False positive PET in lymphoma

Size: px
Start display at page:

Download "False positive PET in lymphoma"

Transcription

1 False positive PET in lymphoma Thomas Krause

2 Introduction and conclusion 2

3 3

4 Introduction 4

5 FDG-PET in staging of lymphoma 34 studies with 2227 Patients CT FDG-PET Sensitivity 63 % 89 % (58%-100%) (63%-100%) Specificity 93 % 97 % (17%-97%) (69%-100%) Gambhir et al.; J Nucl Med. 2001: 42: 18S 5

6 6

7 Causes of false-positive interpretation Technical artifacts Physiological uptake patterns Non-malignant pathological conditions Post therapy 7

8 18F-FDG - embolism Chondrosarcoma post therapy 8

9 18F-FDG - contamination B.M. m; 65y; Colon Ca., hemicolectomy 11/2010 9

10 18F-FDG para vascular injection G.R. m; 72y; squamous cell cancer 10

11 Causes of false-positive interpretation Technical artifacts Physiological uptake patterns Non-malignant pathological conditions Post therapy 11

12 Metabolism (Glucose) Plasma Glucose Cell Hexokinase GLUT Glucose Glucose-6-Phosphate Phosphatase CO2 H2 O Hexokinase 18 FDG GLUT 18FDG Phosphatase 18FDG-6-Phosphate 12

13 18F-FDG normal distribution I A.L. m; 46y; papillary thyroid cancer 13

14 18F-FDG normal distribution II A.L. m; 46y; papillary thyroid cancer 14

15 18F-FDG normal distribution III A.L. m; 46y; papillary thyroid cancer 15

16 18F-FDG normal distribution IV A.L. m; 46y; papillary thyroid cancer 16

17 18F-FDG normal distribution V C.G. m; 53 y; supraglottic squamous cell cancer 17

18 Negative influence on FDG uptake ingestion glucose injection diabetes mellitus increased chance of a false positive physical stress interpretation activation of brown fat chemotherapy 18

19 Diabetes mellitus M.J. 40J, m, Diabetes mellitus Sarkoidose 19

20 Metastasis in Seminoma? 18F-FDG Projektion - PET Coronal 3879/03: M.S., m, cryptorchidism; hemi-orchiectomy 20

21 Hodgkin Lymphom 4759/05, B.D. m, 10y, HD ED 05/03, LN resection, chemotherapy (2 cycles) 21

22 Hodgkin Lymphom 5829/05,, B.D. m, 10y, HD ED 05/03, LN resection, after chemotherapy 22

23 Hodgkin Lymphoma /11G.V. f, 61y, HD IIA ED 02/11; activated bone marrow after chemotherapy / G-CSF 23

24 Causes of false-positive interpretation Technical artifacts Physiological uptake patterns Non-malignant pathological conditions Post therapy 24

25 Non-malignant diseases Sarcoidosis Infection Warthin s tumour Langerhans cell histiocytosis Fracture Osteoarthitis Vasculitis 25

26 Benign diseases with high FDG uptake Sarcoidosis Hodgkin s disease 26

27 NSCLC 2624/06, K.D. f, 50y, NSCLC IIIB restaging after chemotherapy; Paget disease of the sacrum 27

28 CUP Ascariasis 317/09, K.E., f, 69y, CUP, metastases of the liver? 28

29 Recent rip fracture m, 11y, HD IV 29

30 30

31 Maligne transformation Hexokinase Hexokinase 31

32 SUV Nodular lymphocytic predominace Clasical Hodgkin lymohoma Nodular sclerosis Mixed cellularity Not specified 32

33 SUV

34 FDG uptake and histology T-cell lymphoma Mantle cell lymphoma 34

35 Development of PET and PET/CT mm mm mm Transaxial resolution 35

36 Development of PET respectively PET/CT mm mm A.S. f; 25y, Ovarian cancer 36

37 What is a positive finding? Any distinquishable uptake?* Focal or diffuse uptake above background?** Uptake greater than blood pool? Liver?*** Hepatic or splenic lesions 1.5 cm or larger, if uptake is more than uptake in liver or spleen; or diffusely increased splenic uptake?** Any increased uptake in a mass smaller than 2 cm?** Clearly increased focal or multifocal bone involvement?** * Young H. et al: Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer. 1999;35:1773 **Juweid ME et al.: Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol. 2007;25:571 *** Wahl RL et al.: From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors. JNM 2009; 50: 122S 37

38 Causes of false-positive interpretation Technical artifacts Physiological uptake patterns Non-malignant pathological conditions Post therapy 38

39 FDG uptake after therapy What is the time course of uptake after therapy? How much uptake is normal? Are there typical differences depending on Histology? Therapy regimen? Tumor stage? 39

40 40

41 M. Hodgkin 641/06, Z.P., m, 11y, HD IV before therapy and after 3 cycles COPDIC

42 Mantle cell lymphoma 1167/06, K.A., m 61J, Mantle cell lymphoma before therapy and after 4 cycles' R-CHOP 42

43 Hodgkin disease , C.R., m, 42y, Hodgkin disease St. IIIA before, after 2 cycles and after completion of chemotherapy 43

44 Hodgkin disease , W.F., m, 32y, Hodgkin disease St. III before, after 2 cycles and after completion of chemotherapy 44

45 4 Endoxan 3.5 Tumour mouse model SUV 2 Viable Tumor Cells % 1.5 Mononuclear Infiltration % Day 0 Day 1 Day 3 Day 8 Day 10 Day 15 45

