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Dynamic whole-body 18F-FDG PET for differentiating abnormal lesions from physiological uptake

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Serial assessment of visual change in 18F-FDG uptake on whole-body 18F-FDG PET imaging was performed to differentiate pathological uptake from physiological uptake in the urinary and gastrointestinal tracts.

Methods

In 88 suspected cancer patients, serial 3-min dynamic whole-body PET imaging was performed four times, from 60 min after 18F-FDG administration. In dynamic image evaluation, high 18F-FDG uptake was evaluated by two nuclear medicine physicians and classified as “changed” or “unchanged” based on change in uptake shape over time. Detectability of pathological uptake based on these criteria was assessed and compared with conventional image evaluation.

Results

Dynamic whole-body PET imaging provided images of adequate quality for visual assessment. Dynamic image evaluation was “changed” in 118/154 regions of high physiological 18F-FDG uptake (77%): in 9/19 areas in the stomach (47%), in 32/39 in the small intestine (82%), in 17/33 in the colon (52%), and in 60/63 in the urinary tract (95%). In the 86 benign or malignant lesions, 84 lesions (98%) were “unchanged.” A high 18F-FDG uptake area that shows no change over time using these criteria is highly likely to represent pathological uptake, with sensitivity of 97%, specificity of 76%, PPV of 70%, NPV of 98%, and accuracy of 84%.

Conclusion

Dynamic whole-body 18F-FDG PET imaging enabled differentiation of pathological uptake from physiological uptake in the urinary and gastrointestinal tracts, based on visual change of uptake shape.

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Acknowledgments

The authors wish to thank Takeshi Nii, Hiroshi Domoto, Yasutomo Tanada, Koki Shirako, and Azusa Tahata (Department of Radiological Technology, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan) for their technical support.

Funding

This study was funded by a grant from MEXT KAKENHI (number JP182004140).

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Authors and Affiliations

  1. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Motoki Nishimura, Nagara Tamaki, Shigenori Matsushima, Maki Kiba, Tomoya Kotani, Chisa Bamba & Kei Yamada

  2. Department of Radiological Technology, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Yasunori Nakamura

Authors
  1. Motoki Nishimura
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  2. Nagara Tamaki
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  3. Shigenori Matsushima
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  7. Yasunori Nakamura
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  8. Kei Yamada
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Corresponding author

Correspondence to Nagara Tamaki.

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Conflict of interest

Kei Yamada has received research grants from Doctor-NET Inc., Fukushima SIC Applied Engineering Inc., Nihon Mediphysics Co., Ltd., Fuji Pharma Co., Ltd., and Daiichi-Sankyo Co., Ltd. All other authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. No animals were used in the present study, by any author.

Informed consent

Based on the Ethical Guidelines for Medical and Health Research Involving Human Subjects of the Ministry of Health, Labour and Welfare, a waiver of informed consent for the retrospective analyses of the anonymized clinical data in this study was obtained from the Institutional Review Board of Kyoto Prefectural University of Medicine, Japan.

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Nishimura, M., Tamaki, N., Matsushima, S. et al. Dynamic whole-body 18F-FDG PET for differentiating abnormal lesions from physiological uptake. Eur J Nucl Med Mol Imaging 47, 2293–2300 (2020). https://doi.org/10.1007/s00259-020-04726-w

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  • DOI: https://doi.org/10.1007/s00259-020-04726-w

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