INTRODUCTION: Positron emission tomography (PET) is a non-invasive diagnostic method which shows the bio-distribution of positron emitter labelled radiopharmaceuticals in the body. Due to the fact that not only timorous, but in certain conditions also some inflammatory cells may exhibit increased accumulation of 18F-FDG, 18F-FDG PET can be used in the diagnosis of both tumours and certain types of inflammations. OBJECTIVE: The objective of the study is to asses the benefits of 18F-FDG PET in the patients examined for symptoms of fever of uncertain origin whose results suggested the possibility of large vessel vasculitis. SAMPLE AND METHODS: In the years 2003 and 2004, the positron emission tomography centre at Masaryk Oncological Institute in Brno examined 35 patients in order to establish the cause of febrilia using 18F-FDG PET. The suspicion of large vessel vasculitis was based on the detection of high accumulation of radiopharmaceuticals in large vessels walls (in the aorta and the larger outgoing branches). The patients underwent a further standard imaging test to diagnose large vessel vasculitis as follows: CT angiography (CTA) in 4 patients, MR angiography (MRA) in 3 patients and duplex ultrasonography (USG) in 7 patients. A definitive diagnosis of primary autoimmunity of large vessel vasculitis was counter checked histologically or based on a therapeutic test by means of the effect of corticotherapy in immunosuppressive doses. RESULTS: Positive PET findings were recorded in 23 out of 35 patients (65.7%). 11 out of 23 PET positive patients (47.8% of PET positive persons and 31.4% of all patients with febrilia) were suspected to have active large vessel vasculitis based on PET examination. In 10 of the 11 patients, it was possible to perform additional examinations necessary to confirm the diagnosis: a histological test of arteria temporalis in one case, and a therapeutic test using corticotherapy in all 10 cases. Large vessel vasculitis was confirmed in all 10 individuals (2 men and 8 women aged 53-66, median age of 62 years). None of the CTA, MRA or USG examinations in any of the cases detected direct or clear signs ofvasculitis, but 3 CTA and 1 MRA examinations could be considered abnormal. The detection of temporal (giant cell) arteritis based on excision of arteria temporalis superficialis points to the limits of PET examination which is unable to assess veins with a diameter of less than 5 mm. On the other hand, it documents the possibility of extra-cranial damage being proved in this diagnosis with the use PET. In seven of the ten cases, a control PET scan was done during corticotherapy. It showed a drop in the accumulation of radiopharmaceuticals, and therefore a drop in the inflammatory metabolic activity on the walls of the large vessels, which was in line with the drop in the laboratory parameters of the inflammation (FW, CRP). CONCLUSION: Positron emission tomography using 18F-FDG can be used to detect active large vessel vasculitis in patients examined for symptoms of fever of uncertain origin. Apparently, PET can detect cases of large vessel vasculitis where other imaging methods have failed and can be also used to follow the development of vasculitis activity during therapy.

• MeSH
• dospělí MeSH
• fluorodeoxyglukosa F18 * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• obrovskobuněčná arteritida diagnostické zobrazování   MeSH
• pozitronová emisní tomografie * MeSH
• radiofarmaka * MeSH
• senioři MeSH
• Takayasuova arteriitida diagnostické zobrazování   MeSH
• vaskulitida diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• fluorodeoxyglukosa F18 * MeSH
• radiofarmaka * MeSH

Chronic periaortitis involving idiopathic retroperitoneal fibrosis, inflammatory aneurysm of the abdominal aorta and perianeurysmal retroperitoneal fibrosis is a rare disease characterised by the development ofan inflammatory fibrotising process surrounding large vessels and organs of the retroperitoneum. According to some authors, chronic periaortitis results from a systemic autoimmune inflammation with vasculitis affecting aortal vasa vasorum and medium and small calibre retroperitoneal vessels. The disease is assumed to have immunopathogenetic background. Chronic periaortitis is diagnosed with the use ofultrasonography, computed tomography or magnetic resonance, and needle biopsy is mostly used for biopsy examinations. Positron emission tomography (PET) is a non-invasive diagnostic method which shows the bio-distribution of positron emitter labelled radiopharmaceuticals in the body. Due to the fact that not only tumorous, but in certain conditions also some inflammatory cells may exhibit increased accumulation of 18F-FDG (2-[18F]-fluoro-2-deoxy-D-glukose, 18F-FDG PET can be used to diagnose and to ascertain the activity of some types of chronic inflammations. We report a case ofa 60-year old man with idiopathic retroperitoneal fibrosis. 18F-FDG PET examination shoed an increased accumulation of the radiopharmaceutical around the abdominal aorta and of common ileac veins of the retroperitoneum. 18F-FDG PET fusion and computed tomography (CT) showed a correlation between the metabolically active tissue (PET) and the soft tissue infiltrate visible in CT images. A control exam done 4 months after the start of systemic therapy showed that the pathological accumulation of the radiopharmaceutical in the retroperitoneum had disappeared. 18F-FDG PET may be a useful tool to improve diagnosis of chronic periaortitis. A significant contribution of this method is the possibility to assess the activity of the pathologic process while monitoring the effect of the treatment.

