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Semiquantitative analysis using whole-body dynamic F-18 fluoro-2-deoxy-glucose–positron emission tomography to differentiate between benign and malignant lesions

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Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objectives

To investigate whether whole-body dynamic positron emission tomography (PET) is useful for differentiating benign and malignant lesions.

Methods

In this retrospective study, data from a cohort of 146 lesions from 187 patients who consecutively underwent whole-body dynamic PET scans at our hospital for suspected lesions in the lung, lymph nodes, liver, bone, esophagus, and colon were analyzed. Patients with malignant lymphomas, accumulations > 5 cm in length along the long axis of the esophagus, or lesions in the colon in which the site of accumulation moved during the imaging period were excluded. Patients were administered 3.7 MBq/kg of fluorine-18-fluorodeoxyglucose (F-18 FDG), and dynamic imaging was initiated 60 min after administration. We defined the 60–65, 65–70, 70–75, and 75–80 min time mark as the first, second, third, and fourth pass, respectively. The static image is the summed average of all the four pass images. We measured the accumulation in the mean image of the whole-body dynamic PET scan, which was arithmetically similar to the maximum standardized uptake value (SUVmax) throughout the whole-body static images obtained during 20 min of imaging (S-SUVmax). The ratio of SUVmax in the dynamic first pass(60–65 min after FDG administration) and fourth pass(75–80 min after FDG administration) was calculated as R-SUVmax.

Results

The S-SUVmax in the lung, lymph nodes, and bone did not differ significantly between the benign and malignant groups. However, there was a significant difference in R-SUVmax, which was > 1 in most malignant lesions indicating an increase in accumulation during routine scan time. Significant differences were observed between benign and malignant lesions of the liver in both S-SUVmax and R-SUVmax values, with the latter being > 1 in most malignant lesions.

Conclusions

Whole-body dynamic PET for 20 min starting 1 h after FDG administration improved the accuracy of malignant lesion detection in the liver, lymph nodes, lung, and bone. The incremental improvement was small, and the FDG dynamics in the distribution of values between benign and malignant overlapped. Additional information from whole-body dynamic imaging can help detect malignant lesions in these sites without increasing patient burden or prolonging imaging time.

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Acknowledgements

We thank Mr. Hidetaka Sasaki, Mr. Takashi Kamiya, Mr. Sadahiro Naka, the staff of the Department of Nuclear Medicine, and the Cyclotron staff of Osaka University Hospital for their technical support in performing this study.

Funding

This study was funded by management expenses grants from Osaka University.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Tracer Kinetics, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Mirei Watanabe, Hiroki Kato, Daisuke Katayama, Fumihiko Soeda, Tadashi Watabe & Mitsuaki Tatsumi

  2. Institute for Radiation Sciences, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Hiroki Kato

  3. Department of Molecular Imaging in Medicine, Graduate School of Medicine, Osaka University, 2-1 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Keiko Matsunaga & Eku Shimosegawa

  4. Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Mitsuaki Tatsumi & Noriyuki Tomiyama

Authors
  1. Mirei Watanabe
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  2. Hiroki Kato
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  3. Daisuke Katayama
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  4. Fumihiko Soeda
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  5. Keiko Matsunaga
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  6. Tadashi Watabe
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  7. Mitsuaki Tatsumi
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  8. Eku Shimosegawa
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  9. Noriyuki Tomiyama
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Contributions

HK was involved in study design and data interpretation. TW, ES, and MT were involved in data analysis. All the authors critically revised the manuscript, commented on its draft, and approved the final report.

Corresponding author

Correspondence to Hiroki Kato.

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Watanabe, M., Kato, H., Katayama, D. et al. Semiquantitative analysis using whole-body dynamic F-18 fluoro-2-deoxy-glucose–positron emission tomography to differentiate between benign and malignant lesions. Ann Nucl Med 36, 951–963 (2022). https://doi.org/10.1007/s12149-022-01784-y

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  • DOI: https://doi.org/10.1007/s12149-022-01784-y

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