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See detailNoninvasive assessment of Crohn's disease intestinal lesions with F-18-FDG PET/CT
Louis, Edouard ULg; Ancion, Geoffrey; Colard, Arnaud et al

in Journal of Nuclear Medicine (2007), 48(7), 1053-1059

Pilot studies have shown good sensitivity and specificity for F-18-FDG PET in detecting gastrointestinal lesions of Crohn's disease. The combination of F-18-FDG PET with CT may further improve the ... [more ▼]

Pilot studies have shown good sensitivity and specificity for F-18-FDG PET in detecting gastrointestinal lesions of Crohn's disease. The combination of F-18-FDG PET with CT may further improve the localization and characterization of lesions with increased F-18-FDG uptake. Our aim was to assess the use of F-18-FDG PET/CT in evaluating the activity and location of Crohn's disease along the gastrointestinal tract. Methods: After giving informed consent, 22 patients with Crohn's disease were prospectively studied. They underwent F-18-FDG PET/CT, followed by ileocolonoscopy within 1 wk (mean, 2 d). The Crohn's disease activity index (CDAI) was calculated, and serum C-reactive protein (CRP) and fecal calprotectin were measured before endoscopy. The Crohn's disease endoscopy index of severity (CDEIS) was calculated during endoscopy. The global CDEIS score and endoscopic subscores for various ileocolonic segments were used for analysis. Results: Globally, 95 intestinal and colonic segments in 22 patients were analyzed. F-18-FDG PET/CT detected 35 of 48 endoscopically affected segments (sensitivity for the detection of endoscopic lesions, 72.9%). The sensitivity of F-18-FDG PET/CT for the detection of severe endoscopic lesions (deep ulcers and strictures) was 100% (14/14). The global PET/CT score significantly correlated with CDEIS (r = 0.51; 95% confidence interval [Cl], 0.09-0.77; P = 0.017), CDAI (r = 0.58; 95% Cl, 0.17-0.80; P = 0.005), and CRP (r = 0.56; 95% Cl, 0.19-0.81; P = 0.007). Conclusion: F-18-FDG PET/CT was globally well correlated to the clinical, endoscopic, and biologic activity of Crohn's disease. Above all, this technique had a good sensitivity for the detection of intestinal and colonic segments with moderate to severe mucosal lesions. The potential impact of this promising tool on the global management of patients with Crohn's disease should be further evaluated in prospective studies. [less ▲]

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See detailPET/CT of skull base meningiomas using 2-F-18-fluoro-L-tyrosine: Initial report
Rutten, Isabelle; Cabay, Jean-Evrard ULg; Withofs, Nadia ULg 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 ▲]

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See detailAssessment of disease activity in rheumatoid arthritis with 18F-FDG PET
Beckers, Catherine ULg; Ribbens, Clio ULg; Andre, Béatrice ULg et al

in Journal of Nuclear Medicine (2004), 45(6), 956-964

The aim of this study was to assess synovitis by F-18-FDG PET in an individual joint analysis and in a global analysis of rheumatoid arthritis (RA) disease activity and to compare F-18-FDG PET parameters ... [more ▼]

The aim of this study was to assess synovitis by F-18-FDG PET in an individual joint analysis and in a global analysis of rheumatoid arthritis (RA) disease activity and to compare F-18-FDG PET parameters with clinical, biologic, and sonographic (US) rheumatoid parameters. Methods: Three hundred fifty-six joints were assessed in 21 patients with active RA: the knees in all subjects and either wrists as well as metacarpophalangeal and proximal interphalangeal joints in 13 patients, or ankles and the first metatarsophalangeal joints in the remaining 8 patients. PET analysis consisted of a visual identification of F-18-FDG uptake in the synovium and measurements of standardized uptake values (SUVs). Independent assessors performed the clinical and US examinations. Results: PET positivity was found in 63% of joints, whereas 75%, 79%, and 56% were positive for swelling, tenderness, and US analysis, respectively. Both the rate of PET-positive joints and the SUV increased with the number of positive parameters present (swelling, tenderness, US positivity) and with the synovial thickness. The mean SUV was significantly higher in joints where a power Doppler signal was found. In a global PET analysis, the number of PET-positive joints and the cumulative SUV were significantly correlated with the swollen and tender joint counts, the patient and physician global assessments, the erythrocyte sedimentation rate and C-reactive protein serum levels, the disease activity score and the simplified disease activity index, the number of US-positive joints, and the cumulative synovial thickness. Conclusion: F-18-FDG PET is a unique imaging technique that can assess the metabolic activity of synovitis and measure the disease activity in RA. [less ▲]

