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Biomedical subjects

Hongming Zhuang

Publications and source records attributed to Hongming Zhuang.

At least 73 records · Page 4Linked to original sources
PubMed2003

Utility of FDG-PET scanning in lymphoma by WHO classification.

We retrospectively evaluated (18)fluoro-2-deoxyglucose positron emission tomography (FDG-PET) scans in 172 patients with lymphoma and correlated results with pathologic diagnosis using the World Health Organization (WHO) classification system. In total, FDG-PET detected disease in at least one site in 161 patients (94%) and failed to detect disease in 11 patients (6%). The most frequent lymphoma diagnoses were diffuse large B-cell lymphoma (LBCL; n = 51), Hodgkin lymphoma (HL; n = 47), follicular lymphoma (FL; n = 42), marginal zone lymphoma (MZL; n = 12), mantle cell lymphoma (MCL; n = 7), and peripheral T-cell lymphoma (PTCL; n = 5). FDG-PET detected disease in 100% of patients with LBCL and MCL and in 98% of patients with HL and FL. In contrast, FDG-PET detected disease in only 67% of MZL and 40% of PTCL. Comparison with bone marrow biopsies showed that FDG-PET was not reliable for detection of bone marrow involvement in any lymphoma subtype.

Fluorodeoxyglucose F18↗
PubMed2003

Comparison of I-123 and I-131 for whole-body imaging after stimulation by recombinant human thyrotropin: a preliminary report.

PURPOSE: Many studies have established I-123 whole-body scanning (WBS) as an alternative to I-131 WBS in the evaluation of differentiated thyroid cancer. Similarly, recombinant human thyroid-stimulating hormone (rhTSH) has been shown to be an effective alternative to thyroid hormone withdrawal in the stimulation of TSH levels for WBS. The purpose of the current investigation was to compare the ability of rhTSH-stimulated I-123 WBS to that of rhTSH-stimulated I-131 WBS in the evaluation of thyroid cancer. METHODS: The reports of 101 consecutive I-123 WBS and 101 consecutive I-131 WBS were analyzed. All patients had undergone near-total thyroidectomy, were considered to have a low risk for recurrence, and had rhTSH-stimulated serum thyroglobulin levels measured at the time of imaging. Findings of an examination were considered positive if either residual thyroid tissue was detected on imaging or the serum thyroglobulin level was greater than 2 ng/dl. RESULTS: The results of rhTSH-stimulated I-123 scans and thyroglobulin levels were concordant in 91 (90%) cases, whereas the results of rhTSH-stimulated I-131 scans and thyroglobulin levels were concordant in 85 (84%) cases. I-123 WBS detected 9 foci of disease in 6 patients, whereas I-131 WBS detected 10 foci of disease in 9 patients. CONCLUSION: The results of this preliminary investigation are promising regarding the utility of rhTSH-stimulated I-123 WBS as an alternate approach to rhTSH-stimulated I-131 WBS in patients at low risk for recurrence.

Carcinoma↗
PubMed2003

FDG positron emission tomography in the surveillance of hepatic tumors treated with radiofrequency ablation.

PURPOSE: Radiofrequency thermal ablation (RFA) is an emerging technique in the treatment of focal hepatic tumors. Magnetic resonance imaging (MRI) and computed tomography (CT) are currently used to monitor hepatic tumors after RFA for residual disease and recurrence. Fluorodeoxyglucose (FDG) positron emission tomography (PET) is an excellent imaging method for the detection of liver metastases, but it has not been thoroughly evaluated as an alternative to anatomic imaging in the surveillance of liver tumors treated with RFA. The purpose of this investigation was to determine the role of FDG-PET imaging in the surveillance of liver tumors treated with RFA. METHODS: Thirteen patients with histories of malignant tumors of the liver treated with RFA and who had received post-treatment FDG-PET scans were assessed retrospectively. One patient had two post-RFA FDG-PET scans, eight patients had concurrent MRI scans, and six patients had concurrent CT scans. Imaging findings were compared with the results of clinical follow-up. RESULTS: There were either recurrent tumors at the ablation site (8 patients) or new metastases (3 patients) in 11 patients. FDG-PET identified all 11 cases and did not misidentify any cases. Of the seven patients with positive PET findings who received an MRI scan, three were also positive on MRI (42.9%); the other four cases were either negative or equivocal. Of the four patients with positive PET findings who received a CT scan, only two had positive CT scan findings (50%). All recurrences diagnosed by PET were confirmed on clinical follow-up. CONCLUSION: In this preliminary study, FDG-PET was superior to anatomic imaging in the surveillance of patients treated with RFA for malignant hepatic tumors.

