PET/CT of skull base meningiomas using 2-F-18-fluoro-L-tyrosine: Initial report
; Cabay, Jean-Evrard ; Withofs, Nadia et al
in Journal of Nuclear Medicine (2007), 48(5), 720-725
Precise delineation of the shape of skull base meningiomas is critical for their treatment and follow-up but is often difficult using conventional imaging such as CT and MRI. We report our results with ... [more ▼]
Precise delineation of the shape of skull base meningiomas is critical for their treatment and follow-up but is often difficult using conventional imaging such as CT and MRI. We report our results with PET/CT and 2-(18)F-fluoro-L-tyrosine ((18)F-TYR), a marker of amino acid transport, as part of the yearly follow-up of irradiated patients. METHODS: Eleven patients (mean age, 56.5 y) with skull base meningiomas (n=13 lesions) previously irradiated were included. All patients received 300 MBq of (18)F-TYR and were imaged after 30 min of uptake, using a dedicated PET/CT system. The images were first visually examined, and regions of interest (ROI) were then placed over the transaxial PET slice showing the highest uptake. Another ROI was placed over the normal parietal cortex. Tumor-to-cortex activity ratios were obtained by dividing the maximum pixel value in the tumor ROI by the maximum pixel value in the cortex ROI. The PET/CT images were compared with the MR images obtained as part of routine follow-up. RESULTS: Accumulation of the tracer was higher in all meningiomas than in the surrounding tissue. The tumor-to-cortex activity ratio was 2.53 +/- 0.35 (range, 1.3-6). Nonneoplastic tissue such as hyperemic cavernous sinus did not take up the radionuclide and was therefore easily distinguished from the meningioma. The (18)F-TYR anomalies completely overlapped with the MR image in 54% of the tumors, extended beyond the MRI lesion in 38% of the tumors, and were smaller in 8% of the tumors. CONCLUSION: Meningiomas of the skull base are clearly visualized using (18)F-TYR PET/CT, even after irradiation. In addition to MRI, (18)F-TYR PET/CT images may contribute to the evaluation, delineation, and follow-up of these tumors. [less ▲]Detailed reference viewed: 85 (10 ULg)
Prognostic value of metabolic imaging in locally advanced non small cell lung cancers.
DUYSINX, Bernard ; LAROCK, Marie-Paule ; CORHAY, Jean-Louis et al
in Journal of Nuclear Medicine (The) (2007), 48(SUPPL), 358Detailed reference viewed: 12 (0 ULg)
Voxel-based analysis of dementia severity versus age on cerebral metabolic dysfunction in Alzheimer’s disease.
WITHOFS, Nadia ; SALMON, Eric ; LAUREYS, Steven et al
in Journal of Nuclear Medicine (The) (2007), 48(SUPPL), 172Detailed reference viewed: 11 (1 ULg)
Assessment of Crohn’s disease intestinal lesions with FDG PET/CT : A prospective correlation with endoscopy.
HUSTINX, Roland ; SPOTE, Véronique ; et al
in Journal of Nuclear Medicine (The) (2007), 48(SUPPL), 66Detailed reference viewed: 16 (0 ULg)
PET/CT imaging of skull base meningiomas using 2-18F-fluoro-L-tyrosine : Initial report.
; ; WITHOFS, Nadia et al
in Journal of Nuclear Medicine (The) (2007), 48(SUPPL), 11Detailed reference viewed: 9 (0 ULg)
F-18 FDG PET in infectious diseases in children.
