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See detailWhole-body positron emission tomography using 18F-fluorodeoxyglucose for posttreatment evaluation in Hodgkin's disease and non-Hodgkin's lymphoma has higher diagnostic and prognostic value than classical computed tomography scan imaging.
Jerusalem, Guy ULg; Beguin, Yves ULg; Fassotte, Marie-France ULg et al

in Blood (1999), 94(2), 429-33

A residual mass after treatment of lymphoma is a clinical challenge, because it may represent vital tumor as well as tissue fibrosis. Metabolic imaging by 18F-fluorodeoxyglucose (18F-FDG) positron ... [more ▼]

A residual mass after treatment of lymphoma is a clinical challenge, because it may represent vital tumor as well as tissue fibrosis. Metabolic imaging by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) offers the advantage of functional tissue characterization that is largely independent of morphologic criteria. We compared 18F-FDG PET to computed tomography (CT) in the posttreatment evaluation of 54 patients with Hodgkin's disease (HD) or intermediate/high-grade non-Hodgkin's lymphoma (NHL). Residual masses on CT were observed in 13 of 19 patients with HD and 11 of 35 patients with NHL. Five of 24 patients with residual masses on CT versus 1 of 30 patients without residual masses presented a positive 18F-FDG PET study. Relapse occurred in all 6 patients (100%) with a positive 18F-FDG PET, 5 of 19 patients (26%) with residual masses on CT but negative 18F-FDG PET, and 3 of 29 patients (10%) with negative CT scan and 18F-FDG PET studies (P </=.0001). We observed a higher relapse and death rate in patients with residual masses at CT compared with patients without residual masses at CT (progression-free survival at 1 year: 62 +/- 10 v 88 +/- 7%, P =. 0045; overall survival at 1 year: 77 +/- 5 v 95 +/- 5%, P =.0038). A positive 18F-FDG PET study was even more consistently associated with poorer survival: compared with patients with a negative 18F-FDG PET study, the 1-year progression-free survival was 0% versus 86% +/- 5% (P <.0001) and the 1-year overall survival was 50% +/- 20% versus 92% +/- 4% (P <.0001). The detection of vital tumor by 18F-FDG PET after the end of treatment has a higher predictive value for relapse than classical CT scan imaging (positive predictive value: 100% v 42%). This could help identify patients requiring intensification immediately after completion of chemotherapy. However, 18F-FDG PET mainly predicts for early progression but cannot exclude the presence of minimal residual disease, possibly leading to a later relapse. [less ▲]

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See detailIntérêt clinique de la tomographie à émission de positons dans la détection et le bilan d'extension des lymphomes non Hodgkiniens de malignité intermédiaire ou élevée
Najjar, Fadi; Jerusalem, Guy ULg; Paulus, Patrick et al

in Médecine Nucléaire : Imagerie Fonctionnelle et Métabolique (1999), 23

Accurate staging of non-Hodkin's lymphoma (NHL) is important for treatment management. We studied 53 patients (40 patients at initial diagnosis and 13 patients at disease recurrence) with ... [more ▼]

Accurate staging of non-Hodkin's lymphoma (NHL) is important for treatment management. We studied 53 patients (40 patients at initial diagnosis and 13 patients at disease recurrence) with histopathologically proven aggressive NHL to assess the value of whole-body FDG positron emission tomography (PET) as an imaging modality for staging and restaging NHL. All patients in this comparative analysis were submitted to clinical examination ; computed tomography (CT) and whole-body PET studies before starting the treatment. Results : whole-body FDG-PET seems to be more sensitive than clinical examination and CT imaging for detection of lymph node regions infiltrated by NHL : there were 98 abnormal peripheral lymph node regions senn by FDG-PET : 59 observed by clinical examination and 39 clinically undetected. The clinical examination showed 9 additional nodal lesions not seen by PET. Of 77 thoracic and abdominopelvic trated by CT. The CT studies showed 5 additional nodal lesions. Extranodal lymphomatous localisations in the liver (n=5), spleen (n=14), lungs (n=8), pleura (n=9), digestive tract (n=4), pelvis (n=2) and other sites (n=9) were identified by PET. Bone marrow infiltration demonstrated by PET was confirmed by biopsy in 6/10 patients, however known medullary invasion was not seen by PET imaging in 5 patients. Conclusion : whole-body FDG-PET without attenuation correction is an efficient, non-invasive method for staging and restaging aggressive NHL but marrow biopsy remains to be performed in addition to PET. [less ▲]