• MeSH
• fluorodeoxyglukosa F18 * MeSH
• lidé středního věku MeSH
• lidé MeSH
• pozitronová emisní tomografie * MeSH
• radiofarmaka * MeSH
• retroperitoneální fibróza diagnostické zobrazování   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• fluorodeoxyglukosa F18 * MeSH
• radiofarmaka * MeSH

Polymyalgia rheumatica (PMR) is one of the inflammatory rheumatic diseases that can potentially be detected by positron emission tomography/CT. High fluorine-18 fludeoxyglucose (18F-FDG) accumulation around the shoulders, sternoclavicular and hip joints are the most common pre-treatment features of patients with PMR. Another common sign is increased 18F-FDG uptake in extra-articular regions between columnal spinous processes, near ischial tuberosities and in the praepubic area. Some patients also present with high 18F-FDG uptake in main arteries, corresponding to the characteristics of giant cell arteritis. It is possible to observe a decrease or even a disappearance of 18F-FDG uptake after effective therapy, an event which may be useful for the monitoring of treatment as well as for detection of PMR relapse.

• MeSH
• fluorodeoxyglukosa F18 * MeSH
• kyčelní kloub diagnostické zobrazování   MeSH
• lidé MeSH
• PET/CT metody   MeSH
• polymyalgia rheumatica diagnostické zobrazování   MeSH
• radiofarmaka * MeSH
• ramenní kloub diagnostické zobrazování   MeSH
• sternoklavikulární kloub diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• fluorodeoxyglukosa F18 * MeSH
• radiofarmaka * MeSH

BACKGROUND: It is generally accepted that a non-fasting state reduces [18F]FDG-PET quality, but the significance of higher levels of fasting blood glucose has aroused some doubts over time. The aim of this work was to provide further evidence to clarify this issue and its impact on the handling of hyperglycemic patients in daily routine. METHODS: Muscle and liver standardized uptake values (SUV) and their ratio, tumor SUV and the frequency of positive PET findings were retrospectively analyzed in 116 hyperglycemic (HG) patients (>11 mmol/L), in 116 patients with slightly elevated glycemia (SEG) (5.6-7.0 mmol/L) and in 116 normoglycemic (NG) patients (4.7 mmol/L). RESULTS: No significant difference was found in the muscle to liver ratio, in muscle SUV and in the frequency of positive PET findings among HG, SEG and NG patients. HG patients exhibited ~10% higher liver SUV in comparison to SEG and NG patients; a positive correlation (r=0.2849) was found between liver SUV and blood glucose levels. Significantly higher tumor SUV was present in SEG patients. CONCLUSIONS: We did not confirm that hyperglycemia in a fasting state negatively influences the diagnostic quality of [18F]FDG-PET. The positive correlation between liver SUV and blood glucose levels is clinically negligible and might be explained by increased fasting hepatic gluconeogenesis in diabetics. Our data encourage the performance of [18F]FDG-PET investigations under fasting conditions, regardless of the mild to medium elevation of fasting blood glucose level.

