Abass Alavi

Calcific tendinopathy is a common condition of the shoulder caused by the inflammation and deposition of hydroxyapatite crystals in the rotator cuff tendons. PET tracers capturing the molecular changes associated with the crystal deposition of calcific tendinopathy remain underinvestigated. In this report, we present calcified tendinopathy of the infraspinatus tendon demonstrating both 18 F-NaF and 18 F-FDG focal uptake in a 61-year-old woman.

This educational review article aims to discuss growing evidence from PET studies in the diagnosis and treatment of depression. PET has been used in depression to explore the neurotransmitters involved, the alterations in neuroreceptors, non-neuroreceptor targets (e.g., microglia and astrocytes), the severity and duration of the disease, the pharmacodynamics of various antidepressants, and neurobiological mechanisms of non-pharmacological therapies like psychotherapy, electroconvulsive therapy, and deep brain stimulation therapy, by showing changes in brain metabolism and receptor and non-receptor targets. Studies have revealed alterations in neurotransmitter systems such as serotonin, dopamine, GABA, and glutamate, which are linked to the pathophysiology of depression. Overall, PET imaging has furthered the neurobiological understanding of depression. Despite these advancements, PET findings have not yet led to significant changes in evidence-based practices. Addressing the reasons behind inconsistencies in PET imaging results, conducting large sample size studies with a more standardized methodological approach, and investigating further the genetic and neurobiological aspects of depression may better leverage PET imaging in future studies.

Methods: HNC patients who underwent proton and/or photon RT in combination with chemotherapy at the University of Pennsylvania between February 9, 2010, and January 6, 2020 were the subjects of a retrospective study. Following the application of the exclusion criteria, 18F-FDG-PET/CT scans for 26 HNC patients (9 proton RT, 10 photon RT, 7 with combined proton and photon RT) were obtained for before RT and 5-10 months after RT. All subjects underwent 18F-FDG-PET/CT imaging 60 minutes after 5.0 MBq/kg 18F-FDG injection. Delta global SUVmean was determined by taking the difference between the global SUVmean measured 5 to 10 months after radiation therapy and the baseline global SUVmean for both the left common carotid (LCC) and right common carotid (RCC). OsiriX MD was utilized to analyze 18F-FDG uptake in the RCC and LCC. Wilcoxon’s rank-sum test was performed to compare the …

Purpose of ReviewCombined positron emission tomography and computer tomography with 2-deoxy-[fluorine-18]-flouro-D-glucose ([18F]FDG-PET/CT) is increasingly used in suspected infection and inflammation. Evidence is mounting within several areas. We believe [18F]FDG-PET/CT is a key modality in infection and inflammation and this overview outlines the diagnostic values in most common uses within this domain.Recent Findings[18F]FDG-PET/CT is considered helpful in establishing the underlying disease in 50–60% of FUO patients. In patients with complex blood stream infections, [18F]FDG-PET/CT changes treatment and reduces relapse rates and mortality—if scans are negative prognosis is favorable and it may be safe to withhold or de-escalate treatment strategy. In infectious endocarditis, [18F]FDG-PET/CT has an impact in prosthetic valve endocarditis and cardiovascular implantable electronic …

Rheumatoid Arthritis (RA) is a systemic inflammatory disorder that commonly presents with polyarthritis but can have multisystemic involvement and complications, leading to increased morbidity and mortality. The diagnosis of RA continues to be challenging due to its varied clinical presentations. In this review article, we aim to determine the potential of PET/CT to assist in the diagnosis of RA and its complications, evaluate the therapeutic response to treatment, and predict RA remission. PET/CT has increasingly been used in the last decade to diagnose, monitor treatment response, predict remissions, and diagnose subclinical complications in RA. PET imaging with [18F]-fluorodeoxyglucose ([18F]-FDG) is the most commonly applied radiotracer in RA, but other tracers are also being studied. PET/CT with [18F]-FDG, [18F]-NaF, and other tracers might lead to early identification of RA and timely evidence-based …

Background: Cardiovascular disease is a leading cause of illness and death globally, primarily due to atherosclerosis. This disease reduces blood flow and oxygen delivery to organs, and when it affects the carotid arteries, it can lead to cognitive impairment and dementia. In a population of 104 individuals, comprising both healthy controls and individuals at elevated risk for developing cardiovascular diseases (CVD) due to identified risk factors, we used PET imaging with 18F-fluorodeoxyglucose (FDG) to assess cerebral glucose metabolism and 18F-sodium fluoride (NaF) to detect atherosclerotic calcification. Our statistical analysis revealed significant differences in metabolic activity between healthy and at-risk individuals in specific brain regions. 18F-FDG uptake in the brain varied inversely with respect to the clinical assessment of cardiovascular risk in regions such as the cuneus (β = −0.030, SE = 0.014, p = 0.035), middle occipital gyrus (β = −0.032, SE = 0.011, p = 0.005), and posterior cingulate gyrus (β = −0.032, SE = 0.015, p = 0.044). In contrast, areas including the basis pontis (β = 0.025, SE = 0.012, p = 0.038) and the pons (β = 0.034, SE = 0.013, p = 0.008) exhibited direct correlations. Notably, carotid 18F-NaF uptake had inverse associations with 18F-FDG uptake in the cerebellum (β = −0.825, SE = 0.354, p = 0.021), medulla (β = −0.888, SE = 0.405, p = 0.029), and posterior cingulate gyrus (β = −1.253, SE = 0.567, p = 0.028), while increased carotid calcification influenced metabolic activity in the fusiform gyrus (β = 1.660, SE = 0.498, p = 0.001) and globus pallidus (β = 1.505, SE = 0.571, p = 0.009). We observed that atherosclerotic …

FIRST EXPERIENCES WITH AMYLOID-RELATED IMAGING ABNORMALITIES found after treatment with all three antibodies (5), a fact that tends to be passed over in silence. The only way to clarify the alleged beneficial or possibly harmful effects of the treatments is to examine treated patients and their placebo controls under unbiased conditions with MRI and 18F-fluorodeoxyglucose (FDG) PET to establish cerebral volume changes and regional glucose utilization and neuronal function, respectively, to measure the functional effects of ARIAs.

METHODS:The FULIMA clinical trial (NCT02187731) was conducted with 70 newly diagnosed MM patients, with exclusion criteria leaving 33 patients for analysis (9 females, 24 males; mean age 66.6 y). Patients’ trabecular body of the L1-L4 vertebrae was analyzed using 18F-NaF PET/CT scans to calculate and evaluate the linear associations among mean standardized NaF uptake value (SUVmean), mean Hounsfield unit (HU) values, and age. Receiver-operating characteristic (ROC) curve analysis with area under the curve (AUC) using the Wilson/Brown method assessed the predictive value of NaF uptake via SUVmean for osteoporosis determined by HU threshold.RESULTS:There was significant positive correlation between HU value and SUVmean (r= 0.64, p< 0.0001) and negative correlations between age and both HU value (r=-0.59, p< 0.0003) and SUVmean (r=-0.53, p= 0.002). Additionally, on average …

reviewed dedicated systems (brain, breast, and prostate) are reviewed in the articles,“Transforming Neurology and Psychiatry: Organ-Specific PET Instrumentation and Clinical Applications,” by by Taha and colleagues,“Clinical Applications of Dedicated Breast PET,” by Fowler and colleagues, and “Potential Clinical Applications of Dedicated Prostate PET,” by Castellucci and colleagues. The development of advanced organ-specific PET instrumentation and related image reconstruction algorithms, as well as associated clinical applications, has been very fast and thrilling, and there is every reason to trust the field will move forward even more rapidly in the future. There is no scarcity of challenges and opportunities for advanced PET instrumentation and innovative clinical applications nowadays. We hope that, in this limited space, we were able to provide a flavor of recent advances in dedicated PET instrumentation …

The amyloid cascade hypothesis for Alzheimer’s disease is still alive, although heavily challenged. Effective anti-amyloid immunotherapy would confirm the hypothesis’ claim that the protein amyloid-beta is the cause of the disease. Two antibodies, aducanumab and lecanemab, have been approved by the U.S. Food and Drug Administration, while a third, donanemab, is under review. The main argument for the FDA approvals is a presumed therapy-induced removal of cerebral amyloid deposits. Lecanemab and donanemab are also thought to cause some statistical delay in the determination of cognitive decline. However, clinical efficacy that is less than with conventional treatment, selection of amyloid-positive trial patients with non-specific amyloid-PET imaging, and uncertain therapy-induced removal of cerebral amyloids in clinical trials cast doubt on this anti-Alzheimer’s antibody therapy and hence on the amyloid hypothesis, calling for a more thorough investigation of the negative impact of this type of therapy on the brain.

