Recently, remarkable progress in cardiac imaging with FDG PET and MRI has been made. FDG PET dete... more Recently, remarkable progress in cardiac imaging with FDG PET and MRI has been made. FDG PET detects active inflammatory lesions in cardiac sarcoidosis (CS) as hot spots with a better sensitivity than 67Ga scintigraphy. The new guidelines for diagnosis and treatment of CS were published by the Heart Rhythm Society in 2014, and more recently revised by the Japanese Circulation Society in 2017. In the past few years, many studies have demonstrated the diagnostic utility of FDG PET in patients with CS; therefore, abnormally high FDG accumulation in the heart was adopted as the major criteria for cardiac involvement of sarcoidosis. At present, FDG PET/CT is considered mandatory in the clinical diagnosis group of the updated guidelines.
INTRODUCTION AND OBJECTIVES: Fluorodeoxygulcose positron emission tomography/computed tomography ... more INTRODUCTION AND OBJECTIVES: Fluorodeoxygulcose positron emission tomography/computed tomography (FDG-PET/CT) is becoming useful for diagnosis, staging and prognosis in many cancers. In contrary, the use in urological oncology has been slower to develop because the radiotracer is excreted into the urine. Then, to assess the ability of preoperative FDG-PET/CT to detect upper urinary tract cancers (UUTC), compared with pathological examinations of tissues obtained by ureteroscopic biopsy or split cytologic analysis of urines obtained following retrograde pyelography. METHODS: Clinicopathological records of patients who were examined by FDG-PET/CT were retrospectively reviewed. Sixty-four patients (66 lesions) with clinically suspected UUTC, who were diagnosed by ureteroscopy or nephroureterectomy or partial ureterectomy at our institution from September 2010 to September 2014, were included. The patient cohort consisted of 51 men and 13 women, with a median age of 73 (range 54e92) years. RESULTS: 66 lesions were histologically diagnosed as 59 urothelial carcinomas and 1 clear cell carcinoma and 6 benign lesions. Only 22% of 58 lesions with UUTC had positive voided urine cytology and 45% of 47 lesions had positive split urine cytology. In addition, only 53 % of 15 lesions with UUTC had positive endoscopic biopsy. However, 83% of 60 lesions with UUTC had positive FDG-PET/CT examination. The positive predictive value was 93%. The sensitivities of <pT2 and pT2 were 82% and 83%, respectively, and the sensitivities of G1, G2, and G3 tumors were 100%, 86%, and 82%, respectively. There were no correlations between the sensitivity in FDG-PET/CT and tumor stage or tumor grade. Mean SUVmax was 3.0 and 10.0 in benign lesions and UUTC, respectively. The difference was statistically significant (p1⁄40.027). The ROC analysis showed that a SUVmax cut-off value to discriminate UUTC was 5.6. The sensitivity and the specificity were 76% and 80%, respectively. An area under the curve was 0.800 (Fig). CONCLUSIONS: FDG-PET/CT was effective to detect UUTC. Furthermore, SUVmax had a role of supplementary index. FDG-PET/ CT may be able to replace of endoscopic biopsy depending on the patients. Source of Funding: none
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1997
We examined whether 201Tl myocardial scintigraphy with intravenous infusion of adenosine triphosp... more We examined whether 201Tl myocardial scintigraphy with intravenous infusion of adenosine triphosphate (ATP) can be substituted for dipyridamole (DIP) in the diagnosis of coronary artery disease CAD). The coronary flow reserve (CFR) during intravenous infusion of ATP (0.10-0.20 mg/kg/min) was compared with that during intravenous infusion of DIP (0.56 mg/kg) using a Doppler flow wire in 19 subjects with normal coronary arteries. The highest CFR level was found in the ATP dose range of 0.16-0.20 mg/kg/min. The CFR at the ATP dose of 0.16 mg/kg/min was significantly higher than that during DIP infusion (4.2 versus 3.6) (p < 0.01), for which reason we adopted this dose of ATP. According, 201Tl SPECT in 140 patients with suspected CAD was performed after infusion of 0.16 mg/kg/min of ATP in 70 of them and 0.56 mg/kg of DIP in the 70 others. ATP stress 201Tl SPECT showed no significant difference in sensitivity and accuracy from DIP stress 201Tl SPECT (87.0% versus 82.9, and 87.1% vers...
