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21-year-old male presented with recently diagnosed metastatic nonseminomatous germ cell tumour and left orchidectomy. CT demonstrated mixed density in the inferior vena cava (IVC) extending from the union of the common iliac veins to the level of the liver just below the confluence of the hepatic veins. Retroperitoneal nodal disease and deposits in the left lung were suspicious for metastatic deposits. F-18Flurodeoxyglucose (FDG) PET/CT images demonstrated avid FDG uptake within the lumen of the IVC from the level of the renal veins, with extension into both renal veins, to the level of T10. While benign and malignant thrombi have previously been demonstrated on F18-FDG PET imaging, this case highlights the use of F-18 FDG PET/CT when identifying tumour thrombosis in patients with nonseminomatous germ cell tumour.

Sarcoidosis is a systemic granulomatous disease of unknown etiology that involves many organs, occasionally mimicking malignancy. We herein report a 50-yr-old woman of muscular sarcoidosis of chronic myopathic type, manifested by hypercalcemia and muscle wasting. Besides insignificant hilar lymphadenopathy, her sarcoidosis was confined to generalized atrophic muscles and therefore, F-18 FDG PET/CT alone among conventional imaging studies provided diagnostic clues for the non-parathyroid-related hypercalcemia. On follow-up PET/CT during low-dose steroid treatment, FDG uptake in the muscles disappeared whereas that in the hilar lymph nodes remained. PET/CT may be useful in the evaluation of unexpected disease extent and monitoring treatment response in suspected or known sarcoidosis patients.

A 74-year-old man who had experienced priapism for 2 months after radical cystectomy for bladder cancer visited our hospital, and underwent metastatic work-up. 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) showed diffuse hypermetabolic activity along the penis shaft, which was confirmed as a penile metastasis (Figs. 1 and ​and22).

F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) that simultaneously offers anatomic and metabolic information is widely used and has become an effective modality in many clinical fields, especially oncology, and also may detect an unexpected primary cancer. Appendiceal carcinoma is relatively uncommon and not associated with characteristic symptoms. We report the case of a 53-year-old man with appendiceal adenocarcinoma, who had only mild fever. The tumor was detected early on F-18 FDG PET/CT for health screening.

Purpose Although initial studies have shown the utility of fluorine-18 fluorodeoxyglucose (F-18 FDG) PET in the detection and restaging of recurrent breast carcinoma, scarce literature exists on F-18 FDG PET/computed tomography (CT). This retrospective study was carried out to evaluate the role of F-18-FDG PET/CT in recurrent breast carcinoma and its impact on management. Materials and methods Retrospective analysis of data of 111 patients who underwent F-18 FDG PET/CT and were suspected of having recurrent breast carcinoma was carried out. PET/CT imaging was carried out for distant metastases in histologically proven locoregional recurrence in 23 patients, clinically suspicious locoregional recurrence in nine patients, increasing tumour markers in two patients, suspicion of distant metastatic disease in 61 patients or as a part of surveillance in 16 patients. The final diagnosis of recurrence and stage of disease was made after histopathological analysis, correlative imaging and clinical or imaging follow-up of at least 6 months. Results The final diagnosis of recurrent breast carcinoma was made in 76 patients and no evidence of recurrence was found in the remaining 35 patients. Locoregional disease requiring local radiotherapy or surgery was diagnosed in 14 patients and distant metastatic disease was diagnosed in 62 patients. FDG PET/CT was true positive in 75 patients, false positive in six patients, true negative in 35 patients and false negative in one patient, with a sensitivity, specificity, positive predictive value and a negative predictive value of 98.7, 85.3, 92.5 and 97.2%, respectively. FDG PET/CT also accurately restaged 22/23 patients with proven locoregional recurrence with an accuracy of 95.45%. Of 53 patients suspected of having distant metastatic disease on other imaging modalities, true distant metastatic disease was diagnosed in 36 patients and FDG PET/CT identified true metastatic disease in 35/36 patients, accurately ruling out metastases in the remaining 17 patients, and was false negative in one patient. In addition to confirming distant metastatic disease, it revealed more metastatic sites in 22 patients. Overall, F-18 FDG PET/CT had a major impact on management in 41% of the 103 patients being analysed for a major change in treatment. Conclusion F-18 FDG PET/CT is a very sensitive and specific imaging tool in detecting and restaging recurrent breast carcinoma. It can be a very useful imaging tool for restaging locoregional recurrences, and as a one-stop shop imaging technique to confirm suspicious metastatic disease on conventional imaging and to define the total burden of disease.

