Role Of PET-CT Research Articles

The role of Pet-Ct in neuroendocrine tumors without an identified primary focus: A case report and review

The role of Pet-Ct in neuroendocrine tumors without an identified primary focus: A case report and review

Role of PETCT in multiple myeloma: A 3 year data analysis of tertiary care center.

e20030 Background: Bone involvement is one of the most common presentations of multiple myeloma, seen in about two-thirds of patients at the time of diagnosis. Therefore, imaging is an integral part of diagnosis for detection of lytic bone lesions and extra medullary disease. Evaluation of disease burden in both multiple myeloma and plasmacytoma as measured by PET/CT scan and response evaluation to induction therapy using PET based SUV changes is an important research topic. Methods: Single center prospective study done from 1st January,2020 to 30th June,2021 in Sarvodaya hospital and research center, Faridabad. All patients with multiple myeloma and solitary plasmacytoma coming to Sarvodaya hospital were eligible for the study. Total of 42 patients were enrolled into the study. PET-CT was done at baseline and post treatment as planned. Results: Out of 42 patients, 2 patients were diagnosed as solitary plasmacytoma and 40 patients were diagnosed as multiple myeloma. The median age of presentation was 64 years with male predominance (64.29%). PET-CT was done pre-treatment, On the basis of PET-CT findings it was seen that < 3 focal lesions were seen in 24(57.14%) patients and > 3 focal lesions were seen in 18(42.86%) of patients, based on SUV max, lesions with < 4.2 SUV max value were seen in 23(54.77%) patients and lesions with > 4.2 SUV max values were seen in 19(45.23%) patients. Presence of extra medullary disease was seen in 17(40.48%) of patients. 39(92.86%) patients were available for response analysis post treatment.3(7.14%) patients were expired during the study due to treatment complications and comorbidities. On the basis of PET-CT findings post treatment there was statistically significant response seen with p value of < 0.05 in the number of focal lesions, lesions with SUV max and burden of extra medullary disease. Evaluation of response when assessed radio logically by PET-CT scan, it was seen that Complete response was found in 22(56.40%) patients, VGPR was seen in 4(10.25%) patients, PR was found in 12(30.77%) patients and PD was seen in 1(2.58%) patient. But the results of co-relation of PET-CT findings with survival outcomes were not significant. Conclusions: PET-CT plays a significant role in diagnosis and response assessment. But there is still no uniform criteria for quantification and visualization of FDG avid lesions for patients with multiple myeloma.

Functional Imaging in the Evaluation of Treatment Response in Multiple Myeloma: The Role of PET-CT and MRI.

Bone disease is among the defining characteristics of symptomatic Multiple Myeloma (MM). Imaging techniques such as fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) and magnetic resonance imaging (MRI) can identify plasma cell proliferation and quantify disease activity. This function renders these imaging tools as suitable not only for diagnosis, but also for the assessment of bone disease after treatment of MM patients. The aim of this article is to review FDG PET/CT and MRI and their applications, with a focus on their role in treatment response evaluation. MRI emerges as the technique with the highest sensitivity in lesions' detection and PET/CT as the technique with a major impact on prognosis. Their comparison yields different results concerning the best tool to evaluate treatment response. The inhomogeneity of the data suggests the need to address limitations related to these tools with the employment of new techniques and the potential for a complementary use of both PET/CT and MRI to refine the sensitivity and achieve the standards for minimal residual disease (MRD) evaluation.

PET-CT in Clinical Adult Oncology-VI. Primary Cutaneous Cancer, Sarcomas and Neuroendocrine Tumors.