Depas, Gisèle ; ; et al
in Clinical Nuclear Medicine (2007), 32(8), 593-8
PURPOSE: The aim is to report our observations regarding the role of F-18 FDG PET in children's infectious processes. MATERIAL AND METHODS: A presentation is made of 3 neonatal infections unresponsive to ... [more ▼]
PURPOSE: The aim is to report our observations regarding the role of F-18 FDG PET in children's infectious processes. MATERIAL AND METHODS: A presentation is made of 3 neonatal infections unresponsive to treatment, 2 invasive infections in immunocompromised children, and 1 discitis in an immunocompetent child. PET or PET/CT was performed to address a specific question pertaining to the management of the diseases. Results were correlated with the clinical outcome. The impact on patient management is discussed. RESULTS: In 1 neonate, PET localized the infection in a bone which allowed surgical curettage. In another one, it localized the infection in recently renewed exogenous material and led to subsequent removal. It was negative in the third one, whose evolution was rapidly favorable. In the immunocompromised children, treatment of invasive infection was adapted according to the metabolic inflammatory activity of the disease. In a limping child with slight abnormalities on bone scintigraphy but major misleading involvement on MRI, PET/CT demonstrated hypermetabolism limited to a disc, thus avoiding further invasive procedures. CONCLUSIONS: Although not meant as a first choice examination, F-18 FDG PET should be considered in difficult cases of neonatal infection or in challenging diagnoses like discitis in the young child. It provides more accurate staging and treatment monitoring of the inflammatory process in invasive infections of immunocompromised children. [less ▲]Detailed reference viewed: 48 (4 ULg)
Le mélanome cutané dans une perspective liégeoise. Actualisation de son épidémiologie et avancées diagnostiques.
Quatresooz, Pascale ; Hustinx, Roland ; Franchimont, Claudine et al
in Revue Médicale de Liège (2007), 62(Supplément), 52-55
Cutaneous melanoma is one of the research poles at the University Hospital of Liège. Since 20 years or so, the dermatopathology laboratory with the contribution of the Mosan Study Group of Pigmented ... [more ▼]
Cutaneous melanoma is one of the research poles at the University Hospital of Liège. Since 20 years or so, the dermatopathology laboratory with the contribution of the Mosan Study Group of Pigmented Neoplasms have scrutenised the epidemiological evolution of this cancer. We have disclosed a sharp increase in the global incidence of melanoma, more particularly in women in the age of procreation. We have also contributed and innovated in terms of clinical diagnosis by introducing dermoscopy and initiating both the ULEV method and the cyanoacrylate skin surface stripping. In the field of dermatopathology we have developed an immunohistological panel allowing to fine tune the diagnosis and to define some histoprognostic criteria. For the checkup of the disease extension, the PET scan method has been particularly refined. [less ▲]Detailed reference viewed: 41 (7 ULg)
Hepatobiliary disease : primary and metastatic liver tumours
Hustinx, Roland ; Detry, Olivier
in Cook, Gary JR; Maisey, Michael M; Britton, Keith (Eds.) et al Clinical Nuclear Medicine (2007)
PET and PET-CT in Oncology describes the principles of positron emission tomography and is a useful resource for incorporating the technique in clinical practice. In a clear and straightforward fashion ... [more ▼]
PET and PET-CT in Oncology describes the principles of positron emission tomography and is a useful resource for incorporating the technique in clinical practice. In a clear and straightforward fashion, this heavily-illustrated text offers instructive information and overviews of the basic principles of PET and PET-CT as well as the routine clinical PET scanning procedures for all important oncological indications. It is designed to serve as a reference work for specialists in nuclear medicine and radiology (including therapy planning) and for oncologists. It also provides student and physicians in other medical specialities with a general introduction to the effective integration of this modern technique into routine clinical diagnostics. Above all, this volume illustrates the importance of PET and PET-CT in comparison with other imaging techniques. [less ▲]Detailed reference viewed: 27 (3 ULg)
Tomographie a emission de positons: un premier bilan.
