Diagnostic Accuracy of 18F-FDG PET/CT in Detection of Local Recurrence in Rectal Cancer and the Added Value of Dual Time Point Scanning

Farghaly, Husssien

doi:10.21608/egyjnm.2013.5457

Cited by 2 publications

(3 citation statements)

References 23 publications

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“…[ 25 ] in the setting of cervical cancer, where DTP F-18-FDG PET protocol and delayed F-18-FDG PET improved the detection of para-aortic nodes (especially in the lower chains) whereas other modalities such as MRI showed FP results due to inflammation, edema, or scar tissue associated with radiation or postsurgical changes. Our results also comparable with Farghaly et al ., [ 26 ] who studied the added value of DTP F-18-FDG PET/CT scanning in detection of local recurrence in rectal cancer and reported sensitivity, specificity, PPV, NPV and accuracy of delayed PET/CT to detect local recurrence based on ΔSUVmax >0% were 100%, 71.4%, 50%, 100%, and 77.8%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Dual time point fluorodeoxyglucose positron emission tomography/computed tomography in differentiation between malignant and benign lesions in cancer patients. Does it always work?

et al. 2015

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Objectives:Assess the added value of dual time point F-18-fluorodeoxyglucose positron emission tomography/computed tomography (DTP F-18-FDG-PET/CT) in the differentiation of malignant from a benign lesion in cancer patients.Materials and Methods:Totally, 140 F-18-FDG PET/CT scans of 60 cancer patients who underwent DTP protocol (early whole body PET/CT [E] at 60 min [range, 45–76 min] and delayed limited PET/CT [D] on areas of interest at 120 min [range, 108–153 min] after the tracer injection) were retrospectively reviewed. Visual and semi-quantitative analysis was performed on both early and delayed images. All findings were confirmed by histopathology and/or at least 3 months follow-up (F-18-FDG PET/CT, CT, or magnetic resonance imaging). The result was considered true positive (TP) if delayed standardized uptake value (SUV) of suspicious lesions increased and confirmed to be malignant, false positive (FP) if delayed SUV increased and confirmed to be benign, true negative (TN) if delayed SUV unchanged or decreased and confirmed to be benign, and false negative (FN) if delayed SUV unchanged or decreased and confirmed to be malignant.Results:A total of 164 suspicious lesions were detected (20 presacral lesions, 18 lung nodules, 18 Hodgkin's disease (HD) lesions, 16 rectal lesions, 16 head and neck (H and N) lesions, 14 hepatic lesions, 14 non-Hodgkin's lymphoma (NHL) lesions, 12 mediastinal lymph nodes (LNs), 10 focal gastric uptake, 10 soft tissue lesions, 8 breast lesions, 4 peritoneal nodule, and 4 others). Sixty-four lesions were pathologically confirmed, and 100 lesions were confirmed based on 3–6 months follow-up. There were 62 TP lesions, 44 FP, 58 TN and no FN results. The overall sensitivity was 100% of DTP F-18-FDG PET/CT in detecting suspicious lesions. The specificity was 57% in differentiating malignant from benign lesions, and the accuracy was 73%. Positive predictive value was 59%, negative predictive value (NPV) 100%. All hepatic lesions were TP. Accuracy in metastatic hepatic lesions HD, presacral soft tissue, lung nodules, H, and N cancer, breast cancer, NHL and mediastinal LN was100%, 88.8%, 80%, 78%, 75%, 75%, 71%, and 33.3%, respectively.Conclusions:DTP F-18-FDG-PET/CT protocol does not always work in differentiation between benign and malignant lesions. However; it has high NPV, and promising results was noted in hepatic lesions, lymphoma, and recurrent rectal cancer.