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See detail18fdg-Pet for the Assessment of Primary Head and Neck Tumors: Clinical, Computed Tomography, and Histopathological Correlation in 38 Patients
Paulus, Patrick; Sambon, A.; Vivegnis, Danielle et al

in Laryngoscope (1998), 108(10), 1578-83

OBJECTIVES: To evaluate the clinical usefulness of FDG-PET (fluoro-2-deoxy-glucose-positron emission tomography) in the detection of lymph node involvement and recurrences in patients with head and neck ... [more ▼]

OBJECTIVES: To evaluate the clinical usefulness of FDG-PET (fluoro-2-deoxy-glucose-positron emission tomography) in the detection of lymph node involvement and recurrences in patients with head and neck cancer. STUDY DESIGN: Retrospective review of 38 patients with biopsy-proven head and neck cancers who underwent clinical, computed tomography (CT), and FDG-PET examinations. Twenty-five patients were studied prior to therapy and 13 patients were evaluated for disease recurrence. METHODS: All patients were operated and clinical data, CT, and FDG-PET results were correlated with histopathological findings. RESULTS: All primary tumors in 25 patients were detected, with the exception of one small superficial localization of the epiglottis. Histopathological examination showed lymph node involvement in 10 patients; PET detected lymph node involvement in five. FDG-PET found one case of nodal disease not identified by clinical and CT examination. With so few cases, this could be anecdotal. Five false-negative results (microscopic lymph node involvement) and two false positives were noted. Twelve of 13 patients with recurrent disease were correctly identified with FDG-PET. FDG-PET was the only imaging technique to identify local recurrence in two patients and lymph node involvement in two others. One false-positive result occurred in a patient with a foreign body granuloma. CONCLUSIONS: FDG-PET is a useful diagnostic modality for the detection of recurrent tumors and, in selected cases, precise lymph node involvement. The best way to further investigate the utility of clinical FDG-PET is in the follow-up of treated patients. [less ▲]

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See detailFluorine-18 deoxyglucose positron emission tomography for the detection of bone metastases in patients with non-small cell lung cancer
Bury, Thierry ULg; BARRETO, A.; Daenen, Frédéric ULg et al

in European Journal of Nuclear Medicine (1998), 9

Despite advances in morphological imaging, some patients with lung cancer are found to have non resectable disease at surgery or die of recurrence within a year of surgery. At present, metastatic bone ... [more ▼]

Despite advances in morphological imaging, some patients with lung cancer are found to have non resectable disease at surgery or die of recurrence within a year of surgery. At present, metastatic bone involvement is usually assessed using bone scintigraphy, which has a high sensitivity but a poor specificity. We have attempted to evaluate the utility of the fluorine-18 deoxyglucose positron emission tomography (FDG PET) for the detection of bone metastasis. One hundred and ten consecutive patients with histological diagnosis of non-small cell lung cancer (NSCLC) who underwent both FDG PET and bone scintigraphy were selected for this review. In this group, there were 43 patients with metastatic disease (stage IV). Among these. 21 (19% of total group) had one or several bone metastases confirmed by biopsy (n = 8) or radiographic techniques (n = 13). Radionuclide bone scanning correctly identified 54 out of 89 cases without osseous involvement and 19 out of 21 osseous involvements. On the other hand, FDG PET correctly identified the absence of osseous involvement in 87 out of 89 patients and the presence of bone metastasis in 19 out of 21 patients. Thus using PET there were two false-negative and two false-positive cases. PET and bone scanning had, respectively, an accuracy of 96% and 66% in the evaluation of osseous involvement in patients with NSCLC. In conclusion, our data suggest that whole-body FDG PET may be useful in detecting bone metastases in patients with known NSCLC. [less ▲]

