Dataset Information

Diagnostic Value of Positron Emission Tomography Combined with Computed Tomography for Evaluating Critically Ill Neurological Patients.

ABSTRACT:

Purpose

¹⁸F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is a promising new tool for the identification of inflammatory, infectious, and neoplastic foci. The aim of our work was to evaluate the diagnostic value of FDG-PET/CT in patients treated on a neurological/neurosurgical ICU or stroke unit.

Methods

We performed a single-center, 10-year, retrospective evaluation of the value of FDG-PET/CT in critically ill adult patients with severe neurological disease.

Results

42 patients underwent FDG-PET/CT. Of these, 15 were ventilated and 10 were under vasopressor support. We identified four indications for performing FDG-PET/CT: (1) excluding a paraneoplastic etiology in an otherwise unexplained encephalitis, encephalopathy or neuropathy, (2) detecting a large-vessel vasculitis in patients with ischemic stroke, (3) detecting an infectious focus in sepsis, and less frequently (4) evaluating cerebral metabolism. In 22 patients who were evaluated for an unknown malignancy, 5 scans revealed either a previously unknown tumor or unknown metastases of a previously treated malignancy. Of 11 patients investigated for large-vessel vasculitis, 2 showed an inflammation of arteries supplying the brain. Of six sepsis cases, FDG-PET/CT identified an infectious focus in four.

Summary

We found FDG-PET/CT to be a helpful tool in critically ill neurological patients. The results of the FDG-PET/CT had direct therapeutic consequences in the 12 true-positive cases. In 24 of the 29 negative cases, FDG-PET/CT helped exclude alternative diagnoses and/or influenced therapy. Our findings demonstrate the feasibility and diagnostic benefit of FDG-PET/CT in this group of patients.

SUBMITTER: Kampe KK

PROVIDER: S-EPMC5306377 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Diagnostic Value of Positron Emission Tomography Combined with Computed Tomography for Evaluating Critically Ill Neurological Patients.

Kampe Knut Kurt William KK Rotermund Roman R Tienken Milena M Thomalla Götz G Regier Marc M Klutmann Susanne S Kluge Stefan S

Frontiers in neurology 20170214

<h4>Purpose</h4><sup>18</sup>F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is a promising new tool for the identification of inflammatory, infectious, and neoplastic foci. The aim of our work was to evaluate the diagnostic value of FDG-PET/CT in patients treated on a neurological/neurosurgical ICU or stroke unit.<h4>Methods</h4>We performed a single-center, 10-year, retrospective evaluation of the value of FDG-PET/CT in critically ill adult pati ...[more]

PMID: 28261149

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Project description:To investigate the value of preoperative positron emission tomography/computed tomography (PET/CT) in differentiating the invasive degree of hypometabolic lung adenocarcinoma. We retrospectively analyzed the data of patients who underwent PET/CT examination, high-resolution computed tomography, and surgical resection for low-metabolism lung adenocarcinoma in our hospital between June 2016 and December 2021. We also investigated the relationship between the preoperative PET/CT findings and the pathological subtype of hypometabolic lung adenocarcinoma. A total of 128 lesions were found in 113 patients who underwent resection for lung adenocarcinoma, including 20 minimally invasive adenocarcinomas (MIA) and 108 invasive adenocarcinomas (IAC), whose preoperative PET/CT showed low metabolism. There were significant differences in the largest diameter (Dmax), lesion type, maximum standard uptake value (SUVmax), SUVindex (the ratio of SUVmax of lesion to SUVmax of contralateral normal lung paranchyma), fasting blood glucose, lobulation, spiculation, and pleura indentation between the MIA and IAC groups (p < 0.05). Multivariate logistic regression analysis showed that the Dmax (odds ratio (OR) = 1.413, 95% confidence interval (CI: 1.155-1.729, p = 0.001)) and SUVmax (OR = 12.137, 95% CI: 1.068-137.900, p = 0.044) were independent risk factors for predicting the hypometabolic IAC (p < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the Dmax ≥ 10.5 mm and SUVmax ≥ 0.85 were the cut-off values for differentiating MIA from IAC, with high sensitivity (84.3% and 75.9%, respectively) and specificity (84.5% and 85.0%, respectively), the Combined Diagnosis showed higher sensitivity (91.7%) and specificity (85.0%). The PET/CT findings correlated with the subtype of hypometabolic lung adenocarcinoma. The parameters Dmax and SUVmax were independent risk factors for predicting IAC, and the sensitivity of Combined Diagnosis prediction is better.

Dataset Information

Diagnostic Value of Positron Emission Tomography Combined with Computed Tomography for Evaluating Critically Ill Neurological Patients.

Purpose

Methods

Results

Summary

Publications

Diagnostic Value of Positron Emission Tomography Combined with Computed Tomography for Evaluating Critically Ill Neurological Patients.

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