A 52-year-old female smoker presenting with unexplained weight loss underwent CT and FDG PET/CT imaging, which demonstrated an extremely hypermetabolic mediastinal mass with calcification, necrosis, and features of local invasiveness. Mediastinoscopy and biopsy were followed by successful surgical resection of an encapsulated mass showing the typical histologic features of follicular dendritic cell sarcoma (FDCS). FDCS of the mediastinum is a rare neoplasm arising from accessory cells of the immune system. Integrated FDG PET/CT of mediastinal FDCS highlights the importance of histologic assessment of mediastinal tumors that may seem unresectable on initial imaging.

The purpose of this study was to evaluate frequency, intensity, and associations of distal spinal cord F-18 FDG uptake visible on PET/CT. Normal cervical, but not distal cord uptake, has been reported previously.This is a retrospective review of consecutive oncologic whole body PET/CTs from 14 June, 2006 to 9 August, 2006 in 108 patients (49 male, 59 female; mean age, 61.9 years; range, 26-91 years) on Siemens Biograph 6 at 60 minutes post IV F-18 FDG (median dose 577.2 MBq). Distal spinal cord visual intensity was graded on a 3-point scale. Age, gender, race, weight, diabetes, glucose level, F-18 FDG dose, scan delay, and standard uptake value (SUV) of distal cord, vertebra, blood pool, and liver were recorded. The electronic medical record was reviewed more than 2 years later for history of radiation therapy (RT) or evidence of distal spinal cord malignancy, which might cause uptake.There was visible distal spinal cord uptake in 55% of patients, mild in 39% and moderate in 16%, seen as a narrow band of activity up to 2 segments in length at T11-L1. None showed history of regional RT or spinal cord malignancy on medical record review. Statistically significant associations were found between distal cord visual intensity and younger age, lower blood glucose, female gender, and white race (P0.05, χ(2) test). In multiple predictor fitted regression, age and glucose were statistically significant (P0.05); gender and race were not. Higher visual intensity was associated with higher distal cord SUV (highest maximal SUV, 3.7) and higher SUV ratios to vertebra, blood pool, and liver, but with much overlap. There was no significant association with other variables.Mild to moderate distal spinal cord F-18 FDG uptake on PET/CT is a common normal variant, more common in younger age and in patients with lower glucose levels. It likely represents metabolic activity of lumbosacral plexus nerve cell bodies.

The aim of this study was to evaluate the usefulness of F-18 fluorodeoxyglucose (FDG) dual-time-point (DTP) positron emission tomography (PET)/computed tomography (CT) with semiquantitative analyses for the initial staging in patients with malignant lymphoma.Forty-three patients had DTP PET/CT, with 60-min and 2-h scan [n = 8, Hodgkin's lymphoma (HL); n = 12, indolent non-Hodgkin lymphoma (NHL); n = 23, aggressive NHL].A total of 524 lesions were evaluated (406 lymph nodes and 118 extra-nodal lesions). The maximum standardized uptake value (SUV(max)) on 2-h delayed scan (SUV(2)) was significantly higher than those on 1-h early scan (SUV(1)) for all groups (P0.0001 for HL; P0.0001 for indolent NHL; P0.0001 for aggressive NHL). Significant differences were detected between HL and indolent NHL, between indolent NHL and the aggressive NHL for both SUV(1) and SUV(2) (each P0.0001). No significant differences were detected between HL and aggressive NHL for both SUV(1) and SUV(2) (P = 0.6891 for SUV(1); P = 0.8828 for SUV(2)); however, significant differences were detected for the retention index of SUV(max) between these groups (P = 0.0238).DTP F-18 FDG PET/CT with a semiquantitative technique may have the potential to provide the more accurate diagnoses for the staging of malignant lymphoma and the more important role in predicting the histological grades of malignancy compared with single-time-point F-18 FDG-PET scan.

We report a case of a patient with relapse of POEMS syndrome (peripheral neuropathy, organomegaly, endocrinopathy, monoclonal plasma proliferative disorder, skin changes) that occurred 6 years after an autologous peripheral blood stem cell transplantation. F-18 FDG PET/CT showed several hypermetabolic as well as nonhypermetabolic bone lesions. Based on these findings, the patient was referred for radiotherapy to the hypermetabolic bone lesions. After autologous peripheral blood stem cell transplantation, F-18 FDG PET/CT may play a pivotal role in detecting new bone lesions in patients with POEMS syndrome, which may be treated by a focalized radiotherapy and/or systemic therapy.