• MeSH
• fluorodeoxyglukosa F18 * MeSH
• hyperglykemie diagnostické zobrazování   metabolismus   MeSH
• játra diagnostické zobrazování   metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• omezení příjmu potravy * metabolismus   MeSH
• pozitronová emisní tomografie metody   MeSH
• retrospektivní studie MeSH
• svaly diagnostické zobrazování   metabolismus   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• fluorodeoxyglukosa F18 * MeSH

Mastocytosis is a clonal hematopoietic disorder characterized by proliferation of abnormal mast cells in various organs including the skin, digestive system, lymph nodes, and bone marrow. We report on a 75-year-old woman presenting with abdominal pain, vomiting, diarrhoea, myalgia, and weight loss. Abdominal CT showed hepatosplenomegaly with heterogeneous splenic parenchyma, lymphadenopathy, and osteopenia with areas of osteosclerosis but no primary tumour. An 18F-FDG PET/CT revealed an overall low metabolic activity of the lesions with a diffuse bone marrow involvement raising suspicion of a haematological neoplasm. Subsequently, bone marrow and peripheral blood examinations confirmed the diagnosis of aggressive systemic mastocytosis.

Die Mastozytose ist eine klonale hämatopoetische Erkrankung, welche durch eine Proliferation von abnormalen Mastzellen in verschiedenen Organen wie Haut, Verdauungstrakt, Lymphknoten und Knochenmark gekennzeichnet ist. Wir berichten über eine 75-jährige Frau mit Bauchschmerzen, Erbrechen, Diarrhö, Myalgie und Gewichtsverlust. Ein CT des Abdomens zeigte eine Hepatosplenomegalie mit heterogenem Milzparenchym, Lymphadenopathie und Osteopenie mit osteosklerotischen Herden, aber keinen Primärtumor. Im PET/CT fand sich eine insgesamt niedrige metabolische Aktivität der Läsionen, mit einer diffusen Knochenmarkbeteiligung die verdächtig auf eine hämatologische Neoplasie war. Eine Untersuchung des Knochenmarks und des peripheren Blutes bestätigte anschließend die Diagnose einer aggressiven systemischen Mastozytose.

• MeSH
• fluorodeoxyglukosa F18 * MeSH
• kostní dřeň diagnostické zobrazování   MeSH
• lidé MeSH
• PET/CT MeSH
• pozitronová emisní tomografie MeSH
• senioři MeSH
• systémová mastocytóza * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• fluorodeoxyglukosa F18 * MeSH

AIM: The aim of the study was to evaluate the yields of 2-deoxy-2-[18F]-fluoro-D-glucose positron-emission tomography/magnetic resonance imaging (18F-FDG-PET/MRI) and 18F-FDG-PET/computed tomography (CT) for the detection of metastatic involvement of locoregional neck nodes in patients with head and neck malignancy. PATIENTS AND METHODS: A total of 90 patients (66 men and 24 women) met the inclusion criteria. Preoperative staging was performed: 53 examinations using PET/CT and 37 using PET/MRI. RESULTS: For PET/MRI, the study demonstrated a sensitivity of 89%, specificity of 64%, positive predictive value of 85%, and negative predictive value of 70%; PET/CT had a sensitivity of 95%, specificity 47%, positive predictive value of 82%, and negative predictive value of 78%. CONCLUSION: Both methods have a high yield in N-clinical staging with statistically insignificant differences. We assume PET/MRI to be the first-choice method in organ-targeted examinations, for pediatric patients and repeat examinations. In cases of MRI contraindication, PET/CT can be used with no impact on the quality of care.

• Klíčová slova
• Head and neck tumours, PET/CT, PET/MRI, cancer staging, hybrid imaging, lymph node,
• MeSH
• dítě MeSH
• fluorodeoxyglukosa F18 * MeSH
• lidé MeSH
• lymfatické metastázy diagnostické zobrazování   MeSH
• lymfatické uzliny diagnostické zobrazování   MeSH
• magnetická rezonanční tomografie MeSH
• PET/CT * MeSH
• počítačová rentgenová tomografie MeSH
• pozitronová emisní tomografie MeSH
• radiofarmaka MeSH
• senzitivita a specificita MeSH
• staging nádorů MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• fluorodeoxyglukosa F18 * MeSH
• radiofarmaka MeSH

