Epileptogenic Zone Localization With FDG PET Using a New Dynamic Parametric Analysis.

[F]fluorodeoxyglucose (F-FDG) positron emission tomography (PET) is part of the regular preoperative work-up in medically refractory epilepsy. As a complement to visual evaluation of PET, statistical parametric maps can help in the detection of the epileptogenic zone (EZ). However, software packages currently available are time-consuming and little intuitive for physicians.

PISCOM: a new procedure for epilepsy combining ictal SPECT and interictal PET.

Purpose: We present a modified version of the SISCOM procedure that uses interictal PET instead of interictal SPECT for seizure onset zone localization. We called this new nuclear imaging processing technique PISCOM (PET interictal subtracted ictal SPECT coregistered with MRI).

Methods: We retrospectively studied 23 patients (age range 4-61 years) with medically refractory epilepsy who had undergone MRI, ictal SPECT, interictal SPECT and interictal FDG PET and who had been seizure-free for at least 2 years after surgical treatment.

Diagnostic Accuracy of 18F-FDG PET/CT in Infective Endocarditis and Implantable Cardiac Electronic Device Infection: A Cross-Sectional Study.

Unlabelled: Early diagnosis of infective endocarditis (IE) is based on the yielding of blood cultures and echocardiographic findings. However, they have limitations and sometimes the diagnosis is inconclusive, particularly in patients with prosthetic valves (PVs) and implantable cardiac electronic devices (ICEDs). The primary aim of this study was to evaluate the diagnostic accuracy of F-FDG PET/CT in patients with suspected IE and ICED infection.

Correlation between theoretical anatomical patterns of lymphatic drainage and lymphoscintigraphy findings during sentinel node detection in head and neck melanomas.

Purpose: In the diagnosis of head and neck melanoma, lymphatic drainage is complex and highly variable. As regional lymph node metastasis is one of the most important prognostic factors, lymphoscintigraphy can help map individual drainage patterns. The aim of this study was to compare the results of lymphoscintigraphy and sentinel lymph node (SLN) detection with theoretical anatomical patterns of lymphatic drainage based on the location of the primary tumour lesion in patients with head and neck melanoma.

Rapid calcitriol increase and persistent calcidiol insufficiency in the first 6 months after kidney transplantation.

Introduction: Vitamin D deficiency or insufficiency is prevalent in kidney transplant recipients. Little is known about post-transplantation changes in vitamin D forms, which are essential for bone health and other health outcomes. The aim was to measure the levels of calcidiol and calcitriol during the first 6 months after kidney transplantation and examine their relation with other bone mineral metabolic parameters.

Is there a role for PET/CT with esophagogastric junction adenocarcinoma?

The value of 18F-FDG PET/CT in the initial diagnosis and in the locoregional staging of esophagogastric junction adenocarcinoma is not fully established. However, 18F-FDG PET/CT is widely accepted as the best modality for identification of suspected metastases in staging of the disease. Results published in the literature suggest that 18F-FDG PET/CT may provide useful information for response assessment to neoadjuvancy and to differentiate responding and nonresponding tumors.

Prospective comparison of whole-body (18)F-FDG PET/CT and MRI of the spine in the diagnosis of haematogenous spondylodiscitis.

Purpose: To prospectively compare (18)F-FDG PET/CT and MRI in the diagnosis of haematogenous spondylodiscitis

Methods: The study included 26 patients (12 women, 14 men; mean age 59 ± 17 years) with clinical symptoms of infection of the spine. Patients who had had prior spinal surgery or any type of antibiotic therapy in the previous 3 months were excluded from the study. Whole-body PET/CT 60 min after injection of 4.

Changes in bone mineral metabolism parameters, including FGF23, after discontinuing cinacalcet at kidney transplantation.

