F-18 Fluorodeoxyglucose (FDG) used in PET scans. I need to know if FDG
crosses the blood-brain barrier and lights up tumors etc in the brain
itself on PET scan. Second are there any reports on PET scans and
carcinoid tumor diagnosis either in brain or body.

---

Request for Question Clarification by pafalafa-ga on 03 May 2004 09:32 PDT

Hello paternostrum-ga,

The answer to your first question appears to be an unambiguous "Yes". 
FDG is a glucose analogue that crosses the blood-brain barrier, and
can then "light up" brain tumors.

My question to you is:  What kind of details do you need, beyond just
a simple "Yes" answer?  Would an overview of FDG use in PET scan
imaging be what you're looking for?  Or do you want references to
studies using FDG in a PET context to image the brain?  Or is it a
combination of the two (or perhaps, something else entirely) that
you're seeking?

As for your second question, again the answer is "Yes".  I can provide
references to such articles, along with brief summaries -- one or two
of the articles might be available online, in which case, I'll provide
a link to the full article as well.  But for the full text for most of
the articles, you'll have to access a medical database.

Would that sort of answer meet your needs?

pafalafa-ga

---

Clarification of Question by paternostrum-ga on 03 May 2004 11:10 PDT

This looks good. I would like all the citations (not the texts) for
everything if you can. With that you've got the $100 with my thanks.
I'm into brain metastasis right now and plan to have the very latest
PET scan on Wed based on your answer (not really). I'm a doctor as
well.

---

Request for Question Clarification by pafalafa-ga on 03 May 2004 13:05 PDT

Thanks for the feedback.  I'll pull together the many bits and pieces
of information I have into a coherent answer for you, and post it as
soon as I can.

pafalafa-ga

Hello again, paternostrum-ga.

I've included below several web-based resources regarding FDG use in
brain imaging, as well as a list of citations on the same topic.

I've tried to keep the resources well-focused on what you need.  

Before rating this answer, please let me know if anything here is off
the mark, or if you need additional information.  Just post a Request
for Clarification, and I'll be happy to assist you further.

All the best.

pafalafa-ga

==========




http://216.239.39.104/search?q=cache:HSjfo6kTQNMJ:www.die.upm.es/people/gkont/PET_BusBriefing2001.pdf+the+metabolism+with+metabolically+active+tracers+(e.g.+F-18-Deoxyglucose)&hl=en

Molecular Imaging -- Understanding Disease with Positron Emission Tomography 

...The radiopharmaceutical that is used most commonly in PET studies
is fluorodeoxyglucose(FDG), a chemical compound that is similar to
glucose,with the difference that one of the -OH groups hasbeen
replaced by F-18. Carbon-11 can also be used asa radiotracer to
glucose. The short half-lives of theseparticles enable the subject and
the people that arehandling them to receive only a low radiation
dose...

==========


http://www.brighamandwomens.org/referringphysiciansnews/PET_CT.asp

Positron Emission Tomography (PET-CT) 

More accurate diagnosis of brain tumors

Existing methods of identifying brain tumors are often problematic.
With conventional imaging, it is often difficult to distinguish
between fibrosis, necrosis and residual active tumor.

Today, our physicians can delineate both the anatomic changes produced
by a tumor on CT and/or MRI and the presence of a viable tumor by PET.
Because tumor cells demonstrate increased glucose metabolism,
performing PET with the glucose analog FDG (2-Deoxy-2-[18
F]fluoro-D-glucose) can identify the metabolic differences between
benign and malignant cells therefore enabling physicians to provide
more accurate diagnosis...[much more at the site]

==========

http://tezpur.keck.waisman.wisc.edu/~oakes/teaching/fdg_primer.html

FDG Quantitation: 
The theory and assumptions behind a quantitative estimate of local
Cerebral Metabolic Rate of glucose consumption

...In PET, the most popular glucose tracer is
[18F]-2-fluorodeoxyglucose (FDG). The positron-emitting [18F] label
permits in vivo detection of the tracer's location and concentration.
If more FDG is trapped in a region, it may be assumed that the region
has greater metabolic activity. Low uptake compared to a normal person
implies hypometabolism, while increased uptake implies hypermetabolism
of the traced glucose substrate.


