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Objectives: Percutaneous cementoplasty (PC) is used for metastatic bone tumor. Bone metastases patients who are unable to avail regular surgery, because of their poor general condition, undergo PC to gain mechanical stability and pain relief. We evaluated the effect of PC using F-FDG PET-CT and investigated the correlation and predictability between quantitative parameters of F-FDG PET-CT and pain status after PC. Methods: Subjects comprised 18 patients (total 32 sites) who had undergone PC for the metastatic bone tumors. Pain degree of the patients was obtained by visual analog scale (VAS) in the pre-PC, immediate post-PC, and follow-up post-PC state. As PET-CT parameters, maximum and mean standardized uptake value (Max and Mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. Receiver operator characteristic curve analysis was performed for pre-PC, post-PC PET-CT, and delta (Δ) values of PET-CT parameters to correlate and predict the good pain improvement (VAS pain ≤2) after the PC procedure. Results: Patients' pain status improved significantly in immediate post-PC and follow-up post-PC pain (all p < 0.001). Among PET-CT parameters, Max ( p = 0.004) and Mean ( p = 0.007) showed significant interval decrease after PC procedure. All of the post-PC PET-CT and ΔPET-CT values showed significant prediction of pain improvement for follow-up post-PC pain, especially ΔTLG (AUC = 0.804, p = 0.0003) and ΔMTV (AUC = 0.804, p = 0.0004). Conclusions: There was significant reduction of patients' pain after PC, and ΔTLG and ΔMTV of PET-CT parameters showed best predictability for follow-up post-PC pain improvement. PET-CT can be the useful parameter to predict treatment response of PC. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated the efficacy of (99m)Tc-sestamibi SPECT/CT for planning minimally invasive parathyroidectomy (MIP), comparing with dual phase (99m)Tc-sestamibi scintigraphy, (99m)Tc-sestamibi SPECT and conventional imaging (US and CT). Methods: Thirty-one patients (M:F = 10:21, range 35-78 years old) who showed high serum parathyroid hormone (intact PTH) level were included. (99m)Tc-sestamibi scintigraphy was performed 15 and 150 min after injection of (99m)Tc-sestamibi (555 MBq), and (99m)Tc-sestamibi SPECT/CT was obtained just after the delayed scan. Comparison study between imaging modalities was done by patient-based and lesion location-based analysis. The location of the lesion was confirmed by the operative finding. An operation was performed in 24 patients. Seven patients had normal (99m)Tc-sestamibi SPECT/CT, and followed for more than 6 months after SPECT/CT. Results: Among 24 patients, parathyroid adenoma was detected in 19 patients and the other 5 had parathyroid hyperplasia (total 35 lesions). (99m)Tc-sestamibi scintigraphy detected abnormal uptake in 15 patients with 24 lesions. Conventional imaging identified abnormal findings in 17 patients with 27 lesions. SPECT detected abnormal findings in 18 patients with 27 lesions. SPECT/CT identified abnormal findings in 24 patients with 35 lesions. SPECT/CT demonstrated 100 % sensitivity in a patient-based analysis. SPECT/CT exhibited significantly better sensitivity than (99m)Tc-sestamibi scintigraphy, SPECT and conventional imaging (p < 0.05). All lesion location was correctly identified to perform MIP. The final clinical diagnosis of 7 normal SPECT/CT patients was secondary hyperparathyroidism on 6 months follow-up. Conclusions: We correctly identified the precise location of parathyroid adenomas or hyperplasia by (99m)Tc-sestamibi SPECT/CT which was helpful to perform MIP. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated the efficacy of Tc-sestamibi SPECT/CT for planning minimally invasive parathyroidectomy (MIP), comparing with dual phase Tc-sestamibi scintigraphy, Tc-sestamibi SPECT and conventional imaging (US and CT). Methods: Thirty-one patients (M:F = 10:21, range 35-78 years old) who showed high serum parathyroid hormone (intact PTH) level were included. Tc-sestamibi scintigraphy was performed 15 and 150 min after injection of Tc-sestamibi (555 MBq), and Tc-sestamibi SPECT/CT was obtained just after the delayed scan. Comparison study between imaging modalities was done by patient-based and lesion location-based analysis. The location of the lesion was confirmed by the operative finding. An operation was performed in 24 patients. Seven patients had normal Tc-sestamibi SPECT/CT, and followed for more than 6 months after SPECT/CT. Results: Among 24 patients, parathyroid adenoma was detected in 19 patients and the other 5 had parathyroid hyperplasia (total 35 lesions). Tc-sestamibi scintigraphy detected abnormal uptake in 15 patients with 24 lesions. Conventional imaging identified abnormal findings in 17 patients with 27 lesions. SPECT detected abnormal findings in 18 patients with 27 lesions. SPECT/CT identified abnormal findings in 24 patients with 35 lesions. SPECT/CT demonstrated 100 % sensitivity in a patient-based analysis. SPECT/CT exhibited significantly better sensitivity than Tc-sestamibi scintigraphy, SPECT and conventional imaging ( p < 0.05). All lesion location was correctly identified to perform MIP. The final clinical diagnosis of 7 normal SPECT/CT patients was secondary hyperparathyroidism on 6 months follow-up. Conclusions: We correctly identified the precise location of parathyroid adenomas or hyperplasia by Tc-sestamibi SPECT/CT which was helpful to perform MIP. [ABSTRACT FROM AUTHOR]