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The recently announced revision of the Alzheimer's disease (AD) diagnostic ATN classification adds to an already existing disregard for clinical assessment the rejection of image-based in vivo assessment of the brain's condition. The revision suggests that the diagnosis of AD should be based solely on the presence of cerebral amyloid-beta and tau, indicated by the "A" and "T". The "N", which stands for neurodegeneration – detected by imaging – should no longer be given importance, except that A+ ± T+ = AD with amyloid PET being the main method for demonstrating A+. We believe this is an artificial and misleading suggestion. It is artificial because it relies on biomarkers whose significance has never been proven and where the detection of "A" is based on a never-validated PET method using a tracer that marks much more than amyloid-beta. It is misleading because many patients without dementia will be …

The US Food and Drug Administration (FDA)’s recent accelerated approval of two anti-amyloid antibodies for treatment of Alzheimer's disease (AD), aducanumab and lecanemab, has caused substantial debate. To inform this debate, we reviewed the literature on randomized clinical trials conducted with eight such antibodies focusing on clinical efficacy, cerebral amyloid removal, amyloid-related imaging abnormalities (ARIAs) and cerebral volumes to the extent such measurements have been reported. Two antibodies, donanemab and lecanemab, have demonstrated clinical efficacy, but these results remain uncertain. We further argue that the decreased amyloid PET signal in these trials is unlikely to be a one-to-one reflection of amyloid removal, but rather a reflection of increased therapy-related brain damage, as supported by the increased incidence of ARIAs and reported loss of brain volume. Due to these …

P1575Introduction: Bone metastasis detection methods such as X-ray, bone scan (BS), and CT detect osseous changes only after a significant degree of macroscopic changes have occurred. These methods are indirect and suboptimal. MRI is considered the best option for screening bone metastases, and the combination of PET/MRI has the potential for improving detection. FDG PET is particularly suited for detecting bone metastases from FDG-avid tumor cells, as it directly detects the elevated glycolytic metabolism before a significant osseous reaction occurs. The following review examines various PET radiotracers and their sensitivity and specificity for detecting bone metastases.Methods: Multiple databases including PubMed and Google Scholar were referenced to assemble a comprehensive body of literature related to PET imaging bone and bone marrow metastasis. Journal articles discussing the utility of …

PurposeWhile radiotherapy (RT) for head and neck cancer (HNC) has made recent strides, RT-induced vasculitis continues to adversely affect long-term patient outcomes. Guidelines for managing this complication remain scarce, supporting the need for a sensitive imaging modality in post-treatment evaluations. In this review, we discuss the current literature regarding 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and 18F-sodium fluoride (NaF-PET) in evaluating RT-induced vasculitis in HNC patients, highlighting several arenas of evolving clinical significance: (1) early recognition and standardized evaluation of RT-induced vasculitis, and (2) potential for a multifaceted diagnostic tool to stratify cardiovascular risk in HNC patients.MethodsNumerous databases, including, but not limited to, Google Scholar and PubMed, were utilized to compile a body of literature regarding PET imaging of RT …

P1538Introduction: 1. Examine the role of cancer-associated fibroblasts (CAFs) in the survival, maturation, and progression of cancer cells. 2. Discuss the heterogeneity of CAFs, including the various subsets present in different types of cancer and their potential tumor-promoting or tumor-suppressive effects. 3. Determine the utility of metabolic information in the determination of CAF invasion and migration.Methods: PubMed, Scopus, Web of Science were utilized in order assess trends in the existing literature. Articles that examined the role of cancer-associated fibroblasts (CAFs) in the progression of cancer were analyzed. Data regarding study design, sample size, radioligands, and conclusions drawn were extracted from the relevant research. Limitations and potential areas for future investigation were identified. The results of these studies were synthesized to address the objectives and clarify the role of CAFs in …

P464Introduction: 1. Investigate the utility of PET radiotracers in the early detection and characterization of carotid artery atherosclerosis 2. Identify areas for future research and development in this field.Methods: PubMed, Web of Science, Scopus, and Google Scholar, were utilized to conduct a thorough and comprehensive review of the literature. The search included meta-analyses, abstracts, and original research (prospective and retrospective studies). Data on study design, sample size, radioligands used, conclusions drawn, and limitations were extracted from each study. The gathered information was synthesized to provide an overview of current understanding on the use of PET for early detection and treatment monitoring of atherosclerosis.Results: Carotid Artery atherosclerosis is a common form of arterial disease in which plaque builds up on the inner walls of the carotid arteries, which are the major blood …

P1342Introduction: The aim of this study was to measure the global bone marrow uptake of 18F-fluorodeoxyglucose (FDG) before and after treatment in non-Hodgkin lymphoma (NHL) patients who underwent Chimeric Antigen Receptor T-cell (CAR-T) therapy.Methods: Retrospective FDG PET/CT data of 60 NHL patients (mean age 60.3 ± 12.48 years, range 29-81, females 22) who underwent CAR-T therapy at the Hospital of the University of Pennsylvania were included in this study. Baseline scans before initiation of CAR-T therapy for relapsed or refractory NHL and scans at first follow-up after an average of 72 days (ranges 21-179 days) after treatment were analyzed. Three patients were excluded as their baseline scans were performed at an outside facility. All scans were conducted 60 min following intravenous injection of 4 MBq/kg of FDG. Images were analyzed using an iterative thresholding algorithm that …

Hidradenitis suppurativa (HS) is a chronic skin disorder characterized by nodules, comedones, and sinus tracts that often leave prominent scarring. In recent years, non-invasive imaging techniques have been used to assess the inflammatory activity, vascularization, and treatment response of lesions. Specifically, fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans may aid in identifying systemic inflammation in patients with HS, improving diagnosis. Inflamed hypermetabolic tissues exhibit a greater uptake of FDG due to increased glucose uptake and vascularity. A systematic review was conducted to summarize the utility of nuclear imaging techniques in the diagnosis and treatment follow-up of HS. PubMed, Scopus, and ScienceDirect databases were utilized for relevant articles discussing the utility of PET scans in managing HS. A total of 51 citations were identified in the initial search. Following the review of titles, abstracts, and duplicates, 43 articles were excluded, leaving a total of eight articles for analysis. Data were extracted from each article, encompassing the number of patients, imaging techniques employed, and final results. An analysis of the data demonstrated that FDG-PET showed evidence of identifying subclinical lesions of the disease, improving the visualization of HS, and providing an objective method of assessing severity.

P1083Introduction: 1. Evaluate the effectiveness of prostate-specific membrane antigen (PSMA) PET in assessing prostate cancer in comparison to previously used tracers. 2. Discuss the utility of 18F-fluorodeoxyglucose (FDG)-PET in conjunction with PSMA-PET in assessing aggressive forms of prostate cancer.Methods: To identify relevant studies, a comprehensive search of the PubMed, Cochrane Library, and EMBASE databases was conducted; keywords related to PSMA PET scans, FDG PET, prostate cancer, and radiotracers were utilized. Our search intended to capture all original research studies that evaluated the effectiveness of FDG in conjunction with PSMA PET scans in the assessment of prostate cancer. Two reviewers independently screened the titles and abstracts of the identified studies. Discrepancies were resolved through discussion and deliberation. Findings were then synthesized in order to …

Which of the following pairs of radiopharmaceuticals are used for simultaneously studying gastric emptying of both liquids and solids?

Glioblastomas (GBM) are highly invasive, malignant primary brain tumors. The overall prognosis is poor, and management of GBMs remains a formidable challenge, necessitating novel therapeutic strategies such as dendritic cell vaccinations (DCVs). While many early clinical trials demonstrate an induction of an antitumoral immune response, outcomes are mixed and dependent on numerous factors that vary between trials. Optimization of DCVs is essential; the selection of GBM-specific antigens and the utilization of 18F-fludeoxyglucose Positron Emission Tomography (FDG-PET) may add significant value and ultimately improve outcomes for patients undergoing treatment for glioblastoma. This review provides an overview of the mechanism of DCV, assesses previous clinical trials, and discusses future strategies for the integration of DCV into glioblastoma treatment protocols. To conclude, the review discusses challenges associated with the use of DCVs and highlights the potential of integrating DCV with standard therapies.

P1383Introduction: Successful surgical management in focal drug-resistant epilepsy requires rigorous preoperative evaluation and imaging to accurately localize epileptogenic zones and assess risks of resection. Still, approximately 30% of patients who undergo surgical resection for drug-resistant mesial temporal lobe epilepsy do not obtain seizure freedom. Although magnetic resonance imaging (MRI) is the gold standard imaging modality for the detection of focal epilepsy, this imaging modality is not definitive in all cases. In this review, we examine current trends and clinical utility in the use of positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) and 11C-flumazenil (FMZ) for the localization of epileptogenic foci in drug-resistant epilepsy.Methods: Multiple databases including Google Scholar and PubMed were accessed to compile a comprehensive body of literature related to the utility of …

The aim of this study to evaluate the positron emission tomography (PET) scan technology and its role as a diagnostic tool in health care. New PET technology provide the integrated PET and CT or MRI scan have been applicated globally.In performing PET scan, a small amount of a radioactive substance (18F-FDG is widely used) is injected into a vein, and this substance is absorbed mainly by organs and tissues that use the most energy. The patients recieve internal radiation exposure from injected radiotracer and external radiation from CT component technology. PET and integrated PET seem to be used in oncology for diagnosis, tumor staging, evaluation after therapy and finding recurrent cancer.

