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

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

The introduction of integrated PET/MRI imaging combining full magnetic resonance imaging and positron emission tomography is a new milestone in tissue imaging. As usual innovations in clinical practice generate new dilemmas. The questions it poses are: when to use PET/MRI scanning, what radiopharmaceutical to use and how to optimize examination protocols. A range of new radiopharmaceuticals, in addition to 18F-fluorodeoxyglucose (18F-FDG), are now available for assessing and characterizing tissues.

• Klíčová slova
• Hybrid imaging, Multiparametric imaging, PET/MRI,
• MeSH
• fluorodeoxyglukosa F18 MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• multimodální zobrazování metody   MeSH
• pozitronová emisní tomografie metody   MeSH
• radiofarmaka MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• úvodníky MeSH
• Názvy látek
• fluorodeoxyglukosa F18 MeSH
• radiofarmaka MeSH

PURPOSE: To investigate combined MRI and 18F-FDG PET for assessing breast tumor metabolism/perfusion mismatch and predicting pathological response and recurrence-free survival (RFS) in women treated for breast cancer. METHODS: Patients undergoing neoadjuvant chemotherapy (NAC) for locally-advanced breast cancer were imaged at three timepoints (pre, mid, and post-NAC), prior to surgery. Imaging included diffusion-weighted and dynamic contrast-enhanced (DCE-) MRI and quantitative 18F-FDG PET. Tumor imaging measures included apparent diffusion coefficient, peak percent enhancement (PE), peak signal enhancement ratio (SER), functional tumor volume, and washout volume on MRI and standardized uptake value (SUVmax), glucose delivery (K1) and FDG metabolic rate (MRFDG) on PET, with percentage changes from baseline calculated at mid- and post-NAC. Associations of imaging measures with pathological response (residual cancer burden [RCB] 0/I vs. II/III) and RFS were evaluated. RESULTS: Thirty-five patients with stage II/III invasive breast cancer were enrolled in the prospective study (median age: 43, range: 31-66 years, RCB 0/I: N = 11/35, 31%). Baseline imaging metrics were not significantly associated with pathologic response or RFS (p > 0.05). Greater mid-treatment decreases in peak PE, along with greater post-treatment decreases in several DCE-MRI and 18F-FDG PET measures were associated with RCB 0/I after NAC (p < 0.05). Additionally, greater mid- and post-treatment decreases in DCE-MRI (peak SER, washout volume) and 18F-FDG PET (K1) were predictive of prolonged RFS. Mid-treatment decreases in metabolism/perfusion ratios (MRFDG/peak PE, MRFDG/peak SER) were associated with improved RFS. CONCLUSION: Mid-treatment changes in both PET and MRI measures were predictive of RCB status and RFS following NAC. Specifically, our results indicate a complementary relationship between DCE-MRI and 18F-FDG PET metrics and potential value of metabolism/perfusion mismatch as a marker of patient outcome.

• Klíčová slova
• Chemotherapy response, Diffusion weighted MRI, Dynamic 18F-FDG PET, Dynamic contrast enhanced MRI, Recurrence,
• MeSH
• dospělí MeSH
• fluorodeoxyglukosa F18 terapeutické užití   MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• nádory prsu * diagnostické zobrazování   farmakoterapie   MeSH
• neoadjuvantní terapie metody   MeSH
• pozitronová emisní tomografie metody   MeSH
• prospektivní studie MeSH
• radiofarmaka terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• fluorodeoxyglukosa F18 MeSH
• radiofarmaka MeSH

