18F-FDG Uptake in the Anterior Mediastinum Physiologic Thymic Uptake or Disease?

Rini, Josephine N.; Leonidas, John C.; Tomas, Maria B.; Chen, Bohang; Karaylcin, Gungor; Palestro, Christopher J.

doi:10.1016/s1095-0397(00)00049-2

Cited by 13 publications

(8 citation statements)

References 7 publications

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“…The thymus grows from birth to reach its peak weight at puberty, then gradually becomes atrophied with fatty replacement (24). Physiologic uptake of FDG by the thymus is commonly seen in children before puberty, up to the age of 13 years, but this finding is not normal in adults.…”

Section: Discussionmentioning

confidence: 99%

Rebound Thymic Hyperplasia Detected by¹⁸F-FDG PET/CT After Radioactive Iodine Ablation Therapy for Thyroid Cancer

Jeon

Lee

et al. 2014

Thyroid

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Background: Rebound thymic hyperplasia (RTHP) is not an uncommon finding after radiation or chemotherapy in patients with various malignancies. However, there are limited case reports of this phenomenon after radioactive iodine ablation therapy (RIAT) in differentiated thyroid cancer (DTC). The goal of this study was to evaluate the incidence, patterns, and factors affecting RTHP after RIAT using 18 F-FDG PET/CT. Methods: The study design was a retrospective review of 2550 patients (568 men, 1982 women; age 13-79 years) who underwent FDG PET/CT imaging after total thyroidectomy and RIAT from June 2009 through June 2012. Patients were divided into four age-related subgroups. Overall incidence, age-related incidences, and sex distribution were evaluated in patients with thymic FDG uptake on PET/CT (RTHP + ). The correlation between incidence of RTHP and age was assessed using the Cochran-Armitage trend test. The Wilcoxon rank-sum test and multiple regression were applied to investigate the effect of applied dose of radioactive iodine (RAI) and age on the incidence of RTHP. Correlations of standardized uptake value (SUV) and thymic volume with age and morphologic type were also evaluated. Results: Overall incidence of RTHP after RIAT was 1.49%, and all of the RTHP + patients except one were female. The Cochran-Armitage trend test revealed significantly decreased incidence from the second to fifth decade (8.84%, 1.74%, 0.98%, and 0.39% respectively; p < 0.001). In each age-related subgroup, the RAI dose was significantly higher in the RTHP + than RTHP -group ( p < 0.001), while there was no difference in RAI dose in RTHP + patients among age-related subgroups ( p = 0.838). SUV mean and SUV max of RTHP revealed no meaningful correlation with RAI dose or age. There were no differences among morphologic patterns of RTHP in age distribution and ablation dose. Conclusions: RTHP after RIAT showed a strong female predominance, despite the higher administration dose of RAI in male patients. Although the decreased incidence of RTHP after RIAT with age is similar to the pattern of RTHP induced by other causes, the fact that older patients, even sixth decade patients, can present with RTHP after RIAT is noteworthy in the management of DTC.

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Section: Discussionmentioning

confidence: 99%

Rebound Thymic Hyperplasia Detected by¹⁸F-FDG PET/CT After Radioactive Iodine Ablation Therapy for Thyroid Cancer

Jeon

Lee

et al. 2014

Thyroid

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“…Thymic uptake, especially in children, can also be observed. Hepatic and splenic uptake are generally low grade and diffuse (7)(8)(9)(10); in the setting of infection, however, splenic uptake can be quite intense. The spleen, an integral part of the body's immune system, performs multiple tasks, including clearance of encapsulated bacteria, production of inflamma- Figure 1.…”

Section: Fdg Imagingmentioning

confidence: 99%

FDG PET of Infection and Inflammation

et al. 2005

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Nuclear medicine plays an important role in the evaluation of infection and inflammation. Fluorine 18 fluorodeoxyglucose (FDG) is a readily available radiotracer that offers rapid, exquisitely sensitive high-resolution tomography. In patients with acquired immunodeficiency syndrome, FDG positron emission tomography (PET) accurately helps localize foci of infection and is particularly useful for differentiating central nervous system lymphoma from toxoplasmosis. FDG PET can also help localize the source of fever of undetermined origin (FUO), thereby guiding additional testing. In the musculoskeletal system, FDG PET accurately helps diagnose spinal osteomyelitis, and in inflammatory conditions such as sarcoidosis and vasculitis, it appears to be useful for defining the extent of disease and monitoring response to treatment. FDG PET may be of limited usefulness in postoperative patients and in patients with a failed joint prosthesis or a tumor. Nevertheless, this relatively new imaging technique promises to be helpful in the diagnosis of infection and inflammation. FDG PET will likely assume increasing importance in assessing FUO, spinal osteomyelitis, vasculitis, and sarcoidosis and may even become the radionuclide imaging procedure of choice in the evaluation of some or all of these pathologic conditions.