Introduction Atherosclerosis, the occlusion of arteries due to the accumulation of fatty substances, cholesterol, calcium, and fibrin in the arterial walls, can result in reduced blood flow and a subsequent decrease in oxygen delivery to the organs supplied by the affected artery, including the brain. Positron emission tomography‐computed tomography (PET‐CT) utilizing 18F‐fluorodeoxyglucose (FDG) and 18F‐Sodium Fluoride (NaF) have demonstrated efficacy in the assessment of cerebral glucose metabolism and atherosclerotic calcification, respectively. However, the reported literature has not clearly correlated arterial disease throughout the body with cerebral hypometabolism. Utilizing a novel integration of FDG and NaF PET/CT imaging, our study explores the link between cardiovascular risk factors and regional cerebral metabolism. Methods We compared 79 healthy controls (mean age 44.5 ± 13.8 years, 53 …

P341Introduction: 1. Review the role of FDG-PET in neurosurgical procedures for the treatment of epilepsy. 2. Assess the added benefit of artificial intelligence (AI) in FDG-PET imaging of epilepsy patients.Methods: PubMed and Google Scholar search engines were utilized to accrue relevant studies regarding FDG PET and epilepsy. Review articles and scientific studies were compiled from the databases using the COVIDENCE platform as a means of accumulating a comprehensive body of literature. Studies were then assessed for quality, relevance, and potential bias to derive broader conclusions about the standing knowledge of the aforementioned objectives.Results: Epilepsy is a central nervous system disorder characterized by recurring seizures caused by disrupted nervous system activity. In order to select patients eligible for epilepsy surgery and to obtain an optimal treatment response, precise localization …

The method of 18F-sodium fluoride (NaF) positron emission tomography/computed tomography (PET/CT) of atherosclerosis was introduced 12 years ago. This approach is particularly interesting because it demonstrates microcalcification as an incipient sign of atherosclerosis before the development of arterial wall macrocalcification detectable by CT. However, this method has not yet found its place in the clinical routine. The more exact association between NaF uptake and future arterial calcification is not fully understood, and it remains unclear to what extent NaF-PET may replace or significantly improve clinical cardiovascular risk scoring. The first 10 years of publications in the field were characterized by heterogeneity at multiple levels, and it is not clear how the method may contribute to triage and management of patients with atherosclerosis, including monitoring effects of anti-atherosclerosis intervention. The present review summarizes findings from the recent 2¾ years including the ability of NaF-PET imaging to assess disease progress and evaluate response to treatment. Despite valuable new information, pertinent questions remain unanswered, not least due to a pronounced lack of standardization within the field and of well-designed long-term studies illuminating the natural history of atherosclerosis and effects of intervention.

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PurposeTo assess radiation therapy (RT)-induced vasculitis in patients with non-small cell lung cancer (NSCLC) by examining changes in the uptake of 18F-fluoro-D-deoxyglucose ([18F]FDG) by positron emission tomography/computed tomography (PET/CT) images of the ascending aorta (AA), descending aorta (DA), and aortic arch (AoA) before and after proton and photon RT.MethodThirty-five consecutive locally advanced NSCLC patients were definitively treated with proton (n = 27) or photon (n = 8) RT and concurrent chemotherapy. The patients were prospectively enrolled to undergo [18F]FDG-PET/CT imaging before and 3 months after RT. An adaptive contrast-oriented thresholding algorithm was applied to generate mean standardized uptake values (SUVmean) for regions of interest (ROIs) 3 mm outside and 3 mm inside the outer perimeter of the AA, DA, and AoA. These ROIs were employed to …

P181Introduction: Our purpose is to review the potential feasibility of utilizing somatostatin receptor (SSTR) targeting strategies in patients with neuroendocrine differentiation of prostate cancer (NEDPC) for either diagnostic or therapeutic purposes. Prostate cancer (PCa) remains a major public health concern. Despite androgen deprivation therapy (ADT), the mainstay of treatment in advanced PCa, most patients receiving hormonal therapies eventually progress to castration-resistant prostate cancer (CRPC). NEDPC may arise in the late stages of systemic treatments due to lineage plasticity. With the loss of reliance on androgen receptor signaling as a result of treatment-driven trans-differentiation of adenocarcinoma, conventional treatment options are restricted to platinum- and cisplatin-based chemotherapy combinations, typically associated with serious side effects and resulting in short-term responses …

Our article addresses the prevailing trend of new terminology introduced alongside the progress being made in nuclear medicine. Our article provides a historic, current, and future perspective.

In June 2021, the US Federal Drug and Food Administration (FDA) granted accelerated approval for the antibody aducanumab and, in January 2023, also for the antibody lecanemab, based on a perceived drug-induced removal of cerebral amyloid-beta as assessed by amyloid-PET and, in the case of lecanemab, also a presumption of limited clinical efficacy. Approval of the antibody donanemab is awaiting further data. However, published trial data indicate few, small and uncertain clinical benefits, below what is considered “clinically meaningful” and similar to the effect of conventional medication. Furthermore, a therapy-related decrease in the amyloid-PET signal may also reflect increased cell damage rather than simply “amyloid removal”. This interpretation is more consistent with increased rates of amyloid-related imaging abnormalities and brain volume loss in treated patients, relative to placebo. We also challenge the current diagnostic criteria for AD based on amyloid-PET imaging biomarkers and recommend that future anti-AD therapy trials apply: (1) diagnosis of AD based on the co-occurrence of cognitive decline and decreased cerebral metabolism assessed by FDA-approved FDG-PET, (2) therapy efficacy determined by favorable effect on cognitive ability, cerebral metabolism by FDG-PET, and brain volumes by MRI, and (3) neuropathologic examination of all deaths occurring in these trials.

IntroductionPrimary cutaneous lymphoma (PCL) is a cutaneous non-Hodgkin’s lymphoma that originates in the skin and lacks extracutaneous spread upon initial diagnosis. The clinical management of secondary cutaneous lymphomas is different from that of PCLs, and earlier detection is associated with better prognosis. Accurate staging is necessary to determine the extent of disease and to choose the appropriate treatment. The aim of this review is to investigate the current and potential roles of 18F- fluorodeoxyglucose positron emission tomography–computed tomography (18F-FDG PET/CT) in the diagnosis, staging, and monitoring of PCLs.MethodsA focused review of the scientific literature was performed using inclusion criteria to filter results pertaining to human clinical studies performed between 2015 and 2021 that analyzed cutaneous PCL lesions on 18F PET/CT imaging.Results & ConclusionA review of 9 …

P70Introduction: Our purpose is to provide an overview of the applications of state-of-the-art T-cell positron emission tomography (PET) imaging and the potential it has to improve the clinical management of patients receiving cancer immunotherapy. T-lymphocytes are by far the most abundant lymphocyte type acting as the key mediators of the adaptive immune response. T-cells, once activated, expand and create potent effector mechanisms for eliminating aberrant cells. Imbalanced or inappropriate T-cell responses underlie cancer progression. These cell types have been a primary focus in the molecular imaging field owing to the growth in T-cell-based therapeutics and due to T-cells’ dominant roles in cancer immunopathology and driving anti-cancer responses. The noninvasive PET imaging approach has the potential to provide comprehensive information about the distribution and abundance of immune cell …

Cerebrovascular disease (CVD) is a global health concern, and early detection is crucial for effective intervention. This case report presents a 31-year-old male patient with multiple cardiac risk factors who underwent positron emission tomography/computed tomography (PET/CT) with 18F-sodium fluoride (NaF) and 18F-fluorodeoxyglucose (FDG) to evaluate for the presence and degree of atherosclerosis in the aorta, carotid arteries, coronary arteries, iliac arteries, and the femoral arteries. Elevated NaF uptake within the bilateral carotid arteries signified substantial ongoing vascular microcalcification. Reduced global brain metabolism and region-specific hypometabolism measured with FDG PET indicated potential cerebrovascular mechanisms that may be influencing neurological function. The findings highlight the potential of emerging PET tracers, such as NaF, to improve the diagnostic accuracy and therapeutic management of CVD. This case emphasizes the importance of a comprehensive diagnostic approach as well as continued investigation into CVD pathophysiology using PET-based techniques, which may guide the development of innovative therapeutic strategies.