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See detailWithin-patient variability of F-18-FDG: Standardized uptake values in normal tissues
Paquet, Nancy; Albert, Adelin ULg; Willems, Jacqueline ULg et al

in Journal of Nuclear Medicine (2004), 45(5), 784-788

The aim of this study was to evaluate the test-retest variability of standardized uptake values (SUVs) in normal tissues and the impact of various methods for measuring the SUV. Methods: SUVs were ... [more ▼]

The aim of this study was to evaluate the test-retest variability of standardized uptake values (SUVs) in normal tissues and the impact of various methods for measuring the SUV. Methods: SUVs were determined in 70 cancer-free patients (40 female and 30 male) on 2 occasions an average of 271 d apart. Mean values for body weight and height, blood glucose level, injected dose, and uptake period did not change between the 2 groups of studies. Four regions of interest (ROIs) were placed-on the liver, lung, mediastinum, and trapezius muscle. Mean and maximum SUVs normalized for body weight were obtained, and normalizations were then applied for lean body mass (LBM), LBM and blood glucose level, body surface area (BSA), and BSA and blood glucose level. Results: In the lungs and muscle, metabolic activity within the ROIs was significantly different in the 2 studies, no matter which method was used for the SUVs. The differences ranged from 0.02 to 0.1 for SUV normalized for body weight and SUV normalized for LBM and from 0.001 to 0.002 for SUV normalized for BSA. In the liver, results were similar for all SUVs, except for maximum SUV corrected for LBM and maximum SUV corrected for LBM and blood glucose level. The metabolic activity measured in the mediastinum was also comparable in the 2 studies, regardless of the type of SUV. When investigating whether any normalization method for SUVs reduces variability and improves test-retest concordance, we found no significant superiority for any. The best intraclass correlation coefficients were obtained with the SUV normalized for body weight, in both the liver and the mediastinum, but the coefficients of variation were similar for all 3 mean SUVs that were not corrected for glucose level (range, 10.8%-13.4%). However, normalizing for blood glucose level increased the variability and decreased the level of concordance between studies. Conclusion: The SUVs measured in normal liver and mediastinum in cancer-free patients are stable over time, no matter which normalization is used. Correcting for blood glucose level increases the variability of the values and should therefore be avoided. Normalizing for BSA or LBM does not improve the reproducibility of the measurements. [less ▲]

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See detailA reduced extracellular serotonin level increases the 5-HT1A PET ligand F-18-MPPF binding in the rat hippocampus
Zimmer, L.; Rbah, L.; Giacomelli, Fabrice ULg et al

in Journal of Nuclear Medicine (2003), 44(9), 1495-1501

4,2'-(Methoxyphenyl)-1-[2'-(N-2"-pyridinyl)-p-fluorobenzamido]ethylpiperazine (F-18-MPPF) is a radiotracer used in clinical PET studies for the visualization of serotonin-1A (5-HT1A) receptors. In a ... [more ▼]

4,2'-(Methoxyphenyl)-1-[2'-(N-2"-pyridinyl)-p-fluorobenzamido]ethylpiperazine (F-18-MPPF) is a radiotracer used in clinical PET studies for the visualization of serotonin-1A (5-HT1A) receptors. In a previous study, we demonstrated that a rapid enhancement of extracellular serotonin concentrations influences F-18-MPPF-specific binding. Because endogenous serotonin is significantly decreased in some pathologies, the aim of this study was to determine whether F-18-MPPF is sensitive to depletion of this neurotransmitter. Methods: Using the beta-microprobe, an original beta(+)-sensitive intracerebral probe, and micro-dialysis, the effect of decreased serotonin on the specific binding of F-18-MPPF to 5-HT1A receptors was investigated in the hippocampus of the anesthetized rat. Extracellular serotonin was pharmacologically decreased in the hippocampus after a single injection of p-ethynylphenylalanine ([p-EPA] 5 mg/kg), a new tryptophan hydroxylase inhibitor. Results: Our results showed that the F-18-MPPF-specific binding was significantly enhanced after the decrease of extracellular serotonin. These results were confirmed by the F-18-MPPF distribution in cerebral tissues (hippocampus-to-cerebellum ratio) and by the decrease of the extracellular F-18-MPPF collected in hippocampal dialysates. Conclusion: This study further supports the view that 18F-MPPF binding potential is increased in the hippocampus if the endogenous serotonin is pharmacologically decreased after a p-EPA injection. This phenomenon will be an additional factor in the interpretation of the results from F-18-MPPF clinical PET studies. [less ▲]

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