46 Timing of Restaging 2-3 weeks after chemotherapy or chemoimmunotherapy 8-12 weeks after radiation or chemoradiotherapy 4-8 weeks after surgery 46

47 What is a positive finding after therapy? Any distinquishable uptake?* Focal or diffuse uptake above background?** SUV > 1.5 x mean liver SUV + 2 SDs of mean SUV SUV > XY SUV Decrease < 25% (after 2 cycles)* * Young H. et al: Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer. 1999;35:1773 **Juweid ME et al.: Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol. 2007;25:571 47

48 48

49 Background Initial staging of a patient (74) with cervical cancer: PET-positive distant metastases 49

50 but considered negative in CT and MRI FDG PET-CT T1 fat sat with iv contrast CT 2mm slice thickness 50

51 Patient treated as planned: Follow-up PET-CT after chemotherapy and radiotherapy 51

52 PET guided Biopsy ARTORG CENTER BIOMEDICAL ENGINEERING RESEARCH 52

53 45-year-old woman with breast cancer > Suspicion of local recurrence CT: no morphological changes PET: Increased FDG uptake PET-guided biopsy of the hypermetabolic region Histology: Bone metastasis 53

54 Take home message Artifact must be detected by your nuclear medicine specialist. The physiological pattern of metabolism must be known. Correct patient preparation is mandatory. There is no false positive PET but wrong interpretation. Most inflammatory deceases show increased metabolism. Positive or negative interpretation depends on histology, therapy and anatomy. Patient s history is helpful to prevent misinterpretation. Histology? Inflammation? Therapy? Holistic image reading is essential. In a therapeutic setting a basic scan for comparison may be helpful. PET guided biopsy can help to avoid wrong interpretation. 54

55 55

PET/CT: Basic Principles, Applications in Oncology

PET/CT: Basic Principles, Applications in Oncology PET/CT: Basic Principles, Applications in Oncology Mabel Djang, HMS III Overview PET Basics and Limitations PET/CT - Advantages and Limitations Applications of PET/CT in oncology Summary 2 Principles of

More information

PET/CT in Lymphoma. Ur Metser, M.D. Division Head, Molecular Imaging Joint Department of Medical Imaging, UHN- MSH- WCH University of Toronto

PET/CT in Lymphoma. Ur Metser, M.D. Division Head, Molecular Imaging Joint Department of Medical Imaging, UHN- MSH- WCH University of Toronto PET/CT in Lymphoma Ur Metser, M.D. Division Head, Molecular Imaging Joint Department of Medical Imaging, UHN- MSH- WCH University of Toronto Outline 1. Introduction: PET/CT, how does it work? 2.Current

More information

Potential applications of PET/CT in MALT and PMLBC lymphoma Luca Ceriani, Gaetano Paone and Emanuele Zucca

Potential applications of PET/CT in MALT and PMLBC lymphoma Luca Ceriani, Gaetano Paone and Emanuele Zucca Potential applications of PET/CT in MALT and PMLBC lymphoma Luca Ceriani, Gaetano Paone and Emanuele Zucca Nuclear Medicine PET-CT Centre and Research Division Oncology Institute of Southern Switzerland

More information

The Need for Accurate Lung Cancer Staging

The Need for Accurate Lung Cancer Staging The Need for Accurate Lung Cancer Staging Peter Baik, DO Thoracic Surgery Cancer Treatment Centers of America Oklahoma Osteopathic Association 115th Annual Convention Financial Disclosures: None 2 Objectives

More information

Disease Response. Objectives

Disease Response. Objectives Disease Response Susan Barry, Clinical Trials Manager CALGB Statistical Center CRA Committee: New CRA Session 2010 Summer Group Meeting Objectives Review response criteria for solid tumor cancers, lymphomas,

More information

Fact Sheet: Molecular Imaging and Cancer

Fact Sheet: Molecular Imaging and Cancer Fact Sheet: Molecular Imaging and Cancer Cancer causes one in every four deaths in the United States, second only to heart disease. According to the American Cancer Society, an estimated 1.48 million new

More information

Comparison of Threshold-Based Segmentation Methods on Pre- and Post- Therapy PET Scans

Comparison of Threshold-Based Segmentation Methods on Pre- and Post- Therapy PET Scans M. Phillips, S.F. Barrington, D.L.G. Hill, P.K. Marsden 1 Comparison of Threshold-Based Segmentation Methods on Pre- and Post- Therapy PET Scans Michael Phillips 1 Michael.Phillips.1@city.ac.uk Sally F.

More information

Response Criteria for Malignant Lymphoma 2007. Cheson Criteria. Quick Reference Guide

Response Criteria for Malignant Lymphoma 2007. Cheson Criteria. Quick Reference Guide Response Criteria for Malignant Lymphoma 2007 Cheson Criteria Quick Reference Guide Table of Contents Summary of Assessments...3 Baseline Lesion Burden...4 What isameasurable Lesion?...5 Choosing Target

More information

PET. Can we afford PET-CT. Positron annihilation. PET-CT scanner. PET detection

PET. Can we afford PET-CT. Positron annihilation. PET-CT scanner. PET detection PET-CT Can we afford PET-CT John Buscombe New technology Combines functional information-pet anatomical information-ct Machine able to perform both studies in single imaging episode PET imaging depends

More information

PET/CT in Lung Cancer

PET/CT in Lung Cancer PET/CT in Lung Cancer Rodolfo Núñez Miller, M.D. Nuclear Medicine and Diagnostic Imaging Section Division of Human Health International Atomic Energy Agency Vienna, Austria GLOBOCAN 2012 #1 #3 FDG-PET/CT