P1068Introduction: Large vessel vasculitis is an inflammatory disease mainly affecting the large arteries, including Takayasu arteritis, giant cell arteritis (GCA), and polymyalgia rheumatica (PMR). Undiagnosed large vessel vasculitis could lead to devastating outcomes such as irreversible vision loss, aortic dissection, or cerebrovascular events. Although biopsy remains the gold standard for diagnosis, it is invasive and not always feasible. More recently, growing evidence has shown the ability of PET imaging in its diagnosis and treatment monitoring.Methods: We reviewed multiple databases, including PubMed, Google Scholar, and compiled a comprehensive body of literatures related to the PET imaging used in large vessel vasculitis. Findings from multiple research papers were then analyzed and synthesized. We will discuss the evolving role of PET imaging in the diagnosis of large vessel vasculitis and monitor …

P1534Introduction: • Review the structure and function of fibroblast activation protein (FAP), including its domains, catalytic triad, and involvement in dimerization and catalytic activity• Examine the potential of FAP as a marker of activated fibroblasts and its role in molecular imaging in practice.Methods: A comprehensive literature review was conducted using PubMed and Scopus to gather and analyze articles pertaining to the role of FAP in tissue remodeling as well as its structure and function. The search was conducted employing a combination of relevant keywords, including "fibroblast activation protein," OR "FAP," and "DPPIV," OR "dipeptidyl peptidase IV." The evidence for FAP as a marker of activated fibroblasts and its implications in physiological profiling were explored. The findings were synthesized to summarize the role of FAP and its involvement in tissue remodeling. The limitations of current studies and …

P72Introduction: Our purpose is to review and characterize the role of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in assessing the cause of fever of unknown origin (FUO). FUO refers to a prolonged febrile illness in which the background disease cannot be identified by the diagnostic workup. FUO is currently characterized by (1) temperature of ≥ 38.3 °C (≥ 101 ℉) on at least two occasions, (2) duration of ≥ 3 weeks or multiple febrile episodes in ≥ 3 weeks, (3) no known immunocompromised state, and (4) uncertain diagnosis in spite of a broad examination including complete history-taking, physical examination, hematology and urine tests, abdominal ultrasonography, chest X-ray, and tuberculin skin test or interferon gamma release assay. Causes of FUO include a wide group of diseases, including both benign and malignant conditions. The major …

P737Introduction: Breast cancer is a leading cause of cancer-related deaths worldwide, and early detection with close monitoring is crucial for improving patient outcomes. Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) is a commonly used imaging modality for the detection and staging of breast cancer, but its uptake can be insensitive in certain types of tumors. Recently, there has been increasing interest in the use of alternative PET tracers such as 68Ga-fluorinated amino acid analogue of L-phenylalanine (FAPI) for the detection and management of breast cancer. FAPI allows for the visualization of estrogen receptor-positive tumors. When it binds to estrogen receptors, it is detected using PET imaging to identify the presence and location of these tumors. FAPI can be used to visualize other types of tumors, including prostate cancer and endometrial cancer, which also express estrogen …

Atherosclerosis, a leading cause of mortality and morbidity worldwide, involves inflammatory processes that result in plaque formation and calcification. The early detection of the molecular changes underlying these processes is crucial for effective disease management. This study utilized positron emission tomography/computed tomography (PET/CT) with [18F] sodium fluoride (NaF) as a tracer to visualize active calcification and inflammation at the molecular level. Our aim was to investigate the association between cardiovascular risk factors and [18F] NaF uptake in the left and right common carotid arteries (LCC and RCC). A cohort of 102 subjects, comprising both at-risk individuals and healthy controls, underwent [18F] NaF PET/CT imaging. The results revealed significant correlations between [18F] NaF uptake and cardiovascular risk factors such as age (β = 0.005, 95% CI 0.003–0.008, p < 0.01 in LCC and β = 0.006, 95% CI 0.004–0.009, p < 0.01 in RCC), male gender (β = −0.08, 95% CI −0.173–−0.002, p = 0.04 in LCC and β = −0.13, 95% CI −0.21–−0.06, p < 0.01 in RCC), BMI (β = 0.02, 95% CI 0.01–0.03, p < 0.01 in LCC and β = 0.02, 95% CI 0.01–0.03, p < 0.01 in RCC), fibrinogen (β = 0.006, 95% CI 0.0009–0.01, p = 0.02 in LCC and β = 0.005, 95% CI 0.001–0.01, p = 0.01), HDL cholesterol (β = 0.13, 95% CI 0.04–0.21, p < 0.01 in RCC only), and CRP (β = −0.01, 95% CI −0.02–0.001, p = 0.03 in RCC only). Subjects at risk showed a higher [18F] NaF uptake compared to healthy controls (one-way ANOVA; p = 0.02 in LCC and p = 0.04 in RCC), and uptake increased with estimated cardiovascular risk (one-way ANOVA, p < 0.01 in LCC …

A technologist is performing a thyroid uptake with 123I sodium iodide.

Introduction Patients with cognitive impairment often have a history of cardiovascular disease (CVD) or multiple cardiovascular risk factors (CRFs) such as hypertension, obesity, and hypercholesterolemia. The literature reports that CVD with CRFs may increase the risk of developing vascular dementia and Alzheimer’s Disease. 18F‐fluorodeoxyglucose positron emission tomography (FDG‐PET) allows for the in vivo study of cerebral glucose metabolism, and can detect metabolic alterations in several neurological diseases. As we age, the brain undergoes both structural and functional changes; the regional distribution of these alterations mirrors cognitive decline. This study aims to assess the effect of aging on regional glucose uptake in subjects with known cardiovascular risk factors. Methods In total, 40 subjects (mean age 55.9 ± 11.89 years, 50% males) with known cardiovascular risk factors underwent FDG …

P295Introduction: The morbidity and mortality associated with traumatic brain injury present a substantial health problem, with the estimated expense exceeding $60 billion annually. Many patients who have traumatic brain injury experience a wide range of psychiatric and neurological symptoms (including impairment in functional status, cognition, and mood). The persistence of these symptoms is referred to as persistent postconcussion syndrome (PCS). Previous studies suggest that 18F-fluorodeoxyglucose-PET (18F-FDG- PET) brain imaging may be highly useful in the assessment of patients with PCS and chronic symptoms as a way of evaluating their associated brain abnormalities. This study evaluated the varying responses to an integrative treatment regimen by correlating baseline FDG-PET data with the improvement in several clinical measures in a heterogeneous patient population that met the criteria for …

Since the commercial introduction of the first positron emission tomography (PET) scanner in 1978, major subsequent technical advancements have resulted in new scanner designs [1–3]. Conventional PET scanners cover a limited axial field-of-view (FOV; 15–35 cm); these scanners are referred to as short-axial field-of-view (SAFOV)[4]. Whole-body SAFOV PET imaging (from vertex to toes) can be acquired either with step-and-shoot or continuous bed motion (CBM) techniques. SAFOV scanners are characterized by less efficient signal collection because roughly 85–90% of the body is usually outside the standard-axial FOV [5]. Moreover, for the tissues and organs in the scanner’s FOV, only 3–5% of the available signal is collected [5]. To extend a scanner’s FOV to capture more signal, several different approaches have been advanced. The first attempt of extending the axial FOV resulted in two noncommercially …

Which of the following concerning an IV drip should a technologist monitor while a patient is under his or her care?

ObjectivesHIV affects 36 million people globally with prevalence decreasing due to antiretroviral therapy (ART) and social awareness; transmission occurs during substance use. Cocaine usage independently affects brain activity and may result in reduced ART adherence. This study evaluates brain glucose metabolism measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in cocaine users with HIV infection.DesignSixty-three subjects were categorized into groups: 36 HIV infected (HIV+) and 27 non-HIV infected (HIV-) subjects. Each group was further split into cocaine users (CO+) and non-cocaine users (CO-). Of the HIV+, half were cocaine users and half were not. Of the HIV-, 14 were cocaine users and 13 were not. 18F-FDG-PET and low dose CT scans were performed on all subjects.MethodsBrain glucose metabolism was evaluated by 18F-FDG uptake in the whole brain, cortex, basal ganglia, and cerebellum 120 minutes after injection. ROVER software was used for image analysis and ROI masks were applied via an adaptive threshold system. ANOVA tests and t-tests were performed to assess the respective differences between the four groups.ResultsGenerally, the HIV+/CO+ group (group A) displayed the lowest levels of uptake whereas the HIV-/CO-group (group D) showed the highest; the HIV+/CO-and HIV-/CO+ groups (group B and C) showed intermediate levels of activity across the whole brain, cortex, basal ganglia, and cerebellum.ConclusionHIV infection and cocaine usage were independently associated with a decrease in brain glucose uptake as measured by 18F-FDG …

The pathogenesis of Coronavirus Disease 2019 (COVID-19) involves cytokine-driven recruitment and accumulation of inflammatory cells at sites of infection. These activated neutrophils, monocytes, and effector T cells are highly glycolytic and thus appear as [18]F-labeled fluorodeoxyglucose (FDG) avid sites on positron emission tomography (PET) imaging. FDG-PET-computed tomography (FDG-PET/CT) is a highly sensitive modality for the detection, monitoring, and assessing response related to COVID-19 disease activity that holds significant clinical relevance. To date, concerns over cost, access, and undue radiation exposure have limited the use of FDG-PET/CT in COVID-19 to a small number of individuals where PET-based interventions were already indicated. In this review, we summarize the existing literature on the use of FDG-PET in the detection and monitoring of COVID-19 with particular focus on …