The introduction of the integrated hybrid PET/MRI equipment creates the possibility to perform PET and MRI simultaneously. Depending on the clinical question, the metabolic conversion to glycolytic activity or beta-oxidation is performed before the application of FDG. Since FDG aids to evaluate the energetic metabolism of the myocytes and myocardial MRI reaches the imaging capabilities of perfusion and tissue characterization in the daily routine, FDG-PET/MRI looks to be a promising method of PET/MRI exploitation in cardiac imaging. When myocardial FDG uptake should be evaluated in association with the perfusion distribution, the cross-evaluation of FDG accumulation distribution and perfusion distribution pattern is necessary. The different scenarios may be used in the assessment of myocardium, the conversion to glycolytic activity is used in the imaging of the viable myocardium, but the glycolytic activity suppression might be used in the indications of the identification of injured myocardium by ischemia or inflammation. FDG-PET/MRI might aid to answer the clinical tasks according to the structure, current function and possibilities to improve the function in ischemic heart disease or to display the extent or activity of myocardial inflammation in sarcoidosis. The tight coupling between metabolism, perfusion and contractile function offers an opportunity for the simultaneous assessment of cardiac performance using one imaging modality.

• Klíčová slova
• Fluorodeoxyglucose, Myocardium, PET/MRI, Positron emission tomography,
• MeSH
• fluorodeoxyglukosa F18 * MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• multimodální zobrazování metody   MeSH
• nemoci srdce diagnostické zobrazování   MeSH
• pozitronová emisní tomografie metody   MeSH
• radiofarmaka * MeSH
• srdce diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• fluorodeoxyglukosa F18 * MeSH
• radiofarmaka * MeSH

18F-FDG PET/MRI might be the diagnostic method of choice for Hodgkin lymphoma patients, as it combines significant metabolic information from PET with excellent soft-tissue contrast from MRI and avoids radiation exposure from CT. However, a major issue is longer examination times than for PET/CT, especially for younger children needing anesthesia. Thus, a targeted selection of suitable whole-body MRI sequences is important to optimize the PET/MRI workflow. Methods: The initial PET/MRI scans of 84 EuroNet-PHL-C2 study patients from 13 international PET centers were evaluated. In each available MRI sequence, 5 PET-positive lymph nodes were assessed. If extranodal involvement occurred, 2 splenic lesions, 2 skeletal lesions, and 2 lung lesions were also assessed. A detection rate was calculated dividing the number of visible, anatomically assignable, and measurable lesions in the respective MRI sequence by the total number of lesions. Results: Relaxation time-weighted (T2w) transverse sequences with fat saturation (fs) yielded the best result, with detection rates of 95% for nodal lesions, 62% for splenic lesions, 94% for skeletal lesions, and 83% for lung lesions, followed by T2w transverse sequences without fs (86%, 49%, 16%, and 59%, respectively) and longitudinal relaxation time-weighted contrast-enhanced transverse sequences with fs (74%, 35%, 57%, and 55%, respectively). Conclusion: T2w transverse sequences with fs yielded the highest detection rates and are well suited for accurate whole-body PET/MRI in lymphoma patients. There is no evidence to recommend the use of contrast agents.

• Klíčová slova
• Hodgkin lymphoma, MRI sequences, PET/MRI, whole-body imaging,
• MeSH
• celotělové zobrazování metody   MeSH
• difuzní magnetická rezonance metody   MeSH
• dítě MeSH
• fluorodeoxyglukosa F18 MeSH
• Hodgkinova nemoc * diagnostické zobrazování   patologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• nemoci kostí * MeSH
• PET/CT MeSH
• pozitronová emisní tomografie metody   MeSH
• průběh práce MeSH
• radiofarmaka MeSH
• staging nádorů MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• fluorodeoxyglukosa F18 MeSH
• radiofarmaka MeSH

