Fluorine-18 Research Articles

Small cell lung tumour differentiation using F-18 (Fluorine-18) PET and smoothing using Gaussian 3D convolution operator

Small cell lung tumour differentiation using F-18 (Fluorine-18) PET and smoothing using Gaussian 3D convolution operator

Small cell lung tumour differentiation using F-18 (Fluorine-18) PET and smoothing using Gaussian 3D convolution operator

Small cell lung tumour differentiation using F-18 (Fluorine-18) PET and smoothing using Gaussian 3D convolution operator

Evaluation of F-18 FDG radiopharmaceuticals through Molecular Docking and radiation effects

Fluorodeoxyglucose (FDG), marked with the most used Positron Emission Tomography (PET) radiopharmaceutical Fluorine-18 (F-18), is a glucose analog and is taken to living cells through membrane glucose carriers. F-18 FDG involvement in tissue is proportional to glucose use. In many cancers, there is increased glucose use due to increased gluten expression and hexokinase activity. F-18 FDG PET is a proven method for diagnosis, staging, re-staging, and evaluation of treatment response in oncology. The purpose of this study is to find the effect of ionizing radiation on proteins in the mechanism of action of FDG and determine to Molecular mechanisms of F-18 FDG accumulation in metabolism. In the study, two different models were used together, the first method, the study was Molecular Docking method for modeling molecules deconstructed and the structure of FDG was energy minimized by utilizing the density functional theory, and the B3LYP functional was used with 6-311G basis set. The second method was the Monte Carlo method for modeling ionizing radiation interactive with the potential routes of FDG metabolism within the cell. It was determined that the Gibbs free energy (ΔG) change was compatible with the ionizing radiation factors for binding of FDG to the aphthous regions of Glucose-6-phosphate isomerase (G1), hexokinase (G2), and glucose transporter-1 (G3) were selected. In this study, the strong binding of FDG to protein influences the effect of radiation on the active site of enzymes. The G1 and G3 shown in the study interacted with only one charged amino acid FDG, and the absence of an aromatic residue around it can be considered among the results of this study as the cause of the low protective effect against ionizing radiation.

The relation between staging fluorine-18 fluorodeoxyglucose positron emission tomog- raphy/computed tomography metabolic parameters and tumor necrosis rate in pediatric osteosarcoma patients

Background/aimThe aim of this study was to investigate the contribution of fluorine-18 (F-18) fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging in staging of pediatric osteosarcoma patients and also to evaluate the ability of metabolic parameters from the primary tumor to predict tumor necrosis rate (TNR).Material and methodsF-18 FDG-PET/CT imaging was performed in staging 37 pediatric osteosarcoma patients. The metabolic parameters SUVmax (maximum standardised uptake value), MTV (metabolic tumour volume), and TLG (total lesion glycolysis) were measured from the primary tumor. TNR level of the primary tumor was histopathologically measured after standard neoadjuvant chemotherapy treatment. The contribution of F-18 FDG-PET/CT to staging of pediatric osteosarcoma patients and the accuracy of metabolic parameters of the primary tumor to predict TNR were analized by regression analysis.Results MTV and TLG of the primary tumor were found to efficiently predict histopathologic TNR, whereas SUVmax was not (P = 0.012, P = 0.027, P = 0.25, respectively). Also 5 of 12 patients (41.6%) who were initially defined as localised osteosarcoma were upstaged in consequence of staging F-18 FDG-PET/CT findings. Conclusion F-18 FDG-PET/CT staging in pediatric osteosarcoma patients can effectively distinguish metastatic-localised disease. MTV and TLG values are important parameters, which can efficiently be used to predict TNR.

Evaluation of positron emission tomography and contrast-enhanced computed tomography scan in nodal staging of early operable uterine cancers

