Dual –time point 18F-FDG-PET and PET/CT for Differentiating Benign From Malignant Musculoskeletal Lesions: Opportunities and Limitations
In this review, we summarize the false-positive and false-negative results of standard 18F-FDG-PET/CT in characterizing musculoskeletal lesions and discussed the added value and limitations of dual –time point imaging (DTPI) and delayed imaging in differentiating malignant from benign musculoskeletal lesions, based on review of the peer-reviewed literature. The quantitative and semiquantitative parameters adopted for DTPI are standardized uptake value (mainly maximum standardized uptake valu e [SUVmax]) and retention index (RI), calculated as RI (%) = 100% × (SUV [maxD-Delayed] − SUV [maxE-Early])/SUV [max...
Source: Seminars in Nuclear Medicine - April 19, 2017 Category: Nuclear Medicine Authors: Rahul V. Parghane, Sandip Basu Source Type: research
Spectrum of Benign Bone Conditions on NaF-PET
Fluoride imaging with 18F (NaF-PET), although not a new technique, is becoming increasingly utilized for evaluation of skeletal metastatic disease using PET/CT. As its use becomes more widespread, a variety of nonmalignant bone disorders will be encountered by the interpreting physician. It is important, therefore, to recognize these nonmalignant conditions to avoid errors in interpretation. Beyond this, there is increasing evidence in the literature that NaF-PET/CT imaging may provide valuable information for the primary diagnosis of these nonmalignant conditions, and furthermore may provide insight into the underlying bi...
Source: Seminars in Nuclear Medicine - April 18, 2017 Category: Nuclear Medicine Authors: Eric M. Rohren, Homer A. Macapinlac Source Type: research
Guest Editorial
This issue is dedicated to the practice of nuclear medicine in pediatrics, as the previous one, completing an overview of the main themes of pediatric nuclear medicine. (Source: Seminars in Nuclear Medicine)
Source: Seminars in Nuclear Medicine - April 16, 2017 Category: Nuclear Medicine Authors: Pietro Zucchetta Source Type: research
Benign Bone Conditions That May Be FDG-avid and Mimic Malignancy
Positron emission tomography with the radiotracer 18F-fluoro-2-deoxy-d-glucose (FDG) plays an important role in the evaluation of bone pathology. However, FDG is not a cancer-specific agent, and knowledge of the differential diagnosis of benign FDG-avid bone alterations that may resemble malignancy is important for correct patient management, including the avoidance of unnecessary additional invasive tests such as bone biopsy. This review summarizes and illustrates the spectrum of benign bone conditions that may be FDG-avid and mimic malignancy, including osteomyelitis, bone lesions due to benign systemic diseases (Brown t...
Source: Seminars in Nuclear Medicine - April 13, 2017 Category: Nuclear Medicine Authors: Thomas C. Kwee, John M.H. de Klerk, Maarten Nix, Ben G.F. Heggelman, Stefan V. Dubois, Hugo J.A. Adams Source Type: research
Clinical Value of FDG-PET/CT for the Evaluation of Rheumatic Diseases: Rheumatoid Arthritis, Polymyalgia Rheumatica, and Relapsing Polychondritis
FDG is a tracer for visualizing glucose metabolism. PET/CT using FDG is widely used for the diagnosis of cancer, because glycolysis is elevated in cancer cells. Similarly, active inflammatory tissue also exhibits elevated glucose metabolism because of glycolysis in activated macrophages and proliferating fibroblasts. Elevated FDG uptake by active inflammatory tissues, such as those affected by arthritis, vasculitis, lymphadenitis, and chondritis, has enabled the diagnosis of inflammatory diseases using FDG-PET/CT. (Source: Seminars in Nuclear Medicine)
Source: Seminars in Nuclear Medicine - April 11, 2017 Category: Nuclear Medicine Authors: Kazuo Kubota, Hiroyuki Yamashita, Akio Mimori Source Type: research
Benign Cutaneous and Subcutaneous Lesions on FDG-PET/CT
18F-FDG, the most commonly used PET radiopharmaceutical in clinical practice, can also accumulate in inflammatory and infectious conditions. This may account for false-positive PET findings when staging or restaging a patient with malignancy. As clinical use of FDG-PET-CT is increasing, nuclear medicine physicians are encountering a myriad of cutaneous and subcutaneous lesions, many of which are incidental and benign. The most common cause for the FDG avidity of these lesions is inflammation. Although a specific diagnosis may not always be possible, background clinical history and morphologic features of the lesion on CT m...