More information

PET/CT Scan Clinical Indications Protocols for NHS Scotland

PET/CT Scan Clinical Indications Protocols for NHS Scotland PET/CT Scan Clinical Indications Protocols for NHS Scotland Contents Introduction Page 02 Colorectal cancer..page 03 Gynaecological cancer Page 04 Head and Neck...Page 05 Lung cancer Page 07 Lymphoma...Page

More information

Uso della PET nella valutazione della risposta

Uso della PET nella valutazione della risposta La diagnostica per immagini e la radioterapia: una cooperazione nel nostro futuro Uso della PET nella valutazione della risposta Cagliari, 21 giugno 2008 Arturo Chiti Medicina Nucleare, Istituto Clinico

More information

Part I: NCCN Practice Guidelines Tabular Summary (DD 3/20/13) PET and PET/CT

Part I: NCCN Practice Guidelines Tabular Summary (DD 3/20/13) PET and PET/CT Part I: NCCN Practice Guidelines Tabular Summary (DD 3/20/13) PET and NCCN guidelines were reviewed on 3/20/2013 for utilization of PET and (available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp).

More information

PET/CT Imaging in Lung Cancer

PET/CT Imaging in Lung Cancer PET/CT Imaging in Lung Cancer Mylene T. Truong, MD Mylene T. Truong M.D. Objectives To discuss the role of PET/CT in the staging of lung cancer To review the recommendations from American Society of Clinical

More information

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); as04@aub.edu.lb Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT

More information

Continuing Medical Education Article Imaging of Multiple Myeloma and Related Plasma Cell Dyscrasias JNM, July 2012, Volume 53, Number 7

Continuing Medical Education Article Imaging of Multiple Myeloma and Related Plasma Cell Dyscrasias JNM, July 2012, Volume 53, Number 7 Continuing Medical Education Article Imaging of Multiple Myeloma and Related Plasma Cell Dyscrasias JNM, July 2012, Volume 53, Number 7 Authors Ronald C. Walker 1,2, Tracy L. Brown 3, Laurie B. Jones-Jackson

More information

Interview with David Djang, MD On PET Scan in Oncology: Principles and Practice

Interview with David Djang, MD On PET Scan in Oncology: Principles and Practice Interview with David Djang, MD On PET Scan in Oncology: Principles and Practice By Howard (Jack) West, MD May, 2009 Hello and welcome to the GRACE audio podcast on PET scanning. This one is with Dr. David

More information

Pulmonary masses on PET/CT: Distinguishing benign from malignant

Pulmonary masses on PET/CT: Distinguishing benign from malignant Pulmonary masses on PET/CT: Distinguishing benign from malignant Poster No.: C-2063 Congress: ECR 2012 Type: Educational Exhibit Authors: J. James, S. higgins; Torquay/UK Keywords: Lung, Thorax, PET, CT,

More information

Aims and objectives. Methods and materials

Aims and objectives. Methods and materials Detection of early local recurrence of head and neck squamous cell carcinoma with diffusion weighted MRI and FDG PET/CT after radiotherapy: correlation between ADC and SUV values. Poster No.: C-1278 Congress:

More information

PET POSITIVE PLEURAL PLAQUES DECADES AFTER PLEURODESIS: MESOLTHELIOMA? Ellen A. Middleton 1. Jonathan C. Daniel 2. Kenneth S.

PET POSITIVE PLEURAL PLAQUES DECADES AFTER PLEURODESIS: MESOLTHELIOMA? Ellen A. Middleton 1. Jonathan C. Daniel 2. Kenneth S. PET POSITIVE PLEURAL PLAQUES DECADES AFTER PLEURODESIS: MESOLTHELIOMA? Ellen A. Middleton 1 Jonathan C. Daniel 2 Kenneth S. Knox 1 Kathleen Williams 1 Departments of Medicine 1 and Surgery 2, University

More information

Nuclear Medicine Subgroup. Faculty of Radiologists. Royal College of Surgeons in Ireland INDICATIONS FOR PET/CT IMAGING

Nuclear Medicine Subgroup. Faculty of Radiologists. Royal College of Surgeons in Ireland INDICATIONS FOR PET/CT IMAGING Nuclear Medicine Subgroup Faculty of Radiologists Royal College of Surgeons in Ireland INDICATIONS FOR PET/CT IMAGING Report November 2010 Indications for PET/CT Imaging Bladder Carcinoma Staging for nodal

More information

PET/CT in Breast Cancer

PET/CT in Breast Cancer PET/CT in Breast Cancer Rodolfo Núñez Miller, M.D. Nuclear Medicine and Diagnostic Imaging Section Division of Human Health International Atomic Energy Agency Vienna, Austria Overview Introduction Locorregional

More information

Whole Body MRI in Oncology: Neuroblastoma and Lymphoma. Whole Body MRI in Oncology. WB-MRI Techniques. Without a Moving Tabletop

Whole Body MRI in Oncology: Neuroblastoma and Lymphoma. Whole Body MRI in Oncology. WB-MRI Techniques. Without a Moving Tabletop Whole Body MRI in Oncology: Neuroblastoma and Lymphoma Marilyn J. Siegel, M.D. Mallinckrodt Institute of Radiology Washington University Medical Center St. Louis, MO Whole Body MRI in Oncology Describe