Adult↗
PubMed2003

Fluorodeoxyglucose positron emission tomography excludes pericardial metastasis by recurrent lung cancer.

Fluorodeoxyglucose (FDG) positron emission tomography (PET) has been shown to be useful in the diagnosis and staging of a variety of malignancies. Because of its high sensitivity, FDG PET frequently detects malignant lesions that are not demonstrated clearly by anatomic imaging modalities. FDG PET usually has high negative predictive value and, therefore, negative studies are highly suggestive of a benign process. The authors present a patient in whom transesophageal echocardiography and magnetic resonance imaging described pericardial metastasis from a recurrent lung cancer, which on FDG PET was shown correctly to suggest benign scar tissue.

Carcinoma, Small Cell↗
PubMed2003

Diffuse bone marrow involvement of Hodgkin lymphoma mimics hematopoietic cytokine-mediated FDG uptake on FDG PET imaging.

Whole-body fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) has been useful in the management of a variety of malignancies. In patients with chemotherapy followed by bone marrow stimulants such as granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor, the bone marrow will have diffuse, increased FDG accumulation. Therefore, diffuse bone marrow FDG uptake is commonly attributable to the effect of hematopoietic cytokines. However, diffuse bone marrow FDG uptake can also be caused by bone marrow involvement by malignancy. The authors report a patient with diffuse bone marrow involvement of Hodgkin disease that appears indistinguishable from hematopoietic cytokine-mediated FDG bone marrow uptake.

Adolescent↗
PubMed2003

Unrecognized renal transplants as a potential source of false-positive interpretation of FDG PET.

Renal transplantation has become an effective therapy for patients with late-stage renal disease. Fluorodeoxyglucose (FDG) positron emission tomography (PET) is accepted as an important diagnostic technique in the evaluation of suspected or known malignancies or other disorders in the day-to-day practice of medicine. Because FDG is excreted from the kidneys into the urine, unrecognized renal transplants can appear as malignant lesions. Familiarity with the clinical history is a prerequisite in the correct interpretation of FDG PET images in this setting. In addition, FDG PET images should be correlated with anatomic images when such studies are available. When neither clinical history nor anatomic images are available, a combination of "abnormal" activity in the pelvis and absence of normal renal activity should raise suspicion of the existence of a renal transplant.

Adult↗
PubMed2003

Potential false-positive FDG PET imaging caused by subcutaneous radiotracer infiltration.

Whole-body fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) scanning has been useful in the management of a variety of malignancies with high accuracy. However, numerous nonmalignant lesions can also result in increased FDG accumulation and consequently may cause potential false-positive interpretation if the causes are not recognized. A single focus of FDG accumulation in the axilla can often easily be attributed to tracer infiltration when the injection was on the same side. However, multiple foci of FDG uptake can be similar to malignant lesions. A case is presented in which the follow-up study clarified the nature of multifocal increased FDG uptake in the axilla.

Axilla↗
PubMed2003

Roles of positron emission tomography with fluorine-18-deoxyglucose in the detection of local recurrent and distant metastatic sarcoma.

Sarcomas are a heterogeneous group of tumors comprising approximately 1% of all malignancies. Definitive treatment of sarcoma is surgical resection. However, after surgical removal, 40% to 60% of the patients will develop local or distant recurrence. Therefore, the early detection and treatment of recurrence is an important part of modern sarcoma therapy. Positron emission tomography with fluorine-18-deoxyglucose (FDG-PET) has been highly successful in detecting and staging a variety of malignancies. However, its use in the management of patients with sarcoma is less defined. The purpose of our study was to assess the potential roles of FDG-PET in the detection of local recurrence and distant metastases. In this retrospective study, the images of 33 FDG-PET scans, reports of 29 computed tomography (CT) scans, and 8 magnetic resonance imaging (MRI) scans from 28 patients were compared with surgical pathology or clinical follow up for at least 6 months. FDG-PET detected all 25 cases of local and distant recurrences with 100% sensitivity. CT was able to detect 18 of the 22 possible cases of recurrent disease, whereas MRI was able to detect 5 of 7 cases of recurrent disease. PET was particularly useful in patients with extensive histories of surgery and radiation therapy, precisely the setting in which CT and MRI have the lowest specificity and sensitivity. In conclusion, FDG-PET was a sensitive test to detect local and distant recurrences of sarcoma and this warrants further investigation.

Adolescent↗
PubMed2003

Paraneoplastic encephalitis associated with cystic teratoma is detected by fluorodeoxyglucose positron emission tomography with negative magnetic resonance image findings.