Jerusalem, Guy ; Withofs, Nadia ; Rorive, Andrée et al
in Revue du Praticien (La) (2007), 57(17), 1864-70
Positron emission tomography (PET) has been widely used for several years for staging and response evaluation in oncology. It is time to critically review its role in routine patient care. [18F]-labelled ... [more ▼]
Positron emission tomography (PET) has been widely used for several years for staging and response evaluation in oncology. It is time to critically review its role in routine patient care. [18F]-labelled fluorodeoxyglucose ([18F]-FDG) remains the radiotracer of choice in most indications. Its high sensitivity, the half-life of 110 minutes and the easy production of this radiotracer explain its routine use although the specificity is not very good. Infectious or inflammatory processes can mimic tumours. Appropriate selection of patients studied in the recommended indications and interpretation of images by an experienced team having access to both clinical information and other diagnostic studies allows reducing the risk of false positives. Although PET is highly accurate, not all patients suffering from cancer need a PET study. Major improvements were also observed with conventional imaging techniques over the past 10 years. It is important to avoid long waiting lists because otherwise treatment delay may counterbalance the benefit of PET studies. [less ▲]Detailed reference viewed: 38 (2 ULg)
18f-Fdg Pet Imaging in Assessing Exudative Pleural Effusions
DUYSINX, Bernard ; Larock, Marie-Paule ; et al
in Nuclear Medicine Communications (2006), 27(12), 971-6
BACKGROUND: This study evaluates the accuracy of [F]fluorodeoxyglucose positron emission tomography (F-FDG PET) imaging with semi-quantitative analysis for differentiating benign from malignant pleural ... [more ▼]
BACKGROUND: This study evaluates the accuracy of [F]fluorodeoxyglucose positron emission tomography (F-FDG PET) imaging with semi-quantitative analysis for differentiating benign from malignant pleural exudates and for guiding the search for the primary tumour of pleural metastases. METHODS: Whole-body 18F-FDG PET was performed in 79 patients with exudative pleurisy. Standard uptake values were normalized for body weight, body surface area, lean body mass (SUVbw, SUVbsa, SUVlbm) with and without correction for blood glucose levels. Thoracoscopy was systematically performed to reveal pathological diagnosis. RESULTS: All SUVs were significantly higher in all malignant pleural diseases (n = 51) than in benign (n = 28) (P < 0.001). Moreover SUVs were greater in the pleural metastases from pulmonary primaries (n = 25) and in mesotheliomas (n = 8) than in extrathoracic primaries (n = 18) (P < 0.01) with no significant difference between lung cancers and mesotheliomas. Receiver operating curve (ROC) analysis between benign and malignant lesions showed areas under the curves that ranged from 0.803 (SUVbsa g) to 0.863 (SUVbw). The cut-off value for SUVbw which gave the best accuracy (82.3%) was 2.2. When comparing thoracic with extrathoracic primaries the highest accuracy (80.4%) was found for a cut-off value of 2.6. CONCLUSION: Semi-quantitative analysis of 18F-FDG PET imaging helps to differentiate malignant from benign pleural exudates and to distinguish between thoracic or extrathoracic primaries. [less ▲]Detailed reference viewed: 93 (30 ULg)
Pericardite aspergillaire avec tamponnade cardiaque et syndrome hemophagocytaire: un cas non classique d'immunodeficience
Delcroix, Geoffrey ; ; Hustinx, Roland et al
in Revue Médicale de Liège (2006), 61(10), 713-8
We report the case of a 31-year-old woman who died in a context of haemophagocytic syndrome with multiple opportunist infections:viral, mycobacterial and fungal. To our knowledge, this is the tenth case ... [more ▼]
We report the case of a 31-year-old woman who died in a context of haemophagocytic syndrome with multiple opportunist infections:viral, mycobacterial and fungal. To our knowledge, this is the tenth case of invasive aspergillosis manifested by an aspergillus pericarditis with cardiac tamponade. Search for HIV infection, neoplasia, haematological malignancies was negative. In addition, the patient carried on a nonviral, non-ethylic cirrhosis, the etiology of which remained unknow. We will particularly develop the aspergillus pericarditis with cardiac tamponade and the haemophagocytic syndrome. [less ▲]Detailed reference viewed: 138 (11 ULg)
Clinical applications of pinhole single photon emission tomography
Seret, Alain ; Hustinx, Roland
in Current Medical Imaging Reviews (2006), 2(3), 347-352
For some planar scintigraphic explorations, like thyroid or hip, the pinhole collimator is usually preferred to the usual parallel hole collimators because it allows a superior resolution. Progress in 3D ... [more ▼]