Tissue hypoxia becomes the driver of the micro-environmental transformation of the malignant tumorous tissue in majority of solid tumors. Even more, during the development of solid tumors, a large amount of nutrients is consumed due to rapid proliferation of tumor cells. The way of use of nutrients could be assessed using the probes during positron emission tomography (PET), the most frequent is the use of 18F-fluorodeoxyglucose (18F-FDG) demonstrating the turn-over of glucose exploitation in a manner of Warburg phenomenon. Even tumor cells can undergo metabolic reprogramming by changing the expression of glycolysis-related proteins, development of hypoxic condition increases glucose uptake to promote their growth. The hypoxic conditions are stimulation also the development of drug and/or radiation resistance, thus, the identification of the hypoxic tissue could play an important role in therapy planning. The process that enables use of hypoxia specific PET radiopharmaceutical starts when it enters cell by passive diffusion. Intracellularly, a model substance - 18F-fluoromisonidazol (18F-FMISO) is reduced by nitroreductase enzymes to become trapped in cells within reduced tissue oxygen partial pressure. The identification of the hypoxic tissue aids to plan the target to radiotherapy in squamous cell carcinomas of head and neck or cervical carcinoma, when 18F-FMISO-PET/CT is used as a planning procedure for a target volume, while 18F-FDG-PET/MRI is being the local and whole body staging procedure. Hypoxia imaging helps to identify the high-grade component of an astrocytic tumor before stereotactic biopsy.

• Klíčová slova
• (18)F-fluorodeoxyglucose, (18)F-fluoromisonidazol, Hypoxia, Microenvironment, Positron emission tomography,
• MeSH
• fluorodeoxyglukosa F18 MeSH
• hypoxie MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádorové mikroprostředí MeSH
• nádory hlavy a krku * MeSH
• PET/CT MeSH
• počítačová rentgenová tomografie MeSH
• pozitronová emisní tomografie metody   MeSH
• radiofarmaka MeSH
• spinocelulární karcinom * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• fluorodeoxyglukosa F18 MeSH
• radiofarmaka MeSH

A combination of morphological imaging of the brain with microstructural and functional imaging provides a comprehensive overview of the properties of individual tissues. While diffusion weighted imaging provides information about tissue cellularity, spectroscopic imaging allows us to evaluate the integrity of neurons and possible anaerobic glycolysis during tumor hypoxia, in addition to the presence of accelerated synthesis or degradation of cellular membranes; on the other hand, PET metabolic imaging is used to evaluate major metabolic pathways, determining the overall extent of the tumor (18F-FET, 18F-FDOPA, 18F-FCH) or the degree of differentiation (18F-FDG, 18F-FLT, 18F-FDOPA and 18F-FET). Multi-parameter analysis of tissue characteristics and determination of the phenotype of the tumor tissue is a natural advantage of PET/MRI scanning. The disadvantages are higher cost and limited availability in all centers with neuro-oncology surgery. PET/MRI scanning of brain tumors is one of the most promising indications since the earliest experiments with integrated PET/MRI imaging systems, and along with hybrid imaging of neurodegenerative diseases, represent a new direction in the development of neuroradiology on the path towards comprehensive imaging at the molecular level.

• Klíčová slova
• Brain tumors, Hybrid imaging, Multiparametric imaging, PET/MRI, Positron emission tomography,
• MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• mozek diagnostické zobrazování   MeSH
• multimodální zobrazování metody   MeSH
• nádory mozku diagnostické zobrazování   MeSH
• pozitronová emisní tomografie metody   MeSH
• radiofarmaka * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• radiofarmaka * MeSH