...The FDG metabolic process is generally modeled as having three
different compartments in which the tracer may reside. This is more
formally termed a 3-compartment model, and may be diagrammed as
follows: [see website for figure]


...The orange line represents the blood-brain barrier (BBB). Glucose
and FDG move from the blood, across the BBB, and into a brain cell
(red arrow), indicated by a rate constant k1. Once there, it undergoes
a single metabolic step, k3 (purple arrow to right). The reverse
movement or reaction is indicated by, respectively, k2 and k4 (arrows
pointing to the left). The rate constants, k1 - k4, represent the rate
of "movement" from one compartment into another...


==========

All the following citations are from the PubMed database compiled by
the National Institutes of Health.  You can visit PubMed at:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

The "PMID" number at the end of each citation is the PubMed
identification number (but you knew that already...!).  Since there
were not an overwhelming number of studies, I included several that
seemed relevant, even though they are not necessarily focused on tumor
imaging.  If you want the list culled for cancer-only articles, just
let me know.



Slosman DO, Ludwig C, Zerarka S, Pellerin L, Chicherio C, de
Ribaupierre A, Annoni JM, Bouras C, Herrmann F, Michel JP, Giacobini
E, Magistretti PJ.
Brain energy metabolism in Alzheimer's disease: 99mTc-HMPAO SPECT
imaging during verbal fluency and role of astrocytes in the cellular
mechanism of 99mTc-HMPAO retention.
Brain Res Brain Res Rev. 2001 Oct;36(2-3):230-40. 
PMID: 11690620 



Hasselbalch SG, Knudsen GM, Videbaek C, Pinborg LH, Schmidt JF, Holm S, Paulson OB.
No effect of insulin on glucose blood-brain barrier transport and
cerebral metabolism in humans.
Diabetes. 1999 Oct;48(10):1915-21. 
PMID: 10512354 



Eary JF, Mankoff DA, Spence AM, Berger MS, Olshen A, Link JM,
O'Sullivan F, Krohn KA.
2-[C-11]thymidine imaging of malignant brain tumors.
Cancer Res. 1999 Feb 1;59(3):615-21. 
PMID: 9973209 



Cornford EM, Gee MN, Swartz BE, Mandelkern MA, Blahd WH, Landaw EM,
Delgado-Escueta AV.
Dynamic [18F]fluorodeoxyglucose positron emission tomography and
hypometabolic zones in seizures: reduced capillary influx.
Ann Neurol. 1998 Jun;43(6):801-8. 
PMID: 9629850



Hasselbalch SG, Knudsen GM, Holm S, Hageman LP, Capaldo B, Paulson OB.
Transport of D-glucose and 2-fluorodeoxyglucose across the blood-brain
barrier in humans.
J Cereb Blood Flow Metab. 1996 Jul;16(4):659-66. 
PMID: 8964806



Roelcke U, Radu EW, von Ammon K, Hausmann O, Maguire RP, Leenders KL.
Alteration of blood-brain barrier in human brain tumors: comparison of
[18F]fluorodeoxyglucose, [11C]methionine and rubidium-82 using PET.
J Neurol Sci. 1995 Sep;132(1):20-7. 
PMID: 8523026 



Saha GB, MacIntyre WJ, Go RT.
Radiopharmaceuticals for brain imaging.
Semin Nucl Med. 1994 Oct;24(4):324-49. Review. 
PMID: 7817203 



Petruk KC, Wilson AF, Schindel DR, Witt NJ, McLean DR, McFarland PA,
Johnston RG, McPhee MS, Martin WR, Calne DB.
Treatment of refractory Parkinson's disease with adrenal medullary
autografts utilizing two-stage surgery.
Prog Brain Res. 1990;82:671-6. 
PMID: 2127120



Herholz K, Wienhard K, Heiss WD. 
Validity of PET studies in brain tumors.
Cerebrovasc Brain Metab Rev. 1990 Fall;2(3):240-65. Review. 
PMID: 2121212



Herholz K, Patlak CS.
The influence of tissue heterogeneity on results of fitting nonlinear
model equations to regional tracer uptake curves: with an application
to compartmental models used in positron emission tomography.
J Cereb Blood Flow Metab. 1987 Apr;7(2):214-29. 
PMID: 3494028 



