Positron Emission Tomography of Schwannomas: Emphasizing Its Potential in Preoperative Planning

Beaulieu, Sylvain; Rubin, Brian P.; Djang, David; Conrad, Ernest U.; Turcotte, Éric; Eary, Janet F.

doi:10.2214/ajr.182.4.1820971

Cited by 192 publications

(95 citation statements)

References 7 publications

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“…Large accumulations of FDG in schwannomas may result in the potential ability of schwann cells to transport glucose for axonal repolarization [17].…”

Section: Discussionmentioning

confidence: 99%

Gastric schwannomas revisited: has precise preoperative diagnosis become feasible?

et al. 2012

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Background Gastric schwannomas are not common but are clinically important in terms of differential diagnosis from other submucosal lesions. The precise preoperative diagnosis, however, has been challenging mainly owing to the lack of specific findings in conventional imaging studies. The aim of this study was to revisit the possibilities and limitations of modern preoperative diagnostic modalities for gastric schwannomas. Methods Fourteen consecutive patients with a final pathological diagnosis of gastric schwannoma were retrospectively analyzed. Data included demographics, preoperative imaging studies/diagnosis, surgery, histopathology, and follow-up results.Results The series included 6 males and 8 females, with a median age of 49 years (range 26-68 years). No symptoms were presented, except for 1 patient with epigastric pain. The tumors were located in the upper (n = 5), middle (3), and lower stomach (6), with a median size of 41 mm (range 20-75 mm). Twelve schwannomas (86 %) showed homogeneous enhancement on computed tomography. Ulceration was seen on endoscopy in 4 of 12 available cases (33 %). Positron emission tomography was performed in the last 4 patients, showing fluorodeoxy-glucose uptake in all cases (100 %). A preoperative diagnosis of schwannoma was not obtained in the majority of cases (13/14, 93 %); only 1 case was correctly diagnosed, by endoscopic aspiration cytology. Laparoscopic partial gastrectomy was attempted and completed in 13 cases. The patients have been followed up for 4.7 years (range 2.1-20.3 years), with no recurrencesor metastases and acceptable gastrointestinal function. Conclusions The precise preoperative diagnosis of gastric schwannomas remains difficult even with modern imaging studies. Surgery, therefore, should be positively considered for patients without a conclusive preoperative diagnosis.

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“…Large accumulations of FDG in schwannomas may result in the potential ability of schwann cells to transport glucose for axonal repolarization [17].…”

Section: Discussionmentioning

confidence: 99%

Gastric schwannomas revisited: has precise preoperative diagnosis become feasible?

et al. 2012

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“…Although the cutoff values of SUVmax vary among such reports, many papers reported SUVmax values of 3-4 (10,(16)(17)(18)(19). In our study, malignant neurogenic tumors showed high FDG uptake and benign tumors showed low FDG uptake, and the SUVmax had 90.0% sensitivity, 91.7% specificity, and 98.3% accuracy with a cutoff value of 4.8.…”

Section: Discussionmentioning

confidence: 46%

“…There are many reports regarding the utility and limits of FDG-PET for neurogenic tumors. It is known that benign neurogenic tumors often show high FDG accumulation based on the cell density (10,16,17,20,21).…”

Section: Discussionmentioning

confidence: 99%

Correlations between F-18 FDG PET/CT and pathological findings in soft tissue lesions

et al. 2013

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“…They are usually solitary in a patient population of third to fifth decades of life [29] with or without association with neurofibromatosis type 1. Their prominent F-18 FDG uptake, not related to size or tumor proliferation rate characterized by the Ki-67 index may be linked to overexpression of glucose transporter proteins by the tumor cells [30] .…”

Section: Benign Tumorsmentioning

confidence: 99%

Features of non-malignant thoracic lesions on F-18 FDG PET/CT scan

Nguyen

2014

IJDI

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Introduction: During PET/CT chest interpretation, the radiologist may encounter non-malignant positive findings originating from physiologic variants, inflammation, infection, iatrogenic causes, post-surgical/post-therapeutic changes and benign tumors of different components of the thorax. This article illustrates and raises the awareness of these benign FDG-avid findings. Methods:We use a search engine to retrospectively review the 10-year PET/CT and pathology database of our institution for cases with thoracic findings linked to physiologic variations, and to benign processes and diseases. The keywords used for the search include all the entities presented in this article. We select the cases presenting with the most didactic value of benignity related to (1) established imaging patterns already published in the literature, which serves as reference articles in this paper, (2) final diagnosis from tissue sampling of ambiguous and difficult cases, and (3) long term monitoring based on clinical evaluation and anatomic and functional imaging.Results: Among the pool of cases fulfilling the required search criteria, we choose the most illustrative ones to present the different categories of benign findings encompassing the physiologic variants, inflammation, infection, iatrogenic causes, post-operative and post-therapeutic changes, and benign neoplasms. The most representative reference articles of the presented cases concerning all the benign thoracic entities are selected for the bibliography. Conclusion:The presented PET/CT cases raise the awareness and strengthen the interpretation confidence of the radiologist during the evaluation of cancer. The familiarity with these benign thoracic entities would obviate any suspicion of malignancy and avoid unnecessary additional assessment using expansive and potentially harmful procedures.

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Positron Emission Tomography of Schwannomas: Emphasizing Its Potential in Preoperative Planning

Cited by 192 publications

References 7 publications

Gastric schwannomas revisited: has precise preoperative diagnosis become feasible?

Gastric schwannomas revisited: has precise preoperative diagnosis become feasible?

Correlations between F-18 FDG PET/CT and pathological findings in soft tissue lesions

Features of non-malignant thoracic lesions on F-18 FDG PET/CT scan

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