Introduction:In early operable stages of cervical an endometrial malignancies, surgical staging of lymph nodes is advocated as contrast-enhanced computed tomography (CECT) has limited sensitivity and accuracy. Although fluorine-18 (F-18) fluorodeoxyglucose (FDG)/positron emission tomography (PET)-CT has potential to identify subcentimeter-sized nodal metastases, higher prevalence of pelvic inflammatory disease in developing countries could result in lower accuracy. The present study was undertaken to assess the incremental value of PET scan over CECT for nodal staging before radical surgery.Methods:Forty-four patients with the International Federation of Gynecology and Obstetrics (FIGO) Stage IA2–IIb carcinoma cervix and 28 patients of FIGO Stage I–II carcinoma endometrium underwent F-18 FDG-PET-CECT scan. A SUVmax value >2.5 g/ml based on body weight was considered as positive. An enhancing node with >1 cm size in the shortest dimension, with loss of fatty hilum was considered positive on CT images. The histological findings were considered the gold standard against which the two modalities were compared.Results:All 1226 pelvic nodes were dissected, of which 65 were found to be metastatic (i.e., 5.3%). Of the 72 patients, 15 (20.83%) had pelvic nodal metastases. The overall accuracy of PET and CECT for assessment of pelvic nodal metastases was comparable (i.e., 86% vs. 85%).Conclusion:PET and CECT scans have similar accuracy in pelvic nodal staging of operable uterine malignancies. Granulomatous inflammation may not be a major cause of false-positive results. The sensitivity and negative predictive values are not high enough to obviate need of surgical nodal staging.

Activating TiO2 Nanoparticles: Gallium-68 Serves as a High-Yield Photon Emitter for Cerenkov-Induced Photodynamic Therapy.

The classical photodynamic therapy (PDT) requires external light to activate photosensitizers for cancer treatment. However, limited tissue penetration of light has been a long-standing challenge for PDT to cure malignant tumors in deep tissues. Recently, Cerenkov radiation (CR) emitted by radiotracers such as 18F-fluorodeoxyglucose (18F-FDG) has become an alternative and promising internal light source. Nevertheless, fluorine-18 (F-18) only releases 1.3 photons per decay in average; consequently, injection dose of F-18 goes beyond 10-30 times more than usual to acquire therapeutic efficacy because of its low Cerenkov productivity. Gallium-68 (Ga-68) is a favorable CR source owing to its ready availability from generator and 30-time higher Cerenkov productivity. Herein, we report, for the first time, the use of Ga-68 as a CR source to activate dextran-modified TiO2 nanoparticles (D-TiO2 NPs) for CR-induced PDT. Compared with 18F-FDG, 68Ga-labeled bovine serum albumin (68Ga-BSA) inhibited the growth of 4T1 cells and exhibited significantly stronger DNA damage to tumor cells. In vivo studies showed that the tumor growth was almost completely inhibited when tumor-bearing mice were treated with a combination of D-TiO2 NPs and 68Ga-BSA. This study proved that Ga-68 is a more potent radionuclide for PDT than F-18 both in vitro and in vivo offered a promising strategy of using a diagnostic dose of radioactivity to achieve depth-independent cancer therapy without using any external light source.

Muscular damage in a patient with hepatitis B induced by beta-l-2'-deoxythymidine and detected by 18F-FDG PET/CT.

A 58 years old man under 2'-Deoxy-L-thymidine treatment for his hepatitis B was admitted to our hospital complaining for the last 2 months of recurrent upper abdomen discomfort, fatigue and weight loss of 10 kilograms and general muscular soreness, for 2 weeks. He had elevated creatine kinase (CK), myoglobin, CK-MB and other related or common laboratory findings. Fluorine-18- fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) showed a diffuse, homogenous, moderately elevated glucose uptake in all muscle groups. Muscular damage induced by 2'-Deoxy-L-thymidine was suspected and the drug was discontinued. Muscle soreness and the biomarkers for muscular tissue damage improved. Fluorine-18-FDG PET/CT is useful to rule out malignancy and identify muscular tissue damage.

Diagnostic performance of [18F] fluorodeoxyglucose PET/CT and diffusion-weighted magnetic resonance imaging for the evaluation of treatment response to induction chemotherapy followed by definitive chemoradiotherapy in locally advanced head and neck squamous cell carcinoma

Recently, functional imaging such as fluorine-18 fludeoxyglucose integrated with computed tomography (18F-FDG-PET/CT) or difusion-weighted magnetic resonance imaging (DW-MRI) represent an area of highly active research in oncology. DW-MRI is an advanced imaging modality that records the molecular diffusion of protons to further assess tissue caracter, providing the opportunity to differentiate post-treatment tumour recurrence from chemoradiotherapy-induced local tissue changes (1). In the case of PET/CT, besides providing useful diagnostic information regarding pretreatment staging (2,3) and post-treatment follow-up (4), intensity of FDG uptake is emerging as a valuable predictive factor regarding treatment outcome (5).

Prognostic Value of SUVmax Measured by Pretreatment Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Patients with Ewing Sarcoma.

