Superimposition of PET images using 18F-fluorodeoxyglucose with magnetic resonance images in patients with pancreatic carcinoma

Benyounes, H.; Smith, Francis W.; Campbell, C.; Evans, Nicholas; Norton, M. Y.; Mikecz, Pál; Heys, Steven Darryll; Bruce, Duff M.; Eremin, O.; Sharp, P.

doi:10.1097/00006231-199507000-00009

Cited by 12 publications

(4 citation statements)

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“…High sensitivity and specificity ratings are frequently claimed in the literature as being a particular advantage of PET compared with other diagnostic techniques. This comparison is invalid, as PET interpretation relies on available CT or MR scans, so high sensitivity and specificity are not derived solely from PET [27,28]. In addition, we could not confirm the extremely favorable results reported by others [19].…”

Section: Discussionmentioning

confidence: 70%

Limited value of positron emission tomography in treatment of pancreatic cancer: Surgeon’s view

et al. 2001

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We aimed to assess, from a surgical point of view, the value of positron emission tomography (PET) in the routine preoperative diagnostic evaluation of a pancreatic mass. In particular, we were interested in PET's ability to distinguish a malignancy from a nonmalignant process and its impact on surgical decision making. We documented prospectively the results of preoperative ultrasonography, computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), and PET in terms of a correct diagnosis of malignancy in 103 patients. All patients underwent surgery at our department and had a complete histologic workup. We then related the preoperative findings to the intraoperative and histologic findings and analyzed the advantages and limitations of PET in comparison with conventional diagnostic techniques. Both CT and PET showed high sensitivities (82% and 84%, respectively) but rather low specificities (61%). ERCP showed good specificity at 83% but weak sensitivity at 46%. The positive predictive value was higher than 80% for all methods, whereas the negative predictive value was around 60% at best. Both the CT and the PET diagnoses were wrong in 15% of the cases. In all cases with a false CT diagnosis, the results of the other conventional examinations provided sufficient evidence to indicate the need for surgical intervention. In all cases where PET gave misleading results, CT findings indicated the need for surgery. PET overlooked pT1 cancers in three of the patients. PET does not reliably prove or exclude malignancy in situations where conventional diagnostic procedures leave doubt as to the nature of a pancreatic mass. PET does introduce a new procedure-related spectrum of misinterpretations to the diagnostic process.

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Section: Discussionmentioning

confidence: 70%

Limited value of positron emission tomography in treatment of pancreatic cancer: Surgeon’s view

et al. 2001

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“…Several groups, predominantly from Japan and Germany, have evaluated the role of FDG PET in the differentiation of pancreatic adenocarcinoma from benign chronic pancreatitis and mass-forming pancreatitis [163][164][165][166][167][168][169]. Results indicate a sensitivity of ca.…”

Section: Pancreatic Carcinomamentioning

confidence: 99%

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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“…Registration and fusion of PET with MR or computed tomography (CT) images allows accurate tumour localisation and clearer boundary demarcation and helps differentiate between tumour and inflammatory tissue [6,7]. This information is invaluable in planning a curative resection, helping to minimise the invasiveness and risk of such a procedure.…”

Section: Introductionmentioning

confidence: 99%

PET-MR image fusion in soft tissue sarcoma: accuracy, reliability and practicality of interactive point-based and automated mutual information techniques

Somer

Marsden

Benatar

et al. 2003

European Journal of Nuclear Medicine and Molecular Imaging

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The fusion of functional positron emission tomography (PET) data with anatomical magnetic resonance (MR) or computed tomography images, using a variety of interactive and automated techniques, is becoming commonplace, with the technique of choice dependent on the specific application. The case of PET-MR image fusion in soft tissue is complicated by a lack of conspicuous anatomical features and deviation from the rigid-body model. Here we compare a point-based external marker technique with an automated mutual information algorithm and discuss the practicality, reliability and accuracy of each when applied to the study of soft tissue sarcoma. Ten subjects with suspected sarcoma in the knee, thigh, groin, flank or back underwent MR and PET scanning after the attachment of nine external fiducial markers. In the assessment of the point-based technique, three error measures were considered: fiducial localisation error (FLE), fiducial registration error (FRE) and target registration error (TRE). FLE, which represents the accuracy with which the fiducial points can be located, is related to the FRE minimised by the registration algorithm. The registration accuracy is best characterised by the TRE, which is the distance between corresponding points in each image space after registration. In the absence of salient features within the target volume, the TRE can be measured at fiducials excluded from the registration process. To assess the mutual information technique, PET data, acquired after physically removing the markers, were reconstructed in a variety of ways and registered with MR. Having applied the transform suggested by the algorithm to the PET scan acquired before the markers were removed, the residual distance between PET and MR marker-pairs could be measured. The manual point-based technique yielded the best results (RMS TRE =8.3 mm, max =22.4 mm, min =1.7 mm), performing better than the automated algorithm (RMS TRE =20.0 mm, max =30.5 mm, min =7.7 mm) when registering filtered back-projection PET images to MR. Image reconstruction with an iterative algorithm or registration of a composite emission-transmission image did not improve the overall accuracy of the registration process. We have demonstrated that, in this application, point-based PET-MR registration using external markers is practical, reliable and accurate to within approximately 5 mm towards the fiducial centroid. The automated algorithm did not perform as reliably or as accurately.

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Superimposition of PET images using 18F-fluorodeoxyglucose with magnetic resonance images in patients with pancreatic carcinoma

Cited by 12 publications

References 0 publications

Limited value of positron emission tomography in treatment of pancreatic cancer: Surgeon’s view

Limited value of positron emission tomography in treatment of pancreatic cancer: Surgeon’s view

Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose

PET-MR image fusion in soft tissue sarcoma: accuracy, reliability and practicality of interactive point-based and automated mutual information techniques

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