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William H Martin

Publications and source records attributed to William H Martin.

26 records · Page 2Linked to original sources
PubMed2003

[18F]Fluorodeoxyglucose positron emission tomography surveillance of hepatic metastases from prostate cancer following radiofrequency ablation: a case report.

The liver is the organ most commonly involved with metastatic disease. Surgical resection of hepatic metastases is the only potentially curative therapy, but it is possible in only 20 per cent of the patients. Radiofrequency ablation (RFA) of hepatic lesions is a therapeutic option for unresectable hepatic metastases. Today there is no clear consensus about which imaging technique is the most reliable to monitor RFA therapy. [18F]Fluorodeoxyglucose (FDG) positron emission tomography (PET) is a new imaging modality allowing evaluation of glucose metabolism that has become established for monitoring therapy and early detection of recurrence of various types of malignant tumors. We present a case report of a 61-year-old man treated for prostate carcinoma 3 years earlier who presented with rising serum prostate-specific antigen (PSA) levels. A CT scan demonstrated two hepatic metastases that were treated with RFA because the patient refused surgery. During 3 years of follow-up hepatic recurrence was monitored with serum PSA levels, CT of the abdomen, and FDG-PET imaging on multiple occasions. On three separate occasions FDG-PET revealed hypermetabolic foci despite no definite evidence of recurrence on CT. Furthermore FDG-PET imaging 2 months after the last RFA therapy showed two large photopenic areas without evidence of hypermetabolism consistent with successful RFA therapy. Serum PSA levels correlated better with FDG-PET than CT results. We conclude that in this patient FDG-PET imaging was more accurate than CT for monitoring recurrence of hepatic metastases from prostate carcinoma after RFA therapy. PET demonstrated hypermetabolic foci when there was recurrence and no evidence of hypermetabolism early after successful RFA therapy. In addition FDG-PET imaging helped to guide the placement of the RFA probe to the most metabolically active part of the tumor.

Carcinoma↗
PubMed2002

2-deoxy-2-[F-18]fluoro-D-glucose imaging with positron emission tomography for initial staging of Hodgkin's disease and lymphoma.

PURPOSE: To assess the accuracy of 2-Deoxy-2-[F-18] Fluoro-D-Glucose positron emission imaging (FDG-PET) for staging Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) compared to conventional staging (CS) and to evaluate the impact on patient management. METHODS: Forty-five consecutive patients with lymphoma underwent whole-body FDG-PET imaging for initial staging. Discordant lesions were verified with biopsy or clinical follow-up. The impact on staging and management was reviewed retrospectively. RESULTS: A total of 129 sites of disease were identified, and 88 of those were concordant. FDG-PET and conventional staging demonstrated 24 and 17 additional sites, respectively. FDG-PET correctly upstaged five patients and down-staged two patients (16% total), leading to a change in therapy in 6/45 (13%) patients. However, FDG-PET understaged three patients (7%), correctly staged by conventional staging modalities. Assuming that the addition of FDG-PET to conventional staging modalities is 100% accurate for staging lymphoma, the accuracy of FDG-PET alone was 91%, compared to 84% for conventional staging modalities. CONCLUSIONS: FDG-PET is a noninvasive and efficient imaging modality for staging patients with lymphoma and should be used in conjunction with conventional staging modalities, as they appear complementary.

Journal Article↗
PubMed2002

2-Deoxy-2-[18F]fluoro-D-glucose positron emission tomography uptake in a giant adrenal myelolipoma.

Incidental adrenal lesions found on anatomic imaging are not uncommon. 2-Deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET) imaging is highly accurate in the differentiation of benign from malignant adrenal lesions, both in patients with proven malignancy and with adrenal lesions detected incidentally. A 60-year-old white female with a history of lower mid-back pain underwent computerized tomography (CT) imaging that identified a 15-cm complex mass within the left adrenal gland with soft tissue, cystic, and adipose components. FDG-PET imaging showed significant hypermetabolic activity within portions of the mass with central photopenia suggesting a malignant lesion with central necrosis. Surgical excision and pathological examination, however, revealed a benign adrenal myelolipoma with extensive adenomatous and hematopoietic elements. Prior reports of adrenal myelolipoma evaluated with FDG-PET imaging have described no significant FDG uptake within these benign tumors. This case is an unusual example of histologically proven benign adrenal myelolipoma that was hypermetabolic on FDG-PET imaging. Correlation of pathologic and imaging findings demonstrated that the hypodense regions on CT were hypometabolic on FDG-PET and corresponded to cystic necrosis and adipose elements, whereas the adenomatous and hematopoietic elements were hypermetabolic.

Journal Article↗
PubMed2002

Cerebral lesions incidentally detected on 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography images of patients evaluated for body malignancies.