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See detailMalignant Melanoma Staging Using Whole-Body Positron Emission Tomography
Paquet, Philippe ULg; Hustinx, Roland ULg; Rigo, Pierre ULg et al

in Melanoma Research (1998), 8(1), 59-62

The correct staging of potentially metastatic melanoma is essential for an appropriate therapeutic attitude. Current methods include computed tomography, magnetic resonance imaging, ultrasonography and ... [more ▼]

The correct staging of potentially metastatic melanoma is essential for an appropriate therapeutic attitude. Current methods include computed tomography, magnetic resonance imaging, ultrasonography and scintigraphy. Another tool is whole-body positron tomography using the radiopharmaceutical 2-fluorine-18-fluoro-2-deoxy-D-glucose as an emitter because it accumulates inside neoplasms, especially melanoma. We report two cases of malignant melanoma in which computed tomography and magnetic resonance imaging suggested visceral metastatic spread. In contrast, whole-body positron emission tomography indicated the absence of metastases, and this was confirmed by histological examination of the organs where metastases were suspected. Whole-body positron emission tomography appears to have high specificity and sensitivity for clinical melanoma staging. [less ▲]

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See detailClinical evaluation of whole-body 18F-fluorodeoxyglucose positron emission tomography in the detection of liver metastases.
Hustinx, Roland ULg; Paulus, Patrick; Jacquet, Nicolas et al

in Annals of Oncology (1998), 9(4), 397-401

BACKGROUND: Assessment of metastatic involvement of the liver remains a diagnostic challenge. The objective of this study was to evaluate the potential role of FDG PET in the detection of liver metastases ... [more ▼]

BACKGROUND: Assessment of metastatic involvement of the liver remains a diagnostic challenge. The objective of this study was to evaluate the potential role of FDG PET in the detection of liver metastases. PATIENTS AND METHODS: Sixty-four patients with malignancy and possible liver involvement were included. Liver metastases were present in 31 cases, demonstrated by histopathological analysis in 15 cases and by follow-up in 16 cases. The negative cases were confirmed by pathology in four cases, peroperative ultrasonography in 12 cases, and follow-up in 17 cases. Whole-body FDG PET was compared to CT (n = 53) and US (n = 43). RESULTS: PET demonstrated a 97% sensitivity, an 88% specificity and a 92% accuracy, compared to 93%, 75% and 85%, respectively, for CT (P = NS). Concordant results were obtained in 44 of 64 patients (69%: 19 TP. 25 TN). PET provided new and accurate information in 15 of 64 patients (23.4%). PET demonstrated liver metastases in 11 patients in whom conventional methods yielded negative (two cases) or doubtful (nine cases) results. Four patients free of liver involvement were correctly staged with PET, while CT/US were equivocal. PET was erroneous in five of 64 cases (7.8%, four FP, one FN). CONCLUSIONS: FDG PET allows an accurate screening of liver involvement in patients with malignancy. Combined with CT, it provides additional diagnostic information that could directly affect the management of these patients. [less ▲]

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See detailWhole-body 18FDG positron emission tomography in the staging of non-small cell lung cancer.
Bury, Thierry ULg; Dowlati, A.; Paulus, Patrick et al

in European Respiratory Journal (1997), 10(11), 2529-34

Despite advances in morphological imaging, some patients with lung cancer are found to have nonresectable disease at surgery or die of recurrence within yr of surgery. We performed a prospective study in ... [more ▼]

Despite advances in morphological imaging, some patients with lung cancer are found to have nonresectable disease at surgery or die of recurrence within yr of surgery. We performed a prospective study in 109 patients to compare the accuracy of whole-body positron emission tomography (PET) using fluorine-18 deoxyglucose (18FDG) and conventional imaging (CI) methods for the staging of non-small cell lung cancer (NSCLC). When CI or PET study suggested metastatic disease, confirmation was obtained by biopsy or follow-up information. As compared to CI, 18FDG-PET correctly changed the N stage in 22 patients (33%) and the M stage in 15 patients (14%). For the detection of distant metastases, PET study showed five false-positive sites and no false-negative cases. Currently, the accuracy of PET in the detection of M stage is 96%. Our study shows that visual interpretation of whole-body fluorine-18 deoxyglucose-positron emission tomography images can improve the diagnostic accuracy in the staging of non-small cell lung cancer. Further experience is needed to establish if metabolic imaging would be a cost-effective tool in the future management of lung cancer. [less ▲]

