Incidental fleurodeoxyglucose uptake in the prostate.

This commentary confirms the rarity of prostatic cancer associated with incidental prostatic fleurodeoxyglucose (FDG) uptake. The study adds to the literature by showing that even if a prostate lesion is FDG avid it is unlikely to be due to cancer. The commentary considers the management of incidental prostate FDG uptake on the basis of the available evidence.

Diffuse FDG renal uptake in lymphoma.

In patients presenting with acute renal failure and known/suspected lymphoma, the diagnosis of diffuse renal involvement is important, as there is potential for rapid resolution with chemotherapy. Although FDG is excreted through the kidneys and focal renal disease may be difficult to identify, diffuse renal FDG is more easily recognized and is always abnormal. We report a patient presenting with acute renal failure and suspected lymphoma.

Observer variation in interpreting 18F-FDG PET/CT findings for lymphoma staging.

Unlabelled: Many studies demonstrate a high accuracy for PET in staging lymphoma, but few assess observer variation. This study quantified agreement for staging lymphoma with PET/CT.

Methods: The PET/CT images of 100 patients with lymphoma who had been referred for staging were reviewed by 3 experienced observers, with 2 observers reviewing each series a second time.

Lung mass appearing as a dilated left ventricle on Tc-99m tetrofosmin myocardial perfusion scintigraphy.

Tc-99m tetrofosmin is a common tracer used in myocardial perfusion scintigraphy. Several benign and malignant tumors also take up tetrofosmin. We present a case of a 60-year-old woman with a history of a left lung mass awaiting resection.

Observer variation in FDG PET-CT for staging of non-small-cell lung carcinoma.

Purpose: Error and variation in reporting remains one of the weakest features of clinical imaging despite enormous technological advances in nuclear medicine and radiology. The aim of this study was to evaluate agreement amongst experienced readers in staging non-small-cell lung cancer (NSCLC) with PET-CT.

Methods: A series of (18)F-FDG PET-CT scans from 100 consecutive patients were reviewed independently by three experienced readers, with two readers reviewing each scan series a second time.

Positron emission tomography scanning is coming to a hospital near you soon!

Positron emission tomography (PET) is still generally not available in the UK; however, there are plans to introduce a national service in England from April 2008. Plans are also at an advanced stage in Scotland and Wales. The main uses of PET are in preoperative staging of lung cancer, detection of recurrent colorectal cancer, and management of patients with lymphoma.

The relationship between administered radiopharmaceutical activity in myocardial perfusion scintigraphy and imaging outcome.

Introduction: Lower radiopharmaceutical activities are used for myocardial perfusion scintigraphy (MPS) in the UK than in other countries. There is no evidence to suggest that higher activities improve imaging or clinical outcome.

Materials And Methods: We undertook a multicentre study of the relationship between radiopharmaceutical activity and imaging outcome.

The prognostic value of interim positron emission tomography scans combined with immunohistochemical data in diffuse large B-cell lymphoma.

The treatment of hematologic malignancies is moving towards risk-stratified directed therapy, whereby treatment is based on the disease's biological characteristics and response to treatment. We investigated whether BCL2 and BCL6 status could add to the prognostic information yielded by an interim positron emission tomography (PET) scan in the ability to predict outcome. Negative interim scans and BCL2-negative status correlated with continuing remission (p<0.

Prognostic value of interim FDG-PET after two or three cycles of chemotherapy in Hodgkin lymphoma.

Background: Long-term survival from Hodgkin lymphoma (HL) is 80-90%, but the treatment has serious late adverse effects. Modern risk-adapted treatment requires accurate assessment of the patient's prognosis. This investigation assessed the value of positron emission tomography (PET) with 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET) after two or three cycles of chemotherapy for prediction of progression-free survival (PFS) and overall survival (OS).

Misinterpretation of radioisotope imaging in pelvic kidneys.

We report the case of a gentleman referred with apparent worsening function in a hydronephrotic left-sided pelvic kidney. Imaging with Tc-99m-Mercaptoacetyltriglycine (MAG 3) in 1999, showed that the left kidney contributed 46% of renal function with no evidence of obstruction. Three years later, repeat scanning showed ectopic kidney function had decreased to 20% and with worsening pain, nephrectomy had been suggested.

