This article presents the protocol on Quality Controls in PET/CT and PET/MRI published online in May 2022 by the European Federation of Organisations for Medical Physics (EFOMP), which was developed by the Working group for PET/CT and PET/MRI Quality Control (QC) protocol. The main objective of this protocol was to comprehensively provide simple and practical procedures that may be integrated into clinical practice to identify changes in the PET/CT/MRI system's performance and avoid short- and long-term quality deterioration. The protocol describes the quality control procedures on radionuclide calibrators, weighing scales, PET, CT and MRI systems using selected and measurable parameters that are directly linked to clinical images quality. It helps to detect problems before they can impact clinical studies in terms of safety, image quality, quantification accuracy and patient radiation dose. CT and MRI QCs are described only in the context of their use for PET (attenuation correction and anatomical localization) imaging. Detailed step-by-step instructions have been provided, limiting any misinterpretations or interpersonal variations as much as possible. This paper presents the main characteristics of the protocol illustrated together with a brief summary of the content of each chapter. A regular QC based on the proposed protocol would guarantee that PET/CT and PET/MRI systems operate under optimal conditions, resulting in the best performance for routine clinical tasks.
BACKGROUND: At present, lung cancer ranks among the most frequent malignant diseases. However, according to literature data, mesenchymal lung tumors are very rare, representing less than 0.5% of all malignant lung tumours. Epithelioid hemangioendothelioma of the lungs belongs to this group of uncommon entities. CASE REPORT: We present a case of a 45-year-old male with a history of increasing dyspnoea and abdominal and back pains, developing over the past several months. Vertebral lesions were found on imaging studies. PET/ CT following 18F-fluorodeoxyglucose administration (FDG) showed a large FDG-positive malignant infiltration affecting the thorax, abdominal cavity, and bones. The extension and other characteristics of the mass on PET/ CT did not correspond to any of the common oncologic diseases. With its spread in a plaque-like form predominantly in the right hemithorax and on the surface of the liver, the disease closely resembled malignant mesothelioma. The primary tumour origin could not be clearly identified on PET/ CT scans but they allowed us to choose a suitable site to obtain tissue for pathologic examination. Based on a CT-guided bone bio-psy of the 7th right rib, the dia-gnosis was concluded as epithelioid hemangioendothelioma. Despite an early initiation of systemic treatment, the patient succumbed to the disease only 15 days after the dia-gnosis, due to superior vena cava syndrome and progressive pleural effusion leading to respiratory insufficiency. CONCLUSIONS: Given the extremely low prevalence of epithelioid hemangioendothelioma and its heterogeneous manifestation, it is impossible to base the dia-gnosis solely on disease symptoms, laboratory findings, and imaging modalities. In this respect, pathologic examination has a crucial role. For the same reason, there is a lack of recommendations for the standard-of-care systemic therapy of metastatic disease.
- Klíčová slova
- PET/ CT– treatment, epithelioid hemangioendothelioma, type 2 diabetes,
- MeSH
- epiteloidní hemangioendoteliom diagnóza diagnostické zobrazování metabolismus MeSH
- fluorodeoxyglukosa F18 metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- PET/CT metody MeSH
- prognóza MeSH
- radiofarmaka metabolismus 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
AIM: Polymyalgia rheumatica (PMR) is a disease presenting with pain and stiffness, mainly in shoulders, hip joints and neck. Laboratory markers of inflammation may bolster diagnosis. PMR afflicts patients over 50 years old, predominantly women, and may also accompany giant cell arteritis. PATIENTS AND METHODS: 67 patients, who fullfiled Healey´s criteria for PMR in the period between 2004 and 2013 and had positive FDG PET (PET/CT) findings were retrospectively evaluated. FDG uptake was assessed in large arteries, proximal joints (shoulders, hips and sternoclavicular joints), in extraarticular synovial structures (interspinous, ischiogluteal and praepubic bursae). RESULTS: Articular/periarticular involvement (A) was detected in 59/67 (88.1%) patients and extrarticular synovial involvement (E) in 51/67 (76.1%) patients either individually or in combinations. Vascular involvement (V) was detected in 27/67 (40.3%) patients only in combination with articular (A) and/or extraarticular synovial (E) involvement. These combinations were: A+E involvement in 30/67 (44.8%) patients, A+V involvement in 8/67 (11.9%) patients, E+V involvement in 6/67 (9%) patients and A+E+V in 13/67 (19.4%) patients. CONCLUSIONS: PMR presents by articular/periarticular synovitis, extraarticular synovitis and can be accompanied by giant cell arteritis. All types of involvement have their distinct FDG PET (PET/CT) finding, which can be seen either individually or in any of their 4 combinations. FDG PET (PET/CT) examination seems to be an advantageous one-step examination for detecting different variants of PMR, for assessing extent and severity and also for excluding occult malignancy.