Source: Seminars in Nuclear Medicine - April 11, 2017 Category: Nuclear Medicine Authors: Ur Metser, Noam Tau Source Type: research
PET in Benign Bone Marrow Disorders
This review aims to describe the current status of benign bone marrow (BM) imaging using PET. BM imaging is important as the BM is not only involved in poiesis of different vital cell lines and can be affected by primary BM disorders, but it is also frequently affected by several extramedullary diseases. Indications for the use of PET in benign BM disorders are the detection of extramedullary hematopoiesis, evaluation of patients with a discrepancy between BM histology and clinical status, visualizing BM infarctions, location of the optimal site for BM biopsy, diagnosing and staging of other hematological BM disorders, eva...
Source: Seminars in Nuclear Medicine - March 17, 2017 Category: Nuclear Medicine Authors: Wouter van der Bruggen, Andor W.J.M. Glaudemans, Edo Vellenga, Riemer H.J.A. Slart Source Type: research
Nuclear Medicine in Pediatric Nephro-Urology: An Overview
In the context of ante-natally diagnosed hydronephrosis, the vast majority of children with a dilated renal pelvis do not need any surgical treatment, as the dilatation resolves spontaneously with time. Slow drainage demonstrated at Tc-99m-mercaptoacetyltriglycine (MAG3) renography does not necessarily mean obstruction. Obstruction is defined as resistance to urinary outflow with urinary stasis at the level of the pelvic-ureteric junction (PUJ) which, if left untreated, will damage the kidney. Unfortunately this definition is retrospective and not clinically helpful. (Source: Seminars in Nuclear Medicine)
Source: Seminars in Nuclear Medicine - March 4, 2017 Category: Nuclear Medicine Authors: Iosif Mendichovszky, Bernardita Troncoso Solar, Naima Smeulders, Marina Easty, Lorenzo Biassoni Source Type: research
Current Role of FDG-PET in Pediatric Hodgkin ’s Lymphoma
Hodgkin ’s lymphoma is one of the most curable pediatric cancers with long-term survival rates exceeding 90% following intensive treatment. Collaborative group studies worldwide aim on reduction or elimination of radiotherapy to avoid potentially life-limiting late effects especially second cancers and ca rdiovascular diseases. Large prospective trials have integrated early response FDG-PET scans to identify adequate responders to chemotherapy in whom radiotherapy may safely be omitted. The criteria for interpretation of early response PET have changed during the past years and will be further refine d based on trial res...