AimThe aim of this retrospective study was to determine whether glucose metabolism assessed by using Fluorine-18 (F-18) fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) provides prognostic information independent of established prognostic factors in patients with Ewing sarcoma.MethodsWe retrospectively reviewed the medical records of 34 patients (men, 19; women, 15; mean age, 14.5 ± 9.7 years) with pathologically proven Ewing sarcoma. They had undergone F-18 FDG PET/CT as part of a pretreatment workup between September 2006 and April 2012. In this analysis, patients were classified by age, sex, initial location, size, and maximum standardized uptake value (SUVmax). The relationship between FDG uptake and survival was analyzed using the Kaplan-Meier method with the log-rank test and Cox’s proportional hazards regression model.ResultsThe median survival time for all 34 subjects was 999 days and the median SUV by using PET/CT was 5.8 (range, 2–18.1). Patients with a SUVmax ≤ 5.8 survived significantly longer than those with a SUVmax > 5.8 (median survival time, 1265 vs. 656 days; p = 0.002). Survival was also found to be significantly related to age (p = 0.024), size (p = 0.03), and initial tumor location (p = 0.036). Multivariate analysis revealed that a higher SUVmax (p = 0.003; confidence interval [CI], 3.63–508.26; hazard ratio [HR], 42.98), older age (p = 0.023; CI, 1.34–54.80; HR, 8.59), and higher stage (p = 0.03; CI, 1.21–43.95; HR, 7.3) were associated with worse overall survival.ConclusionsSUVmax measured by pretreatment F-18-FDG PET/CT can predict overall survival in patients with Ewing sarcoma.

Value of 18F-FDG PET-CT in monitoring recurrence and metastasis of small intestinal adenocarcinoma

Objective To evaluate the clinical value of 18F-FDG PET-CT imaging on monitoring recurrence, metastasis and therapeutic decision-making in small intestinal adenocarcinoma patients after radical surgery. Methods Twenty-two patients were enrolled, who underwent surgical operation before received PET-CT scan. PET-CT findings were retrospectively observed to compare with the results of follow-up [postoperative pathology and (or) long-term clinical follow-up]. The roles of PET-CT on therapeutic decision-making were then investigated. Results Among 22 patients, 14 cases were finally diagnosed as recurrence and (or) metastasis, the other 8 cases as disease-free survival after long-term follow-up. According to PET-CT, 13 cases were diagnosed as recurrence and (or) metastasis (including 12 true-positive and 1 false-positive), and 9 cases were negative (including 2 false-negative). The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET-CT were 85.7 % (12/14), 87.5 % (7/8), 86.4 % (19/22), 92.3 % (12/13) and 77.8 % (7/9), respectively. The therapeutic decisions were changed in 10 patients (10/22, 45.5 % ) based on PET-CT results. Conclusion 18F-FDG PET-CT has an important clinical value on the detection of recurrence and (or) metastasis of small intestinal adenocarcinoma, which is an ideal method of monitoring. Key words: Small intestinal neoplasms; Positron-emission tomography; Fluorine-18 fluoro-deoxy-glucose; Recurrence; Neoplasm metastasis

Imaging integrin αvβ 3 and NRP-1 positive gliomas with a novel fluorine-18 labeled RGD-ATWLPPR heterodimeric peptide probe.

Radiolabeled Arg-Gly-Asp (RGD) and Ala-Thr-Trp-Leu-Pro-Pro-Arg (ATWLPPR) peptide analogs have received interests for their capability to serve as radiopharmaceuticals for imaging integrin αvβ3 and Neuropilin-1 (NRP-1) positive tumors, respectively. In this study, we developed a RGD-ATWLPPR heterodimeric peptide which contained both RGD and ATWLPPR motifs in one molecular probe. The aim of this study was to investigate the dual receptor-targeting property and tumor diagnostic value of RGD-ATWLPPR heterodimeric peptide labeled with fluorine-18 (F-18). A RGD-ATWLPPR heterodimer was synthesized from c(RGDyK) and ATWLPPR through a glutamate linker. The peptide was radiolabeled by reacting the [(18)F]fluoride-aluminum complex with the cyclic chelator, 1,4,7-triazacyclononane-1,4,7-triacetic acid (NOTA). The receptor-binding characteristics and tumor-targeting efficacy of [(18)F]FAl-NOTA-RGD-ATWLPPR were tested in vitro and in vivo. RGD-ATWLPPR had affinity for both integrin αvβ3 and NRP-1 in vitro. [(18)F]FAl-NOTA-RGD-ATWLPPR displayed significantly higher tumor uptake than [(18)F]FAl-NOTA-RGD and [(18)F]FAl-NOTA-ATWLPPR, both in vitro and in vivo. The uptake of the F-18 labeled heterodimer by an U87MG tumor was inhibited only partially in the presence of an excess amount of unlabeled RGD or ATWLPPR but was blocked completely in the presence of both RGD and ATWLPPR. Compared with the monomeric RGD and ATWLPPR peptides, [(18)F]FAl-NOTA-RGD-ATWLPPR showed improved in vivo pharmacokinetics, resulting in a more preferable imaging quality. [(18)F]FAl-NOTA-RGD-ATWLPPR exhibited significantly improved receptor-targeting properties both in vitro and in vivo compared with the F-18 labeled RGD or ATWLPPR monomers. The improved targeting and localization exhibited by the RGD-ATWLPPR heterodimer provide a foundation for further investigations of its applicability in clinical tumor imaging.