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See detailCardiac Risk Assessment before Vascular Surgery: A Prospective Study Comparing Clinical Evaluation, Dobutamine Stress Echocardiography, and Dobutamine Tc-99m Sestamibi Tomoscintigraphy
VAN DAMME, Hendrik ULg; Pierard, Luc ULg; Gillain, Daniel ULg et al

in Cardiovascular Surgery (1997), 5(1), 54-64

Preoperative evaluation for cardiac risk assessment before peripheral vascular surgery remains controversial. Between January and June 1994, a prospective open study was carried out in 156 patients ... [more ▼]

Preoperative evaluation for cardiac risk assessment before peripheral vascular surgery remains controversial. Between January and June 1994, a prospective open study was carried out in 156 patients scheduled for elective vascular procedures (63 carotid endarterectomies, 34 abdominal aortic aneurysms, 29 aortoiliac and 30 infrainguinal reconstructions) to compare the ability of clinical data, dobutamine stress echocardiography, and dobutamine Tc-99m sestamibi tomoscintigraphy to predict postoperative cardiac events. Pharmacological stress testing consisted of incremental dobutamine infusion (+/-1 mg atropine to achieve 85% of age-predicted maximal heart rate, with continuous echocardiographic monitoring, and injection of Tc-99m sestamibi after dobutamine infusion). Dobutamine echocardiography was abnormal in 36 patients (worsening resting wall motion abnormality in 11; new induced wall motion abnormality in 25). Dobutamine Tc-99m sestamibi tomoscintigraphy revealed a reversible perfusion defect in 34 patients, indicating the presence of myocardial ischaemia. As a result, eight patients underwent myocardial revascularization (n = 5) or the proposed operation was cancelled (n = 3). In the remaining 142 vascular procedures, there were eight (5.6%) adverse cardiac events: three myocardial infarctions (two fatal), three prolonged myocardial ischaemia, one acute congestive heart failure and one sustained ventricular arrhythmia in the post operative period. Univariate analysis selected unstable angina (relative risk (RR) 11.6), previous congestive heart failure (RR 6.4), Detsky's score of > or = 15 (RR 3.0), positive dobutamine stress echocardiography (RR 3.7), and positive dobutamine tomoscintigraphy (RR 7.4) as significant predictors of postoperative cardiac events. In patients without clinical markers of coronary artery disease (n = 66), non-invasive cardiac testing did not predict cardiac complications (n = 2; one prolonged myocardial ischaemia; one infarction). In the subset of 76 patients with definite clinical or electrocardiographic evidence of ischaemic heart disease, dobutamine stress testing provided additional information, and optimized risk stratification: five of six patients who suffered a cardiac complication had a pathologic dobutamine stress test. Furthermore, a negative dobutamine stress test was characterized by a high negative predictive value (0.96 for echocardiography; 0.97 for tomoscintigraphy). The study further demonstrated that the cardiac response (ischaemic versus non-ischaemic) to dobutamine stress was concordantly classified by echocardiographic and tomoscintigraphic techniques in 96% of cases. It is concluded that complementary non-invasive cardiac stress testing by dobutamine is indicated only in patients with clinically apparent coronary artery disease. [less ▲]

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See detailUsefulness of 18fdg Positron Emission Tomography in Detection and Follow-up of Digestive Cancers
Paulus, P.; Hustinx, Roland ULg; Daenen, Frédéric ULg et al

in Acta Gastro-Enterologica Belgica (1997), 60(4, Oct-Dec), 278-80

PET is a diagnostic method that creates high resolution, 3 dimensional tomographic images of the distribution of positron emitting radionuclides in the human body. Recent technological developments allow ... [more ▼]