A 51-year-old man was diagnosed with small cell lung cancer (SCLC) with brain, left adrenal gland, and pancreas metastases. On evaluation of treatment response after chemotherapy and radiation therapy, F-18 FDG PET/CT showed focal FDG uptake in the periappendiceal area with thickened appendiceal wall and inflammatory change. Laparoscopic appendectomy was done, and the findings were consistent with acute suppurative appendicitis with involvement of 2 small masses on the appendiceal body and tip. Histopathologic findings confirmed metastatic small cell carcinoma, involving submucosa, proper muscle, and periappendiceal fat. This is a case of appendiceal metastasis from small cell lung cancer detected on F-18 FDG PET/CT.

A 52-year-old female patient was diagnosed with multiple soft tissue density lung nodules on CT scan during a preoperative evaluation for breast cancer. PET/CT study revealed intense F-18 FDG uptake in those nodules (most metabolic with SUVlbm = 6.1). Biopsy was done and histopathology resu

Metastases to orbit occur rarely but are the most common form of malignant orbital tumors. Usually the orbital metastases occur in disseminated disease. Very rarely orbital metastases can be the presenting feature of systemic malignancy. We report here a case with orbital metastases as the presenting feature of lung malignancy and describe the utility of FDG PET/CT as one-stop-shop imaging modality in this setting.

A 48-year-old man with pathologically proven left buccal squamous cell carcinoma underwent preoperative F-18 fluorodeoxyglucose (FDG) PET/CT for tumor staging. Vivid FDG uptake was noted in the bilateral neck and mediastinum, suggestive of nodal metastases. Video-assisted thoracoscopic surg

Due to the low yield of AFB smear and culture in extrapulmonary tuberculosis, therapeutic responses of patients with extrapulmonary tuberculosis are usually monitored clinically and/or radiographically. Such monitoring techniques, however, are not enough to provide effective diagnosis if a remnant lesion exists after treatment. Tuberculosis presents hypermetabolic activity on F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) scanning. Reported herein is a case of extrapulmonary tuberculosis where the therapeutic response was assessed via serial F-18 FDG PET/CT scanning, which was useful for detecting the extent of extrapulmonary tuberculosis and for estimating the patient’s therapeutic response.

Cases of synchronous non-Hodgkin lymphoma (NHL) and second primary carcinoma in previously untreated immunocompetent patients are relatively rare. The aim of this part of our prospective study was to a revealed 2-F-18 fluoro-2-deoxy-D-glucose (F-18 FDG) positron emission tomography (PET)-positive lesion in an extranodal organ suggestive of second primary neoplasm in newly diagnosed NHL patients.A total of 209 patients with NHL underwent initial staging F-18 FDG PET/computed tomography (CT). The finding was assessed by a radiologist, nuclear medicine physician, and hematologist. In 6 suspicious cases (2.9%) of second neoplasm, the decision was made to perform further investigations before lymphoma therapy.Two patients were diagnosed with colorectal carcinoma, 1 with esophageal adenocarcinoma, 1 with invasive ductal breast carcinoma, 1 with medullary thyroid carcinoma, and 1 with squamous cell lung carcinoma. In 5 of the 6 patients, the second solid tumor was completely asymptomatic and revealed only by F-18 FDG PET/CT examination.We conclude that in patients with NHL, appropriate imaging, clinical, and histologic analysis of organ lesions detected by F-18 FDG PET/CT will occasionally demonstrate significant synchronous neoplasms.

We present a case of a woman with ulcerative colitis who was referred for an F-18 FDG PET/CT after a suspicious colonoscopy and biopsy. PET/CT showed multiple elongated foci of intense FDG uptake in the colon, a pattern commonly reported with inflammatory bowel disease; however, the possibility of lymphoma was raised. Reevaluation of the biopsies with immunohistochemistry and molecular studies revealed a peripheral T-cell lymphoma and the patient was treated with a total colectomy. In this case, F-18 FDG PET/CT was very useful in determining the extent of the disease. This case also highlights a potential pitfall whereby the tubular and multifocal appearance of this lymphoma subtype can mimic the appearance of bowel involved by inflammatory bowel disease especially on novel techniques such as PET/CT enterography and PET/CT colonography.