BACKGROUND: Standard measures of response such as Response Evaluation Criteria in Solid Tumors are ineffective for bone lesions, often making breast cancer patients that have bone-dominant metastases ineligible for clinical trials with potentially helpful therapies. In this study we prospectively evaluated the test-retest uptake variability of 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG) in a cohort of breast cancer patients with bone-dominant metastases to determine response criteria. The thresholds for 95% specificity of change versus no-change were then applied to a second cohort of breast cancer patients with bone-dominant metastases. METHODS: For this study, nine patients with 38 bone lesions were imaged with 18F-FDG in the same calibrated scanner twice within 14 days. Tumor uptake was quantified by the most commonly used PET parameter, the maximum tumor voxel normalized by dose and body weight (SUVmax) and also by the mean of a 1-cc maximal uptake volume normalized by dose and lean-body-mass (SULpeak). The asymmetric repeatability coefficients with confidence intervals for SUVmax and SULpeak were used to determine the limits of 18F-FDG uptake variability. A second cohort of 28 breast cancer patients with bone-dominant metastases that had 146 metastatic bone lesions was imaged with 18F-FDG before and after standard-of-care therapy for response assessment. RESULTS: The mean relative difference of SUVmax and SULpeak in 38 bone tumors of the first cohort were 4.3% and 6.7%. The upper and lower asymmetric limits of the repeatability coefficient were 19.4% and - 16.3% for SUVmax, and 21.2% and - 17.5% for SULpeak. 18F-FDG repeatability coefficient confidence intervals resulted in the following patient stratification using SULpeak for the second patient cohort: 11-progressive disease, 5-stable disease, 7-partial response, and 1-complete response with three inevaluable patients. The asymmetric repeatability coefficients response criteria for SULpeak changed the status of 3 patients compared to the standard Positron Emission Tomography Response Criteria in Solid Tumors of ± 30% SULpeak. CONCLUSION: In evaluating bone tumor response for breast cancer patients with bone-dominant metastases using 18F-FDG SUVmax, the repeatability coefficients from test-retest studies show that reductions of more than 17% and increases of more than 20% are unlikely to be due to measurement variability. Serial 18F-FDG imaging in clinical trials investigating bone lesions in these patients, such as the ECOG-ACRIN EA1183 trial, benefit from confidence limits that allow interpretation of response.

• Klíčová slova
• 18F-FDG PET, Bone metastases, Breast cancer, Repeatability, Test-retest,
• Publikační typ
• časopisecké články MeSH

PURPOSE: The enzyme O6-methylguanine-DNA methyltransferase (MGMT) is an important component of the DNA repair machinery. MGMT removes O6-methylguanine from the DNA by transferring the methyl group to a cysteine residue in its active site. Recently, we detected the single nucleotide polymorphism (SNP) rs12917 (C/T) in the MGMT sequence adjacent to the active site in Hodgkin lymphoma (HL) cell line KM-H2. We now investigated whether this SNP is also present in other HL cell lines and patient samples. Furthermore, we asked whether this SNP might have an impact on metabolic response in 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography ([18F]FDG-PET), and on overall treatment outcome based on follow-up intervals of at least 34 months. PROCEDURES: We determined the frequency of this MGMT polymorphism in 5 HL cell lines and in 29 pediatric HL (PHL) patients. The patient cohort included 17 female and 12 male patients aged between 4 and 18 years. After characterization of the sequence, we tested a possible association between rs12917 and age, gender, Ann Arbor stage, treatment group, metabolic response following two courses of OEPA (vincristine, etoposide, prednisone, and doxorubicin) chemotherapy, radiotherapy indication, and relapse status. RESULTS: We detected the minor T allele in four of five HL cell lines. 11/29 patients carried the minor T allele whereas 18/29 patients showed homozygosity for the major C allele. Interestingly, we observed significantly better metabolic response in PHL patients carrying the rs12917 C allele resulting in a lower frequency of radiotherapy indication. CONCLUSION: MGMT polymorphism rs12917 seems to affect chemotherapy response in PHL. The prognostic value of this polymorphism should be investigated in a larger patient cohort.

• Klíčová slova
• Deauville score, MGMT, Pediatric Hodgkin lymphoma, [18F]FDG-PET, qPET, rs12917,
• MeSH
• dítě MeSH
• DNA modifikační methylasy genetika   MeSH
• enzymy opravy DNA genetika   MeSH
• fluorodeoxyglukosa F18 chemie   MeSH
• Hodgkinova nemoc diagnostické zobrazování   genetika   MeSH
• jednonukleotidový polymorfismus genetika   MeSH
• lidé MeSH
• mladiství MeSH
• nádorové buněčné linie MeSH
• nádorové supresorové proteiny genetika   MeSH
• pozitronová emisní tomografie * MeSH
• předškolní dítě MeSH
• sekvence nukleotidů MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• DNA modifikační methylasy MeSH
• enzymy opravy DNA MeSH
• fluorodeoxyglukosa F18 MeSH
• MGMT protein, human MeSH Prohlížeč
• nádorové supresorové proteiny MeSH