PWE-038 Significance Of Incidental Gastrointestinal Lesion On Pet Scan

IntroductionCT PET scan with fluorine-18 (F-18) fluorodeoxyglucose (FDG), is a increasingly common investigation in the evaluation and management of several malignant and non-malignant conditions. (1–3). The usefulness of this technique...

GATE Simulation of the Biograph 2 PET/CT Scanner

GATE is advanced open source software dedicated to numerical simulations in medical imaging and radiotherapy. It currently supports simulations of Emission Tomography (Positron Emission Tomography - PET and Single Photon Emission Computed Tomography - SPECT), Computed Tomography (CT) and Radiotherapy experiments. This work focused on the commercial Biograph 6 PET/CT scanner. The study targeted to (a) port previously developed and validated GATE codes to the currently available stable version GATE v.6.1, (b) evaluate model's validity detecting sources of bias (c) investigate differentiations imposed if different sources were employed, namely F-18 (Fluorine-18), O-15 (Oxygen-15) and C-11 (Carbon-11). The geometry of the system components was described in GATE, including detector ring, crystal blocks, PMTs etc. Energy and spatial resolution were taken into account. The GATE results were compared to experimental data obtained according to the NEMA NU-2-2001 protocol, Analysis was limited to scatter fraction, count looses and randoms. Good agreement was achieved between experimental and GATE results. Significant sources of bias were the (a) dead time value, (b) dead-time mode (paralysable-nonparalysable), (c) modelled activity (d) modelled source, (e) additional dead time values adopted in GATE modules.

Atherosclerotic inflammatory activity in the aorta and its correlation with aging and gender as assessed by 18F-FDG-PET.

Recent literature demonstrates the potential of fluorine-18 fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) to detect, localize, and quantify the degree of inflammatory changes in the arterial wall due to early atherosclerosis. Our aim was to assess the correlation between the age and 18F-FDG uptake of aortic segments and determine its correlation with respect to in both age and genders. Fluorine-18-FDG uptake in aortic segments in 143 subjects (58 men, 85 women; ages 5-82 years) was evaluated in this study. Subjects were initially grouped according to the gender, and then by age (below or above 50) with at least 26 subjects per group. Mean standardized uptake value (SUV) of ascending aorta, arch, descending thoracic aorta, and abdominal aortic segments were calculated in each subject. Correlative analyses between age and mean SUV of aortic segments in all subjects were undertaken. Mean SUV between genders for all groups were also compared. There was a positive correlation between age and mean SUV of all aortic segments. The correlation values in all aortic segments were higher in subjects below 50 years old compared to those above 50 years in the entire group of patients as well as when they were subdivided and analyzed according to both genders (P<0.001). Descending thoracic and ascending aortic segments in men below 50 years of age had the highest correlation of 18F-FDG uptake and age (0.85 and 0.80, respectively) whereas abdominal aortic segments in men the above 50 years age group had the lowest correlation value (0.20). Comparison between mean SUV in four visible arterial segments between the two genders did not reveal any statistically significant difference. In conclusion, 18F-FDG uptake in aortic segments increases with age irrespective of genders. The increase with age is more significant in younger subjects compared to older subjects for both men and women. This finding may indicate a deceleration in the inflammatory component of atherosclerosis with aging in older subjects.

Hyperaccumulation of (18)F-FDG in order to differentiate solid pseudopapillary tumors from adenocarcinomas and from neuroendocrine pancreatic tumors and review of the literature.