Visually preserved metabolism in posterior cingulate cortex relative to hypometabolism in precuneus and cuneus, the cingulate island sign, is a feature of dementia with Lewy bodies (DLB) on FDG-PET. Lower cingulate island sign ratio (posterior cingulate cortex/cuneus+precuneus; FDG-CISr) values have been associated with a higher Braak neurofibrillary tangle stage in autopsied DLB. Using voxel-wise analysis, we assessed the patterns of regional cortical perfusion and metabolism, and using an atlas-based approach, we measured perfusion cingulate island sign ratio on arterial spin labeling MRI (ASL-CISr), and its associations with FDG-CISr, uptake on tau-PET and clinical severity in DLB. Our study sample (n = 114) included clinically probable DLB patients (n = 19), age-matched patients with probable Alzheimer's disease dementia (AD; n = 19) and matched controls (n = 76) who underwent MRI with 3-dimensional pseudo-continuous arterial spin labeling, 18F-FDG-PET and 18F-AV-1451 tau PET. Patterns of cortical perfusion and metabolism were derived from quantitative maps using Statistical Parametric Mapping. DLB patients showed hypoperfusion on ASL-MRI in precuneus, cuneus and posterior parieto-occipital cortices, compared to controls, and relatively spared posterior cingulate gyrus, similar to pattern of hypometabolism on FDG-PET. DLB patients had higher ASL-CISr and FDG-CISr than AD patients (p <0.001). ASL-CISr correlated with FDG-CISr in DLB patients (r = 0.67; p =0.002). Accuracy of distinguishing DLB from AD patients was 0.80 for ASL-CISr and 0.91 for FDG-CISr. Lower ASL-CISr was moderately associated with a higher composite medial temporal AV-1451 uptake (r = -0.50; p =0.03) in DLB. Lower perfusion in precuneus and cuneus was associated with worse global clinical scores. In summary, the pattern of cortical hypoperfusion on ASL-MRI is similar to hypometabolism on FDG-PET, and respective cingulate island sign ratios correlate with each other in DLB. Non-invasive and radiotracer-free ASL-MRI may be further developed as a tool for the screening and diagnostic evaluation of DLB patients in a variety of clinical settings where FDG-PET is not accessible.

• Klíčová slova
• Arterial spin labeling MRI, Cingulate island sign ratio, Cortical perfusion, Dementia with Lewy bodies, FDG PET, Or AV1–1451 tau PET,
• MeSH
• demence s Lewyho tělísky diagnostické zobrazování   metabolismus   patofyziologie   MeSH
• glukosa metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mozková kůra diagnostické zobrazování   metabolismus   patofyziologie   MeSH
• mozkový krevní oběh fyziologie   MeSH
• pozitronová emisní tomografie MeSH
• proteiny tau metabolismus   MeSH
• senioři MeSH
• spinové značení MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• glukosa MeSH
• proteiny tau MeSH
• spinové značení MeSH

The aim of this retrospective study was to analyze invasive EEG findings, histopathology, and postoperative outcomes in patients with MRI-negative, PET-positive temporal lobe epilepsy (TLE) (MRI-/PET+TLE) who had undergone epilepsy surgery. We identified 20 patients with MRI-/PET+TLE (8.4% of all patients with TLE who had undergone surgery; 11 men, 9 women). Of the 20 patients, 16 underwent invasive EEG. The temporal pole and hippocampus were involved in the seizure onset zone in 62.5% of the patients. We did not identify a lateral temporal or extratemporal seizure onset in any patient. Of the 20 patients, 17 had follow-up periods >1 year (mean follow-up=3.3 years). At the final follow-up, 70.6% patients were classified as Engel I, 5.8% of patients as Engel II, and 11.8% of patients as Engel III and IV (11.8%). Histopathological evaluation showed no structural pathology in any resected hippocampus in 58% of all evaluated temporal poles. The most common pathology of the temporal pole was focal cortical dysplasia type IA or IB. MRI-/PET+TLE should be delineated from other "nonlesional TLE." The ictal onset in these patients was in each case in the temporal pole or hippocampus, rather than in the lateral temporal neocortex. Standard surgery produced a good postoperative outcome, comparable to that for patients with lesional TLE. Histopathological findings were limited: the most common pathology was focal cortical dysplasia type I.

• MeSH
• dospělí MeSH
• epilepsie temporálního laloku diagnóza   chirurgie   MeSH
• fluorodeoxyglukosa F18 MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• magnetická rezonanční tomografie metody   MeSH
• mladý dospělý MeSH
• neurochirurgie metody   MeSH
• pozitronová emisní tomografie metody   MeSH
• retrospektivní studie MeSH
• spánkový lalok diagnostické zobrazování   patologie   chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• fluorodeoxyglukosa F18 MeSH