Malignant melanoma is well known for its propensity to spread to unpredictable sites. F-18 FDG PET can highlight metastases at unusual sites that may be missed with conventional imaging modalities. In this study, we present the case of a 57-year-old male patient who was referred to our department for PET/CT imaging because of metabolic characterization of the lesion located in distal common biliary duct and biopsied as malignant melanoma. His PET/CT images revealed a hypermetabolic lesion at the mentioned site. Interestingly, his images also showed mild FDG accumulation on right frontoparietal skin, and the biopsy of this lesion was also reported as malignant melanoma.

Central nervous system (CNS) is a rare site of involvement by non-Hodgkin lymphoma (NHL). Therapeutic approach for primary and secondary CNS NHL is different and remains challenging. Therefore imaging data are essential at staging to discriminate these 2 clinical entities and during follow-up to assess therapy response. The adjunct role of positron emission tomography using F-18 fluorodeoxyglucose to morphologic imaging is still undefined. We report 2 didactic cases of primary and secondary CNS NHL assessed by F-18 fluorodeoxyglucose positron emission tomography. Metabolic imaging seems to be complementary to conventional imaging techniques for the extent-of-disease evaluation and therapy monitoring of CNS lesions.

We report F-18 FDG PET/CT images of biopsy-proven intramuscular metastasis from primary uterine cervix cancer. A 70-year-old woman was admitted because of a mass in the left axilla. She was diagnosed with uterine cervix cancer and underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic node dissection and received adjuvant chemotherapy and radiation therapy 9 years ago. Magnetic resonance imaging showed a large soft tissue mass in the intramuscular region of the left axilla. The mass showed intense F-18 FDG uptake with a central necrotic portion on F-18 FDG PET/CT. Hypermetabolic lymph nodes were also noted in the left axilla, interpectoral, and left supraclavicular areas. Additionally, several hypermetabolic nodules were noted in both lungs. The lesion in the left axilla was excised and the pathologic results were consistent with metastasis from uterine cervix cancer.

The aim of the current study was to investigate the predictive value of dual-time-point F-18 FDG PET/CT for pathologic N1 metastasis in patients with non-small cell lung cancer (NSCLC).A retrospective review identified 70 patients with NSCLC patients who received dual-time-point F-18 FDG PET/CT at diagnosis of cancer. The F-18 FDG PET/CT findings for all primary NSCLC and mediastinal lymph node involvement were compared with the pathologic diagnosis within 5 weeks after surgical resection. The pathologic diagnoses of N1 state were confirmed by surgical resection. Univariate and multivariate analyses were used to analyze the associations among the pathologic N1 status and age, sex, tumor size, histology, standardized uptake value (SUV(maxE)), SUV(maxD), and %ΔSUV(max).The N1 (+) group showed statistically significant higher value of SUV(maxE) and SUV(maxD) than N1 (-) group. The %ΔSUV(max) did not show the statistical difference between pathologic N1 (+) and N1 (-) groups. Receiver operating characteristic analyses showed that the SUV(maxE) was superior to the %ΔSUV(max) for the prediction of pathologic N1 involvement in NSCLC. In univariate analysis, pathology (adenocarcinoma or nonadenocarcinoma), SUV(maxE) (6.9 or ≤6.9), SUV(maxD) (7.1 or ≤7.1) were factors significantly associated with pathologic N1 involvement. However, in multivariate analysis, only the SUV(maxE) was factor significantly associated with pathologic N1 involvement in NSCLC.Based on the presented results, the dual-time-point F-18 FDG PET/CT is not a useful method for the prediction of pathologic N1 status in NSCLC patients. Further studies are needed to confirm these results and improve statistical accuracy.

PURPOSE Pulmonary sclerosing hemangioma (PSH), or the alternative name of "sclerosing pneumocytoma," is a rare benign neoplasm. PSH is often asymptomatic and presents as a solitary pulmonary nodule on radiologic imaging studies. Few articles have been reported to describe the FDG PET findings about PSH. We reported FDG PET findings of 6 cases of PSH and reviewed the literatures. MATERIALS AND METHODS FDG PET and PET/CT imaging studies of 6 patients with proven PSH were reviewed. The relation between the degree of FDG uptake and tumor size was analyzed. RESULTS All 6 tumors were detected by FDG PET or PET/CT. Mean diameter of these tumors was 2.9 cm. Mean standard uptake value was 2.45 (range, 1.8-3.93). The maximal standard uptake value of FDG uptake was positively correlated with the tumor size (R = 0.9694, P < 0.05). CONCLUSIONS PSH demonstrates low to moderate uptake on FDG PET imaging. The larger PSH has higher uptake and might be misrecognized as a malignancy. The possibility of false-positive result caused by PSH should be considered while interpreting FDG PET images of solitary pulmonary nodules.

