Preliminary assessment of fluorine-18 fluorodeoxyglucose positron mission tomography in patients with bladder cancer

The purpose of this study was to assess the feasibility of imaging of bladder cancer with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) scanning. We studied 12 patients with histologically proven bladder cancer who had undergone surgical procedures and/or radiotherapy. Retrograde irrigation of the urinary bladder with 1000–3710 ml saline was performed during nine of the studies. Dynamic and static PET images were obtained, and standardized uptake value images were reconstructed. FDG-PET scanning was true-positive in eight patients (66.7%), but false-negative in four (33.3%). Of 20 organs with tumor mass lesions confirmed pathologically or clinically, 16 (80%) were detected by FDG-PET scanning. FDG-PET scanning detected all of 17 distant metastatic lesions and two of three proven regional lymph node metastases. FDG-PET was also capable of differentiating viable recurrent bladder cancer from radiation-induced alterations in two patients. In conclusion, these preliminary data indicate the feasibility of FDG-PET imaging in patients with bladder cancer, although a major remaining pitfall is intense FDG accumulation in the urine.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46842/1/259_2004_Article_BF00841398.pd

Capabilities of two- and three-dimensional FDG-PET for detecting small lesions and lymph nodes in the upper torso: a dynamic phantom study

The capabilities and limitations of two-(2D) and three-dimensional (3D) fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting small tumors and lymph nodes were studied in a phantom modeling the human chest and axilla. Multiple dual-radionuclide phantom studies were performed. Five hollow spheres ranging in diameter from 3 mm to 15 mm were filled with carbon-11 and placed in the axillary and mediastinal regions of an anthropomorphic phantom containing hollow organs filled with 18 F to simulate FDG uptake 1 h after injection. Dynamic imaging was performed to acquire PET images with varying target-to-background ratios. Imaging was performed in 2D and 3D acquisition modes, with and without attenuation correction, on a modern PET scanner. Lesion detectability was visually and quantitatively assessed. For objects larger than 9 mm in diameter, target-to-background ratios ranging from ∼3:1 to ∼10:1 were detectable. Objects < 9 mm in diameter required a target-to-background ratio of ≥18:1. Target-to-background ratios required for lesion detectability were equivalent for 2D and 3D PET images with and without attenuation correction. In conclusion, 2D and 3D PET with attenuation correction consistently detected ”tumors”≥ 9 mm. Lesions < 9 mm could be detected if there was high enough tumor uptake. No statistically significant differences in lesion detection were found for 2D versus 3D PET, or for attenuation-corrected versus non-attenuation-corrected images.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42075/1/259-26-1-39_90260039.pd

Rapid detection of human infections with fluorine-18 fluorodeoxyglucose and positron emission tomography: preliminary results

The purpose of this study was to evaluate the feasibility of 2-[fluorine-18]fluoro-2-deoxy- d -glucose (FDG) and positron emission tomography (PET) for rapid detection of human infections. Eleven patients who were known or suspected to be harboring various infections were studied with FDG-PET. Dynamic scans over the putative infection sites were performed immediately after FDG (370 MBq) injection through 60 min, and static images including multiple projection images were then obtained. FDG uptake was assessed visually into four grades (0, normal; 1, probably normal; 2, probably abnormal; 3, definitely abnormal). For the semiquantitative index of FDG uptake in infections, the standardized uptake value of FDG normalized to the predicted lean body mass (SUV-lean, SUL) was determined from the images obtained at 50–60 min after FDG injection. PET results were compared with final clinical diagnoses. Eleven lesions in eight patients, which were interpreted as grade 2 or 3 by FDG-PET, were all concordant with active infectious foci. The SUL values of infections ranged from 0.97 to 6.69. In two patients, FDG-PET correctly showed no active infection. In one patient, it was difficult to detect infectious foci by FDG-PET due to substantial normal background uptake of FDG. In total, FDG-PET correctly diagnosed the presence or absence of active infection in 10 of 11 patients. Fusion images of PET with computed tomography showed the most intense FDG uptake to be within an abscess wall. In conclusion, FDG-PET appears to be a promising modality for rapid imaging of active human infections. More extensive clinical evaluation is warranted to determine the accuracy of this method.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42074/1/259-25-9-1238_80251238.pd