Comparison of sestamibi, thallium, echocardiography and PET for the detection of hibernating myocardium.

The detection of hibernating myocardium is important because revascularisation results in improved function and prognosis in patients with hibernation but not in those with non-viable myocardium. The primary aim of this study was to compare the diagnostic accuracy of four techniques with respect to hibernation in the same study population with 6-12 months of follow-up. Twenty-five males underwent rest-stress sestamibi and delayed (>18 h) thallium scintigraphy, high-dose dobutamine stress echocardiography and nitrogen-13 ammonia/fluorine-18 fluorodeoxyglucose (NH(3)/FDG) positron emission tomography (PET).

Nuclear medicine and radionuclide imaging: a survey of recruitment issues in the United Kingdom.

This wide ranging survey has highlighted difficulties in recruiting trained and committed individuals into nuclear medicine and radionuclide radiology. Several key factors have been recognised that reduce the attractiveness of the training. Recommendations include the rotation of medical senior house officers through nuclear medicine, reconsideration of dual accreditation in nuclear medicine and medicine, an increase in the number of consultant posts in nuclear medicine, parity of remuneration for nuclear medicine trainees and finally, an appropriate sessional provision for those providing radionuclide radiology services.

A survey of the role of the UK physicist in nuclear medicine: a report of a joint working group of the British Institute of Radiology, British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine.

Guidelines for the provision of physics support to nuclear medicine were published in 1999 by a joint working group of the British Institute of Radiology, the British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine. Following publication of the guidelines, a survey was conducted by the working group to gather data on the actual level of physicist support in UK hospitals of different types and on the activities undertaken by physicists. The data were collected in the 12 months following the publication of guidelines and cover different hospital models and seven UK regions.

Value of isotope lymphography in the diagnosis of lymphoedema of the leg.

Background: Isotope lymphography has largely replaced contrast lymphography in the diagnosis of lymphoedema. Its accuracy has only been assessed in small studies and it is not known if it can identify patients with a proximal lymphatic obstruction who may be suitable for lymphatic bypass surgery.

Methods: Three hundred and ninety-five patients suspected to have lymphoedema were investigated by isotope lymphography between 1985 and 1995.

Comparison of positron emission tomography scanning and sentinel node biopsy in the detection of micrometastases of primary cutaneous malignant melanoma.

Purpose: Sentinel node biopsy (SNB) is a surgical technique for detecting micrometastatic disease in the regional draining nodes. 2-fluorine-18-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) scanning is an imaging technique that can detect clinically undetectable metastases. This prospective study was undertaken to compare the sensitivity of FDG-PET scanning with SNB in the detection of micromatastatic malignant melanoma.

Chromium-51 ethylenediamine tetraacetic acid glomerular filtration rate: a better predictor than glomerular filtration rate calculated by the Cockcroft-Gault formula for renal involvement in systemic lupus erythematosus patients.

Objective: To investigate whether the ethylenediamine tetraacetic acid (EDTA) glomerular filtration rate (GFR) is a better indicator of the degree of renal involvement than serum creatinine concentration or creatinine clearance calculated by the Cockroft-Gault formula.

Methods: We studied prospectively all systemic lupus erythematosus (SLE) patients with normal or borderline serum creatinine concentration (<110 micromol/l) and urinary sediment abnormalities and/or proteinuria in the last 2 yr. EDTA-GFR, serum creatinine concentration, calculated creatinine clearance (Cockroft-Gault formula) and 24-h urine protein were determined at the same time.

Time for abstention from caffeine before an adenosine myocardial perfusion scan.

Seventy patients undergoing adenosine myocardial perfusion scintigraphy were studied. All patients reported abstention from products containing caffeine in the 12 h prior to the test. Blood samples were drawn prior to initiation of the stress test, and serum caffeine levels were determined using high-performance liquid chromatography.

A one-hour walk-in service for wrist trauma imaging.

We investigated the feasibility of rapid imaging of wrist trauma following casualty presentation and any subsequent effect on image quality and interpretability. All patients referred for wrist imaging were injected with 370 MBq 99Tcm-hydroxymethyl diphosphonate (HDP) and imaged 1, 2 and 3 h later. Palmar images were acquired on a 256 x 256 x 16 matrix using a high-resolution collimator, 140 keV photopeak and a 20% window.