Solid pseudopapillary tumors (SPT) are rare, unique pancreatic tumors with benign entity and low malignant potential. Limited information is available in the literature reporting their accumulation of fluorine-18 fluoro deoxyglucose ((18)F-FDG) using positron emission tomography/computed tomography (PET/CT). The aim of this retrospective study was to define t he uptake-accumulation of (18)F-FDG PET/CT in a comparatively large cohort of SPT, and to compare their uptake with the uptake of (18)F-FDG in pancreatic ductal adenocarcinomas (PAC) and neuroendocrine tumors (PNET). Between June 2007 and January 2013, 18 pathologically proven SPT were identified from the total of patients studied by PET/CT in our Center, including 13 women and 5 men, aging from 23 to 56 years old (mean age, 38.5 years). Malignant SPT was histologically classified using the WHO criteria. Eighty-six PAC patients and 28 PNET patients were also identified and included in this study for comparison. Positron emission tomography results were considered as positive if focal accumulation of (18)F-FDG exceeded the surrounding normal pancreatic tissue. Regions of interest were drawn on the pancreatic lesions, and the maximal standardized uptake values (SUVmax values) were calculated. The mean values of SUVmax were compared with independent-samples t test or with the nonparametric Mann-Whitney U method. Correlation of SUVmax values and tumor size were analyzed in cases of SPT. Receiver operating characteristics (ROC curve) were used to study the efficiency of SUV values for the differential diagnosis between SPT versus (vs) PAC and SPT vs PNET. A value of P<0.05 was considered statistically significant. All SPT cases were (18)F-FDG-PET positive, with SUVmax values ranging from 3.5-18.3. The SUVmax values of SPT had poor correlation with tumor size, and no significant difference by gender and age. Areas under the curve ROC were 0.619 and 0.526, respectively for the differentiation of SPT from PNET and PAC tumors. Five SPT tumors were malignant, and exhibited relatively low (18)F-FDG uptake (SUVmax range, 3.0-4.5) except a tumor after recurrence (SUVmax 17.7). Images of CT were of low dose and thus were not evaluated. In conclusion, our results suggest that SPT benign or malignant are consistently hyperaccumulating (18)F-FDG above SUVmax 3. Differentiation from PAC and PNET if only based on the higher SUVmax values was not possible but if based on lower SUVmax, of ≤2.6 (in 14%) and ≤2.5 (in 21,4%) of PAC and PNET, respectively, these pancreatic tumors could be differentiated from SPT.

Five benign myoskeletal diseases in paediatrics and the role of nuclear medicine. Do they differ from those in adults?

In this paper we discuss trauma, osteomyelitis, fibrous dysplasia, Legg-Calvé-Perthes disease and osteopetrosis in children. Pathophysiology, incidence, clinical signs, diagnosis and specific trteatment of these diseases are described. We have focused on diagnostic imaging techniques which can be applied in children: X-rays, magnetic resonance imaging bone scintigraphy with technetium- 99m-methylene diphosphonate ((99m)Tc-MDP) and positron emission tomography (PET) with fluorine-18 fluorodesoxyglucose ((18)F-FDG) and fluorine-18 fluoro sodium fluoride ((18)F-NaF). In conclusion, bone scintigraphy with (99m)Tc-MDP and better with PET ((18)F-FDG and (18)F-NaF) can support diagnosis of most of these myoskeletal diseases in children. Radiology is usually applied for local lesions examinations. Magnetic resonance imaging can be used in specific cases in periosteal and bone marrow lesions and CT may be avoided due to its radiation burden, in children.

Assessment of the diagnostic performance of (18)F-FDG-PET/CT for detection and characterization of solid renal malignancies.

To evaluate the sensitivity of the positron emission tomography (PET) portion of fluorine-18 fluorodeoxyglucose- PET-computerized tomography ((18)F-FDG-PET/CT) to detect solid malignant renal masses, and to assess for metabolic differences based on histopathological type. Nineteen subjects with 25 known solid malignant renal masses who underwent (18)F-FDG-PET/CT were retrospectively evaluated. Qualitative analysis of the PET portion only of (18)F-FDG-PET/CT examinations to assess visual detection of renal masses was initially performed in blinded fashion. Subsequently, measurements of standardized uptake value (SUV) and lesion-to-background ratios were performed for all masses and compared between histopathological types. Of 25 solid malignant renal masses, 18 were renal cell carcinoma (RCC), 3 were renal lymphoma, and 4 were metastases. Twenty-two of 25 were detectable, and all were correctly spatially localized. Fifteen of 22 detectable lesions were exophytic in configuration. The three non-detectable masses were non-exophytic RCC's with average diameter of 2.0cm. Fifteen of 18 of RCC were detectable, whereas all renal lymphomas and metastases were detectable. None of the metabolic parameters were statistically significant between RCC and renal lymphoma. However, all metabolic parameters were statistically significantly greater for renal metastases compared to RCC and renal lymphoma, and for clear cell RCC compared to papillary RCC. In conclusion, the PET portion of (18)F-FDG-PET/CT had a sensitivity of 88% for detection of solid malignant renal lesions in patients with known renal malignancy, and reveals differences in metabolic activity based on histopathological type, which may be useful for purposes of individualized medicine. Further studies are required for more in depth assessment of these preliminary observations.