Simple SummaryPositron emission tomography (PET), typically combined with computed tomography (CT), has become a critical advanced imaging technique in oncology. With PET-CT, a radioactive molecule (radiotracer) is injected into the bloodstream and localizes to tumor sites because of specific cellular features of the tumor that accumulate the targeting radiotracer. The CT scan is performed at the same time, facilitating better visualization of radioactivity from deep or dense structures and providing detailed anatomic information. PET-CT has a variety of applications in oncology, including staging, therapeutic response assessment, restaging and surveillance. This series of six articles provides an overview of the value, applications, imaging and interpretive strategies of PET-CT in the more common adult malignancies. In the current and sixth report in this series, the application of PET-CT is reviewed for more aggressive skin cancers, sarcomas and neuroendocrine tumors.PET-CT is an advanced imaging modality with many oncologic applications, including staging, therapeutic assessment, restaging and surveillance for recurrence. The goal of this series of six review articles is to provide practical information to providers and imaging professionals regarding the best use of PET-CT for specific oncologic indications, the potential pitfalls and nuances that characterize these applications, and guidelines for image interpretation. Tumor-specific clinical information and representative PET-CT images are provided. The current, sixth article in this series addresses PET-CT in an evaluation of aggressive cutaneous malignancies, sarcomas and neuroendocrine tumors. A discussion of the role of FDG PET for all types of tumors in these categories is beyond the scope of this review. Rather, this article focuses on the most common malignancies in adult patients encountered in clinical practice. It also focuses on Food and Drug Agency (FDA)-approved and clinically available radiopharmaceuticals rather than research tracers or those requiring a local cyclotron. This information will serve as a guide to primary providers for the appropriate role of PET-CT in managing patients with cutaneous malignancies, sarcomas and neuroendocrine tumors. The nuances of PET-CT interpretation as a practical guide for imaging providers, including radiologists, nuclear medicine physicians and their trainees, are also addressed.

Role of PET-CT in detection of primary tumor in cases of metastases of unknown primary

Role of PET-CT in detection of primary tumor in cases of metastases of unknown primary

PET-CT in Clinical Adult Oncology: III. Gastrointestinal Malignancies.

Simple SummaryPositron emission tomography (PET), typically combined with computed tomography (CT), has become a critical advanced imaging technique in oncology. With PET-CT, a radioactive molecule (radiotracer) is injected in the bloodstream and localizes to sites of tumor because of specific cellular features of the tumor that accumulate the targeting radiotracer. The CT scan, performed at the same time, provides information to facilitate the characterization of radioactivity from deep or dense structures, and to provide detailed anatomic information. PET-CT has a variety of applications in oncology, including staging, therapeutic response assessment, restaging and surveillance. This series of six review articles provides an overview of the value, applications, and imaging interpretive strategies of PET-CT in the more common adult malignancies. The third report in this series provides a review of PET-CT imaging in gastrointestinal malignancies.PET-CT is an advanced imaging modality with many oncologic applications, including staging, assessment of response to therapy, restaging and longitudinal surveillance for recurrence. The goal of this series of six review articles is to provide practical information to providers and imaging professionals regarding the best use of PET-CT for specific oncologic indications, and the potential pitfalls and nuances that characterize these applications. In the third of these review articles, key tumor-specific clinical information and representative PET-CT images are provided to outline the role that PET-CT plays in the management of patients with gastrointestinal malignancies. The focus is on the use of 18F fluorodeoxyglucose (FDG), rather than on research radiopharmaceuticals under development. Many different types of gastrointestinal tumors exist, both pediatric and adult. A discussion of the role of FDG PET-CT for all of these is beyond the scope of this review. Rather, this article focuses on the most common adult gastrointestinal malignancies that may be encountered in clinical practice. The information provided here will provide information outlining the appropriate role of PET-CT in the clinical management of patients with gastrointestinal malignancies for healthcare professionals caring for adult cancer patients. It also addresses the nuances and provides interpretive guidance related to PET-CT for imaging providers, including radiologists, nuclear medicine physicians and their trainees.

