Journal of nuclear medicine : official publication, Society of Nuclear Medicine
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In newly diagnosed diffuse large B-cell lymphoma (DLBCL), the sensitivity of bone marrow biopsy (BMB) for the detection of bone marrow involvement (BMI) can be low because of sampling error if the BMI is focal and not diffuse. Although (18)F-FDG PET/CT is now recommended for initial staging of DLBCL, its role regarding BMI is not well defined. This study evaluated whether (18)F-FDG PET/CT, in comparison with BMB, is useful for the detection of BMI and predictive of outcome. ⋯ Assessment of BMI with (18)F-FDG PET/CT provides better diagnostic performance and prognostic stratification in newly diagnosed DLBCL than does BMB.
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Patients with differentiated thyroid carcinoma (DTC) are treated with (131)I therapy after total thyroidectomy or surgical resection of recurrent tumor. However, some recurrent DTC lesions are not iodine-avid, which affects further treatment planning. The aim of this study was to evaluate the clinical benefit of (18)F-FDG PET/CT performed concurrently with (131)I therapy in DTC patients with intermediate to high risk. ⋯ (18)F-FDG PET/CT performed concurrently with (131)I therapy detected additional lesions in 14% of DTC patients and was particularly helpful for detecting additional lesions in patients undergoing (131)I therapy after resection of recurrent tumor or in stage T3-T4N1 patients with tumor size > 2.0 cm.
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The spatial normalization of PET amyloid imaging data is challenging because different white and gray matter patterns of negative (Aβ-) and positive (Aβ+) uptake could lead to systematic bias if a standard method is used. In this study, we propose the use of an adaptive template registration method to overcome this problem. ⋯ The derived adaptive template registration method allows for robust, accurate, and fully automated quantification of uptake for (18)F-flutemetamol and (11)C-PIB scans without the use of MR imaging data.
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To date, the use of structural MR imaging (including contrast-enhanced and T2-weighted or fluid-attenuated inversion recovery-weighted images) is the standard method to diagnose tumor progression and to assess antiangiogenic treatment effects. However, several studies have suggested that O-(2-(18)F-fluoroethyl)-L-tyrosine ((18)F-FET) PET adds valuable clinical information to the information derived from structural MR imaging alone. We evaluated the effectiveness and cost-effectiveness of the addition of (18)F-FET PET to structural MR imaging for the management of treatment with bevacizumab and irinotecan (BEV/IR) in patients with recurrent high-grade glioma compared with MR imaging alone from the perspective of the German Statutory Health Insurance. ⋯ The model suggests that the additional use of (18)F-FET PET in the management of patients with recurrent high-grade glioma treated with BEV/IR may be cost-effective. Integration of (18)F-FET PET has the potential to avoid overtreatment and corresponding costs, as well as unnecessary side effects to the patient.
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Ventilation-perfusion (V/Q) SPECT has been reported to improve the diagnostic performance of V/Q imaging for the diagnosis of pulmonary embolism (PE). However, only sparse data based on an objective reference test are available, and the criteria used for interpretation have varied widely. Therefore, the aim of our study was to assess the performance of V/Q SPECT using various criteria for interpretation, in comparison with a validated independent diagnostic strategy. ⋯ For V/Q SPECT interpretation, a diagnostic cutoff of 1 segmental or 2 subsegmental mismatches seems best for confirming or excluding acute PE.