- Klíčová slova
- FDG, PET, PET/CT, bursitis, giant cell arteritis, polymyalgia rheumatica, synovitis, vasculitis,
- MeSH
- burzitida diagnostické zobrazování MeSH
- fluorodeoxyglukosa F18 MeSH
- lidé středního věku MeSH
- lidé MeSH
- multimodální zobrazování metody MeSH
- obrovskobuněčná arteritida diagnostické zobrazování MeSH
- PET/CT metody MeSH
- polymyalgia rheumatica diagnostické zobrazování MeSH
- pozitronová emisní tomografie metody MeSH
- radiofarmaka MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- synovitida diagnostické zobrazování MeSH
- vaskulitida diagnostické zobrazování MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- fluorodeoxyglukosa F18 MeSH
- radiofarmaka MeSH
INTRODUCTION: Ultrasound and CT angiography are common diagnostic methods of abdominal aortic pathologies. In the last decade, hybrid methods (PET/CT, PET/MRI) have become more common in this diagnostic algorithm. Originally they were indicated in malignancies or inflammatory processes. Currently, efforts are developed to visualize possible local inflammatory activity in the aortic wall and thus to assess a certain “disease activity” with the goal to anticipate further development of aortic pathology. The aim of our study was to analyze potential benefits of hybrid methods in predicting abdominal aortic pathology progression. METHODS: In this prospective, open-label, observational study we examined 75 patients referred to PET/CT (N=61) or PET/MRI (N=14) due to any aortic pathology in 2015-2017. The patients included those with abdominal aortic aneurysm (AAA) (N=48; 64%), aortitis (N=5; 6.7%), aortic dissection (N=4; 5.3%), patients undergoing EVAR (N=6; 8%), patients with excessive atherosclerosis (N=7; 9.3%), patients with concomitant AAA and retroperitoneal fibrosis (N=4; 5.3%) and patient with an intramural hematoma (N=1; 1.3%). The minimum follow-up period was 6 months (0.5-2.5 years). Clinical symptoms, aortic diameter, growth rate and CRP levels were analyzed during the follow-up and correlation with PET/CT or PET/MRI findings was evaluated. RESULTS: Increased metabolic activity in the aorta was found in 25 of the 75 examined patients (33.3%). Based on statistical analysis there were no associations between increased activity based on PET/CT or PET/MRI in the aortic wall and disease symptoms or progression. CONCLUSION: Our results provide no evidence that hybrid methods can predict further development of pathological findings in the abdominal aorta. PET/CT- or PET/MRI-based activity did not correlate with disease symptoms, AAA progression rate or dissection, either. Our results are also supported by some recent literature data.