P35Introduction: 1. Review the present use of artificial intelligence (AI)-based positron emission tomography (PET) in the diagnosis and treatment of traumatic brain injury (TBI) 2. Compare the current status of AI applications in FDG-PET with that of alternative imaging modalities in TBI 3. Discuss possible future directions for the development of AI-based PET imaging in TBI.Methods: A comprehensive search was conducted to extract articles related to the use of AI-based PET in the diagnosis and treatment of TBI. A comprehensive literature review was performed after querying Web of Science, Scopus, PubMed, and Google Scholar. Studies regarding the application of AI-based PET with respect to TBI were selected and evaluated to understand the performance and potential of the AI-technology. Selected studies were compiled and assessed on quality measures such as study design, number of subjects, and rigor …

Objectives There is growing evidence that sodium fluoride ([18F]fluoride) PET/CT can detect active arterial calcifications at the molecular stage. We investigated the relationship between arterial mineralization in the left common carotid artery (LCC) assessed by [18F]fluoride PET/CT and cardiovascular/thromboembolic risk. Methods In total, 128 subjects (mean age 48 ± 14 years, 51% males) were included. [18F]fluoride uptake in the LCC was quantitatively assessed by measuring the blood-pool-corrected maximum standardized uptake value (SUVmax) on each axial slice. Average SUVmax (aSUVmax) was calculated over all slices and correlated with 10-year risk of cardiovascular events estimated by the Framingham model, CHA2DS2-VASc score, and level of physical activity (LPA). Results The aSUVmax was …

Rheumatoid arthritis (RA) involves chronic inflammation of synovial joints, causing pain, stiffness, and limited mobility. 18F-sodium fluoride (NaF) is a PET tracer whose uptake reflects bone turnover, while 18F-fludeoxyglucose (FDG) shows glucose metabolism and can serve as a marker for inflammation. The aim of this study is to determine the feasibility of calculating the FDG and NaF mean standardized uptake value (SUVmean) in the knee joint, hip joint, and sacroiliac (SI) joint of RA patients and to determine their association with patient characteristics. Prospective FDG-PET/CT as well as NaF-PET/CT imaging was performed on 18 RA patients. The global SUVmean was calculated on FDG-PET/CT and NaF-PET/CT images using a semiautomated CT-based method of segmentation. FDG and NaF uptake were found to be significantly correlated in the knee (r = 0.77, p < 0.001), but not in the hip and SI joints. In the knee, both NaF SUVmean and FDG SUVmean were significantly correlated with body weight, BMI, leptin, and sclerostin levels (p < 0.05). NaF SUVmean was significantly positively correlated with BMI and leptin for both the hip and SI joints (p < 0.05). No significant correlation was observed between either PET parameter and age, height, erythrocyte sedimentation rate (ESR), and interleukins 1 and 6 (IL-1 and IL-6); however, FDG was correlated with inflammatory markers such as C-reactive protein (CRP) and patient global visual analogue scale (VAS-PtGlobal) in some joints. In this study, both FDG and NaF uptake were quantified in large joints of patients with RA using CT segmentation. NaF and FDG SUVmean were correlated with …

To the Editor: We enjoyed reading the recent com-mentary by Drs Wassef and Colletti1 in Clinical Nuclear Medicine to an opinion article published shortly before in the same journal. 2 Not only because the authors support some of the stated opinions, but in particular because their communication is an impressive concentrate of existing literature in the field, which very few have presented in so little space, making it a recommended read for new researchers interested in dementia and Alzheimer disease (AD). Moreover, the commentary points to new developments focusing on presymptomatic detection and development of effective prevention and therapy.On a single point, however, we do not agree with Wassef and Colletti. This applies to the sentence:“Negative amyloid PET can reliably rule out AD.” It is far away from the impression we have. They refer to an article in which authors Scheltens et al3 state that …

Passive immunotherapy for Alzheimer disease has been tried for over 10 years without success. However, in 2021 and most recently in January 2023, the US Food and Drug Administration granted accelerated approval of 2 antibodies for this purpose, aducanumab and lecanemab. In both cases, the approval was based on a presumed therapy-related removal of amyloid deposits from the brain and, in the case of lecanemab, also some delay in cognitive decline. We question the validity of the evidence for the removal of amyloid in particular as assessed by amyloid PET imaging, believing that what is observed is more likely a large nonspecific amyloid PET signal in the white matter that diminishes during immunotherapy—in line with dose-dependent increases in amyloid-related imaging abnormalities and increased loss of cerebral volume in treated compared with placebo patients. To investigate this further, we …

P1566Introduction: 1. Discuss the role of the microenvironment in determining the growth patterns of tumors, including the formation of finger-like margins and the fragmentation of the tumor into separate invasive colonies 2. To evaluate the effectiveness of computational models in representing the functions and behaviors of malignant cells. 3. Determine the utility metabolic information in the creation of hybrid models of tumor growth.Methods: A review of the current literature was conducted using online databases, including PubMed and Scopus. Articles that relate to the role of the microenvironment in tumor growth were collected. Clinical studies that explored the use of computational models in cancer biology were of particular importance. The results of these studies were synthesized to identify trends and patterns in the existing literature.Results: In seeking the growth pattern of cells in the biosphere among …

P523Introduction: 1.) Review the current positron emission tomography (PET) radiotracers used to diagnose and treat neuroendocrine tumors (NETs) 2.) Identify the future directions for PET radiotracers used to visualize or treat NETs.Methods: A comprehensive search using PubMed, Google Scholar, and Scopus search engines was conducted to identify relevant studies on the diagnosis and treatment of neuroendocrine tumors (NETs). This search included terms such as "neuroendocrine tumors," "peptide receptor radionuclide therapy," "PET/CT," and "α particle emitters." Studies were included if they were primary research articles that focused on the diagnosis or treatment of NETs, and the data was analyzed to identify trends in the use of various modalities for the diagnosis and treatment of NETs.Results: NETs are a heterogenous group of neoplasms that most commonly originate in the small bowel, stomach …

P1444Introduction: This study aims to use total-body FDG PET/CT scans of individuals with lymphoma to compare the differences in global uptake in metabolically active lymph nodes between early and delayed acquisitions.Methods: Data from FDG-PET/CT scans performed at the University of California, Davis from 20 patients referred for initial staging of lymphoma - age 12 to 74.9 years (mean = 44.12 ± 19.70 years; males = 9; females = 11) were analyzed. It included 40 scans conducted 60 and 120 minutes following intravenous injection of 8 mCi of FDG. Out of 20 patients, 10 patients had non-Hodgkin’s lymphoma (NHL), and the remaining 10 had Hodgkin’s lymphoma (HL). Of 20 patients, 2 patients were excluded from the study as the lesions were not large enough to be appreciated and quantified on the software used in this study. FDG-PET/CT scans taken at 60 minutes and 120 minutes were examined by …

P471Introduction: Patients with, or at risk of developing cardiovascular disease (CVD), show significant structural and functional brain imaging changes. Risk factors for CVD are associated with pathophysiological neurological alterations related to cognitive impairments. Dementia subtypes are associated with reduced brain glucose metabolism compared to healthy brains, as indicated by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). FDG-PET has proven effective in detecting and characterizing the metabolic and cognitive effects of vascular dementia at the molecular level, even before conventional imaging methods can detect structural changes or behavioral symptoms. Previous studies have demonstrated that there is an inverse correlation between increased CVD risk and global brain FDG uptake. This study analyzed the effect of chronic cardiovascular risk on regional brain glucose …

Alterations in cerebral glucose metabolism can be indicative of both normal and pathological aging processes. In this retrospective study, we evaluated global and regional neurological glucose metabolism in 73 healthy individuals (mean age: 35.8 ± 13.1 years; 82.5% female) using 18F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). This population exhibited a low prevalence of comorbidities associated with cerebrovascular risk factors. We utilized 18F-FDG-PET/CT imaging and quantitative regional analysis to assess cerebral glucose metabolism. A statistically significant negative correlation was found between age and the global standardized uptake value mean (SUVmean) of FDG uptake (p = 0.000795), indicating a decrease in whole-brain glucose metabolism with aging. Furthermore, region-specific analysis identified significant correlations in four cerebral regions, with positive correlations in the basis pontis, cerebellar hemisphere, and cerebellum and a negative correlation in the lateral orbital gyrus. These results were further confirmed via linear regression analysis. Our findings reveal a nuanced understanding of how aging affects glucose metabolism in the brain, providing insight into normal neurology. The study underscores the utility of 18F-FDG-PET/CT as a sensitive tool in monitoring these metabolic changes, highlighting its potential for the early detection of neurological diseases and disorders related to aging.