Hawkins RA, Phelps ME, Huang SC.
Effects of temporal sampling, glucose metabolic rates, and disruptions
of the blood-brain barrier on the FDG model with and without a
vascular compartment: studies in human brain tumors with PET.
J Cereb Blood Flow Metab. 1986 Apr;6(2):170-83. 
PMID: 3485641 



Brooks DJ, Beaney RP, Lammertsma AA, Herold S, Turton DR, Luthra SK,
Frackowiak RS, Thomas DG, Marshall J, Jones T.
Glucose transport across the blood-brain barrier in normal human
subjects and patients with cerebral tumours studied using
[11C]3-O-methyl-D-glucose and positron emission tomography.
J Cereb Blood Flow Metab. 1986 Apr;6(2):230-9. 
PMID: 3007547



Tsuyuguchi N, Sunada I, Ohata K, Takami T, Nishio A, Hara M, Kawabe J,
Okamura T, Ochi H.
Evaluation of treatment effects in brain abscess with positron
emission tomography: comparison of fluorine-18-fluorodeoxyglucose and
carbon-11-methionine.
Ann Nucl Med. 2003 Feb;17(1):47-51. 
PMID: 12691130



Bingham EM, Hopkins D, Smith D, Pernet A, Hallett W, Reed L, Marsden PK, Amiel SA.
The role of insulin in human brain glucose metabolism: an
18fluoro-deoxyglucose positron emission tomography study.
Diabetes. 2002 Dec;51(12):3384-90. 
PMID: 12453890 



Popperl G, Gotz C, Gildehaus FJ, Yousry TA, Reulen HJ, Hahn K, Tatsch K.
[Initial experiences with adjuvant locoregional radioimmunotherapy
using 131I-labeled monoclonal antibodies against tenascin (BC-4) for
treatment of glioma (WHO III and IV)]
Nuklearmedizin. 2002 Jun;41(3):120-8. German. 
PMID: 12109031 




Hayashida K. 
[Usefulness of SPECT images in helping radiologists understand brain diseases]
Nippon Igaku Hoshasen Gakkai Zasshi. 2001 Apr;61(5):208-14. Review. Japanese. 
PMID: 11398344 



Cutts DA, Maguire RP, Stedman JD, Leenders KL, Spyrou NM.
A comparative study in Alzheimer's and normal brains of trace element
distribution using PIXE and INA analyses and glucose metabolism by
positron emission tomography.
Biol Trace Elem Res. 1999 Winter;71-72:541-9. 
PMID: 10676530 



Roelcke U, Radu EW, Hausmann O, Vontobel P, Maguire RP, Leenders KL.
Tracer transport and metabolism in a patient with juvenile pilocytic
astrocytoma. A PET study.
J Neurooncol. 1998 Feb;36(3):279-83. 
PMID: 9524106 



Uehara H, Miyagawa T, Tjuvajev J, Joshi R, Beattie B, Oku T, Finn R, Blasberg R.
Imaging experimental brain tumors with 1-aminocyclopentane carboxylic
acid and alpha-aminoisobutyric acid: comparison to fluorodeoxyglucose
and diethylenetriaminepentaacetic acid in morphologically defined
tumor regions.
J Cereb Blood Flow Metab. 1997 Nov;17(11):1239-53. 
PMID: 9390656 



Fink GR, Pawlik G, Stefan H, Pietrzyk U, Wienhard K, Heiss WD.
Temporal lobe epilepsy: evidence for interictal uncoupling of blood
flow and glucose metabolism in temporomesial structures.
J Neurol Sci. 1996 Apr;137(1):28-34. 
PMID: 9120484 



Shioya H, Mineura K, Sasajima T, Kowada M, Iida H, Ogawa T, Hatazawa J, Uemura K.
[Kinetics of glucose metabolism in central neurocytomas]
No To Shinkei. 1995 Oct;47(10):981-7. Japanese. 
PMID: 7577144 