More information

Case Report: Whole-body Oncologic Imaging with syngo TimCT

Case Report: Whole-body Oncologic Imaging with syngo TimCT Case Report: Whole-body Oncologic Imaging with syngo TimCT Eric Hatfield, M.D. 1 ; Agus Priatna, Ph.D. 2 ; John Kotyk, Ph.D. 1 ; Benjamin Tan, M.D. 1 ; Alto Stemmer 3 ; Stephan Kannengiesser, Ph.D. 3 ;

More information

Does PET Scan change NSCLC management

Does PET Scan change NSCLC management Does PET Scan change NSCLC management V. Ninane, Bordet and Saint-Pierre Hospitals, Brussels, Belgium 1 Positron emission tomography imaging of structures based on the fact that they concentrate specific

More information

Metastatic Cancer: Questions and Answers. Key Points

Metastatic Cancer: Questions and Answers. Key Points CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Metastatic Cancer: Questions

More information

Non-Hodgkin s Lymphomas Version

Non-Hodgkin s Lymphomas Version NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Non-Hodgkin s Lymphomas Version 2.2015 NCCN.org Continue Lugano Response Criteria for Non-Hodgkin's Lymphoma PET should be done with contrast-enhanced

More information

Thoracic 18F-FDG PETCT

Thoracic 18F-FDG PETCT Thoracic 18F-FDG PETCT RAD Magazine, 41, 482, 13-16 Dr Allanah arker Specialist registrar radiology Dr Nagmi Qureshi Consultant cardiothoracic radiologist Papworth Hospital, Cambridge email: allanahbarker@nhs.net

More information

Recommendations for cross-sectional imaging in cancer management, Second edition

Recommendations for cross-sectional imaging in cancer management, Second edition www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Breast cancer Faculty of Clinical Radiology www.rcr.ac.uk Contents Breast cancer 2 Clinical background 2 Who

More information

Elements of PET/CT Reporting

Elements of PET/CT Reporting Elements of PET/CT Reporting 1. Clinical History a. Indication i. tumor type ii. abnormality to be evaluated iii. specific clinical question b. Relevent history i. biopsy results ii. chemotherapy iii.

More information

Crosswalk for Positron Emission Tomography (PET) Imaging Codes G0230 G0030, G0032, G0034, G0036, G0038, G0040, G0042, G0044, G0046

Crosswalk for Positron Emission Tomography (PET) Imaging Codes G0230 G0030, G0032, G0034, G0036, G0038, G0040, G0042, G0044, G0046 Positron Emission Tomography (PET) CPT to HCPCS Level Crosswalk Changes below from CMS Change Request 3741 Transmittals 518 & 31 published on April 1, 2005; mplementation of CPT codes are effective January

More information

Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical

Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical Summary. 111 Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical recurrence (BCR) is the first sign of recurrent

More information

Molecular Imaging and Prostate Cancer

Molecular Imaging and Prostate Cancer Molecular Imaging and Prostate Cancer Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. Based on rates from 2004 2006, the National Cancer Institute

More information

Treating Thyroid Cancer using I-131 Maximum Tolerable Dose Method

Treating Thyroid Cancer using I-131 Maximum Tolerable Dose Method Treating Thyroid Cancer using I-131 Maximum Tolerable Dose Method Christopher Martel, M.Sc., CHP Lisa Thornhill,, NRRPT, RT(NM) Boston University Medical Center Thyroid Carcinoma New cases and deaths in

More information

Oncology. Objectives. Cancer Nomenclature. Cancer is a disease of the cell Cancer develops when certain cells begin to grow out of control

Oncology. Objectives. Cancer Nomenclature. Cancer is a disease of the cell Cancer develops when certain cells begin to grow out of control Oncology Objectives Describe the etiology and pathophysiological mechanisms of cancer Discuss medical and family history findings relevant to cancer Identify general signs and symptoms associated with

More information

Malignant Pleural Diseases Advances Clinicians Should Know F Gleeson

Malignant Pleural Diseases Advances Clinicians Should Know F Gleeson Malignant Pleural Diseases Advances Clinicians Should Know F Gleeson The following relevant disclosures, conflicts of interest and/ or financial relationships exist related to this presentation: Consultant

More information

Whole-Body MRI for Accurate Assessment of Tumor Load of Bone Metastases Originate from Mamma Carcinoma

Whole-Body MRI for Accurate Assessment of Tumor Load of Bone Metastases Originate from Mamma Carcinoma Clinical Women s Health Whole-Body MRI for Accurate Assessment of Tumor Load of Bone Metastases Originate from Mamma Carcinoma Philip Aschoff; Christina Pfannenberg; Claus Claussen; Heinz-Peter Schlemmer

More information

Practice Guidelines in Oncology. A summary of the recommendations and practice guidelines of professional groups. April 2013 EXECUTIVE SUMMARY

Practice Guidelines in Oncology. A summary of the recommendations and practice guidelines of professional groups. April 2013 EXECUTIVE SUMMARY 18 F-fluorodeoxyglucose (FDG) PET and PET/CT Practice Guidelines in Oncology A summary of the recommendations and practice guidelines of professional groups April 2013 The recommendations and practice

More information

MYOCARDIAL PET/CT SCAN (FDG tracer)

MYOCARDIAL PET/CT SCAN (FDG tracer) MYOCARDIAL PET/CT SCAN (FDG tracer) Contact information and registration: Meilahti Hospital, Department of Nuclear Medicine Tower Hospital, Haartmaninkatu 4, 00290 Helsinki tel. 09-471 72554 Appointment

More information

King s College London & Guy s and St Thomas PET Centre. A Guide for Clinicians

King s College London & Guy s and St Thomas PET Centre. A Guide for Clinicians King s College London & Guy s and St Thomas PET Centre A Guide for Clinicians PET-CT PET-MR Contents 1 Effective patient management 2 The benefits of PET-CT and PET-MR technology 7 How PET-CT and PET-MR

More information

FDG-PET scanning in extranodal marginal zone mucosaassociated lympoid tissue (MALT) lymphoma.