Recently, remarkable progress in cardiac imaging with FDG PET and MRI has been made. FDG PET dete... more Recently, remarkable progress in cardiac imaging with FDG PET and MRI has been made. FDG PET detects active inflammatory lesions in cardiac sarcoidosis (CS) as hot spots with a better sensitivity than 67Ga scintigraphy. The new guidelines for diagnosis and treatment of CS were published by the Heart Rhythm Society in 2014, and more recently revised by the Japanese Circulation Society in 2017. In the past few years, many studies have demonstrated the diagnostic utility of FDG PET in patients with CS; therefore, abnormally high FDG accumulation in the heart was adopted as the major criteria for cardiac involvement of sarcoidosis. At present, FDG PET/CT is considered mandatory in the clinical diagnosis group of the updated guidelines.
INTRODUCTION AND OBJECTIVES: Fluorodeoxygulcose positron emission tomography/computed tomography ... more INTRODUCTION AND OBJECTIVES: Fluorodeoxygulcose positron emission tomography/computed tomography (FDG-PET/CT) is becoming useful for diagnosis, staging and prognosis in many cancers. In contrary, the use in urological oncology has been slower to develop because the radiotracer is excreted into the urine. Then, to assess the ability of preoperative FDG-PET/CT to detect upper urinary tract cancers (UUTC), compared with pathological examinations of tissues obtained by ureteroscopic biopsy or split cytologic analysis of urines obtained following retrograde pyelography. METHODS: Clinicopathological records of patients who were examined by FDG-PET/CT were retrospectively reviewed. Sixty-four patients (66 lesions) with clinically suspected UUTC, who were diagnosed by ureteroscopy or nephroureterectomy or partial ureterectomy at our institution from September 2010 to September 2014, were included. The patient cohort consisted of 51 men and 13 women, with a median age of 73 (range 54e92) years. RESULTS: 66 lesions were histologically diagnosed as 59 urothelial carcinomas and 1 clear cell carcinoma and 6 benign lesions. Only 22% of 58 lesions with UUTC had positive voided urine cytology and 45% of 47 lesions had positive split urine cytology. In addition, only 53 % of 15 lesions with UUTC had positive endoscopic biopsy. However, 83% of 60 lesions with UUTC had positive FDG-PET/CT examination. The positive predictive value was 93%. The sensitivities of <pT2 and pT2 were 82% and 83%, respectively, and the sensitivities of G1, G2, and G3 tumors were 100%, 86%, and 82%, respectively. There were no correlations between the sensitivity in FDG-PET/CT and tumor stage or tumor grade. Mean SUVmax was 3.0 and 10.0 in benign lesions and UUTC, respectively. The difference was statistically significant (p1⁄40.027). The ROC analysis showed that a SUVmax cut-off value to discriminate UUTC was 5.6. The sensitivity and the specificity were 76% and 80%, respectively. An area under the curve was 0.800 (Fig). CONCLUSIONS: FDG-PET/CT was effective to detect UUTC. Furthermore, SUVmax had a role of supplementary index. FDG-PET/ CT may be able to replace of endoscopic biopsy depending on the patients. Source of Funding: none
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1997
We examined whether 201Tl myocardial scintigraphy with intravenous infusion of adenosine triphosp... more We examined whether 201Tl myocardial scintigraphy with intravenous infusion of adenosine triphosphate (ATP) can be substituted for dipyridamole (DIP) in the diagnosis of coronary artery disease CAD). The coronary flow reserve (CFR) during intravenous infusion of ATP (0.10-0.20 mg/kg/min) was compared with that during intravenous infusion of DIP (0.56 mg/kg) using a Doppler flow wire in 19 subjects with normal coronary arteries. The highest CFR level was found in the ATP dose range of 0.16-0.20 mg/kg/min. The CFR at the ATP dose of 0.16 mg/kg/min was significantly higher than that during DIP infusion (4.2 versus 3.6) (p < 0.01), for which reason we adopted this dose of ATP. According, 201Tl SPECT in 140 patients with suspected CAD was performed after infusion of 0.16 mg/kg/min of ATP in 70 of them and 0.56 mg/kg of DIP in the 70 others. ATP stress 201Tl SPECT showed no significant difference in sensitivity and accuracy from DIP stress 201Tl SPECT (87.0% versus 82.9, and 87.1% vers...
Uploads
Papers by Masao Miyagawa