Shioya H, Mineura K, Sasajima T, Kowada M, Iida H, Ogawa T, Hatazawa J, Uemura K. 
[Kinetic analysis of glucose metabolism in meningiomas--comparison
with malignant gliomas]
No To Shinkei. 1995 Jun;47(6):549-56. Japanese. 
PMID: 7605682



Schober O, Meyer GJ.
[Evaluation of brain tumors using positron emission tomography]
Radiologe. 1992 Jun;32(6):282-9. Review. German. 
PMID: 1322547



Coleman RE, Hoffman JM, Hanson MW, Sostman HD, Schold SC.
Clinical application of PET for the evaluation of brain tumors.
J Nucl Med. 1991 Apr;32(4):616-22. Review. 
PMID: 2013802



Valk PE, Budinger TF, Levin VA, Silver P, Gutin PH, Doyle WK. 
PET of malignant cerebral tumors after interstitial brachytherapy.
Demonstration of metabolic activity and correlation with clinical
outcome.
J Neurosurg. 1988 Dec;69(6):830-8. 
PMID: 2848111



Doyle WK, Budinger TF, Valk PE, Levin VA, Gutin PH.
Differentiation of cerebral radiation necrosis from tumor recurrence
by [18F]FDG and 82Rb positron emission tomography.
J Comput Assist Tomogr. 1987 Jul-Aug;11(4):563-70. 
PMID: 3496366

==========

Well...that's it.  I hope these are useful resources for you.  

Again, if anything needs clarification, just say the word, and I'll be
happy to help out as best I can.

pafalafa-ga



search strategy:  

Google search on: (fdg OR Fluorodeoxyglucose) PET ("blood brain" OR bbb)

and a similar search on PubMed.

---

Request for Answer Clarification by paternostrum-ga on 04 May 2004 09:10 PDT

Looking good. ButI would like also to know if any publications exist
showing the reveal of carcinoid tumors anywhere in the body (usually
liver metatases although the origins are usually pancreas and gut -
generally called "carcinoid").

Right now I might be the only patient in the world with my specific
tumor which originated in the pancreas. It is a "pancreatic
neuroendocrine tumor". Poorly understood. I am having a PET scan
Wednesday which depends on the uptake of any tumor in the brain where
they say that there may be ways with a new unit they have to highlight
the FDG in the brain. I wondered if anyone had maybe specifically done
this with FDG?

The other question is if there any reports on the FDG takeup by
carcinoid tumors say in the liver. That would be a key thing to learn.
If that is reliable and the brain readout is dependable then this
would be a hell of a follow-up for the entire problem which now
requires multiple CT scans and MRIs and Octreoscans (very expensive)
every time I go through this.

Does this help you at all?

---

Clarification of Answer by pafalafa-ga on 04 May 2004 10:12 PDT

paternostrum-ga,

I am adding some additional references very quickly, since your test
is tomorrow.  Best of luck to you.

HOWEVER, I want to make clear that I am not finished with research on
your question.  If you have any feedback on the usefullness (or not)
of the links below, let me know.  I will continue looking into this,
and hope to have more information to add by tomorrow.

pafalafa-ga

==========

1:  Cheran SK, Nielsen ND, Patz EF Jr.
 False-Negative Findings for Primary Lung Tumors on FDG Positron
Emission Tomography: Staging and Prognostic Implications.
AJR Am J Roentgenol. 2004 May;182(5):1129-32. 
PMID: 15100107 

2:  Groves AM, Mohan HK, Wegner EA, Hain SF, Bingham JB, Clarke SE. 
 Positron emission tomography with FDG to show thymic carcinoid.
AJR Am J Roentgenol. 2004 Feb;182(2):511-3. 
PMID: 14736691 

3:  Scanga DR, Martin WH, Delbeke D. 
 Value of FDG PET imaging in the management of patients with thyroid,
neuroendocrine, and neural crest tumors.
Clin Nucl Med. 2004 Feb;29(2):86-90. 
PMID: 14734903 

4:  Chander S, Ergun EL, Chugani HT, Chugani DC, Juhasz C, Shields AF, Weaver DW.  
 High 2-deoxy-2-[18F]fluoro-D-glucose accumulation in a case of
retroperitoneal fibrosis following resection of carcinoid tumor.
Mol Imaging Biol. 2002 Oct;4(5):363-8. 
PMID: 14537112 