Diagnostic Role of PET CT in Hepatocellular Carcinoma Compaired with Triphasic CT Imaging

Diagnostic Role of PET CT in Hepatocellular Carcinoma Compaired with Triphasic CT Imaging

Interim-PET As a Predictive Factor in Patients with Hodgkin's Lymphoma

Introduction. PET-CT is the new standard for staging of patients with Hodgkin Lymphoma (HL). However, it is becoming obvious that the role of PET-CT in assessment of response is not limited to imaging at the end-of-treatment. In recent years the prognostic role of interim PET-CT and attempt to use PET response-adapted therapy has come under evaluation across a number of international studies with promising results. Here we report the results of a multicenter retrospective study of interim PET in HL.Methods. 53 patients with HL with a stage I-II (64%), III-IV (36%) who were admitted between August 2012 and May 2017 to 10 Ukrainian hematological centers were included in this retrospective analysis. Metabolic PET-CT imaging was performed at participating PET centers according to routine protocols, compatible with EANM guidelines for FDG PET-CT imaging in malignant tumors. Interim PET (PET2) was performed at 15.5 ±3 days (range, 5-26) after 2d and 4th cycles of traetment in 75% and 25% cases, respectively. Patients were treated with ABVD or BEACOPP-14/esc based on risk group. The primary endpoint was event-free survival (EFS), defined as disease progression or death from HL.Results. Median age of patients at diagnosis was 32 years (range 17-56), and 63% of patients were female. B symptoms were present in 42% (22/53), extranodal disease in 4% (2/53), and bulky disease (>10 cm in any dimension) in 25% (13/53) of pts. Median follow-up was 24 months from diagnosis. Interim PET-CT, performed after chemotherapy, was categorized as Deauville 1-2 in 34 patients (56%), Deauville 3 in 12 (32%), Deauville 4 in 5 (10%), and Deauville 5 in 2 (2%). The threshold of positivity was set for a residual uptake higher than the liver background (grade 4 and 5 of the scale).13% (7/53) and 87% (46/53) patients in our cohort were PET2-positive (PET2+) and negative (PET2-), respectively (p<0.05). In total, disease progression was documented in 43% (3/7) of PET2+ patients and 11% (5/46) if PET2-negative patients (p<0.05). There was 1 death from refractory disease. 3-year EFS for patients with PET2+ vs PET2- was 45% vs 77%, respectively (p<0.05).Also, we compared EFS in patients with PET2 according to the Deauville score subgroups: 1-2 vs 3 vs 4-5 scores. The 3-year EFS was significant difference: 91% for the Deauville 1-2 subgroup versus 86% for Deauville 3 versus 46% for Deauville 4-5, (p < 0.004).Conclusion. Interim PET-CT is an important tool for clinicians in the diagnosis and management of patients with HL. The pronostic role and validity of the Deauville 5PS for interpretation of interim PET should be confirmed prospectively. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Clinical utility of FDG PET-CT in stage 1 and advanced testicular seminoma.