Little is known about the effects of the administration of cinacalcet in dialytic patients who are scheduled for kidney transplantation, and in particular about the changes in FGF23 and other mineral metabolism parameters after surgery compared with recipients not on cinacalcet at kidney transplantation. We performed a prospective observational cohort study with recruitment of consecutive kidney transplant recipients at our institution. Patients were classified according to whether they were under treatment with cinacalcet before transplantation.

Clinical Role of Subtraction Ictal SPECT Coregistered to MR Imaging and (18)F-FDG PET in Pediatric Epilepsy.

Unlabelled: A precise assessment of the drug-resistant epileptic pediatric population for surgical candidacy is often challenging, and to date there are no evidence-based guidelines for presurgical identification of the epileptogenic zone. To evaluate the usefulness of radionuclide imaging techniques for presurgical evaluation of epileptic pediatric patients, we compared the results of video-electroencephalography (EEG), brain MR imaging, interictal SPECT, ictal SPECT, subtraction ictal SPECT coregistered to MR imaging (SISCOM), and interictal PET with (18)F-FDG.

Methods: Fifty-four children with drug-resistant epilepsy who had undergone video-EEG monitoring, brain MR imaging, interictal and ictal brain perfusion SPECT, SISCOM, and (18)F-FDG PET were included in this study.

Mirror-image lymph node in FDG PET/CT and SPECT/CT for sentinel node detection.

We report a case of a patient with presumed stage IB1 squamous cell carcinoma of the cervix in which FDG PET/CT scan revealed 1 hypermetabolic left iliac node suggestive to be malignant. Lymphoscintigraphy and SPECT/CT studies previous to sentinel node (SLN) biopsy revealed unilateral drainage in the right pelvis. Intraoperative pathological assessment of the SLN showed no tumoral involvement, and the hypermetabolic node revealed macrometastasis.

Advantages of pinhole collimator double-phase scintigraphy with 99mTc-MIBI in secondary hyperparathyroidism.

Purpose: The aim of the study was to determine if pinhole collimator-acquired images can improve the detection of hyperfunctioning parathyroid glands in patients with secondary hyperparathyroidism.

Methods: Forty-two patients being treated with cinacalcet for secondary hyperparathyroidism were studied prospectively. Patients were divided into 2 groups according to their levels of parathyroid hormone (PTH), the hormone that defines response to treatment: "responders" (PTH <300 pg/mL) and "nonresponders" (PTH ≥ 300 pg/mL).

Interim FDG PET/CT as a prognostic factor in diffuse large B-cell lymphoma.

Purpose: Interim (18)F-FDG PET performed early during the course of therapy in diffuse large B-cell lymphoma (DLBCL) is a good predictor of outcome. However, interpretation criteria for interim PET for the evaluation of tumour response are still not clearly defined. The study aim was to assess whether interim PET can predict overall survival (OS) and progression-free survival (PFS) in DLBCL patients following three different sets of parameters, two qualitative (visual) methods and one semiquantitative.

A prospective study comparing whole-body FDG PET/CT to combined planar bone scan with 67Ga SPECT/CT in the Diagnosis of Spondylodiskitis.

Purpose: This study aimed to prospectively evaluate the usefulness of PET/CT using F-FDG in comparison to bone scan and Ga in the diagnosis of spondylodiskitis.

Material And Methods: This prospective study included 34 patients (15 women and 19 men) aged 59 (18) years with clinical symptoms of spondylodiskitis. Whole-body PET/CT and bone scan combined with planar and SPECT/CT Ga was performed in all patients.

Accuracy and reproducibility of lymphoscintigraphy for sentinel node detection in patients with cutaneous melanoma.

Unlabelled: Lymphoscintigraphy is an important part of the mapping and identification of sentinel lymph nodes (SLNs). However, few studies report its reproducibility, and some concerns prevail. The aim of the study was to determine the reproducibility of lymphoscintigraphy performed by different team members following a strict protocol to assess lymphatic drainage and the location and number of SLNs.

Validation of an automatic dose injection system for Ictal SPECT in epilepsy.