5:  Goshen E, Cohen O, Rotenberg G, Oksman Y, Karasik A, Zwas ST.  
 The clinical impact of 18F-FDG gamma PET in patients with recurrent
well differentiated thyroid carcinoma.
Nucl Med Commun. 2003 Sep;24(9):959-61. 
PMID: 12960594 

6:  Higashi K, Matsunari I, Ueda Y, Ikeda R, Guo J, Oguchi M, Tonami
H, Yamamoto I.
 Value of whole-body FDG PET in management of lung cancer.
Ann Nucl Med. 2003 Feb;17(1):1-14. Review. 
PMID: 12691125 

7:  Ho CL, Yu SC, Yeung DW. 
 11C-acetate PET imaging in hepatocellular carcinoma and other liver masses.
J Nucl Med. 2003 Feb;44(2):213-21. 
PMID: 12571212 

8:  Eriksson B, Bergstrom M, Sundin A, Juhlin C, Orlefors H, Oberg K,
Langstrom B.
 The role of PET in localization of neuroendocrine and adrenocortical tumors.
Ann N Y Acad Sci. 2002 Sep;970:159-69. Review. 
PMID: 12381551 

9:  Belhocine T, Foidart J, Rigo P, Najjar F, Thiry A, Quatresooz P, Hustinx R. 
 Fluorodeoxyglucose positron emission tomography and somatostatin
receptor scintigraphy for diagnosing and staging carcinoid tumours:
correlations with the pathological indexes p53 and Ki-67.
Nucl Med Commun. 2002 Aug;23(8):727-34. 
PMID: 12124477 

10:  Marom EM, Sarvis S, Herndon JE 2nd, Patz EF Jr. 
 T1 lung cancers: sensitivity of diagnosis with fluorodeoxyglucose PET.
Radiology. 2002 May;223(2):453-9. 
PMID: 11997552 

11:  Virgolini I, Patri P, Novotny C, Traub T, Leimer M, Fuger B, Li
SR, Angelberger P, Raderer M, Wogritsch S, Kurtaran A, Kletter K,
Dudczak R.
 Comparative somatostatin receptor scintigraphy using
in-111-DOTA-lanreotide and in-111-DOTA-Tyr3-octreotide versus
F-18-FDG-PET for evaluation of somatostatin receptor-mediated
radionuclide therapy.
Ann Oncol. 2001;12 Suppl 2:S41-5. 
PMID: 11762351 

12:  Hoegerle S, Altehoefer C, Ghanem N, Koehler G, Waller CF,
Scheruebl H, Moser E, Nitzsche E.
 Whole-body 18F dopa PET for detection of gastrointestinal carcinoid tumors.
Radiology. 2001 Aug;220(2):373-80. 
PMID: 11477239 

13:  Le Rest C, Bomanji JB, Costa DC, Townsend CE, Visvikis D, Ell PJ. 
 Functional imaging of malignant paragangliomas and carcinoid tumours.
Eur J Nucl Med. 2001 Apr;28(4):478-82. 
PMID: 11357498 

14:  Eriksson B, Bergstrom M, Orlefors H, Sundin A, Oberg K, Langstrom B. 
 Use of PET in neuroendocrine tumors. In vivo applications and in vitro studies.
Q J Nucl Med. 2000 Mar;44(1):68-76. Review. 
PMID: 10932603 

15:  Dietlein M, Knapp WH, Lauterbach KW, Schicha H. 
 Economic evaluation studies in nuclear medicine: the need for standardization.
Eur J Nucl Med. 1999 Jun;26(6):663-80. Review. 
PMID: 10369954 

16:  Erasmus JJ, McAdams HP, Patz EF Jr, Coleman RE, Ahuja V, Goodman PC.  
 Evaluation of primary pulmonary carcinoid tumors using FDG PET.
AJR Am J Roentgenol. 1998 May;170(5):1369-73. 
PMID: 9574618 

17:  Adams S, Baum R, Rink T, Schumm-Drager PM, Usadel KH, Hor G.   
 Limited value of fluorine-18 fluorodeoxyglucose positron emission
tomography for the imaging of neuroendocrine tumours.
Eur J Nucl Med. 1998 Jan;25(1):79-83. 
PMID: 9396878 