FDG-PET scanning in extranodal marginal zone mucosaassociated lympoid tissue (MALT) lymphoma. FDG-PET scanning in extranodal marginal zone mucosaassociated lympoid tissue (MALT) lymphoma. Poster No.: C-3424 Congress: ECR 2010 Type: Scientific Exhibit Topic: Molecular Imaging Authors: K. HAYASAKA

More information

HERC Coverage Guidance Advanced Imaging for Staging of Prostate Cancer Disposition of Public Comments

HERC Coverage Guidance Advanced Imaging for Staging of Prostate Cancer Disposition of Public Comments Table of Contents Commenters... 1 Public Comments... 2 References Provided by Commenters... 6 Commenters Identification Stakeholder A Medical Imaging & Technology Alliance (MITA), Arlington, VA [Submitted

More information

How to measure effect of treatment? chest radiography CT scan MRI scan PET scan ultrasound physical examination bone scintygraphy

How to measure effect of treatment? chest radiography CT scan MRI scan PET scan ultrasound physical examination bone scintygraphy respons meting Bonne Biesma Franz Schramel Terschelling 2012 How to measure effect of treatment chest radiography CT scan MRI scan PET scan ultrasound physical examination bone scintygraphy guidelines

More information

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background Imaging of Pleural Tumors Mylene T. Truong, MD Imaging of Pleural Tumours Mylene T. Truong, M. D. University of Texas M.D. Anderson Cancer Center, Houston, TX Objectives To review tumors involving the

More information

BEYOND 18 F-FDG: INTRODUCTION TO NEW RADIOPHARMACEUTICALS

BEYOND 18 F-FDG: INTRODUCTION TO NEW RADIOPHARMACEUTICALS BEYOND F-FDG: INTRODUCTION TO NEW RADIOPHARMACEUTICALS Asti Mattia Nuclear Medicine Department Santa Maria Nuova Hospital, Reggio Emilia, Italy SUMMARY: F-Labelled Choline analogues. Comparison between

More information

mid 80 s 2000 Nuclear Medicine in Oncology By tumor types Neuroendocrine tumors The changing focus of PET Indications: FDG PET

mid 80 s 2000 Nuclear Medicine in Oncology By tumor types Neuroendocrine tumors The changing focus of PET Indications: FDG PET Radiopharmaceuticals Nuclear Medicine in Oncology Practice Pharmaceutical Radionuclide Function Tumor type Diphosphonates Tc-99m Osteoblast Bone tumor & metast. Ga-citrate Ga-67 Fe-analogue Bronchogenous

More information

Lymphoma. Measurability of Quality Performance Indicators Version 2.0

Lymphoma. Measurability of Quality Performance Indicators Version 2.0 Lymphoma Measurability of Quality Performance Indicators Version 2.0 To be read in conjunction with: Lymphoma Clinical Quality Performance Indicators (September 2013) Lymphoma Data Definitions V2.0 (September

More information

4/15/2013. bi/o carcin/ chem/o immun/o onc/o radi/o sarc/o. anabrachydysectoendoneo- -ectomy -genesis -oma -plasia -sarcoma

4/15/2013. bi/o carcin/ chem/o immun/o onc/o radi/o sarc/o. anabrachydysectoendoneo- -ectomy -genesis -oma -plasia -sarcoma Chapter Sixteen Oncology bi/o carcin/ chem/o immun/o onc/o radi/o sarc/o Combining Forms Prefixes and Suffixes Carcinogenesis anabrachydysectoendoneo- -ectomy -genesis -oma -plasia -sarcoma Causes of cancer

More information

Part II: NCCN Practice Guidelines Narrative Summary PET and PET/CT

Part II: NCCN Practice Guidelines Narrative Summary PET and PET/CT Part II: NCCN Practice Guidelines Narrative Summary PET and PET/CT NCCN guidelines were reviewed on 3/25/2013 for utilization of 18 F-fluorodeoxyglucose (FDG) PET and PET/CT (available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp).

More information

Chirurgie des métastases cérébrales. Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals

Chirurgie des métastases cérébrales. Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals Chirurgie des métastases cérébrales Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals The Westmead patient population THE INCONVENIENT TRUTHS Cerebral metastases occur in 10 16 % of

More information

Leukemias and Lymphomas: A primer

Leukemias and Lymphomas: A primer Leukemias and Lymphomas: A primer Normal blood contains circulating white blood cells, red blood cells and platelets 700 red cells (oxygen) 1 white cell Neutrophils (60%) bacterial infection Lymphocytes

More information

Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases.

Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases. Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases. Abstract This paper describes the staging, imaging, treatment, and prognosis of renal cell carcinoma. Three case studies

More information

TNM Staging Fact Sheet

TNM Staging Fact Sheet TNM Staging Fact Sheet Jan 2010 This document provides answers to some of the frequently asked questions posed by physicians, health information management professionals, and cancer program administrators,

More information

When a patient presents with cancer, the oncologist has

When a patient presents with cancer, the oncologist has CONTINUING EDUCATION F-FDG PET and PET/CT in the Evaluation of Cancer Treatment Response* Simona Ben-Haim and Peter Ell Institute of Nuclear Medicine University College London, London, United Kingdom Multimodality

More information

Health Technology Board for Scotland

Health Technology Board for Scotland Health Technology Board for Scotland Health Technology Assessment Advice 2: Positron emission tomography (PET) in cancer management Summary of recommendations It is recommended that a PET imaging facility

More information

Locoregional recurrence or persistence of papillary carcinoma: radioiodine treatment

Locoregional recurrence or persistence of papillary carcinoma: radioiodine treatment Locoregional recurrence or persistence of papillary carcinoma: radioiodine treatment Michele Klain, Marco Salvatore Department of Functional and Biomorphological Science University of Naples "Federico

More information

IAEA HumAn HEAltH SErIES

IAEA HumAn HEAltH SErIES IAEA HumAn HEAltH SErIES no. 9 Appropriate Use of FDG-PET for the Management of Cancer Patients IAEA HUMAN HEALTH SERIES PUBLICATIONS The mandate of the IAEA human health programme originates from Article

More information

Hodgkin s Lymphoma (HL)

Hodgkin s Lymphoma (HL) Hodgkin s Lymphoma (HL) Hematology Practice Guideline Dr. Joy Mangel, MD, FRCPC (Hematology Consultant) Approval Date: February 2008 This guideline is a statement of consensus of the Hematology Disease

More information

Multiple Myeloma. Abstract. Introduction

Multiple Myeloma. Abstract. Introduction Multiple Myeloma Abstract Multiple Myeloma is a plasma cell cancer that causes an overproduction of plasma cells. Multiple Myeloma is a difficult disease to diagnosis because symptoms might not be present

More information

Diagnostic Slide Session Case Jennifer Ziskin MD, PhD, and Edward D Plowey MD, PhD Stanford University, Stanford, CA

Diagnostic Slide Session Case Jennifer Ziskin MD, PhD, and Edward D Plowey MD, PhD Stanford University, Stanford, CA Diagnostic Slide Session Case 2015-2 Jennifer Ziskin MD, PhD, and Edward D Plowey MD, PhD Stanford University, Stanford, CA Clinical History: 18 year old woman with right facial pain and hyperalgesia Past

More information

PET after the administration of 18 F-FDG is widely used

PET after the administration of 18 F-FDG is widely used Do Hyperglycemia and Diabetes Affect the Incidence of False-Negative F-FDG PET/CT Studies in Patients Evaluated for Infection or Inflammation and Cancer? A Comparative Analysis Zoya Rabkin 1, Ora Israel

More information

Extrahepatic bile duct cancer is a rare disease in which malignant (cancer) cells form in the part of bile duct that is outside the liver.

Extrahepatic bile duct cancer is a rare disease in which malignant (cancer) cells form in the part of bile duct that is outside the liver. EXTRAHEPATIC BILE DUCT CANCER General Information Extrahepatic bile duct cancer is a rare disease in which malignant (cancer) cells form in the part of bile duct that is outside the liver. A network of

More information

Pre-HCT Treatment for Hodgkin s / Non-Hodgkin s Lymphoma

Pre-HCT Treatment for Hodgkin s / Non-Hodgkin s Lymphoma Pre-HCT Treatment for Hodgkin s / Non-Hodgkin s Lymphoma This appendix is intended to provide additional information on: Common pre-hct treatments for lymphoma, Lines of therapy, Cycles, and How to report

More information

FDG-PET/CT in Head & Neck Cancer

FDG-PET/CT in Head & Neck Cancer FDG-PET/CT in Head & Neck Cancer IAEA PET/CT Workshop: Improving Patient Care Midrand, November 2010 Ora Israel, MD Department of Nuclear Medicine Rambam Health Care Campus Haifa, Israel Head & Neck Malignancies

More information

The Medical Imaging Detective

The Medical Imaging Detective Solving Medical Mysteries with Imaging Richard S. Breiman, M.D. Professor of Radiology and Biomedical Imaging (Medical Imaging Detective) UCSF The Medical Imaging Detective Peering into the Patient to

More information

The Di Bella Method (DBM) improves Survival, Objective Response and Performance Status in Breast Cancer

The Di Bella Method (DBM) improves Survival, Objective Response and Performance Status in Breast Cancer BIT's 4th World Cancer Congress 2011 People s Republic of China Dalian The Di Bella Method (DBM) improves Survival, Objective Response and Performance Status in treated with DBM therapy Retrospective observational

More information

Hodgkin Lymphoma Disease Specific Biology and Treatment Options. John Kuruvilla

Hodgkin Lymphoma Disease Specific Biology and Treatment Options. John Kuruvilla Hodgkin Lymphoma Disease Specific Biology and Treatment Options John Kuruvilla My Disclaimer This is where I work Objectives Pathobiology what makes HL different Diagnosis Staging Treatment Philosophy

More information

(Osteosarcoma; Chondrosarcoma; Ewing s Sarcoma; Fibrosarcoma; Malignant Fibrous Histiocytoma; Primary Lymphoma of Bone; Giant Cell Tumor; Chordoma)

(Osteosarcoma; Chondrosarcoma; Ewing s Sarcoma; Fibrosarcoma; Malignant Fibrous Histiocytoma; Primary Lymphoma of Bone; Giant Cell Tumor; Chordoma) Bone Cancer (Osteosarcoma; Chondrosarcoma; Ewing s Sarcoma; Fibrosarcoma; Malignant Fibrous Histiocytoma; Primary Lymphoma of Bone; Giant Cell Tumor; Chordoma) by Krisha McCoy, MS En Español (Spanish Version)

More information

RESEARCH EDUCATE ADVOCATE. Just Diagnosed with Melanoma Now What?

