and the left/right femoral artery were involved in 4 patients and the superior mesenteric artery was involved in 2 cases. The SUVmax range was 1.4-7.6, the highest SUVmax was in the left subclavian artery (n=2), the right subclavian artery (n=1) and the abdominal aorta artery (n=2). (2)The SUVmax of TA group and the control group were 3.96±1.35 and 2.13±0.53, respectively(t=10.40, P<0.001). (3) As to the TA patient in stable phase after treatment, the FDG uptake of the wall of aorta and its major branches decreased obviously compared with that before treatment. The SUVmax of left subclavian artery decreased from 6.8 to 3.2. Conclusions 18F-FDG PET/CT is helpful in diagnosis of TA. It could accurately display the range of involved arteries, reflect the activity of the lesion and evaluate the therapeutic response. Key words: Takayasu arteritis; Tomography, emission-computed; Tomography, X-ray computed; Deoxyglucose

Clinical application of 18F-FDG PET/CT on tumor staging and tumor thrombus grading of renal cell carcinoma

Objective To investigate the value of 18F-FDG PET/CT in the phasing and grading of renal cell carcinoma (RCC) complicated with vena cava tumor thrombus (VCTT). Methods From December 2011 to September 2015, a total of 72 patients (52 males, 20 females, age: 36-74 years) were enrolled in this retrospectively study. All patients underwent 18F-FDG PET/CT and contrast-enhanced CT studies, and were diagnosed as RCC. The RCC patients combined with VCTT were classified by Mayo-level. Wilcoxon rank sum test was used to compare the grading of VCTT by PET/CT and contrast-enhanced CT. NM staging on abdominal area level was performed and the results were compared with χ2 test. Results VCTT was identified in 18 RCC patients and the grading results by PET/CT were as follows: 9 cases in Level 0, 4 cases in Level Ⅰ, 2 cases in Level Ⅱ, 1 case in Level Ⅲ, and 2 cases in Level Ⅳ. When evaluated by PET/CT, 20 cases were in N0M0, 21 were in N1M0, 9 were in N0M1, and 22 were in N1M1. NM staging results by contrast-enhanced CT were as follows: 50 cases in N0M0, 10 in N1M0, 10 in N0M1, and 2 in N1M1. In addition, 2 N1 and 2 M1 were found by the whole body PET/CT. The classification results of VCTT and staging of abdominal level by PET/CT were significantly better than those by contrast-enhanced CT (z=-2.462, P<0.05; χ2 =32.806, P<0.01). Conclusion 18F-FDG PET/CT is not only valuable for detecting primary RCC and local metastasis, but also useful for finding where the VCTT extends, which is conducive to therapeutic planning and further clinical treatment. Key words: Carcinoma, renal cell; Neoplasm staging; Tomography, emission-computed; Tomography, X-ray computed; Deoxyglcose