P360Introduction: 1. Discuss the utility of 18F-fluorodeoxyglucose (FDG)-PET/CT in the diagnosis of multiple myeloma. 2. Assess the ability of FDG-PET in monitoring the response to therapeutic interventions. 3. Assess the ability of dual time point (DTP) FDG-PET in differentiating benign from malignant lesions.Methods: PubMed, Google Scholar, and Web of Science were queried for primary literature examining the use of any somatostatin receptor targeting strategies in the diagnosis and/or therapeutic purpose. Searches were performed with the following terms: "FDG PET/CT", "multiple myeloma", "MM", "dual-time-point", "imaging", "diagnosis", and "therapy".Results: Multiple myeloma (MM) is a hematologic, plasma cell proliferative disorder of the bone marrow characterized by an abnormal number of plasma cells. Complications associated with MM include bone fractures, anemia, renal insufficiency, spinal cord …

The venous phase of a cerebral blood flow study is signaled by.

Introduction Atherosclerosis, the hardening and narrowing of the arteries, occurs due to the buildup of plaque on the inner walls of the arteries which can result in reduced blood flow to the organs and tissues. Risk factors such as smoking, chronic kidney disease, and aging can contribute to plaque formation. The gradual loss of elasticity in arterial walls and the presence of other risk factors, such as high blood pressure and diabetes, contribute to the increased risk of cardiovascular disease (CVD) observed in aging populations. Early detection through sensitive and specific imaging methods is important for the detection and treatment of CVD. 18F‐Sodium Fluoride positron emission tomography/computerized tomography (NaF‐PET/CT) can be utilized to detect and quantify molecular calcification and therefore early atherosclerosis in patients with CVD. Research has shown a positive correlation between NaF …

Tracer with increased uptake in tumor tissues includes.

Calcification and formation of calculi in the genitourinary system such as the bladder, kidney, and prostate are common processes of aging. Despite being in different parts of the body, these calculi can share risk factors; for instance, bladder and prostate calculi are seen in older men with benign prostatic hyperplasia. There have been increasing reports of detection of calculi using PET tracers such as 18 F-NaF and 18 F-FDG, suggesting their role for detection of extraosseous calcification. In this report, we present simultaneous detection of bladder and prostate calculi with both 18 F-NaF and 18 F-FDG avidity in a 74-year-old man with multiple myeloma.

The application of [18F]-fluorodeoxyglucose ([18F]FDG) as a radiotracer to detect sites of inflammation (either due to bacterial infection or primary inflammation) has led to exploring the role of PET in visualizing bacteria directly at sites of infection. However, the results from such efforts are controversial and inconclusive so far. We aimed to assess the limitations of PET as an effective modality in the diagnosis of bacterial infections. Inflammation due to bacterial infections can be visualized by using [18F]FDG-PET. However, the non-specificity of [18F]FDG makes it undesirable to visualize bacteria as the underlying cause of inflammation. Hence, more specific radiotracers that possibly bind to or accumulate in bacteria-specific receptors or enzymes are being explored. Several radiotracers, including 2-deoxy-2-[18F]fluorosorbitol ([18F]FDS), 6-[18F]-fluoromaltose, [11C]para-aminobenzoic acid ([11C]PABA), radiolabeled trimethoprim (11C-TMP) and its analog fluoropropyl-trimethoprim (18F-FPTMP), other radiolabeled sugars, and antimicrobial drugs have been used to image microorganisms. Unfortunately, no progress has been made in translating the results to routine human use; feasibility and other factors have constrained their success in clinical settings. In the current article, we discuss the limitations of direct bacterial visualization with PET tracers, but emphasize the important role of [18F]FDG-PET as the only option for detecting evidence of infection.

Physiologic and Metabolic Assessment of Pulmonary Disorders Using Conventional Imaging Techniques and Positron Emission Tomography — University of Southern Denmark Skip to main navigation Skip to search Skip to main content University of Southern Denmark Home University of Southern Denmark Logo Help & FAQ Dansk English Home Researchers Research units Research output Activities Projects Press / Media Prizes Teaching Impacts Datasets Search by expertise, name or affiliation Physiologic and Metabolic Assessment of Pulmonary Disorders Using Conventional Imaging Techniques and Positron Emission Tomography Ghassan El-Haddad, Søren Hess, Abass Alavi Department of Regional Health Research IRS - Esbjerg and Grindsted Hospital, Research Unit of Radiology and nuclear medicine (Esbjerg) KI, OUH, Research unit of Clinical Physiology and Nuclear Medicine (Odense) University of …

P192Introduction: Cutaneous melanoma, deriving from the malignant transformation of melanocytes, has the highest mortality rate among skin cancers. Its incidence continues to increase annually, and survival odds are significantly worsened if metastasis to distant sites occurs. Combined positron emission tomography/computed tomography (PET/CT) using the radioactively labeled glucose analogue [18F]fluorodeoxyglucose (18F-FDG)plays an important role in the staging of melanoma patients, however, 18F-FDG PET/CT imaging potential goes beyond diagnosis and staging. Recent studies have suggested that 18F-FDG PET/CT could play a vital role in monitoring melanoma progression and evaluating responses to novel, highly specific targeted therapeutic approaches.The purpose of this educational exhibit is to review the most recent literature pertaining to the vast utility of 18F-FDG PET/CT in clinical …

P194Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting up to 33 million individuals worldwide. AF has been identified to increase stroke risk. Diagnosing AF continues to remain challenging as up to 40% of patients with underlying AF may not exhibit symptoms that meet diagnostic criteria. FDG quantitative imaging may be able to identify cryptic atrial fibrillation and point to areas of atrial endothelial damage, which increases risk for ischemic stroke, prior to abnormal findings detected by electrocardiogram (ECG). Increased FDG uptake seen in the right atria has been proposed to be related to an increased metabolic activity, cardiac remodeling, and inflammatory damage in the right atrial tissue and endocardial cells. The purpose of this educational exhibit is to review the most recent literature pertaining to cardiac PET imaging in the prediction of ischemic stroke. Methods: Several large …

67Ga emits gamma rays of 93, 184, 269, and 394 keV. 111In emits gamma rays of 172 and 247 keV, so choice (c) is not true. Labeled leukocytes are used for infection imaging rather than neoplasms. Medium-energy collimation is used for both.

Objectives:HIV affects 36 million people globally with prevalence decreasing due to antiretroviral therapy (ART) and social awareness; transmission occurs during substance use. Cocaine usage independently affects brain activity and may result in reduced ART adherence. This study evaluates brain glucose metabolism measured by 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) in cocaine users with HIV infection.Design:Sixty-three participants were categorized into groups: 36 HIV infected (HIV+) and 27 non-HIV infected (HIV−) individuals. Each group was further split into cocaine users (CO+) and non-cocaine users (CO−). Of the HIV+, half were cocaine users and half were not. Of the HIV−, 14 were cocaine users and 13 were not. 18 F-FDG-PET and low dose CT scans were performed on all participants.Methods:Brain glucose metabolism was evaluated by 18 …

Study Design.Cross-sectional; observational.Objectives.To determine whether sodium fluoride (NaF) positron emission tomography/computed tomography (PET/CT) can be used to monitor decreased bone turnover with aging in the spine.Background.Osteoporosis is characterized by structural changes in the bone such as decreased bone mineral density leading to an increased risk for fractures. An imaging modality capable of identifying molecular changes that precede these structural changes could be critical for the early diagnosis and monitoring of osteoporosis and other metabolic bone disorders.Materials and Methods.The potential of 18 F-sodium fluoride (NaF)–PET/CT in detecting changes in bone turnover associated with aging was examined in the lumbar spine of 88 healthy volunteers (43 females, 45 males; mean age 44.6 yr). Regions of interest equal to the trabecular body of the L1 to L4 vertebrae …

P1179Introduction: The recent advent of dual-modality positron emission tomography (PET)/computed tomography (PET/CT) and PET/magnetic resonance imaging (MRI) imaging systems has revolutionized molecular imaging and has added unprecedented diagnostic capability by facilitating molecular characterization of normal and abnormal structures. PET/CT in clinical practice has increasingly become a fundamental diagnostic tool for assessing a wide variety of both adult and pediatric malignancies. Integrated PET/MRI is also a safe, sensitive, and efficient imaging technology in children which provides cancer staging and restaging with up to 80% reduced radiation exposure. The aim of this review is to provide a brief overview on the uses of PET-based hybrid imaging in pediatric oncology.Methods: An integrative literature review was conducted using the OVID Medline, and PubMed databases and the …

P749Introduction: Breast cancer is the second most common cause of cancer in women, preceded by various skin cancers. While thoracic radiotherapy (RT) in these patients may reduce risks of cancer recurrence, the close proximity of the heart, especially to the left breast, often results in incidental irradiation to cardiac tissue and the coronary arteries. Recent RT sophistications, such as intensity modulated RT, proton therapy and deep inspiration breath holding are being implemented to better target radiation dose. However, a heterogeneous array of cardiovascular sequelae continue to raise concern, with RT-induced vascular injury, atherosclerotic plaque formation, and subsequent coronary artery disease (CAD) recently gaining particular interest. Although these complications are well-known, clear recommendations regarding the assessment of CAD in breast cancer patients receiving RT remain relatively …