cer with higher sensitivity (85.25%, 95% CI 73.8–93.0%) and specificity (100.00%, 90.4–100.0%) than urine cytology, which showed 52.29% sensitivity (42.5–61.9%) and 87.88% specificity (77.5– 94.6%). In the 62 treated patients, urine survivin expression had 22.92% sensitivity (12.0–37.3%) and 92.86% specificity (66.1– 98.8%) for detecting bladder cancer. Surprisingly, among the 62 treated patients, 13 (21%) showed survivin expression. Followup of these patients for 1 year revealed recurrence of TCC in nine patients (69%). Interpretation: This study shows the clinical utility of survivin expression in new or recurrent bladder cancer, and in patients with a negative biopsy receiving follow-up care. Thus, highly sensitive and specific determination of survivin in exfoliated cells in urine, by use of qRT-PCR, seems to provide a simple, non-invasive diagnostic biomarker for routine screening of bladder cancer. Funding: PKS is a recipient of the independent Senior Research Fellowship (SRF) award from the Indian Council of Medical Research (ICMR). The authors declared no conflicts of interest.

Thymic lesions may represent an unresolved diagnostic problem that often requires surgical procedure for an accurate diagnosis and staging. A noninvasive imaging study to determine the nature of thymic lesions would help to identify patients who are true candidates for surgery. Published preliminary clinical observations have suggested a role of fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography-computed tomography (PET-CT) in the characterization of thymic lesions. Benign uptake of the thymus on F-18 FDG PET-CT is seen in children and young adults, and may also indicate thymic hyperplasia in patients after chemotherapy or with Graves' disease. F-18 FDG PET-CT proves to be effective in differentiating thymic carcinoma from other entities within the thymus, and thymoma from thymic hyperplasia. The intensity of FDG uptake is useful for predicting the grade of malignancy in thymic epithelial tumors. However, the literature is equivocal with regard to the ability of F-18 FDG PET-CT to differentiate between invasive and noninvasive thymomas. Further larger studies are required to clarify the effectiveness and explore more clinical implications of F-18 FDG PET-CT on thymic lesions.

This is a case of a 52-year-old woman who underwent a hyster-ectomy to treat a large uterine perivascular epithelioid cell tumor. She wasfollowed with serial F-18 FDG PET/CT scans due to positive surgicalmargins and vascular invasion on pathology. Initial surveillance PET/CTperformed 6 months post surgery was negative; however, a second surveil-lance PET/CT performed 12 months post surgery showed an intenselyFDG-avid recurrence in the pelvic surgical site. The patient received localradiotherapy, 2 cycles of taxol and carboplatin, and was placed on imatinibmesylate (Gleevec). A final PET/CT performed 6 months after initiation oftherapy showed rapidly disseminating metastatic disease and the patient died1 month later. This rare report highlights a potentially new utility of F-18FDG PET/CT for surveillance of recurrence of a malignant uterine perivas-cular epithelioid cell tumor, as well as for evaluation of response to therapy. Key Words: malignant perivascular epithelioid cell tumor, PEComa,uterus tumors, FDG, PET/CT(

Bone lesions of Kaposi sarcoma are rare. A 56-year-old man who was HIV positive and was diagnosed with Kaposi sarcoma on the basis of the results of a biopsy of skin lesions, underwent F-18 FDG PET/CT scan for detecting Kaposi sarcoma lesions and other AIDS-related diseases. An abnormal uptake was observed in the lumbar spine. MRI showed a diffuse enhanced spine lesion, and Ga-67 and ²⁰¹Tl scanning were negative. As a result, the lesion was considered to be a Kaposi sarcoma, and the shrinkage of the lesion was noted after the therapy for Kaposi sarcoma.

A 29-year-old woman presented with a new right supraclavicular mass on a background of resection of a malignant melanoma from her right shoulder before 4 years. F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging revealed uptake in a right supraclavicular node and the inferior pole of the left lobe of the thyroid gland. Subsequent resection and histology of the right supraclavicular node and the left lobe of the thyroid gland demonstrated metastatic melanoma and palpation thyroiditis, respectively. A number of malignant and benign pathologies of the thyroid demonstrate FDG uptake, with 75% being benign. To our knowledge, the findings of palpation thyroiditis on FDG PET/CT have never been previously described.