PET is a diagnostic method that creates high resolution, 3 dimensional tomographic images of the distribution of positron emitting radionuclides in the human body. Recent technological developments allow the use of whole-body PET devices in clinical oncology. 18FDG is a glucose analog transported and competitively used with glucose reflecting the increased glucose metabolism into malignant cells. Differential diagnosis between chronic pancreatitis and pancreatic cancer is already a well-documented indication. For initial staging of gastro-esophageal and colorectal tumours, results are preliminary but the clinical impact seems to be rather limited. At present, the major indication of FDG-PET is the detection and staging of colorectal cancer recurrences. FDG-PET allows the differentiation between scared tissue and tumour when structural imaging is often confusing. In the same time, the whole-body imaging capability provides unique information that can modify loco-regional and liver staging. Overall, FDG-PET affects the clinical management of 30 to 40% of these patients. Quantitative assessment of therapeutic response to chemotherapy regimen appears to be one of the most promising applications of FDG-PET. Since the most effective therapy of colorectal cancer are often surgical, the role of chemotherapy in colorectal cancer remains limited to adjuvant therapy and in advanced disease. However, FDG-PET could be of great value in assessing the response of oesophageal carcinomas to chemo-radio therapy, before surgery. In our experience, FDG-PET appears to be the first line diagnostic method in the detection and staging of colorectal recurrence and differential diagnosis of pancreatic tumour versus chronic pancreatitis. [less ▲]

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See detailClinical PET in Oncology
Rigo, Pierre ULg; Paulus, Patrick; Bury, Thierry ULg et al

in Bergmann, H.; Kroiss, A.; Sinzinger H (Eds.) Radioactive Isotopes in Clinical Medicine and Research (1997)

18-FDG is accumulated in cancer cells. It has been proven useful to image a variety of tumors in conjunction with whole-body positron emission tomography. This review details somes of the indications of ... [more ▼]

18-FDG is accumulated in cancer cells. It has been proven useful to image a variety of tumors in conjunction with whole-body positron emission tomography. This review details somes of the indications of PET at various stages of the cancerous process : differential diagnosis, preoperative staging, diagnosis of residual or recurrent disease as well as follow-up of therapy. Consideration of several potential improvements in clinical PET and of the need for careful patients selection conclude this review. [less ▲]

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See detailEvaluation of pleural diseases with FDG-PET imaging: preliminary report.
Bury, Thierry ULg; Paulus, P; Dowlati, A et al

in Thorax (1997), 52(2), 187-9

BACKGROUND: Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) is an accurate method for differentiating benign from malignant disease. The use of FDG-PET for the aetiological diagnosis ... [more ▼]

BACKGROUND: Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) is an accurate method for differentiating benign from malignant disease. The use of FDG-PET for the aetiological diagnosis of pleural disease was investigated in 25 patients. METHODS: PET was performed on each subject before invasive procedures were used to determine the aetiological diagnosis. The PET data were analysed by visual interpretation of coronal, sagittal, and transverse slices. RESULTS: Sixteen patients were found to have malignant pleural disease and nine had benign disease. All patients with histologically confirmed malignant disease showed FDG uptake within the pleural thickening which was intense in 14 cases and moderate in two. PET imaging showed the absence of FDG uptake and correctly categorised seven non-malignant lesions. Two patients with infectious pleural diseases showed a localised and moderate FDG uptake. CONCLUSION: Our preliminary results suggest that FDG-PET could be an effective tool for differentiating between benign and malignant pleural diseases. [less ▲]

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See detailStaging of the Mediastinum: Value of Positron Emission Tomography Imaging in Non-Small Cell Lung Cancer
Bury, Thierry ULg; Paulus, P.; Dowlati, A. et al

in European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology (1996), 9(12), 2560-4

Recent studies have shown limitations of morphological imaging in staging mediastinal lymph node involvement in lung cancer. In contrast to computed tomography (CT), which depends primarily on anatomical ... [more ▼]