For some planar scintigraphic explorations, like thyroid or hip, the pinhole collimator is usually preferred to the usual parallel hole collimators because it allows a superior resolution. Progress in 3D tomography reconstruction methods allows single photon emission tomography (SPET) to be today performed using the-pinhole collimator with again the advantage of a higher resolution. Pinhole collimator imposes a short distance (a few centimetres) to the target area and a restricted field of view. Over the last ten years, the potential of pinhole SPET has been essentially investigated for the ankle and the hind foot, the detection of thyroid nodules or abnormal parathyroid glands, the exploration of axillary lymph nodes. The technique was usually compared to planar scintigraphy performed with parallel hole or pinhole collimator. Sometimes a comparison to standard (with parallel hole collimator) SPET or to a morphologic imaging technique was also available. All studies highlight the improvement in resolution afforded by the use of the pinhole collimator. In bone scintigraphy, the delineation of the structures was largely superior allowing the visualisation of significant details usually never seen on scintigraphic images. In thyroid scintigraphy, the better resolution allowed to detect more nodules (essentially infra-centimetre nodules), and to reduce the number of equivocal cases. For abnormal parathyroid gland detection, the number of false negative cases decreased, with a concomitant increase of true positive cases; the glands were more sharply delineated on the images. Pinhole SPET with Tc-99m-tetrofosmin was the only scintigraphic method able to successfully reveal the number of involved lymph nodes in patients with breast cancer. In conclusion pinhole single photon appears as a promising new scintigraphic method allowing to explore small areas with a high resolution. [less ▲]Detailed reference viewed: 36 (2 ULg)
FDG-PET for the routine follow-up in NHL: First prospective evaluation
Jerusalem, Guy ; ; Beguin, Yves et al
in Journal of Clinical Oncology (2006, June 20), 24(18, Part 1 Suppl. S), 439Detailed reference viewed: 28 (8 ULg)
F-18-FDG PET imaging of rheumatoid knee synovitis correlates with dynamic magnetic resonance and sonographic assessments as well as with the serum level of metalloproteinase-3
Beckers, Catherine ; ; Ribbens, Clio et al
in European Journal of Nuclear Medicine and Molecular Imaging (2006), 33(3), 275-280
Purpose: The aim of this study was to assess rheumatoid arthritis (RA) synovitis with positron emission tomography (PET) and F-18-fluorodeoxyglucose (F-18-FDG) in comparison with dynamic magnetic ... [more ▼]
Purpose: The aim of this study was to assess rheumatoid arthritis (RA) synovitis with positron emission tomography (PET) and F-18-fluorodeoxyglucose (F-18-FDG) in comparison with dynamic magnetic resonance imaging (MRI) and ultrasonography (US). Methods: Sixteen knees in 16 patients with active RA were assessed with PET, MRI and US at baseline and 4 weeks after initiation of anti-TNF-alpha treatment. All studies were performed within 4 days. Visual and semi-quantitative (standardised uptake value, SUV) analyses of the synovial uptake of FDG were performed. The dynamic enhancement rate and the static enhancement were measured after i.v. gadolinium injection and the synovial thickness was measured in the medial, lateral patellar and suprapatellar recesses by US. Serum levels of C-reactive protein (CRP) and metalloproteinase-3 (MMP-3) were also measured. Results: PET was positive in 69% of knees while MRI and US were positive in 69% and 75%. Positivity on one imaging technique was strongly associated with positivity on the other two. PET-positive knees exhibited significantly higher SUVs, higher MRI parameters and greater synovial thickness compared with PET-negative knees, whereas serum CRP and MMP-3 levels were not significantly different. SUVs were significantly correlated with all MRI parameters, with synovial thickness and with serum CRP and MMP-3 levels at baseline. Changes in SUVs after 4 weeks were also correlated with changes in MRI parameters and in serum CRP and MMP-3 levels, but not with changes in synovial thickness. Conclusion: F-18-FDG PET is a unique imaging technique for assessing the metabolic activity of synovitis. The PET findings are correlated with MRI and US assessments of the pannus in RA, as well as with the classical serum parameter of inflammation, CRP, and the synovium-derived parameter, serum MMP-3. Further studies are warranted to establish the place of metabolic imaging of synovitis in RA. [less ▲]Detailed reference viewed: 92 (10 ULg)
Diagnostic and therapeutic management of carcinoma of unknown primary: radio-imaging investigations.