RESEARCH EDUCATE ADVOCATE. Just Diagnosed with Melanoma Now What? RESEARCH EDUCATE ADVOCATE Just Diagnosed with Melanoma Now What? INTRODUCTION If you are reading this, you have undergone a biopsy (either of a skin lesion or a lymph node) or have had other tests in which

More information

Report series: General cancer information

Report series: General cancer information Fighting cancer with information Report series: General cancer information Eastern Cancer Registration and Information Centre ECRIC report series: General cancer information Cancer is a general term for

More information

The Spleen in Sarcoidosis

The Spleen in Sarcoidosis CHAPTER 11 The Spleen in Sarcoidosis SPLENIC ENLARGEMENT The true incidence of splenic enlargement in sarcoidosis is not known. Asymptomatic, mild enlargement of the spleen is common and requires no treatment.

More information

Liver Cancer What is the liver? What is liver cancer?

Liver Cancer What is the liver? What is liver cancer? Liver Cancer What is the liver? The liver is the largest internal organ in the body and is important in digesting food. The liver performs many other functions, including collecting and filtering blood

More information

Lung Cancer: Practical Application of Imaging In Determining Resectability. Jeremy J. Erasmus, M. D.

Lung Cancer: Practical Application of Imaging In Determining Resectability. Jeremy J. Erasmus, M. D. Lung Cancer: Practical Application of Imaging In Determining Resectability Jeremy J. Erasmus, M. D. 62 year old man with a superior sulcus tumor. Which of the following precludes surgical resection in

More information

Sources and resources for oncologists to help answer the question: Is PET/CT appropriate for my patient?

Sources and resources for oncologists to help answer the question: Is PET/CT appropriate for my patient? Sources and resources for oncologists to help answer the question: Is PET/CT appropriate for my patient? Dimitrios Karantanis MD, PhD, Martin Allen-Auerbach MD, Johannes Czernin MD Department of Molecular

More information

Critical Care, Theatre & Diagnostics Introducing the PET-CT service at Denmark Hill

Critical Care, Theatre & Diagnostics Introducing the PET-CT service at Denmark Hill Critical Care, Theatre & Diagnostics Introducing the PET-CT service at Denmark Hill Information for referrers and healthcare professionals 1 Why choose King s College Hospital (KCH) department of Nuclear

More information

Introduction Cost-effectiveness Protocols Codes & Fees

Introduction Cost-effectiveness Protocols Codes & Fees Introduction Cost-effectiveness Protocols Codes & Fees Structural imaging Radiology General Xray CT Ultrasound Magnetic Resonance Imaging Metabolic Imaging Nuclear Medicine Planar scintigraphy SPECT PET

More information

MALIGNANT LYMPHOMAS. Dr. Olga Vujovic (Updated August 2010)

MALIGNANT LYMPHOMAS. Dr. Olga Vujovic (Updated August 2010) MALIGNANT LYMPHOMAS Dr. Olga Vujovic (Updated August 2010) Malignant lymphomas consist of Hodgkin and non-hodgkin lymphomas. The current management of these diseases involves a multi-disciplinary approach.

More information

Management of Non-Small Cell Lung Cancer Guide for General Practitioners

Management of Non-Small Cell Lung Cancer Guide for General Practitioners Management of n-small Cell Lung Cancer Guide for General Practitioners Clinical Stage I Cancer only in one lobe of lung and

More information

Malignant Lymphomas and Plasma Cell Myeloma

Malignant Lymphomas and Plasma Cell Myeloma Malignant Lymphomas and Plasma Cell Myeloma Dr. Bruce F. Burns Dept. of Pathology and Lab Medicine Overview definitions - lymphoma lymphoproliferative disorder plasma cell myeloma pathogenesis - translocations

More information

Liver Cancer And Tumours

Liver Cancer And Tumours Liver Cancer And Tumours What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood from all parts of the body, cancer cells from elsewhere can

More information

Aggressive lymphomas. Michael Crump Princess Margaret Hospital

Aggressive lymphomas. Michael Crump Princess Margaret Hospital Aggressive lymphomas Michael Crump Princess Margaret Hospital What are the aggressive lymphomas? Diffuse large B cell Mediastinal large B cell Anaplastic large cell Burkitt lymphoma (transformed lymphoma:

More information

FieldStrength. Asan Medical Center proves the power of pediatric whole body MRI

FieldStrength. Asan Medical Center proves the power of pediatric whole body MRI FieldStrength Publication for the Philips MRI Community Issue 38 Summer 2009 Asan Medical Center proves the power of pediatric whole body MRI New approaches for pediatric whole body MRI help visualize

More information

Skin cancer Patient information

Skin cancer Patient information Skin cancer Patient information What is cancer? The human body is made up of billions of cells. In healthy people, cells grow, divide and die. New cells constantly replace old ones in an orderly way. This

More information

TAMPERE UNIVERSITY OF TECHNOLOGY

TAMPERE UNIVERSITY OF TECHNOLOGY TAMPERE UNIVERSITY OF TECHNOLOGY ABHISEK DEV BHATTARAI SIDE-EFFECT OF CHEMOTHERAPY ON LIVER IN LYMPHOMA PATIENTS STUDIED BY STANDARD UPTAKE VALUE Master s Thesis Examiner: Professor Hannu Eskola Examiner

