Bone Pseudometastasis on 18F-FDG PET in Japanese Patients With Esophageal Cancer

Purpose of the Report False-positive bone lesions mimicking bone metastases (bone pseudometastasis) on 18F-FDG PET/CT have often been reported in patients with esophageal cancer. We aimed to evaluate the prevalence and features of these lesions in Japanese patients with esophageal cancer.Methods In this retrospective study, we analyzed 83 FDG PET/CT studies for initial staging of esophageal cancer, and extracted patients with 1 or more localized high uptake sites with no subsequent progression, which were therefore judged to be bone pseudometastasis. The FDG PET/CT imaging features of the bone pseudometastasis were evaluated, and other available imaging and clinical features reviewed.Results Of the 83 patients, 7 had bone pseudometastasis. All 7 were males diagnosed with squamous cell cancer, of which 5 had T1a tumors. Bone pseudometastasis showed normal or ill-defined hyperdense (nonosteolytic) sites compared with the surrounding area on the CT. Additionally, accumulation in the upper vertebral levels of each case was contiguously high compared with the lumbar spines (we named this finding “contiguous accumulation”). On MRI, these findings were visualized as low signals on T1-weighted imaging (T1WI) and T2WI images but were unclear on fat-suppressed T2WI images.Conclusions Among all PET/CT performed for staging of esophageal cancer, 8.3% demonstrated bone pseudometastasis characterized by heterogeneous distribution with severe fatty degeneration of bone marrow accompanied by contiguous accumulation. Caution is required during diagnoses of bone lesions in esophageal cancer patients in Japan to prevent inappropriate therapeutic choices

Physiologically decreased F-18 fluorodeoxyglucose uptake in the lower vertebrae associated with daily drinking habit in Japanese men with alcohol flushing reaction.

Alcohol flushing reaction (AFR) is known as one of risks for esophageal squamous cell cancer and scientists have been elucidating this issue. However, little attention has been given to relevant imaging features. This study aims to investigate whether physiological F-fluorodeoxyglucose (FDG) uptake patterns in vertebrae are associated with drinking-habit or AFR. Japanese male patients who underwent FDG positron emission tomography/computed tomography for evaluation of their known or suspected malignancy or inflammatory disease were asked about their drinking-habit and AFR. Altogether, 192 patients, 139 everyday-drinkers and 53 non-drinkers were evaluated. Comparing the FDG uptake between in the thoracic region and that in the lumbar region, vertebral uptake was visually classified into 4 patterns: Ld, dominant in lumbar region; TL, almost equal in both regions; BL, slightly higher in thoracic region (borderline pattern); Td, dominant in thoracic region. The uptake patterns were evaluated according to drinking-habit (everyday- or non-drinker), AFR (flusher or non-flusher) and the combination of these two factors (habit/reaction: everyday-drinker/flusher, everyday-drinker/non-flusher, non-drinker/flusher, or non-drinker/non-flusher). There were 95 flushers (51 everyday-drinkers and 44 non-drinkers) and 97 non-flushers (88 everyday-drinkers and 9 non-drinkers). Ld, TL, BL, and Td patterns were observed in 0, 109 (56.8%), 31 (16.1%), and 52 (27.1%) patients, respectively. Td and BL patterns were more frequently observed in everyday-drinkers compared with non-drinkers (p = 0.0467). Though the uptake patterns did not differ between in flushers and non-flushers (p = 0.116), Td pattern was more frequently observed in everyday-drinkers/flusher (51%) compared with everyday-drinkers/non-flusher (20.5%), non-drinker/flusher (13.6%), and non-drinker/non-flusher (22.2%) (p = 0.0014). Td pattern was observed in patients with various diseases, with higher frequency in esophageal cancer, head and neck cancer and lung cancer compared with other diseases. In conclusion, drinking-habit and AFR were related to the vertebral uptake pattern with decreased uptake in the lumbar region in Japanese male patients

Diffusely Decreased Liver Uptake on FDG PET and Cancer-Associated Cachexia With Reduced Survival.

We investigated clinical characteristics of patients with extremely increased or decreased physiologic F-FDG uptake of the liver and their prognosis

Predominance and Homogeneity Patterns of Physiological FDG Accumulation in Thoracic and Lumbar Vertebrae: Suspected Mechanism of "Bone Pseudometastasis" on FDG-PET in Japanese Patients With Esophageal Cancer

ObjectiveFalse-positive bone lesions (bone pseudometastases) have been often reported in patients with esophageal cancer (EsoC). This study aimed to evaluate the vertebral 2-deoxy-2-[18F] fluoro-D-glucose (FDG) accumulation pattern in patients with newly diagnosed esophageal cancers and other malignancies (OtherT) to elucidate the possible mechanism that causes bone pseudometastasis.MethodsFDG positron emission tomography/computed tomography performed for 90 patients with EsoC, and 112 patients with OtherT was retrospectively evaluated. The uptake pattern in the thoracic (Th) and lumbar (L) vertebrae was visually assessed regarding predominance (TL, Th ≒ L; Td, Th > L; Ld, L > Th), main intensity compared with the uptake in the blood pool (BP) (Grade 1  BP), and homogeneity (homogeneous, heterogeneous, marginal, or spotty). The patterns between EsoC and OtherT and between Th and L were compared.ResultsTL, Td, and Ld patterns were observed in 51.1%, 48.9%, and 0% in EsoC and 79.7%, 20.3%, and 0% in OtherT. Though Grade 2 was most frequently observed in both groups, the ratio of Grade 3 in Th and Grade 1 in L was significantly higher in EsoC than in OtherT. Heterogeneous and spotty patterns were more frequently observed in L and in EsoC, and these were strongly associated with Td pattern.ConclusionTd pattern was frequently seen, especially in EsoC, and was strongly associated with a heterogeneous or marginal pattern in the L. Heterogeneous marrow distribution with declined lumbar uptake is suspected as the mechanism of bone pseudometastasis

ILC Reference Design Report Volume 1 - Executive Summary

The International Linear Collider (ILC) is a 200-500 GeV center-of-mass high-luminosity linear electron-positron collider, based on 1.3 GHz superconducting radio-frequency (SCRF) accelerating cavities. The ILC has a total footprint of about 31 km and is designed for a peak luminosity of 2x10^34 cm^-2s^-1. This report is the Executive Summary (Volume I) of the four volume Reference Design Report. It gives an overview of the physics at the ILC, the accelerator design and value estimate, the detector concepts, and the next steps towards project realization.The International Linear Collider (ILC) is a 200-500 GeV center-of-mass high-luminosity linear electron-positron collider, based on 1.3 GHz superconducting radio-frequency (SCRF) accelerating cavities. The ILC has a total footprint of about 31 km and is designed for a peak luminosity of 2x10^34 cm^-2s^-1. This report is the Executive Summary (Volume I) of the four volume Reference Design Report. It gives an overview of the physics at the ILC, the accelerator design and value estimate, the detector concepts, and the next steps towards project realization