P1076Introduction: The aim of this study was to compare the pulmonary uptake of 18F-fluorodeoxyglucose (FDG) before and after treatment in patients with non-Hodgkin lymphoma (NHL) who underwent Chimeric Antigen Receptor T-cell (CAR-T) therapy.Methods: Retrospective FDG PET/CT data of 60 patients (males = 38, females = 22) with NHL and a mean age of 60.3±12.48 years (range: 29-81) were collected from the Hospital of the University of Pennsylvania. Included were baseline scans from before initiation of CAR T therapy for relapsed or refractory NHL and first follow-up scan after the treatment. The mean number of days between treatment date and the first follow up scan was 71.9 days (range 21-179). Three patients were excluded from the study as their baseline scans were performed at an outside institution. All scans were conducted 60 min following intravenous injection of 4 MBq/kg of FDG. The …

P1576Introduction: The main goal of this systematic review is 1. To assess the prediction machine learning based radiomics features of prostate-specific membrane antigen (PSMA)-PET imaging in detection of prostate cancer (PCa), 2. Determine the most accurate model applied among machine learning (ML) models, 3. Determine the most dominant radiomics feature among all employed features.Methods: We conducted a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), Cochrane library, and Google Scholar. The methodological quality of included observational studies was determined using the modified version of the Newcastle-Ottawa Scale (NOS) by two independent authors, and disagreements were resolved by discussion or a third reviewer. The results of these studies were synthesized to identify trends and patterns in the existing literature …

We review the rationale, methodology, and clinical utility of quantitative [18F] sodium fluoride ([18F]NaF) positron emission tomography-computed tomography (PET-CT) imaging to measure bone metabolic flux (Ki, also known as bone plasma clearance), a measurement indicative of the local rate of bone formation at the chosen region of interest. We review the bone remodelling cycle and explain what aspects of bone remodelling are addressed by [18F]NaF PET-CT. We explain how the technique works, what measurements are involved, and what makes [18F]NaF PET-CT a useful tool for the study of bone remodelling. We discuss how these measurements can be simplified without loss of accuracy to make the technique more accessible. Finally, we briefly review some key clinical applications and discuss the potential for future developments. We hope that the simplified method described here will assist in promoting the wider use of the technique.

P1072Introduction: Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide; however, non-invasive assessment of CAD still remains a challenging task. Myocardial perfusion imaging (MPI) with single-photon emission computed tomography (SPECT) agents has been an important evaluating tool in CAD. With the emerging role of positron emission tomography (PET), PET MPI has demonstrated improvement in diagnostic and prognostic value.Methods: We reviewed multiple databases, including PubMed, Google Scholar, and compiled a comprehensive body of literatures related to the MPI used in CAD. Findings from multiple research papers were then analyzed and synthesized. We will discuss the difference between SPECT and PET MPI, available radiotracers in PET MPI, and the evolving role of 18F-flurpiridaz in PET MPI.Results: Prior to the exponential growth in the use of PET …

Multimodal molecular imaging has revolutionized both clinical practice and biomedical research. PET/CT performed using the positron emission tomography (PET) radiotracer 18F-fluorodeoxyglucose (18F-FDG) has become a pivotal modality for imaging a variety of pathologies and is particularly useful in the detection and evaluation of cancers. Hybrid whole-body PET/CT yields complementary sets of structural data and metabolic or functional information in one harmonious setting and allows for successful utilization in clinical settings with results superior to both PET and CT individually.However, despite its many benefits as an imaging modality, 18F-FDG PET/CT has several limitations, most notably being the ionizing radiation and lower soft tissue resolution associated with CT. In this setting, where high spatial resolution, soft-tissue contrast, or radiation exposure are

Which of the following is a malignant bone disease?

Which of the following is true of 67Ga citrate- and 111In-labeled leukocytes?

P1067Introduction: Cardiac tumors account for only a small proportion of cardiac masses. Although extremely rare, its classification is vital in order to predict patient prognosis. Cardiac tumors can be categorized as neoplastic or non-neoplastic. Neoplastic lesions can be further classified into primary cardiac tumors (PCT) and secondary tumors. The majority of the cardiac masses are non-neoplastic tumors (75%), however, secondary malignant cardiac tumors are found to be 50% more common than PCT. Patients with cardiac tumors can be asymptomatic or symptomatic with non-specific presentations, including constitutional symptoms, valvular dysfunction, dyspnea, or syncope. Given the rarity of the disease, there is no established approach for the diagnostic workup of cardiac tumors.Methods: We reviewed multiple databases, including PubMed and Google Scholar, and compiled a comprehensive body of …

The past five decades have witnessed the birth of some very powerful techniques that have substantially enhanced the role of imaging. Modern tomography was introduced by David Kuhl at the University of Pennsylvania in the late 1960s by utilizing conventional single gamma-emitting compounds but was not adopted clinically at the time [1]. However, the invention of X-ray-based computed tomography (CT) by Hounsfield in the early 1970s was adopted within a short period of time as a major revolution in medical imaging [2]. While the initial CT instruments were confined to imaging brain disorders, by the late 1970s, significant advances allowed images of the entire body. Also, the field of view of early CT scans was very limited and therefore total body CT was impractical until the mid-tolate 1980s. Soon after the introduction of CT, investigators at Penn introduced the concept of molecular imaging by …

In contrast to the discipline of conventional radiology, to which medical school students, trainees, and many practitioners of medicine are heavily exposed, the field of nuclear medicine is somewhat specialized and requires special training for optimal understanding of its role in various domains in medicine. Therefore, there is a dire need for a simplified exposure to the specialty that provides some practical knowledge about the field and its unique role in the day-to-day practice of medicine.“The Essentials” series is a collection of radiology textbooks that follow such a standardized format. The series is designed to provide a practical tool for those who wish to gain a broad base of knowledge on various specialties in medical imaging. The content is confined to the essentials of the specialty and can be understood by the novice. However, enough details are included to be useful for those who teach the specialty and to …

In appreciation of our 2017 reviewers In appreciation of our 2017 reviewers Full Text NEWS IN APPRECIATION OF OUR 2017 REVIEWERS The Editors of the Journal thank the following 2017 reviewers for their dedication and superb contributions. The number of manuscripts reviewed by each reviewer during 2017 is shown in parentheses. We regret any omission or incorrect citation of the number. Starting next year, the number of reviews completed will be an important factor in selecting the Zaret-Beller Award for best reviewer. The list below is in alphabetical order. • Abdallah, Mouin (1) • Abidov, Aiden (1) • Acampa, Wanda (6) • Acharya, Deepak (1) • Aggarwal, Niti (1) • Al Badarin, Firas (1) • Al-Mallah, Mouaz (1) • Alavi, Abass (1) • Alessio, Adam (0) • Alexanderson, Erick (1) • AlJaroudi, Wael (7) • Allam, Adel (1) • Andrikopoulou, Efstathia (2) • Armstrong, Ian (2) • Arumugam, Parthiban (1) • Bangalore, Sripal (1) • Bax…

P492Introduction: Patients with cognitive impairment often have a history of cardiovascular disease (CVD) or multiple cardiovascular risk factors (CRFs) such as hypertension, obesity, and hypercholesterolemia. The literature reports that CVD with CRFs may increase the risk of developing vascular dementia and Alzheimer’s Disease. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) allows for the in vivo study of cerebral glucose metabolism, and can detect metabolic alterations in several neurological diseases. As we age, the brain undergoes both structural and functional changes; the regional distribution of these alterations mirrors cognitive decline. This study aims to assess the effect of aging on regional glucose uptake in subjects with known cardiovascular risk factors.Methods: In total, 40 subjects (mean age 55.9 ± 11.89 years, 50% males) with known cardiovascular risk factors underwent …

In addition to providing a map of tissue attenuation values, the CT serves to localize features seen on the SPECT or PET.

P297Introduction: 1. Discuss the utility of 18F-sodium fluoride (NaF)-PET/CT in the assessment of osteoporosis. 2. Assess the feasibility of NaF-PET/CT in evaluating the response in osteoporosis patients to therapeutic treatments.Methods: Osteoporosis is a chronic metabolic condition caused by altered bone microstructure and is the most common bone disorder. It is associated with increased mortality, morbidity, disability, reducing overall quality of life. Osteoporosis is characterized by low bone mineral density and results in fragile bone structure and fractures. Weakened bone strength and fractures results from improper bone remodeling activity in which the rate of bone resorption through osteoclast activity is greater than the rate of bone formation through osteoblast activity. Currently, dual x-ray absorptiometry (DXA) is used to evaluate osteoporosis by assessing the bone mineral density (BMD), which is …

For more than two years, lingering sequalae of COVID-19 have been extensively investigated. Approximately 10% of individuals infected by COVID-19 have been found to experience long-term symptoms termed “long COVID-19”. The neurological and psychiatric manifestations of long COVID-19 are of particular concern. While pathogenesis remains unclear, emerging imaging studies have begun to better elucidate certain pathological manifestation. Of specific interest is imaging with [18F]FDG PET which directly reflects cellular glycolysis often linked to metabolic and inflammatory processes. Seeking to understand the molecular basis of neurological features of long COVID-19, this review encompasses the most recent [18F]FDG PET literature in this area.