5027 Background: Testicular seminoma is highly curable; however, treatments can cause long-term morbidity in survivors. Following chemotherapy for advanced seminoma, positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose together with computerised tomography (PET-CT) can identify patients with residual masses who do not need additional treatment. Its role in detecting recurrence during active surveillance, particularly in patients with small indeterminate masses, is unknown. We assessed the clinical utility of PET-CT in testicular seminoma undergoing active surveillance for stage 1 disease and following curative-intent treatment for advanced disease. Methods: An institutional database was interrogated to identify patients with testicular seminoma who underwent PET-CT between 2000-2020. Demographic, clinicopathological, PET-CT findings and outcome data were retrieved. The positive predictive value (PPV) of PET-CT for correctly identifying disease recurrence was calculated, with disease recurrence (true positive) defined as progressive radiological change, response to treatment or histological confirmation. Negative predictive value (NPV) was calculated for correctly identifying non-recurrence (true negative) at 24-months post PET-CT. Results: We identified 193 PET-CT in 181 stage 1 patients. Of these, 18 (10%) PET-CT were positive, with all correctly diagnosing recurrence, PPV 100%. Of the 138 negative PET-CT with at least 24 months follow up, 5 recurrences developed, NPV 96%. In the subset of PET-CT conducted for suspicion of recurrence in stage 1 patients (n = 71: abnormal imaging n = 65, elevated markers n = 4, other clinical suspicion n = 2), 16 (23%) PET-CT were positive, with all correctly diagnosing recurrence, PPV 100%. In this subset, the NPV is 93% at 24 months (3 recurrences in 44 negative PET-CT). We also identified 154 PET-CT in 77 post-treatment, advanced stage patients. Of these, 69 (45%) PET-CT were positive, with 51 correctly diagnosing recurrence, PPV 74%. Of the 66 negative PET-CT with at least 24 months follow up, 5 recurrences developed, NPV 92%. In the subset of PET-CT performed for suspicion of recurrence following treatment for advanced disease (n = 61: abnormal imaging n = 49, elevated markers n = 5, other clinical suspicion n = 7), 41 (67%) PET-CT were positive, with 36 correctly diagnosing recurrence, PPV 88%. In this subset, the NPV is 94% at 24 months (1 recurrence in 17 negative PET-CT). Conclusions: At our centre, PET-CT has a very high PPV for recurrence, particularly in stage 1 disease, and a very high NPV for non-recurrence in all disease settings. In the subset of PET-CT performed for suspicion of recurrence, PPV is &gt; 88% and NPV is &gt; 93%. The role of PET-CT should be considered in patients with suspicion of recurrence where it may prevent over-treatment in up to 70% patients in stage 1 or 30% in advanced disease.

The role of PET-CT in staging anal cancers planned for radical intensity-modulated radiotherapy: a single centre experience

The role of PET-CT in staging anal cancers planned for radical intensity-modulated radiotherapy: a single centre experience

Essential role of PET-CT in the management of patients with severe infectious complication CIEDS: multicentre study

Abstract Background With the increasing number of implanted cardiac pacemakers, ICDs and CRTs, the number of serious infectious complications of these procedures increases significantly, especially in the longer term from the primary implantation. The systematic solution is in most cases endovasal extraction of these systems. Methods In a multicenter, prospective, randomized, controlled trial evaluating the benefit of CIEDS infection management in 277 patients, a conventional approach using blood cultures, microbiological examinations and TEE versus innovative management of these patients using PET-CT was compared. PET-CT examination is able to differentiate very well the infection of the implant pocket (Figure A) against bacterial endocarditis (Figure B). Thanks to this, it is possible to individualize the management of the patient and to shorten the dates of hospitalization, resp. time to re-implantation of the new system in patients without the presence of bacterial endocarditis. Results The results of the multicentre study are summarized in Table 1. Conclusions A comprehensive examination of patients with CDRIE using PET-CT significantly shortens hospital stay, time of antibiotic therapy and, as a consequence, leads to a lower incidence of serious complications of extraction procedures. PET-CT in CDRIE patients Funding Acknowledgement Type of funding source: None

The Role of PET-CT in Gastric Cancer – A Narrative Review

Background: Gastric cancer is one of the most common and leading causes of cancer death worldwide, with an increasing risk and prevalence. Although the usage of 18-FDG PET-CT in gastric cancer evaluation remains a matter of debate and is not consistently recommended by international guidelines, our descriptive review aims to highlight its actual role in the diagnostic accuracy, staging, therapeutic management, and relapse monitoring of this malignancy.&#x0D; Methods: The current research was conducted using scholarly databases including PubMed, Scopus, and Google Scholar by searching useful science journals, references, and abstracts on the topic. The keywords used were “gastric cancer” AND “PET-CT”.&#x0D; Results: 18-FDG PET-CT remains a promising method with increasing clinical utility not only across a wide variety of malignancies, but also among gastric cancer patients.&#x0D; Conclusions: We are certain that with further improvements, this technique could improve the diagnosis and evaluation of gastric cancer, and make it more approachable and accurate.&#x0D; Keywords&#x0D; gastric cancer (GC), PET-CT, 18-FDG PET-CT, 18F-FDG uptake, ceCT (contrast-enhanced CT)

