Cancer Detection with Whole-Body PET Using 2-[18F]Fluoro-2-Deoxy-D-Glucose

Hoh, Carl K.; Hawkins, Richard A.; Glaspy, John A.; Dahlbom, M; Tse, Nielson; Hoffman, Eric; Schiepers, C; Choi, Youn Jin; Rege, Sheila; Nitzsche, Egbert U.

doi:10.1097/00004728-199307000-00012

Cited by 231 publications

(62 citation statements)

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“…Let us first examine the clinical indications for FDG imaging as they present along the course of the cancerous process [6,62,[82][83][84][85][86]. We shall later discuss these indications in detail, tumour by tumour.…”

Section: Clinical Indications For Fdg In Oncologymentioning

confidence: 99%

“…Although the first feasibility studies included only small numbers of patients with large tumours, larger more representative series have now been reported [245][246][247][248]. Using a whole-body imaging technique, Hoh et al [83] detected 15/17 primary breast carcinomas. Nieweg et al [249,250] identified 10/11 primary lesions.…”

Section: Breast Cancermentioning

confidence: 99%

“…Results in subsequent studies have varied from 67% [83] to 90% [251] but the number of patients studied remains low and results appear to vary in part with the technique used (sensitivity is potentially higher using an attenuation-corrected static scan than with a whole-body non-attenuated technique) (Table 7). Recent results and our own experience suggest a 75%-80% sensitivity with good specificity (96%) [253].…”

Section: Breast Cancermentioning

confidence: 99%

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Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose

Rigo¹,

Paulus²,

et al. 1996

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Abstract. Positron emission tomography (PET) is now primarily used in oncological indication owing to the successful application of fluorine-18 fluorodeoxyglucose (FDG) in an increasing number of clinical indications at different stages of diagnosis, and for staging and followup. This review first considers the biological characteristics of FDG and then discusses methodological considerations regarding its use. Clinical indications are considered, and the results achieved in respect of various organs and tumour types are reviewed in depth. The review concludes with a brief consideration of the ways in which clinical PET might be improved.

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Section: Clinical Indications For Fdg In Oncologymentioning

confidence: 99%

Section: Breast Cancermentioning

confidence: 99%

Section: Breast Cancermentioning

confidence: 99%

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Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose

Rigo¹,

Paulus²,

et al. 1996

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“…Tumor cells, especially nonsmall cell lung cancer, exhibit increased glucose metabolism. Thus, 18 F-FDG PET is able to visualize not only the primary tumor but also its metastases (12). Several studies investigated the diagnostic performance of 18 F-FDG PET in mediastinal lymph node staging, and their results were comprehended in meta-analyses (13)(14)(15)(16).…”

mentioning

confidence: 99%

18F-FDG PET for Mediastinal Staging of Lung Cancer: Which SUV Threshold Makes Sense?

Hellwig

Graeter²,

Ukena

et al. 2007

Journal of Nuclear Medicine

173

111

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18 F-FDG PET is the most accurate noninvasive modality for staging mediastinal lymph nodes in lung cancer. Besides using visual image interpretation, some institutions use standardized uptake value (SUV) measurements in lymph nodes. Mostly, an SUV of 2.5 is used as the cutoff, but this choice was never deduced from respective studies. Receiver operating characteristic (ROC) analyses demonstrated that SUV thresholds of more than 4 resulted in the highest accuracy. But these high cutoffs imply high false-negative rates (FNRs). The aim of our evaluation was to determine an optimal SUV threshold and to compare its diagnostic performance with the results of visual interpretation. Methods: This retrospective study included 95 patients with suspected lung cancer who underwent mediastinoscopy/mediastinal lymphadenectomy after 18 F-FDG PET (90-150 min after 250 MBq of 18 F-FDG). Maximum SUV was measured in 371 lymph node regions biopsied afterward and visually interpreted using a 6-level score (2 2 2 through 1 1 1). Diagnostic performance was assessed by ROC analysis. FNR and false-positive rate (FPR), the sum of both error rates (FNR 1 FPR), and diagnostic accuracy were plotted against a hypothetical SUV threshold to determine the optimum SUV threshold. Results: SUVs in metastatic lymph nodes were higher (mean 6 SD, 7.1 6 4.5; range, 1.4-26.9; n 5 70) than in tumor-free lymph node stations (2.4 6 1.7; range, 0.6-14.9; n 5 301; P , 0.01). Inflammatory lymph nodes exhibited slightly increased SUVs (2.7 6 2.0; range, 0.8-14.9; n 5 146). The plot of error rates featured a minimum of the sum FNR 1 FPR for an SUV of 2.5. With increasing SUV threshold, the FPR decreased most prominently up to that value whereas a continuous rise of FNR was noticed. Highest diagnostic accuracy was achieved with an SUV of 4.5. The areas under the ROC curves demonstrated that visual interpretation tends to be more accurate than SUV quantification (visual, 0.930 6 0.022; SUV, 0.899 6 0.025; P 5 0.241). Using an SUV of 2.5 as the threshold, the resulting sensitivity, specificity, and negative predictive value were 89%, 84%, and 96%, respectively. Conclusion: For mediastinal staging, the choice of an SUV of 2.5 as the threshold is justified because FNR 1 FPR is minimized. The resulting high negative predictive value of 96% allows the omission of mediastinoscopy in patients with negative mediastinal findings on 18 F-FDG PET images. For the experienced observer, visual analysis should be relied on primarily, with calculation of the SUV used, at most, as a secondary aid. For the less experienced observer, the SUV may be of greater value.

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“…In most PET centers, the SUVs of malignant lesions are calculated from F-18 FDG PET images with acquisition start 40～60 minutes after F-18 FDG injection (3,4). However, whereas the time taken to reach an SUV plateau in malignant lesions is known to be longer than 2 hours (5～8), that in most benign tumors and inflammatory lesions is known to be shorter, usually occurring within 2 hours (7,9～12).…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Additional Delayed Regional F-18 Fluorodeoxy-glucose Positron Emission Tomography in the Lymph Node Staging of Non-Small Cell Lung Cancer Patients

Chung

Jeong

et al. 2005

Cancer Res Treat

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Cancer Detection with Whole-Body PET Using 2-[18F]Fluoro-2-Deoxy-D-Glucose

Cited by 231 publications

References 0 publications

Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose

Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose

18F-FDG PET for Mediastinal Staging of Lung Cancer: Which SUV Threshold Makes Sense?

Usefulness of Additional Delayed Regional F-18 Fluorodeoxy-glucose Positron Emission Tomography in the Lymph Node Staging of Non-Small Cell Lung Cancer Patients

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