The introduction of hybrid PET/MRI imaging using integrated systems into clinical practice has opened up the possibility of reducing the radiation dose from hybrid imaging by eliminating the contribution from computed tomography. Studies comparing the possibilities of PET/CT and PET/MRI imaging demonstrated it is possible to use the advantages of the high contrast resolution of magnetic resonance for soft tissue and bone marrow along with PET records in a quality comparable to PET/CT imaging. The significant feature for PET imaging in Hodgkińs lymphoma is that it is a tissue with high levels of radiopharmaceutical accumulation, which decreases proportionally after successful therapeutic effect, the effect of therapy is assessed using Deauville score system on interim examinations. While the efficacy of prognosis determined using the Deauville scale in HL is widely accepted, it turns out that in DLBCL, the prognostic value of PET imaging is bound to the evaluation of subtypes. PET/MRI scanning can be used to evaluate a relapse if follicular lymphoma has already been treated, or to confirm transformation into more aggressive forms. In children and adults with Burkitt's lymphoma, negative findings after induction therapy have a high negative predictive value for relapse prognosis.

• Klíčová slova
• Deauville score, Fluorodeoxyglucose, Hybrid imaging, Lymphoma, PET/MRI,
• MeSH
• dítě MeSH
• dospělí MeSH
• fluorodeoxyglukosa F18 * MeSH
• lidé MeSH
• lymfom diagnostické zobrazování   MeSH
• magnetická rezonanční tomografie metody   MeSH
• multimodální zobrazování metody   MeSH
• pozitronová emisní tomografie metody   MeSH
• radiofarmaka * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• fluorodeoxyglukosa F18 * MeSH
• radiofarmaka * MeSH

OBJECTIVE: An arteriovenous graft (AVG) is indicated in hemodialysis patients with failed arteriovenous access. Early treatment of AVG infection is important because an advanced prosthetic infection leads to the removal of the prosthesis. The aim of this study was to evaluate the benefits of 18F-FDG PET/CT and 99mTc-HMPAO-WBC SPECT/CT in early detection of AVG infections. SUBJECTS AND METHODS: Fifty-one AVGs were evaluated. 18F-FDG PET/CT and 99mTc-HMPAO-WBC SPECT/CT studies were performed at intervals of 10, 20-30, and 40-50 weeks after AVG insertion. Agreement between the imaging methods and reference parameters (i.e. clinical presentation, C-reactive protein and microbiological findings on the hemodialysis cannula extracted after hemodialysis from AVG) was evaluated. RESULTS: The study results showed that focal accumulation of the radiopharmaceuticals can be considered a sign of AVG infection. At 10 weeks after AVG implantation, the focal 18F-FDG findings showed the best agreement with the reference parameters (agreement coefficients AC1 - clinical status: 0.693, CRP: 0.605, cannula microbiology: 0.518, respectively). At 20 to 30 weeks after AVG implantation, the diagnostic value of focal 99mTc-HMPAO-WBC accumulation increased (AC1 coefficients: 0.658, 0.658, 0.408) and was similar to that of focal 18F-FDG uptake (AC1s: 0.656, 0.570, 0.409). Between 40 and 50 weeks since AVG implantation, the diagnostic significance of focal 99mTc-HMPAO-WBC accumulation (AC1 coefficients: 0.771, 0.811, 0.611) slightly exceeded the diagnostic value of focal 18F-FDG accumulation (AC1 coefficients: 0.524, 0.456, 0.569). CONCLUSION: 18F-FDG PET/CT and 99mTc-HMPAO-WBC SPECT/CT can both serve as important tools contributing to early diagnosis of AVG infection.

• Klíčová slova
• 18F-FDG PET/CT, 99mTc-HMPAO-WBC SPECT/CT, arteriovenous graft, hemodialysis, infection,
• MeSH
• biologické markery krev   MeSH
• časná diagnóza MeSH
• dospělí MeSH
• fluorodeoxyglukosa F18 krev   MeSH
• infekce diagnóza   etiologie   MeSH
• kontinuální metody náhrady funkce ledvin škodlivé účinky   MeSH
• kontrola infekce metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• radiofarmaka krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery MeSH
• fluorodeoxyglukosa F18 MeSH
• radiofarmaka MeSH