Recurrent gliomas are usually histologically high grade; either due to recurrence of a de novo high-grade primary or anaplastic transformation in case of low-grade tumors. Survival in these patients is variable. The objective of the present study is to evaluate the role of FDG PET-CT for predicting survival in a large group of patients with suspected recurrent glioma.A total of 81 previously treated histopathologically proven glioma patients; with clinical and conventional imaging findings suspicious of recurrence were included in this study. All patients underwent FDG PET-CT study. Based on tumor to white matter (T/W) and tumor to grey matter (T/G) ratios, all lesions were scored on PET-CT (PET scores 0, 1 and 2). Patients were followed up clinically and by repeated imaging. Data was censored, if the patient died of disease or at the end of the study. Survival analysis was done for each variable employing univariate analysis followed by multivariate analysis, using variables found significant on univariate analysis.PET score was found to be the most significant predictor of survival in univariate and multivariate analysis (p 0.003). Patients having PET score 2 had poorer survival compared to both PET score 0 (p 0.001) and PET score 1 (p 0.004). Other covariates found to have significant correlation with survival were primary treatment modality and clinical symptoms at the time of recurrence.FDG uptake on PET-CT is a strong predictor of survival in patients with suspected recurrent glioma.

We present the case of a 56-year-old man with the clinical diagnosis of ocular melanoma. As a part of staging, he underwent an F-18 FDG PET/CT scan for investigating distant metastasis. On PET scan, an increased focal area of F-18 FDG uptake was seen behind patient's right knee that can be confused with distant metastasis. On CT scan, there was a fluid density in the same location. The probable diagnosis was Baker’s cyst. Later, USG and MRI confirmed this diagnosis. Conflict of interest:None declared.

Hepatoblastoma (HB) is the most common pediatric liver cancer representing 1% of all pediatric malignances and occurring mostly within 5 years of age. Liver recurrences and secondary lesions (abdomen, lung, and brain) can occur. Surgery and chemotherapy are widely accepted. Focal nodular hy

We present a case of catheter tract implantation metastasis of hilar cholangiocarcinoma after preoperative percutaneous transhepatic biliary drainage (PTBD) on F-18 FDG PET/CT. A 65-year-old woman had received preoperative PTBD before a left hemihepatectomy due to hilar cholangiocarcinoma 17 months ago. Recently, the patient complained of pain in the right flank. Serum CEA and CA 19–9 levels were within the normal range. Contrast-enhanced abdominal CT was done and interpreted as no definite abnormality, so F-18 FDG PET/CT was undertaken and showed metastatic implantation on the right flank. On a retrospective review of the previous CT, a small nodule was noted at the corresponding site of the lesion on FDG PET/CT (Fig. 1). CT-guided biopsy was done and pathologic finding revealed metastasis from hilar cholangiocarcinoma (Fig. 2).

We report a case of 63-year-old man with symmetrical joint swelling of the interphalangeal and metacarpal joints, associated with isolated hypogammaglobulinemia. Accessory glands biopsy revealed the presence of amyloidal deposits. PET/CT showed increased F-18 FDG activity in thickened soft tissues corresponding to amyloid arthropathy. Like multiple myeloma, PET/CT could be an interesting imaging in light-chain amyloidosis.

The purpose of this study was to evaluate the prognostic value of the metabolic tumor volume (MTV), in FIGO stage IA-IIB cervical cancer patients, measured by F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) imaging.Forty-five patients with invasive cervical cancer who underwent FDG-PET imaging were recruited. Metabolically active tumor regions were delineated on the pretreatment FDG-PET scans by encompassing regions equal to or greater than an standardized uptake value (SUV) of 40% of the peak tumor intensity. The relationship of the metabolic tumor volume (MTV) to the disease-free survival was analyzed. The MTV of the cervical cancer was compared with pathological and clinical prognostic factors, including lymph node metastasis, parametrial invasion, the depth of invasion, resection margins, tumor differentiation and FIGO stages.Cox proportional hazard regression analysis showed that the MTV was a significant independent predictor of recurrence of cervical cancer (p = 0.027). Patients with an MTV of20 cm(3) had a significantly reduced disease-free survival compared with patients with an MTV ≤ 20 cm(3) (p = 0.029). The correlation of the MTV with traditional prognostic factors showed significantly higher values in patients that were lymph node (LN) metastasis positive (p = 0.028) and parametrial invasion positive (p = 0.022). The MTV significantly differed among the groups according to tumor differentiation (p = 0.0319) and FIGO stage (p = 0.001).The MTV measured by FDG-PET was an independent prognostic factor for tumor recurrence in patients with stage IA-IIB cervical cancer. These findings must be confirmed by large population based prospective studies.