Unlabelled: The purpose of our study was to evaluate the performance and clinical usefulness of an automated injector system (AIS) that administers an automated injection for ictal SPECT after calculating the volume of tracer to be injected over time.

Methods: To test the AIS, repeated injections were performed at different times after tracer preparation. The clinical study consisted of 56 patients with drug-resistant, complex partial seizures.

Validation of FDG-PET/MRI coregistration in nonlesional refractory childhood epilepsy.

Purpose: To validate the use of 18F-fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging (FDG-PET/MRI) coregistration for epileptogenic zone detection in children with MRI nonlesional refractory epilepsy and to assess its ability to guide a second interpretation of the MRI studies.

Methods: Thirty-one children with refractory epilepsy whose MRI results were nonlesional were included prospectively. All patients underwent presurgical evaluation following the standard protocol of our epilepsy unit, which included FDG-PET and FDG-PET/MRI coregistration.

Assessment of radiofrequency ablation of lung metastasis from colorectal cancer using dual time-point PET/CT.

A 70-year-old man with operated colorectal cancer relapsed with a solitary lung metastasis. Dual time-point PET/CT performed at 60' (standard images) and after 2 hours (delayed images) showed focal uptake in the lung nodule. A second uptake in the liver dome was also visualized only in the delayed images.

Diagnostic cutoff points for ¹²³I-MIBG myocardial scintigraphy in a Caucasian population with Parkinson's disease.

Purpose: Molecular imaging with (123)I-metaiodobenzylguanidine (MIBG) has been used in Parkinson's disease (PD), but there is no consensual index to discriminate between normal and PD patients in the Caucasian population. The purpose of this study was to determine diagnostic cutoff points in the quantification of MIBG cardiac uptake in our population of PD patients. We have also calculated the reproducibility over a range of interpretation expertise.

Other PET Tracers and Prospects for the Future.

(18)F FDG-PET has proven its use as a technique in the field of melanoma, but there are valid concerns related to the specificity of (18)F FDG-PET findings and the degree of accuracy we can expect in the assessment of response to new treatment protocols. The main avenues currently being explored for future use in staging and management of melanoma with PET other than FDG include monoclonal antibodies against melanoma-associated antigens, α-MSH analogues, amino acids involved in melanin formation, nicotinamide-based compounds, heterodimeric glycoproteins such as integrins, reporter gene imaging, cell proliferation, and hypoxia tracers.

Recurrence of Melanoma.

When cutaneous melanoma recurrence is suspected, several imaging techniques can be used to confirm or rule out this possibility as well as performing an adequate follow-up of the disease. [(18)F]Fluorodeoxyglucose (FDG)-PET may play an important role in this setting. Ultrasonography and FDG-PET can be useful in the assessment of regional node involvement but sentinel node biopsy is the gold standard.

Usefulness of 99mTc-ciprofloxacin scintigraphy in the diagnosis of prosthetic joint infections.

Objective: To evaluate the usefulness of 99Tc-ciprofloxacin scintigraphy (CFS) in patients with hip or knee arthroplasty and suspected infection.

Methods: Forty patients (26 women, 14 men) with a mean age of 66±10 years and local pain in the hip (21), knee (16), or shoulder (three) prosthesis were recruited. CFS was performed at 1, 4, and 24 h after intravenous injection of 370 MBq.

Added value of intraoperative real-time imaging in searches for difficult-to-locate sentinel nodes.

Unlabelled: Localization of sentinel lymph nodes can be challenging if they are in difficult anatomic locations or near high radiotracer activity. The purpose of this study was to assess the value of intraoperative real-time imaging using a portable gamma-camera in conjunction with a conventional gamma-counting probe when it is difficult to localize the sentinel node.

Methods: After (99m)Tc-nanocolloid injection, patients with various malignancies underwent presurgical lymphoscintigraphy followed by surgery (usually the next day).