Evaluation of the Use of Carbon-11 Methionine PET Scans in Pediatric Patients With Craniopharyngioma

The most commonly used tracer for PET imaging is fluorine-18 (F-18) fluorodeoxyglucose (FDG). Its use is limited in the detection and evaluation of brain tumors due to the high basal activity of the cerebral cortex and white matter. Carbon-11 (C-11) methionine (MET) has little uptake under normal conditions in the brain. This allows for slight elevations in MET uptake to be more readily detected, making it an attractive PET tracer for the evaluation of brain tumors. We investigated the uptake of C-11 MET PET in patients with craniopharyngioma prior to proton therapy.

An efficient synthesis of ([ 18F]fluoropropyl)quinoline-5,8-diones by rapid radiofluorination–oxidative demethylation

Since many molecules bearing quinoline-5,8-dione or fused 1,4-quinone moieties possess a wide spectrum of biological activities, efficient methods for incorporation of fluorine-18 (F-18) into quinoline-5,8-diones have received considerable attention in positron emission tomography (PET) molecular imaging studies. In this paper, we describe an efficient synthetic route for the regioselective preparation of fluoropropyl-substituted quinoline-5,8-diones on the C3, C4, and C6 positions by tert-alcohol media fluorination, followed by oxidative demethylation of the corresponding dimethoxy compound using N-bromosuccinimide (NBS) in the presence of catalytic amounts of sulfuric acid. Moreover, F-18 labeled [ 18F]fluoropropylquinoline-5,8-diones [ 18F] 21– 23 were prepared from the corresponding mesylate precursors by a method of rapid and efficient one-pot, two-step reactions: radiofluorination using TBA [ 18F]F generated under no-carrier-added (NCA) conditions; oxidative demethylation, resulting in a 45% radiochemical yield of [ 18F] 21– 23 (decay-corrected) with a total synthesis time (including HPLC purification) of 75 min and high radiochemical purity (>99%), as well as high specific activity (∼230 GBq/μmol).

Differentiation of benign from malignant lesions of heart and pericardium: the feasibility of Fluorine-18 fluorodeoxyglucose positron emission tomography CT

Objective To assess the feasibility of integrated 18F-FDG PET-CT for the differentiation of malignancy from benign lesions of heart and pericardium. Methods A total of 23 cases (malignancy∶benign= 13∶10) with cardiac and pericardial lesions confirmed by pathology or clinic were analyzed in the present study. All lesions were evaluated semi-quantitatively using maximum standard uptake values (SUVmax) and SUVmax lesion/blood, and the density of the heart and pericardium lesions and the relationship with surrounding tissues were evaluated. The differences of SUVmax and SUVmax lesion/blood between benign and malignant lesions were analyzed using Mann-Whitney test. Subsequently, the diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated for CT and PET-CT respectively. Results The maximum SUV showed significant difference between malignancy(6. 5 ) and benign ( 1.5 ) ( Z = - 3. 601, P ＜ 0. 01 ), the SUVmax Lesion/Blood of malignancy and benign were 3.4 and 0. 9 respectively, also with significant difference(Z = -3. 600, P ＜0. 01 ). The optimal cut-off value of SUVmax is 3.5-4. 0 and SUVmax Lesion/Blood is 1.3-2. 0. The sensitivity, specificity, accuracy, PPV and NPV of CT and PET-CT were 76. 9％ ( 10/13 ), 100. 0％ ( 10/10) ,87.0％ (20/23), 100. 0％ ( 10/10 ), 76. 9％ ( 10/13 ) and 100. 0％ ( 13/13 ), 90. 0％ (9/10), 95.7％(22/23),92.9％ (13/14),100.0％ (9/9) respectively. Conclusion 18F-FDG PET-CT can correctly differentiate benignity and malignancy of cardiac and pericardial lesions. Key words: Pericardium; Heart neoplasms; Tomography, X-ray computed; Positron-emission tomography; Diagnosis, differential