Source: Seminars in Nuclear Medicine - March 4, 2017 Category: Nuclear Medicine Authors: Regine Kluge, L. Kurch, Thomas Georgi, Monika Metzger Source Type: research
Pediatric Nuclear Medicine and its Development as a Specialty
Pediatric Nuclear Medicine (PNM) offers to the pediatrician noninvasive procedures, with high clinical impact and low dosimetry. New techniques have been adapted to children, diminishing doses, always looking for less dosimetry, higher sensitivity and higher resolution images.PNM is and will remain a minority subspecialty, but highly complex for general NM physicians due to the different diagnostics in children and due to the higher technical complexity of the examinations. General NM physicians have to be trained and regularly receive CME in this field. (Source: Seminars in Nuclear Medicine)
Source: Seminars in Nuclear Medicine - February 24, 2017 Category: Nuclear Medicine Authors: Isabel Roca Bielsa Source Type: research
Letter From the Editors
This issue of the Seminars concludes our two-part series on Nuclear Medicine and pediatric practice. The Seminars has been referred to by some as a “living textbook.” The journal serves to fill the gap between the standard textbook that is used to reflect current state-of-the-art practice techniques and the medical journal, which publishes ongoing research and offers cutting-edge material. The time delay for the average textbook is usually 2 years or more from the date at which most of the material is submitted to the editor revised and finally published. (Source: Seminars in Nuclear Medicine)
Source: Seminars in Nuclear Medicine - February 23, 2017 Category: Nuclear Medicine Authors: Leonard M. Freeman, M. Donald Blaufox Source Type: research
18F-FDG-PET/CT Imaging of Thoracic and Extrathoracic Tuberculosis in Children
Tuberculosis (TB) remains a major health problem, affecting approximately one-third of the world ׳s population. The tubercle bacillus can affect virtually any organ of the human body and if left untreated can lead to severe morbidity and death. Diagnosis of active TB is challenging, especially in children. As a “great imitator,” the disease can mimic numerous other pathologies, both clinic ally and at imaging. Although recognition of active TB is crucial to initiate adequate treatment in a timely fashion, thereby preventing transmission of disease, differentiation of active and quiescent disease is not always straight...
Source: Seminars in Nuclear Medicine - February 17, 2017 Category: Nuclear Medicine Authors: Matthieu Pelletier-Galarneau, Patrick Martineau, Lionel S. Zuckier, Xuan Pham, Raymond Lambert, Sophie Turpin Source Type: research
Optimization of Pediatric PET/CT
PET/CT, the most common form of hybrid imaging, has transformed oncologic imaging and is increasingly being used for nononcologic applications as well. Performing PET/CT in children poses unique challenges. Not only are children more sensitive to the effects of radiation than adults but, following radiation exposure, children have a longer postexposure life expectancy in which to exhibit adverse radiation effects. Both the PET and CT components of the study contribute to the total patient radiation dose, which is one of the most important risks of the study in this population. (Source: Seminars in Nuclear Medicine)
Source: Seminars in Nuclear Medicine - February 15, 2017 Category: Nuclear Medicine Authors: Marguerite T. Parisi, Mohammed S. Bermo, Adam M. Alessio, Susan E. Sharp, Michael J. Gelfand, Barry L. Shulkin Source Type: research
Scintigraphic Evaluation of Gastroesophageal Reflux and Pulmonary Aspiration in Children
Gastroesophageal reflux (GER) and pulmonary aspiration are encountered in children of all ages. Signs, symptoms, and complications vary from mild and transient to severe life-threatening conditions. This review will present relevant clinical information on these conditions as well as common diagnostic procedures. The role of scintigraphic techniques used in the evaluation of these conditions will be discussed in detail including protocols and performance in comparison to other diagnostic methods. (Source: Seminars in Nuclear Medicine)
Source: Seminars in Nuclear Medicine - February 9, 2017 Category: Nuclear Medicine Authors: Zvi Bar-Sever Source Type: research
Nuclear Medicine Imaging in Pediatric Infection or Chronic Inflammatory Diseases
In this review article, we focus on the most recent applications of nuclear medicine techniques (mainly 99mTc/111In white blood cells (WBC) scan, [18F]-FDG-PET/CT, [18F]-FDG-PET/MRI, and 99mTc-IL-2 scintigraphy) in the study of children affected by peripheral bone osteomyelitis, fungal infections, inflammatory bowel diseases, and type 1 diabetes, owing to recent important published evidences of their role in the management of these diseases. For osteomyelitis in children, both bone scintigraphy and [18F]-FDG-PET have a major advantage of assessing the whole body in one imaging session to confirm or exclude multifocal invol...
Source: Seminars in Nuclear Medicine - February 9, 2017 Category: Nuclear Medicine Authors: Alberto Signore, Andor W.J.M. Glaudemans, Olivier Gheysens, Chiara Lauri, Onofrio A. Catalano Source Type: research