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Section: Discussionmentioning

confidence: 99%

Dual time point fluorodeoxyglucose positron emission tomography/computed tomography in differentiation between malignant and benign lesions in cancer patients. Does it always work?

et al. 2015

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Section: Discussionmentioning

confidence: 99%

“…The usefulness of DTP 18 F-FDG PET/CT protocol in differentiation of malignant from benign lesions has been reported in some studies of certain body regions and certain cancer types [15,[27][28][29] In the present study we are evaluating the usefulness of both visual and quantitative parameters related to DTP 18 F-FDG PET/CT after gastric distention using oral water, in differentiating malignant from benign gastric lesions. Such parameters included the lesional uptake pattern, early SUVmax (SUVmax1), delayed SUVmax (SUVmax2) and difference in SUVmax between early and delayed imaging (ΔSUVmax).…”

Section: Discussionmentioning

confidence: 99%

Dual time point [18F]Flurodeoxyglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) with water gastric distension in differentiation between malignant and benign gastric lesions

Farghaly

Alshareef

Alqarni

et al. 2020

European Journal of Radiology Open

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Objectives To assess diagnostic accuracy and added value of dual time point 18 F-FDG PET/CT after gastric distention using oral water in differentiating malignant from benign gastric lesions. Methods Patients (n = 30, 19 males, mean age 58.6 ± 16.4 years). All patients are known or suspected oncology patients. All patients underwent whole body 18 F-FDG PET/CT scan and 2 h delayed PET/CT abdominal images following oral water gastric distension. The best cut off values for early SUVmax (SUVmax1), delayed SUVmax (SUVmax2) and SUVmax2-SUVmax1 (ΔSUVmax) to differentiate benign from malignant lesions were set based on ROC analysis. Data analyzed included in addition; age, sex and 18 F-FDG uptake pattern in delayed images. Suspicious gastric lesions were correlated with biopsy in 18 patients (60 %) and with clinical and follow-up imaging ( 18 F-FDG PET/CT, CT or MRI) in 12 patients (40 %). Unpaired t -test was used to compare the mean deference in continuous variables between patients with gastric malignancy and those with benign gastric lesions. Fisher’s exact test was used to analyze categorical variables. Logistic regression analysis was performed to identify the most powerful factors to predict malignant lesions. Results Fifteen patients (50 %) had confirmed malignant gastric lesions. Patients with confirmed gastric malignancy were older (65 ± 13 vs 52 ± 17; p = 0.023) and had significantly higher mean ΔSUVmax (1.29 ± 1.76 vs −0.89 ± 1.59; p = 0.003). The mean SUVmax1 (6.99 ± 6.66 vs 5.31 ± 2.53; p = 0.367) and SUVmax2 (8.29 ± 7.41 vs 4.44 ± 3.34; p = 0.077) although both higher in patients with malignant lesions, they did not reach statistical significance. Sensitivity, specificity, PPV, NPV, and accuracy to detect malignant gastric lesions were highest for lesions with localized uptake pattern in delayed images post water oral contrast as well as for lesions with ΔSUVmax>0. Regression analysis revealed both variables as independent predictors for malignant lesions with odd ratios of 22.9 and 9.5 respectively and final model Chi-Square of 19.9 (p < 0.0001). The model correctly identified 12/15 (80 %) malignant lesions and 13/15 (86.7 %) benign lesions with 2 false positives confirmed as chronic active gastritis with helicobacter pylori and 3 false negatives including 1 signet ring gastric cancer and 1 low grade gastrointestinal stromal tumor (GIST), both with poor 18 F-FDG uptake. Conclusion Localized uptake pattern in delayed PET/CT images following gastric distention with oral water contrast as well as ΔSUVmax>0 are powerful independent variables to identify malignant gastric lesions with fairly high sensitivity and reasonable accuracy. Malignancies with inherently low 18 F-FDG avidity are the main cause of false negatives while active gastritis is th...

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Diagnostic Accuracy of 18F-FDG PET/CT in Detection of Local Recurrence in Rectal Cancer and the Added Value of Dual Time Point Scanning

Cited by 2 publications

References 23 publications

Dual time point fluorodeoxyglucose positron emission tomography/computed tomography in differentiation between malignant and benign lesions in cancer patients. Does it always work?

Dual time point fluorodeoxyglucose positron emission tomography/computed tomography in differentiation between malignant and benign lesions in cancer patients. Does it always work?

Dual time point [18F]Flurodeoxyglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) with water gastric distension in differentiation between malignant and benign gastric lesions

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