Recent studies have shown limitations of morphological imaging in staging mediastinal lymph node involvement in lung cancer. In contrast to computed tomography (CT), which depends primarily on anatomical imaging features, positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) depends mainly on the metabolic characteristics of a tissue for the diagnosis of disease. We have performed a prospective study comparing FDG-PET and CT of the thorax in the presurgical assessment of the mediastinum in 50 patients with newly diagnosed non-small cell lung cancer (NSCLC). CT and PET scans were interpreted separately, and results were compared to pathological staging obtained during thoracotomy. Hilar or mediastinal lymph node involvement was present in 58%. In staging for lymph node involvement, CT had a sensitivity of 72% and specificity of 81%, whereas PET had a sensitivity and specificity of 90% and 86%, respectively. When the PET study was compared to histological results, there were four cases showing more advanced mediastinal involvement with PET and four cases showing less involvement with PET. From our preliminary results, we conclude that positron emission tomography with 18-fluorodeoxyglucose is significantly more accurate than computed tomography in the mediastinal staging of non-small cell lung cancer. [less ▲]

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See detailOncological Applications of Positron Emission Tomography with Fluorine-18 Fluorodeoxyglucose
Rigo, Pierre ULg; Paulus, Patrick; Kaschten, Bruno et al

in European Journal of Nuclear Medicine (1996), 23(12), 1641-74

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 ... [more ▼]

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 follow-up. 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. [less ▲]

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See detailComment j'explore ... une suspicion de cancer broncho-pulmonaire par tomographie a émission de positrons
Bury, Thierry ULg; Paulus, Patrick; Weber, Thierry et al

in Revue Médicale de Liège (1996), 51(4), 317-9

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See detailEvaluation of the Solitary Pulmonary Nodule by Positron Emission Tomography Imaging
BURY, Thierry ULg; Dowlati, A.; Paulus, P. et al

in European Respiratory Journal (1996), 9(3), 410-4

Current noninvasive imaging methods are not sufficiently reliable for accurate detection of malignancy in most solitary pulmonary nodules (SPNs). Positron emission tomography (PET) using 18 ... [more ▼]

Current noninvasive imaging methods are not sufficiently reliable for accurate detection of malignancy in most solitary pulmonary nodules (SPNs). Positron emission tomography (PET) using 18-fluorodeoxyglucose (FDG), showing increased FDG uptake and retention in malignant cells, has proved useful to differentiate malignant from benign tissue and could, therefore, contribute to the evaluation of the SPN. We performed a prospective study of 50 patients referred to the Pneumology Department with unclear diagnoses of SPN after conventional radiological screening. PET study was performed on each subject before an invasive procedure was proposed. Thirty three patients had a malignant nodule and 17 had a benign nodule. The mean size of malignant nodule was 3 cm (range 1.5-4.5 cm). All showed a marked increase in 18-FDG uptake. The mean size of benign nodule was 1.8 cm (range 0.5-3.5 cm). PET imaging showed the absence of 18-FDG uptake and correctly identified 15 of 17 benign nodules. There was two false-positive cases with a moderate increase in 18-FDG uptake (1 postprimary tuberculosis; and 1 anthracosilicotic nodule with nonspecific inflammation). At present, the sensitivity and specificity of the method are 100 and 88%, respectively. The positive and negative predictive values of PET imaging for SPNs are 94 and 100%, respectively. Our preliminary results demonstrate that PET-FDG imaging is a noninvasive technique, which appears highly accurate in differentiating malignant SPN from benign SPN. [less ▲]

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See detailStaging of Non-Small-Cell Lung Cancer by Whole-Body Fluorine-18 Deoxyglucose Positron Emission Tomography
Bury, Thierry ULg; Dowlati, A.; Paulus, Patrick et al

in European Journal of Nuclear Medicine (1996), 23(2), 204-6

Positron emission tomography (PET) using fluorine-18 deoxyglucose (FDG), showing increased FDG uptake and retention in malignant cells, has been proven useful to differentiate malignant from benign tissue ... [more ▼]