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“…In the same study, since the possibility of local invasion is high in lesions with a high SUV max value, it is recommended to prefer open surgery instead of needle biopsy [33]. Researching the use of PET-CT in thymoma, Rini et al [34] argued that in general, PET-CT is an important imaging technique in the evaluation of a patient presenting with an anterior mediastinal mass, but it is not very reliable in determining the stage of thymoma and thymic carcinoma.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of the effect of PET/CT Fluorodeoxyglucose inclusion on mortality and survival in operated thymoma patients

Agaoglu Sanli,

Duman,

Gulmez

et al. 2023

Nuclear Medicine Communications

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Purpose In recent years, the use of fluorodeoxyglucose PET-computed tomography (PET-CT) has become widespread to evaluate the diagnosis, metabolism, stage and distant metastases of thymoma. In this study, it was aimed to investigate the connection of malignancy potential, survival and maximum standardized uptake value (SUVmax) measured by PET-CT before surgery according to the histological classification of the WHO in patients operated for thymoma. In addition, the predictive value of the Glasgow prognostic score (GPS) generated by C-reactive protein (CRP) and albumin values on recurrence and survival was investigated and its potential as a prognostic biomarker was evaluated. Methods Forty-five patients who underwent surgical resection for thymoma and were examined with PET-CT in the preoperative period between January 2010 and January 2022 were included in the study. The relationship between WHO histological classification, tumor size and SUVmax values on PET-CT according to TNM classification of retrospectively analyzed corticoafferents were evaluated. Preoperative albumin and CRP values were used to determine GPS. Results The cutoff value for SUVmax was found to be 5.65 in the patients and the overall survival rate of low-risk (<5.65) and high-risk (>5.65) patients was compared according to the SUVmax threshold value (5.65) and found to be statistically significant. In addition, the power of PET/CT SUVmax value to predict mortality (according to receiver operating characteristics analysis) was statistically significant (P = 0.048). Survival expectancy was 127.6 months in patients with mild GPS (O points), 96.7 months in patients with moderate GPS (1 point), and 25.9 months in patients with severe GPS (2 points). Conclusion PET/CT SUVmax values can be used to predict histological sub-type in thymoma patients, and preoperative SUVmax and GPS are parameters that can provide information about survival times and mortality in thymoma patients.

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18F-FDG Uptake in the Anterior Mediastinum Physiologic Thymic Uptake or Disease?

Cited by 13 publications

References 7 publications

Rebound Thymic Hyperplasia Detected by¹⁸F-FDG PET/CT After Radioactive Iodine Ablation Therapy for Thyroid Cancer

Rebound Thymic Hyperplasia Detected by¹⁸F-FDG PET/CT After Radioactive Iodine Ablation Therapy for Thyroid Cancer

FDG PET of Infection and Inflammation

Evaluation of the effect of PET/CT Fluorodeoxyglucose inclusion on mortality and survival in operated thymoma patients

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18F-FDG Uptake in the Anterior Mediastinum Physiologic Thymic Uptake or Disease?

Cited by 13 publications

References 7 publications

Rebound Thymic Hyperplasia Detected by18F-FDG PET/CT After Radioactive Iodine Ablation Therapy for Thyroid Cancer

Rebound Thymic Hyperplasia Detected by18F-FDG PET/CT After Radioactive Iodine Ablation Therapy for Thyroid Cancer

FDG PET of Infection and Inflammation

Evaluation of the effect of PET/CT Fluorodeoxyglucose inclusion on mortality and survival in operated thymoma patients

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Product

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Rebound Thymic Hyperplasia Detected by¹⁸F-FDG PET/CT After Radioactive Iodine Ablation Therapy for Thyroid Cancer

Rebound Thymic Hyperplasia Detected by¹⁸F-FDG PET/CT After Radioactive Iodine Ablation Therapy for Thyroid Cancer