To evaluate the clinical significance of incidental focal prostate fluorodeoxyglucose (FDG) uptake, we reviewed 18-F-FDG positron emission tomography (PET)/CT scans from 2003 to 2007 and selected cases with focal FDG uptake in prostate. Cases of known prostate cancer were excluded. The maximum standardised uptake value (SUV(max)), site (central or peripheral) and pattern (discrete or ill-defined) of FDG uptake, calcification (present or absent) and prostate volume (<30 or ≥30 cc) were recorded. The PET/CT findings were correlated with serum prostate-specific antigen (PSA) levels, imaging studies, clinical follow-up and biopsy. Of a total of 5119 cases, 63 (1.2%) demonstrated focal FDG uptake in prostate. Eight cases were lost to follow-up. Among the 55 cases with follow-up, malignancy was confirmed by biopsy in 3 (5.4%). The three malignant cases had SUV(max) values of 3.3, 3.6 and 2.3, and all were noted in the peripheral portion of prostate; two of these cases had a discrete FDG uptake pattern, none had calcification corresponding to the FDG uptake area and one had a prostatic volume greater than 30 cc. The mean SUV(max) of 52 benign cases was 3.2 ± 1.7 and focal FDG uptake was noted in the peripheral portion in 34 (65%), 20 (38%) cases showed a discrete FDG uptake pattern, 35 (67%) were accompanied by calcification and 32 (62%) had a prostatic volume greater than 30 cc. The majority of cases demonstrating focal FDG uptake in prostate were benign and no PET/CT finding could reliably differentiate benign from malignant lesions; however, when discrete focal FDG uptake without coincidental calcification is seen, particularly in the peripheral zone of the prostate, further clinical evaluation is recommended.
SUVmax from both early and delayed PET/CT scans are useful parameters in the differentiation of extrahepatic biliary malignancy from benign disease. However, there was no added benefit of delayed PET/CT in patients suspicious for extrahepatic cholangiocarcinoma.
MIMneuro provides comparable performance to PMOD without the need to acquire brain MRI. Therefore, MIMneuro might be suitable for clinical use to determine amyloid positivity.
Previous studies have shown aberrant functional connectivity in preclinical Alzheimer’s disease (AD). However, the effects of beta-amyloid (Aβ) retention on regional functional synchronization in cognitively normal older adults still remain unclear. The aim of this study was to explore the distinctive association pattern between Aβ retention and regional functional synchronization in cognitively normal older adults. Sixty-one older adults with normal cognition underwent functional magnetic resonance imaging and regional functional synchronizations were quantified using regional homogeneity (ReHo). Subjects were dichotomized using 18F-Florbetaben positron emission tomography imaging into subjects with (Aβ+; n = 30) and without (Aβ-; n = 31) Aβ burden. The Aβ+ group exhibited significantly higher ReHo in the fusiform gyrus and lower ReHo in the precuneus compared with the Aβ- group. We found significant negative correlations between global Aβ retention and ReHo in the precuneus and medial prefrontal cortex and positive correlations between global Aβ retention and ReHo in the bilateral lingual gyrus, left fusiform gyrus, and right middle temporal gyrus in the Aβ+ group. Our findings suggest that regional functional synchronization might have distinctive association patterns with Aβ retention in the cognitively normal older adults. These findings can enrich the functional characterization of early stages of disease progression in AD.
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