The added value of hybrid 18F-FDG PET/CT over CT in the detection of breast cancer metastatic deposits

BackgroundBreast cancer is a major health problem resulting in high morbidity and mortality. Early diagnosis of primary and secondary lesions is crucial to optimize treatment options. Our study aimed to investigate the role of PET-CT and CT alone in detecting metastatic lesions in breast cancer patients.ResultThis retrospective study showed better PET diagnostic performance in the detection of lymph nodal and lytic bony metastatic deposits with more accurate detection of the malignant nature of hepatic focal lesions and detection of activity in sclerotic bony lesions, compared with CT alone, while CT had a higher value in the localization of lesions. Hybrid PET/CT showed optimal diagnostic performance than each modality separately.ConclusionThe combination of CT and PET was a powerful diagnostic tool that is more accurate than CT alone in the detection of distant metastases.

Role of PET CT in comparison to triphasic CT in early follow-up of hepatocellular carcinoma after transarterial chemoemoblization

BackgroundThe aim of the study is to compare the role of PET/CT and that of triphasic CT in hepatocellular carcinoma post chemoembolization evaluation, thus guiding clinicians for proper management strategy.Thirty patients who had transarterial chemoembolization done for HCC were subjected to both radiological modalities, 18F-FDG PET/CT and triphasic CT, with the results compared.ResultsIn our study, triphasic CT revealed 20 true positive results, 3 true negative results, 7 false negative results, and no false positive cases thus exhibiting calculated sensitivity, specificity, and accuracy of 74%, 100.0%, and 76.7% respectively. On the other hand, PET/CT showed 26 true positive results, 2 true negative results, 1 false negative result, and 1 false positive result to exhibit calculated sensitivity, specificity, and accuracy of 96.3%, 66.7%, and 93.3%, respectively.Conclusion18F-FDG PET/CT showed high diagnostic accuracy over triphasic CT in interventional bed evaluation following TACE especially for patients with non-conclusive triphasic CT results and persistent elevated levels of AFP.

Predictive Value of PET-CT in Patients with T-Cell Lymphoma Undergoing Autologous and Allogeneic Stem Cell Transplant