P1062Introduction: Atherosclerosis is a pathological process with inflammation playing a central role in plaque initiation and progression, causing disease of the coronary arteries, aorta, and cerebral and peripheral arteries. Treatment of atherosclerosis begins with aggressive lifestyle modifications and often involves pharmacological intervention with statin therapy, particularly in individuals with elevated atherosclerotic cardiovascular disease (ASCVD) risk. Importantly, the plaque burden in coronary arteries predicts risk of major adverse cardiovascular events (MACE). However, the effects of statins and oral hypoglycemic agents on active metabolic processes implicated in atherogenesis are less well established.Methods: We reviewed multiple databases, including PubMed, Google Scholar, and compiled a comprehensive body of literatures related to the medical therapy effect on atherosclerosis plaque …

P354Introduction: 1. Review and summarize the literature regarding the application of artificial intelligence (AI) methods to positron emission tomography (PET) imaging in the context of ischemic stroke diagnosis and management. 2. Evaluate the potential accuracy and reliability of AI-assisted diagnosis and the potential for improved patient outcomes. 3. Propose recommendations for the future development and implementation of AI in PET imaging for stroke.Methods: A comprehensive search of the literature was conducted using the following electronic databases: PubMed, Scopus, and Web of Science. Eligible studies for inclusion were peer-reviewed papers that applied AI methods to PET imaging for stroke diagnosis or management. Data were then extracted from eligible studies, including information regarding study design, sample size, AI methodologies utilized, limitations, and research findings. Information …

Simple Summary Recent advances in PET/CT technology led to the development of long-axial field-of-view (LAFOV) PET/CT with the possibility of simultaneously scanning a large portion of the body with reduced acquisition time, reduced radiation burden, and improved spatial resolution. This article explores the potential applications of LAFOV PET/CT imaging in gynecological malignancies. Patients affected by these diseases are expected to gain multiple and major benefits from this technology and have some of their unmet needs answered in all phases of management, from initial staging to surgery and radiotherapy planning, assessment of treatment response, and restaging, with improved patient-tailored care. Abstract Gynecological malignancies currently affect about 3.5 million women all over the world. Imaging of uterine, cervical, vaginal, ovarian, and vulvar cancer still presents several unmet needs when using conventional modalities such as ultrasound, computed tomography (CT), magnetic resonance, and standard positron emission tomography (PET)/CT. Some of the current diagnostic limitations are represented by differential diagnosis between inflammatory and cancerous findings, detection of peritoneal carcinomatosis and metastases <1 cm, detection of cancer-associated vascular complications, effective assessment of post-therapy changes, as well as bone metabolism and osteoporosis assessment. As a result of recent advances in PET/CT instrumentation, new systems now offer a long-axial field-of-view (LAFOV) to image between 106 cm and 194 cm (i.e., total-body PET) of the patient’s body …

P1159Introduction: The aim of this study was to compare the global pathologic nodal uptake of FDG before and after treatment in non-Hodgkin lymphoma (NHL) patients who underwent chimeric antigen receptor T-cell (CAR-T) therapy.Methods: Retrospective FDG PET/CT data of 60 NHL patients between ages of 29 years and 81 years (mean = 60.3 ± 12.48; males=38, females=22) were collected. FDG PET/CT was performed before initiation of CAR-T therapy for relapsed or refractory NHL and after treatment (mean days 71.85, range from 21 to 179 days). Out of 60 patients, 5 patients were excluded from the study as baseline scans of 3 patients were taken outside the facility whereas in 2 patients the lymph node involvement was grossly non appreciable. All scans were conducted 60 min following intravenous injection of 4 MBq/kg of FDG. Pre-treatment and post-treatment FDG-PET/CT scans were examined by two …

The utilization of machine learning techniques in medicine has exponentially increased over the last decades due to innovations in computer processing, algorithm development, and access to big data. Applications of machine learning techniques to neuroimaging specifically have unveiled various hidden interactions, structures, and mechanisms related to various neurological disorders. One application of interest is the imaging of Alzheimer’s disease, the most common cause of progressive dementia. The diagnoses of Alzheimer’s disease, mild cognitive impairment, and preclinical Alzheimer’s disease have been difficult. Molecular imaging, particularly via PET scans, holds tremendous value in the imaging of Alzheimer’s disease. To date, many novel algorithms have been developed with great success that leverage machine learning in the context of Alzheimer’s disease. This review article provides an overview of …

P893Introduction: FDG-PET/CT is often used to detect the extent and location of pathology in patients with inflammatory, infectious, or malignant disease. However, with variability in FDG uptake in certain organs, there can be misinterpretation of physiologic FDG uptake as pathologic. The brain, liver, and blood pool are areas of the body with the most physiologically active FDG uptake, influenced by a variety of patient-dependent factors. Understanding physiologic FDG uptake is vital so that it may be used as a reference for which pathologic uptake may be compared to. The purpose of this study was to examine physiologic FDG uptake in the liver and its association with patient factors, including age, BMI, gender, presence of angina pectoris, fasting blood glucose level, and hemoglobin A1c. Methods: FDG-PET/CT data from the Cardiovascular Molecular Calcification Assessed by 18F-NaF PET/CT (CAMONA) trial …

The abbreviation COR stands for.

BackgroundCoronavirus disease 2019 (COVID-19) has been associated with nervous system involvement, with more than one-third of COVID-19 patients experiencing neurological manifestations. Utilizing a systematic review, this study aims to summarize brain MRI findings in COVID-19 patients presenting with neurological symptoms.MethodsSystematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist. The electronic databases of PubMed/MEDLINE, Embase, Scopus, and Web of Science were systematically searched for literature addressing brain MRI findings in COVID-19 patients with neurological symptoms.Results25 publications containing a total number of 3118 COVID-19 patients with neurological symptoms who underwent MRI were included. The most common MRI findings and the respective pooled incidences in …

Which one of the following statements is true about hybrid PET/CT or SPECT/CT imaging systems?

P1328Introduction: As research and treatment for cancer continue to develop, minimally invasive regional therapy through interventional procedures have become a major partaker in oncologic management of numerous malignancies including hepatocellular carcinoma, colorectal cancer, non-small cell lung cancer, renal cell carcinoma, thyroid cancer, and breast cancer. These interventional procedures include ablative therapy such as cryoablation, heat-based thermal ablation, microwave (MWA), radiofrequency ablation (RFA), and percutaneous ethanol ablation (PEI). Tumors are also treated with embolization through use of microscopic beads that are locally transferred with radioactivity or chemotherapy to targeted tumors. Furthermore, newer techniques including irreversible electroporation (IRE) are being utilized more frequently for oncologic management, especially in cases where post-treatment …

Introduction Emerging evidence suggests a robust association between cardiovascular disease (CVD) and cognitive decline, accentuating the necessity for early detection and intervention. 18F‐fluorodeoxyglucose‐positron emission tomography (FDG‐PET) has proven efficacious in identifying metabolic neurological changes at a molecular level, even before conventional imaging methods can detect structural changes. This study analyzed regional glucose metabolism in individuals with known CVD risk factors. The detection of such metabolic changes could assist in determining the necessity and timing of vascular interventions, such as carotid endarterectomy (CEA) or carotid artery angioplasty with stenting (CAS), contributing to improved patient outcomes and reduced postoperative complications. Methods We compared 79 healthy controls (mean age 44.5 ± 13.8 years, 53.2% males) and 40 individuals (mean …

P494Introduction: Atherosclerosis, the hardening and narrowing of the arteries, occurs due to the buildup of plaque on the inner walls of the arteries which can result in reduced blood flow to the organs and tissues. Risk factors such as smoking, chronic kidney disease, and aging can contribute to plaque formation. The gradual loss of elasticity in arterial walls and the presence of other risk factors, such as high blood pressure and diabetes, contribute to the increased risk of cardiovascular disease (CVD) observed in aging populations. Early detection through sensitive and specific imaging methods is important for the detection and treatment of CVD. 18F-Sodium Fluoride positron emission tomography/computerized tomography (NaF-PET/CT) can be utilized to detect and quantify molecular calcification and therefore early atherosclerosis in patients with CVD. Research has shown a positive correlation between NaF …

PurposeWe hypothesized that unilateral leg pain following surgical treatment of lumbar disc herniation (LDH) is associated with an increase in the glucose metabolism of the contralateral thalamus.MethodsPatients scheduled for surgery due to LDH underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography less than two weeks prior to surgery. Their thalamic FDG uptake was measured and expressed as the mean and partial volume corrected mean standardized uptake values (SUVmean and cSUVmean). These measures were compared with patient-related outcome measures collected pre- and 1-year post-operatively: back and leg pain on a 0–100 VAS scale and health-related quality of life as measured by the EuroQol-5D (EQ-5D).ResultsTwenty-six patients (ten females) aged 49.7 ± 7.4 (mean ± SD) years were included. There was a significant correlation between painful …