OBJECTIVES: The purpose of this work was done to evaluate the value of including the brain in the field of view of a whole-body 2-deoxy-2-[18F] fluoro-D-glucose positron emission tomography (FDG-PET) study of patients referred for the evaluation of body malignancies. METHODS: A total of 1026 consecutive patients were included in this work. The primary diagnoses were the following: lung (n = 253), colorectal (n = 148), head and neck (n = 61), lymphoma (n = 249), melanoma (n = 84), and others (n = 231). Whole-body FDG images including the brain were acquired with a dedicated PET tomograph (GE advance, General Electronic Medical Systems, Milwaukee, WI) one hour after the intravenous administration of 10 mCi of FDG. Two experienced nuclear medicine physicians interpreted the images. Positive findings in the brain or the skull were correlated with other imaging studies and clinical follow-up. RESULTS: Abnormal findings were detected in 3.9% (40/1026) of the patients. Among the 40 abnormal focal lesions, 29 patients had a known history of cerebral disease, cerebrovascular or metastatic disease in most patients. Of the 11 patients without a prior history of cerebral disease, four patients had increased focal FDG uptake suggestive of metastases. Among these, two were proven clinically, one was proven to be a skull base metastasis on MRI, and the other had negative clinical follow-up, but only of two months duration. The other seven patients had a decreased focal FDG uptake most consistent with infarct, one was proven clinically, and the other six had a negative clinical follow-up (mean of 6.3 months, range 1-10), but had multiple risk factors for cerebrovascular disease. CONCLUSIONS: We conclude that FDG-PET screening for cerebral lesions in patients with body malignancy has little clinical impact. Unsuspected cerebral or skull metastases were detected in 0.4% (4/1026) of the patients.

Journal Article↗
PubMed2002

Serendipitous detection of Cushing's disease by FDG positron emission tomography and a review of the literature.

A 70-year-old woman was referred for F-18 fluorodeoxyglucose (FDG) positron emission tomographic (PET) imaging of the brain to evaluate progressive dementia and neuropsychiatric symptoms. Although she had a history of hypertension and diabetes mellitus, she did not exhibit phenotypic features of Cushing's disease. The FDG-PET images revealed marked FDG uptake in the pituitary gland but no evidence of degenerative dementia. Two macroadenomas were confirmed by magnetic resonance imaging. Endocrinologic evaluation revealed Cushing's disease. After surgical resection of the tumors, the patient's symptoms decreased markedly.

Adenoma↗
PubMedDate not supplied

Positron emission tomography/computed tomography of a rare xanthogranulomatous process: Erdheim-Chester disease.

Erdheim-Chester disease (ECD) is a disseminated xanthogranulomatous infiltrative disease of unknown etiology due to infiltration of different organs and bones by foamy histiocytes. A 37-year-old male with cerebral and periorbital lesions was diagnosed with this rare disease and was evaluated with magnetic resonance imaging (MRI) and 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) with positron emission tomography/computed tomography (PET/CT) imaging at baseline and following therapy. FDG-PET imaging allowed accurate evaluation of the extent of the disease at baseline, as well as assessment of response to therapy.

Adult↗
PubMedDate not supplied

Metabolic imaging with FDG: a primer.

The rapid advances in imaging technologies are a challenge for both radiologists and clinicians who must integrate these technologies for optimal patient care and outcomes at minimal cost. Multiple indications for functional imaging using fluorode-oxyglucose (FDG) are now well accepted in the fields of neurology, cardiology, and oncology, including differentiation of benign from malignant lesions, staging of malignant lesions, detection of malignant recurrence, and monitoring of therapy. The fusion of anatomic and molecular images (computed tomography [CT] and FDG) obtained with integrated positron emission tomography (PET)-CT systems, sequentially in time but without moving the patient from the imaging table, allows optimal co-registration of anatomic and molecular images, leading to accurate attenuation correction and precise anatomic localization of lesions with increased metabolism. This powerful technology provides a valuable new tool for diagnostic and therapeutic applications. The diagnostic accuracy is improved in approximately 50% of patients because of improvement of lesion detection on both CT and FDG PET images, better differentiation between physiologic and pathological foci of FDG uptake, and better localization of malignant foci of FDG uptake. This new technology affects the management of 10%-20% of cases by guiding further therapy. Promising clinical applications include guiding biopsy to the metabolically active sites of tumors, guiding surgery, and planning intensity-modulated radiation therapy. In addition, new PET radiopharmaceuticals are emerging for indications for which FDG has limitations. Some of the new PET tracers are labeled with (18)F, which has a practical half-life for commercial distribution. In the past few years, the clinical indications for FDG have broadened dramatically, and the rapid technical developments of integrated multimodality imaging systems and new PET tracers further extend the horizon.

Fluorodeoxyglucose F18↗