Jerusalem, Guy ; Rorive, Andrée ; et al
in Annals of Oncology (2006), 17 Suppl 10Detailed reference viewed: 11 (3 ULg)
Intratissular Lymphaticovenous Anastomoses Demonstrated by Perioperative Intramuscular Injection of 99mtc-Colloids
; Fallais, Charles ; Hustinx, Roland
in Lymphatic Research and Biology (2006), 4(1, Spring), 29-33
BACKGROUND: The existence of intratissular lymphaticovenous anastomoses has often been suggested, but it has never been demonstrated. This study aims at demonstrating the presence of such anastomoses ... [more ▼]
BACKGROUND: The existence of intratissular lymphaticovenous anastomoses has often been suggested, but it has never been demonstrated. This study aims at demonstrating the presence of such anastomoses. METHODS AND RESULTS: The free flap model was used to investigate the drainage of radiolabeled colloid particles whose size prevents direct passage to the blood vessels. The tracer was injected into the muscle or the skin during the surgical procedure. Blood samples were sequentially drawn from the venous pedicle over the 30 minutes that followed the tracer injection. The blood samples were counted using a gamma well-counter. In all 14 patients, the venous blood radioactivity steadily increased over time. Radiochemical analyses performed on the blood samples demonstrated that the radioactivity is related to the labeled colloids and not to free pertechnetate. Planar imaging performed 24 hours after the surgical procedure showed a significant liver uptake, and no accumulation in the area of normal lymphatic relays. CONCLUSIONS: As, in the free flap model, there is no lymphatic drainage through the classical pathways whatsoever, and since the size of the radiolabeled particles prevents them from directly entering the blood stream, the results strongly suggest the presence of functional intratissular lymphovenous anastomoses. [less ▲]Detailed reference viewed: 31 (2 ULg)
Clinical added-value of 18FDG PET in neuroendocrine-merkel cell carcinoma
; Pierard, Gérald ; et al
in Oncology Reports (2006), 16(2), 347-352
Merkel cell carcinoma (MCC) is a rare and highly malignant skin cancer with neuroendocrine differentiation. We studied the potential value of 18FDG PET in the management of MCC. Eleven patients with MCC ... [more ▼]
Merkel cell carcinoma (MCC) is a rare and highly malignant skin cancer with neuroendocrine differentiation. We studied the potential value of 18FDG PET in the management of MCC. Eleven patients with MCC were examined by 18FDG PET and PET-CT for staging purpose (n=4) or for detection of recurrence (n=7). Qualitative and quantitative interpretation of PET studies was performed routinely. 18FDG PET observations were compared to clinical and radiological findings. In 6 patients, PET findings were also compared to histology. In 7 patients, the 18FDG tumor uptake was compared to the MCC proliferative activity expressed by the Ki-67 index. 18FDG PET was contributive in 10/11 MCC patients. In 7 patients, 18FDG PET detected focal lesions or a disseminated stage of the disease including dermal, nodal and visceral metastases. In 3 patients, a normal 18FDG PET confirmed complete remission of disease. Most MCC patients exhibited highly 18FDG-avid sites suggestive of increased glucose metabolism. This imaging pattern was related to a high proliferative activity (Ki-67 index >50%). In 1 patient with a weakly proliferative nodal MCC (Ki-67<10%), a false negative result was yielded by metabolic imaging. In 4/11 patients, 18FDG PET revealed an unsuspected second neoplasm in addition to MCC. It is concluded that whole-body 18FDG PET may be useful in the management of MCC patients. However, a normal 18FDG PET aspect cannot rule out MCC with low proliferative activity. [less ▲]Detailed reference viewed: 85 (9 ULg)
Effect of diazepam on the efficacy of dual-phase FDG PET imaging.
; Hustinx, Roland ;
in European Journal of Nuclear Medicine and Molecular Imaging (2006), 33(2), 228-9230Detailed reference viewed: 24 (2 ULg)
Le cas clinique du mois. Colite a clostridium difficile.
Laret, Vinciane ; ; et al
in Revue Médicale de Liège (2006), 61(11), 750-2
A 55-year-old patient with mant e cels underwent a cytotoxic chemotherapy (D.H.A.P. + Rituximab). During the medullar aplasia related to the third cycle, diarrhoea due to Clostridium difficile arised and ... [more ▼]
A 55-year-old patient with mant e cels underwent a cytotoxic chemotherapy (D.H.A.P. + Rituximab). During the medullar aplasia related to the third cycle, diarrhoea due to Clostridium difficile arised and relapsed 15 days later despite normal blood counts. This colitis was very severe with pluribacterial peritonitis, but resolved with intensive medical treatment. The incidence, the patient's risk factors, the iatrogenic and nosocomial characters of cl. difficile colitis are discussed. [less ▲]Detailed reference viewed: 171 (10 ULg)