- Klíčová slova
- Aorta, PET/CT, PET/MRI, aneurysm, dissection,
- MeSH
- aneurysma břišní aorty * diagnostické zobrazování MeSH
- aorta abdominalis diagnostické zobrazování MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- PET/CT * MeSH
- počítačová rentgenová tomografie * MeSH
- prospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
PURPOSE OF REVIEW: The aim of this study was to summarize the available evidence on different PET imaging modalities for the staging of patients diagnosed with bladder cancer (BCa). We further discuss the use of PET/computed tomography (CT) and PET/MRI with different radiopharmaceuticals to characterize tumour biology for treatment guidance. RECENT FINDINGS: Available evidence supports the benefits of PET/CT in BCa staging due to its higher accuracy in the detection of nodal metastases compared with CT alone. The use of PET/MRI is of major future interest due to the higher soft tissue contrast of MRI, which might enable the early detection of the tumour in the bladder. For the time being, the sensitivity of PET/MRI is still too low, when it comes to the diagnosis of early-stage BCa. This is mainly due to the renal excretion of the commonly used [ 18 F]FDG PET tracer, wherefore small lesions in the wall of the bladder can be missed. Novel studies using PET radiopharmaceuticals to target immune checkpoints or other immune cell targets (immunoPET) demonstrated high uptake in tumour lesions with high PD-L1 expression. The use of immunoPET could therefore help identify BCa patients who exhibit PD-L1 positive tumours for systemic immune-therapy. SUMMARY: PET/CT and PET/MRI seem to be promising imaging tools in BCa staging, especially for the detection of lymph node and distant metastases, as they are more accurate than conventional CT. Future clinical trials with novel radiopharmaceuticals and machine-learning driven PET-technologies bear the potential to help in the early detection, staging, monitoring and precision-medicine approach. Specifically, immunoPET is of high future interest, as it could help develop the concept of precision-medicine in the age of immunotherapy.
- MeSH
- antigeny CD274 MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- nádory močového měchýře * diagnostické zobrazování terapie patologie MeSH
- PET/CT MeSH
- pozitronová emisní tomografie metody MeSH
- radiofarmaka * MeSH
- senzitivita a specificita MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antigeny CD274 MeSH
- radiofarmaka * MeSH
18F-fluorocholine (FCH) PET/computed tomography (CT) is a valuable imaging modality in prostate cancer disease. Probably, its main role is restaging of patients with biochemical recurrence after radical prostatectomy or external beam radiotherapy. 18F-FCH PET/CT is strengthening its position in the initial staging, biopsy target definition, radiotherapy planning, and therapy monitoring. Gleason score and prostate-specific antigen value, doubling time, and velocity can influence positivity of 18F-FCH PET/CT. The influence of androgen deprivation therapy on choline uptake is not precisely clarified. Collaboration between nuclear medicine physicians, radiologists, urologists, oncologists, and radiotherapists is crucial to help patients with prostate cancer disease.
- Klíčová slova
- (18)F-choline, Choline, FCH (fluorocholine), PET/CT, Prostate cancer,
- MeSH
- časná detekce nádoru metody MeSH
- cholin analogy a deriváty MeSH
- lidé MeSH
- lokální recidiva nádoru diagnostické zobrazování MeSH
- nádory prostaty diagnostické zobrazování MeSH
- PET/CT metody MeSH
- prostatický specifický antigen metabolismus MeSH
- radiofarmaka * MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- cholin MeSH
- fluorocholine MeSH Prohlížeč
- prostatický specifický antigen MeSH
- radiofarmaka * MeSH
BACKGROUND: Positron emission tomography (PET) is a state-of-the-art diagnostic method of nuclear medicine, used for diagnostics of many pathological states in the organism, first and foremost in oncological issues. The first analysis of utilization and potential utilization of PET in the Czech Republic was published in 2013. In the following years, there was a sharp increase in a number of PET/CT and PET/MRI scanners in the country; in 2013-2021, it doubled. Simultaneously with the increase in scans performed, the range of available radiopharmaceuticals also broadened. MATERIAL AND METHODS: The study analyses the numbers and structure of PET, PET/CT and PET/MRI scans in the 2013-2021 period, using the pseudonymized data acquired from the General Health Insurance Company of the Czech Republic. The data was evaluated through a series of qualitative and quantitative indicators (number of scans performed, structure of diagnoses, use of different tracers, and availability of a scan for a patient). RESULTS: In the observed interval of time, the number of scans performed practically doubled, both thanks to more scanners installed and more radiopharmaceuticals available. The percentage of oncological and non-oncological scans remains more or less the same. Nevertheless, the regional differences in a number of scans performed persist, as does the availability of the scan for patients. CONCLUSION: PET is still a dynamically developing molecular imaging method in the Czech Republic. The analysis of a number and structure of scans performed offers a priceless overview of the development of the method over the years, in regard to diagnoses, utilization of individual radiopharmaceuticals or geographic distribution of scans performed. The observed findings are a motivation for further analyses.