Positron emission tomography (PET) using fluorine-18 deoxyglucose (FDG), showing increased FDG uptake and retention in malignant cells, has been proven useful to differentiate malignant from benign tissue. We undertook a prospective study in 61 patients to compare the accuracy of whole-body FDG PET and conventional imaging (CI) methods for the staging of non-small-cell lung cancer (NSCLC). CI included chest and abdomen computed tomographic scanning and bone scintigraphy. When CI or PET study suggested metastatic disease, confirmation was obtained by biopsy or clinical or radiological follow-up. As compared to CI, PET correctly changed the N stage in 13 patients (21%) and the M stage in six patients (10%). There were three false-positive and no false-negative distant PET findings. Our preliminary results show that whole-body FDG PET can improve the diagnostic accuracy in the staging of NSCLC. [less ▲]

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See detailTomographie a emission de positons dans l'evaluation de l'extension ganglionnaire intrathoracique du cancer bronchique non petites cellules. Etude preliminaire chez 30 patients.
Bury, Thierry ULg; CORHAY, Jean-Louis ULg; Paulus, P et al

in Revue des Maladies Respiratoires (1996), 13(3), 281-286

Current methods for evaluating the mediastinum include chest radiography, computed tomography (CT) or magnetic resonance (MR) imaging and mediastinoscopy. Despite advances in morphologic imaging, some ... [more ▼]

Current methods for evaluating the mediastinum include chest radiography, computed tomography (CT) or magnetic resonance (MR) imaging and mediastinoscopy. Despite advances in morphologic imaging, some lung cancer patients are found to have unresectable disease at surgery. In contrast to CT scan or MR imaging, which depend primarily on anatomic and morphological criteria, positron emission tomography (PET) with 18fluorodeoxyglucose (FDG) depends mainly of the metabolic characteristics of a tissue for the diagnosis of disease. We perform a prospective study to compare FDG-PET and CT of the thorax in the presurgical assessment of the mediastinum in patients with newly diagnosed non-small cell lung cancer. Thirty patients have been included. CT and PET-scans were interpreted separately and results were compared to surgical staging during thoracotomy. In assessing mediastinal involvement, CT scan had a sensitivity of 56% and a specificity of 64%. For diagnosis mediastinal nodal disease, FDG-PET was 87% sensitive and 78% specific. Its positive predictive value was 82%, and the negative value was 83%. In conclusion, our preliminary results show that FDG-PET appears more accurate than CT in staging of mediastinal non-small cell lung cancer. [less ▲]

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See detailClinical PET in Oncology
Hustinx, Roland ULg; Paulus, Danusia ULg; Rigo, Pierre ULg et al

Book published by GE Medical Systems (1996)

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See detailDifferential diagnosis of Alzheimer's disease with PET.
Salmon, Eric ULg; Sadzot, Bernard ULg; Maquet, Pierre ULg et al

in Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine (1994), 35(3), 391-8

PET studies have demonstrated bilateral temporo-parietal hypoperfusion and hypometabolism in probable and definite Alzheimer's disease (AD), a pattern that may help differentiate AD from other dementias ... [more ▼]

PET studies have demonstrated bilateral temporo-parietal hypoperfusion and hypometabolism in probable and definite Alzheimer's disease (AD), a pattern that may help differentiate AD from other dementias. METHODS: To evaluate the diagnostic power of cerebral metabolic distribution patterns for "cortical" degenerative dementias, PET scans obtained from 129 patients referred for differential diagnosis of dementia were analyzed visually. RESULTS: Sixty-five patients had a final clinical diagnosis of probable AD. Ninety-seven percent (97%) of those had abnormal metabolic scans and 94% showed a suggestive pattern of bilateral or unilateral temporo-parietal hypometabolism (with or without frontal involvement). Hypometabolism was unilateral in 23% of patients. Five subjects with a neuropathologically proven diagnosis of Alzheimer's disease had a suggestive metabolic pattern. One of those was an early case with frontal hypometabolism exceeding temporo-parietal involvement. Two patients with Alzheimer's-type dementia had isolated bilateral frontal hypometabolism. CONCLUSIONS: This alternative metabolic pattern may correspond to a non-Alzheimer pathology occurring in 10%-20% of patients suffering from clinically probable Alzheimer's disease. Most of the patients with possible but atypical Alzheimer's-type dementia showed isolated bilateral frontal involvement. This metabolic pattern probably corresponds to different diseases, such as Pick's disease, frontal lobe dementia or progressive subcortical gliosis. [less ▲]

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