18:  Cook GJ, Houston S, Barrington SF, Fogelman I. 
 Technetium-99m-labeled HL91 to identify tumor hypoxia: correlation
with fluorine-18-FDG.
J Nucl Med. 1998 Jan;39(1):99-103. 
PMID: 9443745  

19:  Jadvar H, Segall GM.   
 False-negative fluorine-18-FDG PET in metastatic carcinoid.
J Nucl Med. 1997 Sep;38(9):1382-3. 
PMID: 9293792 

20:  Rege SD, Hoh CK, Glaspy JA, Aberle DR, Dahlbom M, Razavi MK,
Phelps ME, Hawkins RA.
 Imaging of pulmonary mass lesions with whole-body positron emission
tomography and fluorodeoxyglucose.
Cancer. 1993 Jul 1;72(1):82-90. 
 PMID: 8389668

Bourguet P; Groupe de Travail SOR. 
 [Standards, Options and Recommendations for the use of PET-FDG in
cancerology. Results in digestive system neoplasms]
Bull Cancer. 2003 Feb;90 Spec No:S56-66. Review. French. No abstract available. 
PMID: 12739337 


Eriksson B, Bergstrom M, Sundin A, Juhlin C, Orlefors H, Oberg K, Langstrom B. 
 The role of PET in localization of neuroendocrine and adrenocortical tumors.
Ann N Y Acad Sci. 2002 Sep;970:159-69. Review. 
PMID: 12381551 


Bombardieri E, Maccauro M, De Deckere E, Savelli G, Chiti A. 
 Nuclear medicine imaging of neuroendocrine tumours.
Ann Oncol. 2001;12 Suppl 2:S51-61. Review. 
PMID: 11762353 


Eriksson B, Bergstrom M, Orlefors H, Sundin A, Oberg K, Langstrom B. 
 Use of PET in neuroendocrine tumors. In vivo applications and in vitro studies.
Q J Nucl Med. 2000 Mar;44(1):68-76. Review. 
PMID: 10932603 


Adams S, Baum R, Rink T, Schumm-Drager PM, Usadel KH, Hor G. 
 Limited value of fluorine-18 fluorodeoxyglucose positron emission
tomography for the imaging of neuroendocrine tumours.
Eur J Nucl Med. 1998 Jan;25(1):79-83. 
PMID: 9396878  


==========

Please provide any feedback you can about the utility of these references.

---

Clarification of Answer by pafalafa-ga on 04 May 2004 18:27 PDT

Hello again,

I found a few more.  These are all on the web so you can review them
pretty easily.  I've included some excerpts here.  It's hard to know
how well (or not) these hit the target for you, but I hope there is
some good information here.  By the way, the articles by Dr. Ramos
include his email address, in case you want to drop him a line.

Once again, let me know if there are any research areas you
specifically need that I haven't yet included.

All the best,

pafalafa-ga

==========


http://www.emedicine.com/radio/topic126.htm

Recently [fluorine 18]-dopa PET has been used to image primary
gastrointestinal carcinoid tumors and lymph node and organ metastases
with promising results...
 
PET imaging with 2-[fluorine 18]-fluoro-2-deoxy-D-glucose (FDG) is now
more available and more widely used. In general, FDG is useful in
poorly differentiated carcinoids and other neuroendocrine tumors, but
should not be used as a first-line imaging agent. FDG PET is primarily
useful when the results of somatostatin-receptor scintigraphy are
negative...

Degree of Confidence: More than 90% of gastrointestinal carcinoids and
their metastases are identified using somatostatin receptor
scintigraphy, and accumulation is often seen in clinically unsuspected
sites not recognized using other imaging techniques. 18F-dopa PET is a
promising procedure and useful supplement to morphologic imaging
methods. FDG PET imaging is useful in poorly differentiated carcinoids
when the results of somatostatin-receptor scintigraphy are negative...

==========

http://www.rad.kumc.edu/nucmed/clinical/pet_bronch_carcin.htm

The patient is a 35-year-old male who was first diagnosed with
bronchial carcinoid tumor of the left upper lobe in 1991. This tumor
is now thought to be recurrent and we have been asked to rule out
other sites of disease prior to external beam radiation therapy...
 
