024 Validation with thallium 201 of a new cadmium-zinc-telluride (CZT) cardiac camera

BackgroundNovel dedicated ultrafast cardiac cameras had recently be introduced to improve myocardial perfusion imaging.ObjectivesWe report the first validation study with thallium-201 and the new GE Discovery NM 530c CZT cardiac camera.MethodsWe prospectively studied with thallium-201 153 consecutive patients referred for myocardial perfusion imaging at exercise (111 to 148MBq) then redistribution (with a 37MBq reinjection).We performed sequential acquisitions, first with conventional dual head tomographic Anger camera (CC) in 11 to 16mn, then with CZT camera (CZT) in 5mn, in prone then in supine position.Results– we excluded 7 patients: 1 for mispositionning, 1 for camera failure, 1 for too late acquisition after exercise, 1 for non acceptation of redistribution by the patient, 1 for motion of the patient.– acquisition was more comfortable with CZT for all patients.– counts rate was 3 times more with CZT than with CC (3.5 to 5KCts/s vs 1 to 1.5).– myocardial counts rate was 6 to 8 times more with CZT than with CC.– comparison between CZT and CC: quality of CZT images was considered as better in 38%, equal in 59% and worse in 3% of cases; diagnostic conclusions were the same in 137 of 146 cases (94%); discordances were 2 artifacts with CC, 1 artifact with CZT, 4 early redistributions and 2 discordances about reversibility of thallium defect.– comparison between prone and supine with CZT: quality of prone images was considered as better in 41%, equal in 34% and worse in 25%; there were 2 times more artifacts in supine (14%) than in prone (7%) (p=0.05).ConclusionsWith thallium-201, the GE Discovery NM 530c CZT cardiac camera allows 5 minutes acquisitions with an increased image quality and a reliable diagnosis quality, both in prone and in supine positions

Détection du ganglion sentinelle par méthode isotopique dans les carcinomes épidermoïdes T1 T2 de la cavité buccale (étude prospective)

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

First Extensive Analysis of 18 F-Labeled Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in a Large Cohort of Patients With HIV-Associated Hodgkin Lymphoma: Baseline Total Metabolic Tumor Volume Affects Prognosis

International audiencePURPOSE 18 F-labeled fluorodeoxyglucose positron emission tomography with computed tomography (18 F-FDG PET-CT) data in HIV-associated Hodgkin lymphoma (HIV-HL) are scarcely reported. In addition to the description of the characteristics of both baseline and interim 18 F-FDG PET-CT examinations (PET1 and iPET, respectively), the aim of this study was to assess the prognostic value of PET1 and previously identified clinical parameters in this population. PATIENTS AND METHODS PET1 of 109 patients with HIV-HL, treated with doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy regimen since 2007, and 104 iPET were centrally reviewed. All the patients were enrolled in an ongoing prospective single-center cohort of HIV-associated lymphoma. RESULTS Most patients had a disseminated disease according to the Ann Arbor classification (30% stage III and 43% stage IV), with especially bone marrow and liver as extranodal localizations. After a median follow-up of 6.7 years, 12 patients relapsed (11%) and 13 died (12%). Five-year progression-free survival (PFS) was 75.1%, and 5-year overall survival was 86.1%. Median total metabolic tumor volume (TMTV) was 121.4 cm 3. The optimal TMTV cutoff identified for prognostic analysis was 527 cm 3 , with a 2-year PFS of 71% in the 20 patients with TMTV. 527 cm 3 , compared with 91% in the 89 patients with TMTV # 527 cm 3 (P 5 .004). On multivariate analysis, a high TMTV was the only parameter independently associated with PFS. CONCLUSION In this large series of HIV-HL patients with a homogeneous management, high TMTV on PET1 examination was associated with a poor prognosis

Comparison Between ESC and Duke Criteria for the Diagnosis of Prosthetic Valve Infective Endocarditis

International audienceObjectives: The primary objective was to assess the value of the European Society of Cardiology (ESC) criteria, including 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in prosthetic valve infective endocarditis (PVE). Secondary objectives were: 1) to assess the reproducibility of 18F-FDG-PET/CT; 2) to compare its diagnostic value with that of echocardiography; and 3) to assess the diagnostic value of the presence of a diffuse splenic uptake BACKGROUND: 18F-FDG PET/CT has been added as a major criterion in the ESC 2015 infective endocarditis (IE) guidelines, but the benefit of the ESC criteria has not been prospectively compared with the conventional Duke criteria.Methods: Between 2014 and 2017, 175 patients with suspected PVE were prospectively included in 3 French centers. After exclusion of patients with uninterpretable 18F-FDG PET/CT, 115 patients were evaluated, including 91 definite and 24 rejected IE, as defined by an expert consensus.Results: Cardiac uptake by 18F-FDG PET/CT was observed in 67 of 91 patients with definite PVE and 6 with rejected IE (sensitivity 73.6% [95% confidence interval (CI): 63.3% to 82.3%], specificity 75% [95% CI: 53.3% to 90.2%]). The ESC 2015 classification increased the sensitivity of Duke criteria from 57.1% (95% CI: 46.3% to 67.5%) to 83.5% (95% CI: 74.3% to 90.5%) (p < 0.001), but decreased its specificity from 95.8% (95% CI: 78.9% to 99.9%) to 70.8% (95% CI: 48.9% to 87.4%). Intraobserver reproducibility of 18F-FDG PET/CT was good (kappa = 0.84) but interobserver reproducibility was less satisfactory (kappa = 0.63). A diffuse splenic uptake was observed in 24 (20.3%) patients, including 23 (25.3%) of definite PVE, and only 1 (4.2%) rejected PVE (p = 0.024).Conclusions: 18F-FDG PET/CT is a useful diagnostic tool in suspected PVE, and explains the greater sensitivity of ESC criteria than Duke criteria. However, 18F-FDG PET/CT also presents with important limitations concerning its feasibility, specificity, and reproducibility. Our study describes for the first time a new endocarditis criterion, that is, the presence of a diffuse splenic uptake on 18F-FDG PET/CT