The role of fluorodeoxyglucose (FDG) positron emission tomography (PET) as a functional imaging technique used in the evaluation of a variety of malignancies has been well known. Paraneoplastic encephalitis is a rare central nervous complication, which has been reported in some tumors. Traditionally, magnetic resonance imaging of the brain is performed to aid in its diagnosis. The authors report a case of paraneoplastic encephalitis, associated with cystic teratoma, which had positive FDG-PET findings but appeared normal on magnetic resonance imaging.

Adult↗
PubMed2002

Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET.

The purpose of this study was to determine the actual standardized uptake value (SUV) by using the lesion size from computer tomography (CT) scan to correct for resolution and partial volume effects in positron emission tomography (PET) imaging. This retrospective study included 47 patients with lung lesions seen on CT scan whose diagnoses were confirmed by biopsy or by follow up CT scan when the PET result was considered negative for malignancy. Each lesion's FDG uptake was quantified by the SUV using two methods: by measuring the maximum voxel SUV (maxSUV) and by using the lesion's size on CT to calculate the actual SUV (corSUV). Among small lesions (2.0 cm or smaller on CT scan), ten were benign and 17 were malignant. The average maxSUV was 1.43+/-0.77 and 3.02+/-1.74 for benign and malignant lesions respectively. When using an SUV of 2.0 as the cutoff to differentiate benignity and malignancy, the sensitivity, specificity, and accuracy were 65%, 70%, and 67% respectively. When an SUV of 2.5 was used for cutoff, the sensitivity, specificity, and accuracy were 47%, 80%, and 59% respectively. The average corSUV was 1.65+/-1.09 and 5.28+/-2.71 for benign and malignant lesions respectively. Whether an SUV of either 2.0 or 2.5 was used for cutoff, the sensitivity, specificity, and accuracy remained 94%, 70%, and 85% respectively. The only malignant lesion that was falsely considered benign with both methods was a bronchioalveolar carcinoma which did not reveal any elevated uptake of fluorine-18 fluorodeoxyglucose (FDG). Of the large lesions (more than 2.0 cm and less than 6.0 cm), one was benign and 19 were malignant and the corSUV technique did not significantly change the accuracy. It is concluded that measuring the SUV by using the CT size to correct for resolution and partial volume effects offers potential value in differentiating malignant from benign lesions in this population. This approach appears to improve the accuracy of FDG-PET for optimal characterization of small lung nodules.

Adult↗
PubMed2002

Persistent non-specific FDG uptake on PET imaging following hip arthroplasty.

Hip arthroplasty is a common surgical procedure, but the diagnosis of infection associated with hip arthroplasty remains challenging. Fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) has been shown to be a promising imaging modality in settings where infection is suspected. However, inflammatory reaction to surgery can result in increased FDG uptake at various anatomic locations, which may erroneously be interpreted as sites of infection. The purpose of this study was to assess the patterns and time course of FDG accumulation following total hip replacement over an extended period of time. Firstly, in a prospective study nine patients with total hip replacement were investigated to determine the patterns of FDG uptake over time. Three FDG-PET scans were performed in each patient at about 3, 6 and 12 months post arthroplasty. Secondly, in a retrospective analysis, the medical and surgical history and FDG-PET imaging results of 710 patients who had undergone whole-body scans for the evaluation of possible malignant disorders were reviewed. The history of arthroplasty and FDG-PET findings in the hip region were reviewed for this study. Patients with symptomatic arthroplasties or related complaints during FDG-PET scanning were excluded from the analysis. During the entire study period, all nine patients enrolled in the prospective study were demonstrated to have increased FDG uptake around the femoral head or neck portion of the prosthesis that extended to the soft tissues surrounding the femur. Among the patients reviewed in the retrospective study, 18 patients with a history of 21 hip arthroplasties who were asymptomatic at the time of FDG-PET scan met the criteria for inclusion. The time interval between the hip arthroplasty and the FDG-PET study ranged from 3 months to 288 months (mean+/-SD: 80.4+/-86.2 months). In 81% (17 of 21) of these prostheses, increased FDG uptake could be noted around the femoral head or neck portion of the prosthesis. The average time interval between arthroplasty and FDG-PET scan in these patients was 71.3 months. In only four prostheses (19%, 4 of 21) was no abnormally increased FDG uptake seen around the prostheses or adjacent sites. The average time interval in these patients was 114.8 months. It is concluded that following hip arthroplasty, non-specifically increased FDG uptake around the head or neck of the prosthesis persists for many years, even in patients without any complications. Therefore, to minimize the number of false-positive results for infection with PET studies obtained to evaluate a painful hip prosthesis, caution should be exercised when interpreting FDG uptake around the head or neck portion of the prosthesis.

Arthroplasty, Replacement, Hip↗