Introduction T-NHL are associated with an aggressive clinical course and poor outcomes. The role of PET-CT at the time of SCT (pre-SCT), BM biopsy, and peripheral blood (PB) flow cytometry have not been well investigated. We retrospectively analyzed 83 pts with T-NHL undergoing auto or allo SCT to determine the predictive value of pre-SCT PET-CT scan, BM and PB flow for relapse-free survival (RFS) and OS. Methods PET CR was defined as the absence of any radiographic dz by PET-CT (5-pt score). Overall CR was defined as negative PET, BM and PB flow. Pre-SCT variables were assessed for their effects on RFS and OS: age, number of previous lines of therapy, CIBMTR dz risk, pre-SCT BM, pre-SCT PB flow, and pre-SCT PET-CT. Results Of 83 pts studied, 49 were autoSCT and 34 were alloSCT. Six pts who underwent alloSCT had received a prior autoSCT. Diagnosis was PTCL NOS 34, AITL 23, CTCL/Sezary syndrome 11, nasal NK-T 6, EATL 3, SPTCL 2, hepatosplenic 1, ALK-ALCL 1, HTLV-2 ATL 1, T-lymphoblastic 1. The majority of pts with AITL (16/23) underwent autoSCT upfront. Conditioning for autoSCT was BEAM. Conditioning for alloSCT was Pentostatin/TBI in all but 6 SCT. Median lines of therapy prior to SCT were 1 for auto and 4 (r 2-13) for alloSCT. Median age at SCT was 60 (r 20-75). A total of 6 out of 49 (12%) autoSCT and 8 out of 34 (24%) alloSCT had positive PET-CT (score 4-5) at the time of SCT. BM was positive in 8 out of 49 (16%) at the time of autoSCT and 7 out of 34 (21%) at the time of alloSCT. PB flow was positive in 9 out of 49 (18%) at the time of auto SCT and 6 out of 34 (12%) at the time of alloSCT. CIBMTR dz index was low in 57(69%), intermediate in 15(18%), and high in 11 (13%) of 83 SCT. The majority of allo-SCT were intermediate-high risk. The median follow-up 56 months (r 6 - 122). Twenty (24%) pts had expired. Univariate analysis of pre-autoSCT variables did not reveal statistically significant (SS) results for BM or PET positivity. Univariate analysis of pre-alloSCT variables identified positive BM and positive PET/CT scan as being SS. There was a SS lower incidence of relapse, longer RFS and OS in alloSCT pts with either negative pre-SCT PET-CT scan or negative pre-SCT BM. Other pre-SCT variables tested were not SS. In multivariate analysis, pre-alloSCT PET-CT alone retained SS. Pre-alloSCT PET-CT scan was a strong predictor of 2-yr RFS and 2-yr OS. Conclusion This data indicates that in heavily pretreated pts with T- NHL undergoing alloSCT, a negative pre-SCT PET-CT is a statistically significant predictor of long-term RFS and OS regardless of dz risk and number of lines of therapy. Due to the small number of autoSCT with positive PET-CT scans, BM biopsy, or PB flow at the time of SCT, no association between the above-mentioned variables and relapse was identified. Further studies with larger numbers of pts are warranted to determine the role of pre-autoSCT PET-CT, BM and PB flow as prognostic factors in T-NHL.

Role of PETCT in locally advanced gall bladder cancer

Background: Locally advanced gall bladder cancer (LAGBC) portends a grave prognosis. Its management entails a critical balance of choosing the patients who will benefit from radical and often morbid multimodality treatment. This study aims to study the role of 18F-FDG (Fluoro-deoxyglucose) PET (Positron emission tomography)CT in detecting metastatic disease and deciding treatment intent in patients with LAGBC. Materials and Methods: This is an audit of a prospectively maintained database of GBC . Patients found to have locally advanced (T3/4,N+) but non-metastatic disease on initial imaging i.e. Contrast Enhanced Computed Tomography (CECT)/ Magnetic Resonance Imaging (MRI) Scan underwent an additional PETCT for staging and the changes impacting treatment decision were recorded. Results: 103 patients with LAGBC underwent both CECT/MRI and PETCT. 48/103 (46.6%) were found to be upstaged to stage IV after PETCT. The most common metastatic site was retroperitoneal lymph nodes (12 patients, 11.7%) followed by liver( 11,10.7%). The mean interval between CT and PETCT was 19 days. 14 (13.6%) patients had equivocal findings on PET scan which needed tissue diagnosis out of which 10(71.4%) were subsequently confirmed to have metastatic disease. Equivocal findings on CT scan (OR 1.5), poorly differentiated histology (OR 1.89), T3/4 disease (OR 1.16,1.33) had a higher incidence of upstaging on PETCT however only the presence of loco-regional nodes had a statistically significant increased risk (OR 6.15, p 0.006). Conclusion: PETCT appears to be a valuable tool in the armamentarium of oncologists while evaluating patients of LAGBC because of its high yield of detecting metastatic disease especially in patients with locoregional nodes on cross sectional imaging.