The patient received an intravenous injection of 10 millicuries of F18
FDG and 45 minutes later whole body PET imaging was carried out from
the upper cervical region to the upper femoral region. Coronal, axial,
sagittal, volume displays were created and regions of interest placed
about selected regions for the measurement of standard uptake values
(SUV)...

==========


http://www.alasbimnjournal.cl/revistas/2/aboncology9.htm

CARCINOID TUMOR WITHOUT [I-131]MIBG UPTAKE STUDIED WITH [F-18]FDG AND
[In-111]OCTREOTIDE. A CASE REPORT.

Ramos CD,
cdramos@mn-d.com

Two months ago [F-18]FDG SPECT images in combination with
[Tc-99m]sulfur colloid images showed multiple focal areas of increased
tracer uptake in the base of the left lung, left breast, liver,
ascending colon and left inferior quadrant of the abdomen. After 24
hours of the [F-18]FDG SPECT images, [In-111]octreotide SPECT images
were performed and detected all the lesions seen with [F-18]FDG, with
a better target-to-background ratio. [In-111]octreotide SPECT images
also detected a lesion in the left parietal region, not demonstrated
by any other method...

=========


http://www.alasbimnjournal.cl/revistas/2/abpetspect4.htm

[F-18]FDG SCINTIGRAPHY IN ONCOLOGICAL PATIENTS. PRELIMINARY DATA. 

Ramos CD

Oncologic studies with [F-18] FDG have been recently further expanded
with the new scintillation cameras that perform positron emission
images using high energy collimators or coincidence detection. To
evaluate the usefulness of [F-18] FDG images acquired on a
two-detector scintillation camera equipped with high energy
collimators...

==========


http://jjco.oupjournals.org/cgi/content/full/31/2/51

Differentiation of Radiographically Indeterminate Solitary Pulmonary
Nodules with [18F]Fluoro-2-deoxyglucose Positron Emission Tomography
Gang-Uei Hung1, Yu-Chien Shiau2, Shih-Chuan Tsai3, Yung-Jen Ho4,
Chia-Hung Kao1 and Ruoh-Fang Yen5

The purpose of this preliminary study was to evaluate the efficacy of
positron emission tomography (PET) with [18F]fluoro-2-deoxyglucose
(FDG) for differentiating benign from malignant solitary pulmonary
nodules...
 
The mean L/B ratio of malignant lesions (8.81 3.71, n = 20) was not
significantly higher than that of benign lesions (4.71 3.00, n = 6) (p
= 1.00). Using a cut-off L/B ratio of 5.0 for malignancy, FDG-PET
correctly detected 19 true positive and three true negative cases, but
failed to detect three false positive (two abscesses and one
cryptococcus) cases and one false negative (adenocarcinoma) case...

==========
 
http://collection.nlc-bnc.ca/100/201/300/cdn_medical_association/carj/vol-52/issue-4/0259.htm

Visual and semiquantitative analysis of 18F-fluorodeoxyglucose
positron emission tomography using a partial-ring tomograph without
attenuation correction to differentiate benign and malignant pulmonary
nodules

Stephen J. Skehan

Many studies have reported the use of attenuation-corrected positron
emission tomography with 18F-fluorodeoxyglucose (FDG PET) with
full-ring tomographs to differentiate between benign and malignant
pulmonary nodules. We sought to evaluate FDG PET using a partial-ring
tomograph without attenuation correction...
 
Conclusions: FDG PET without attenuation correction is accurate for
differentiating between benign and malignant lung nodules. Results
using simple LB ratios without attenuation correction compare
favourably with the published sensitivity and specificity for standard
uptake ratios. Visual analysis is equally accurate...

==========

http://www.carcinoid.org/ObergDxTx2004.pdf

Review:  Diagnosis and Treatment of Carcinoid Tumors

I will look forward to anything you might elicit. I'm getting the PET scan tomorrow

Thank you so much, and know that I'll have my spiritual fingers
crossed for good luck.

I hope to have some additional information to add tomorrow. 

pafalafa-ga