More information

PSMA imaging of high risk and recurrent disease. Robert E. Reiter MD MBA Bing Professor of Urologic Research Geffen School of Medicine at UCLA

PSMA imaging of high risk and recurrent disease. Robert E. Reiter MD MBA Bing Professor of Urologic Research Geffen School of Medicine at UCLA PSMA imaging of high risk and recurrent disease Robert E. Reiter MD MBA Bing Professor of Urologic Research Geffen School of Medicine at UCLA Imaging in Prostate Cancer By Clinical Stage Visualize disease

More information

How CanCer becomes critical in the claims

How CanCer becomes critical in the claims How CanCer becomes critical in the claims arena Cancer is a disease in which cells in your body grow in an uncontrolled way and form a lump called a tumour. In a healthy individual cells grow and reproduce

More information

A Practical Guide to Advances in Staging and Treatment of NSCLC

A Practical Guide to Advances in Staging and Treatment of NSCLC A Practical Guide to Advances in Staging and Treatment of NSCLC Robert J. Korst, M.D. Director, Thoracic Surgery Medical Director, The Blumenthal Cancer Center The Valley Hospital Objectives Revised staging

More information

H ODGKIN AND NON-HODGKIN LYMPHOMA STAGING FORM

H ODGKIN AND NON-HODGKIN LYMPHOMA STAGING FORM CLINICAL Extent of disease before any treatment y clinical staging completed after neoadjuvant therapy but before subsequent surgery PRIMARY TUMOR (T) No T category exists for Hodgkin and Non-Hodgkin Lymphoma

More information

.org. Metastatic Bone Disease. Description

.org. Metastatic Bone Disease. Description Metastatic Bone Disease Page ( 1 ) Cancer that begins in an organ, such as the lungs, breast, or prostate, and then spreads to bone is called metastatic bone disease (MBD). More than 1.2 million new cancer

More information

Radiotherapy in locally advanced & metastatic NSC lung cancer

Radiotherapy in locally advanced & metastatic NSC lung cancer Radiotherapy in locally advanced & metastatic NSC lung cancer Dr Raj Hegde. MD. FRANZCR Consultant Radiation Oncologist. William Buckland Radiotherapy Centre. Latrobe Regional Hospital. Locally advanced

More information

Recommendations for cross-sectional imaging in cancer management, Second edition

Recommendations for cross-sectional imaging in cancer management, Second edition www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Testicular cancer Faculty of Clinical Radiology www.rcr.ac.uk Contents Testicular cancer 3 Clinical background

More information

Thyroid Cancer. This reference summary will help you better understand what thyroid cancer is and what treatment options are available.

Thyroid Cancer. This reference summary will help you better understand what thyroid cancer is and what treatment options are available. Thyroid Cancer Introduction The thyroid is a gland in the neck. Thyroid cancer is a common type of cancer. It accounts for 1% to 5% of cancer cases worldwide. As medical technology advances, more cases

More information

Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate e P rofessor Professor Radiation Oncology

Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate e P rofessor Professor Radiation Oncology Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate Professor Radiation Oncology Disclosure Information I have no financial relationships to disclose relevant to the conten of this presentation.

More information

NOTTINGHAM UNIVERSITY NHS TRUST BREAST INSTITUTE GUIDELINE NEOADJUVANT CHEMOTHERAPY (NACT) FOR BREAST CANCER

NOTTINGHAM UNIVERSITY NHS TRUST BREAST INSTITUTE GUIDELINE NEOADJUVANT CHEMOTHERAPY (NACT) FOR BREAST CANCER NOTTINGHAM UNIVERSITY NHS TRUST BREAST INSTITUTE GUIDELINE NEOADJUVANT CHEMOTHERAPY (NACT) FOR BREAST CANCER Definitions: NACT is recommended initial treatment for inflammatory breast cancer and inoperable

More information

New Evaluation Criteria for Response and Toxicity in Lung Cancer Treatment

New Evaluation Criteria for Response and Toxicity in Lung Cancer Treatment Lung Cancer New Evaluation Criteria for Response and Toxicity in Lung Cancer Treatment JMAJ 46(12): 554 558, 2003 Masahiko SHIBUYA Chief, Division of Respiratory Medicine, Tokyo Metropolitan Komagome Hospital

More information

MRI of Bone Marrow Radiologic-Pathologic Correlation

MRI of Bone Marrow Radiologic-Pathologic Correlation MRI of Bone Marrow Radiologic-Pathologic Correlation Marilyn J. Siegel, M.D. Mallinckrodt Institute of Radiology Washington University School of Medicine St. Louis, MO and Visiting Scientist, AFIP, Washington,

More information

THYROID CANCER. I. Introduction

THYROID CANCER. I. Introduction THYROID CANCER I. Introduction There are over 11,000 new cases of thyroid cancer each year in the US. Females are more likely to have thyroid cancer than men by a ratio of 3:1, and it is more common in

More information

PET and PET/CT in Clinical Trials

PET and PET/CT in Clinical Trials PET and PET/CT in Clinical Trials Nathan C. Hall, M.D., Ph.D. The Ohio State University Medical Center CALGB Imaging Core Lab CALGB Imaging Committee Outline Introduction to PET Positron Emitter Physics

More information

LIVER CANCER AND TUMOURS

LIVER CANCER AND TUMOURS LIVER CANCER AND TUMOURS LIVER CANCER AND TUMOURS Healthy Liver Cirrhotic Liver Tumour What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood

More information