EP-1485 Role of PET-CT in patients of recurrent carcinoma cervix treated with definitive chemoradiotherapy

EP-1485 Role of PET-CT in patients of recurrent carcinoma cervix treated with definitive chemoradiotherapy

The role of PET-CT in the evaluation of the response of the vertebra metastases in stereotactic radiosurgery

Amaç: Bu çalışmada vertebra metastazlarında stereotaktik radyocerrahi (SRC) sonrası yanıt değerlendirmesinde pozitron emisyon tomografisinin (PET-BT) rolü araştırılmıştır.Gereç ve Yöntem: Geriye dönük olarak 16 veya 18 Gy SRC uygulanmış hastalar incelenmiştir. Analizlere SRC öncesinde herhangi bir derecede vertebra kompresyon kırığı gelişmemiş, radyosensitif olarak bilinen küçük hücreli akciğer ve hematolojik kanserlerli olgular dışındaki tedavi öncesi ve sonrası PET-BT verileri olan hastalar dâhil edilmiştir. Tüm vertebra segmentleri stabilite açısından spinal instability neoplastic score ’e göre sınıflandırılmış ve yanıt değerlendirmesinde PET Response Criteria in Solid Tumors (PERCIST) kriterleri kullanılmıştır.Bulgular: Toplam 75 hasta 119 VS’e (101 tek, 9 çift) SRC uygulanmış olup büyük kısmını (%66,7) meme kanserli hastalar oluşturmaktadır. VS’lerin %70,6’sı SINS 0-6’ya uymaktadır. Lokal kontrol hastaların %87,4’nde sağlanmış olup 1 yıllık lokal nükssüz sağkalım oranı %92,5 olarak bulunmuştur. İlk yanıt değerlendirme PET-BT’si ortanca 3 ayda (aralık: 1-35 ay) çekilmiş olup sadece 4 (%3.3) VS’de progresyon raporlanırken diğer VS’lerde SRC’ye yanıt mevcuttur (%30.3 tam, %43.7 kısmi, %22.7 stabil). Son PET’de sadece 11 VS’de lokal nüks tespit edilirken ilk PET’de tam yanıt olan hiçbir VS’de nihai olarak lokal nüks gelişmemiştir. İlk PET’de tam yanıt olması son PET’de de yanıt olmasıyla ilişkili bulunmuştur.Sonuç: SRC sonrası yanıt değerlendirmesinde ilk PET-BT yanıtı gerek son kontrol durumunu göstermesi açısından gerekse alternatif tedavileri planlamak açısından değerli bulunmuştur.

Role of PET CT in the detection of second synchronous primary tumors and distant metastasis in head and neck cancers at initial presentation

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The patients with the head and neck cancer are strongly at risk of developing a second primary tumor which can be related to share etiological factors such as tobacco, alcohol and smoking. The aim of the study is to evaluate the percentage of synchronous second primaries and distant metastasis that are identified on PET CT imaging in head and neck cancer patients at initial presentation.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study is a retrospective observational study. A total of 503 patients with histological confirmation of head and neck cancer and who had undergone 18F FDG PET CT imaging from 2007 to 2013 were included in the study. The PET CT scan images of all 503 patients were reviewed. The patients with PET CT scan images indicating the presence of abnormal metabolic uptake suggestive of additional primary malignant lesion or distant metastasis were identified. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of the total 503 patients with histological confirmation of head and neck cancer, 34 patients were excluded due to non-availability of complete details, among the 469 patients of head and neck cancer, 7 patients (1.49%) were diagnosed with synchronous primary tumors and 33 patients (7.03%) were diagnosed with distant metastasis in PET CT imaging at the time of initial presentation.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; PET CT imaging is a useful tool to detect distant metastasis and second primary synchronous tumors in advanced head and neck cancers. The incidence of distant metastasis is a much more valid indication for the PET CT imaging in advanced head and neck cancers.&lt;/p&gt;

The role of PET-CT in differential diagnosis of malignant-paramalignant pleural effusion

The role of PET-CT in differential diagnosis of malignant-paramalignant pleural effusion