- Klíčová slova
- radiopharmaceuticals, Positron emission tomography, nuclear medicine, positron emission tomography, radiopharmaceuticals,
- MeSH
- lidé MeSH
- magnetická rezonanční tomografie * statistika a číselné údaje MeSH
- PET/CT * metody MeSH
- pozitronová emisní tomografie * statistika a číselné údaje MeSH
- radiofarmaka MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- radiofarmaka MeSH
OBJECTIVE: We present a case of peritoneal tuberculosis of young woman with focus on difficult diagnosis of this low incidence disease in developed countries. DESIGN: Case report. SETTING: Department of Gynaecology and Obstetrics, Faculty Hospital, Olomouc. Department of Obstetric and Gynaecology, Nový Jičín Hospital. Department of Pulmonary Diseases and Tuberculosis, Faculty Hospital, Olomouc. Department of Pathology nad Molecular Medicine, Faculty Hospital, Olomouc. Department of Micobiology, Faculty Hospital, Olomouc. CASE REPORT: Peritoneal tuberculosis is an uncommon site of extrapulmonary infection caused by Mycobacterium tuberculosis. Diagnosis is often difficult and because of its nonspecific clinical, laboratory and radiological findings, the disease may be mistaken as ovarian malignancy. We present a case of 28 years old woman with ascites, enlarged lymphonodes, elevated Ca 125 and unusuall adnexal masses on PET/CT in ovarian locality. The diagnosis of tuberculosis in our case was made by laparoscopy and cultivation of Mycobacterium tuberculosis. CONCLUSION: In women with ascites and Ca 125 elevation, the posibility of TB infection should be, despite the low incidence of this disease in developed countries, still considered.
- Klíčová slova
- elevation of Ca 125 ascites., tuberculosis,
- MeSH
- antigen CA-125 krev MeSH
- ascites diagnostické zobrazování patologie MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- laparoskopie * MeSH
- lidé MeSH
- peritoneum diagnostické zobrazování patologie MeSH
- peritonitida tuberkulózní diagnóza diagnostické zobrazování MeSH
- PET/CT metody MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- antigen CA-125 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: In Masaryk Memorial Cancer Institute (MMCI), there is a long-running intensive joint effort of the RECAMO project and commercial entities, involving mainly clinical evaluations of state-of-the-art PET radiopharmaceuticals leading to their future availability for Czech physicians and their patients. Recently, the PET tracers [11C]methionine and [18F]fluorocholine, among others, were developed in this cooperation, both of them tracers with high importance for oncologic positron emission tomography diagnostics. [11C]methionine, labeled by carbon-11 with a half-life of 20 min, is a proteosynthesis marker used primarily for brain tumor visualization, whereas [18F]fluorocholine, labeled by fluorine-18 with a half-life of 109 min, is a marker of synthesis of cellular membranes and cell proliferation, its primary use being PET diagnostics of prostate carcinoma. AIM: The results of clinical evaluations of both PET radiopharmaceuticals, performed on the basis of parameters agreed and approved beforehand in cooperation of MMCI, RECAMO and the manufacturer of said radiopharmaceuticals, aimed to prove the efficiency and suitability of both compounds for oncologic PET diagnostics for said tumors. In both cases, the radiopharmaceuticals were evaluated in regard to their major use. CONCLUSION: The obtained results prove the benefits and efficiency of both compounds in PET diagnostics of respective tumors. The results, in the form of clinical evaluation reports, will be used as part of the documentation required for marketing authorization of these compounds for use in the Czech Republic.Key words: positron emission tomography - radiopharmaceuticals - L-methyl-11C-methionine - 18F-fluorocholineThis work was supported by the project MEYS - NPS I - LO1413.The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 10. 6. 2016Accepted: 17. 6. 2016.
- MeSH
- lidé MeSH
- pozitronová emisní tomografie * MeSH
- radiofarmaka chemie MeSH
- radioizotopy fluoru chemie MeSH
- radioizotopy uhlíku chemie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- radiofarmaka MeSH
- radioizotopy fluoru MeSH
- radioizotopy uhlíku MeSH
