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Wang GJ, Chen JY, Hu QY, Chen SQ, Zhang J, Wang Y. 18F-FDG PET/CT findings of endometriosis and corpus luteum cyst. Int J Gynaecol Obstet 2024; 166:891-893. [PMID: 38404034 DOI: 10.1002/ijgo.15432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/30/2024] [Indexed: 02/27/2024]
Abstract
SynopsisPET/CT can differentiate between endometriosis, the malignant progression of endometriosis, and ovarian cysts.
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Affiliation(s)
- Guo-Jie Wang
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jun-Yong Chen
- Department of Urology, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China
| | - Qi-Yi Hu
- Department of Nuclear Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- Department of Magnetic Resonance Imaging, Hui Zhou First Hospital, Huizhou, China
| | - Shang-Qiu Chen
- Department of Gynecology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jie Zhang
- Department of Radiology, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China
| | - Ying Wang
- Department of Nuclear Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
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2
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Fox R, Chang S, Hicks L, Mooney S, Rogers PAW, Hicks RJ, Tyson K, Holdsworth-Carson SJ. Positron emission tomography in the evaluation of endometriosis: A systematic review. Eur J Obstet Gynecol Reprod Biol 2024; 299:258-265. [PMID: 38917749 DOI: 10.1016/j.ejogrb.2024.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/19/2024] [Accepted: 06/08/2024] [Indexed: 06/27/2024]
Abstract
Despite the profound impact of endometriosis worldwide, delays in diagnosis and suboptimal surveillance techniques are well-recognised issues. Case studies have reported incidental uptake of 18F-FDG PET tracer in endometriotic lesions. However, the utility of PET imaging as a non-invasive diagnostic tool for endometriosis is currently unclear. The purpose of this systematic review was to summarise the existing evidence and determine the value of available PET scanning techniques in the detection and monitoring of endometriosis. MEDLINE, EMBASE, CENTRAL, SCOPUS and Web of Science were searched from conception to 05/03/23. Eligible studies included participants with a history of known or suspected endometriosis who underwent a PET scan for any indication. All PET tracers and protocols were eligible. Outcomes included correlation of PET tracer uptake with the presence of endometriosis seen at laparoscopy or confirmed on histology, sensitivity of tracer uptake, specificity of tracer uptake, site of lesions with tracer uptake, stage of lesions with tracer uptake, SUVmax of endometriosis lesions and adverse reactions to PET imaging. The protocol for this review was registered with PROSPERO (ID: CRD42023405260). Eight studies describing 110 participants were eligible for inclusion. Six studies assessed 18F-FDG with combined PET-CT, one study assessed 18F-FDG PET alone, and the remaining study assessed PET-CT with an alternative tracer, 68Ga-DOTATATE. For 18F-FDG imaging, the correlation of PET avidity with lesions or sites of endometriosis ranged from 0-55 %. Pre-operative 68Ga-DOTATATE PET-CT detected endometriosis in 33 % of cases. All included studies were cohort studies, six were assessed to have low risk of bias, one with moderate risk and one with high risk of bias. Overall, 18F-FDG PET scanning does not appear to consistently identify endometriotic lesions, and therefore its reliability and usefulness in endometriosis diagnosis is limited. The utility of 68Ga-DOTATATE PET-CT remains uncertain. Findings are constrained by limited available evidence reporting outcomes of PET imaging for endometriosis. Other existing PET tracers with biological plausibility in the detection or monitoring of endometriosis warrant further investigation.
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Affiliation(s)
- Rachael Fox
- The Royal Women's Hospital, 20 Flemington Rd, Parkville 3052, Victoria, Australia; Julia Argyrou Endometriosis Centre, Epworth HealthCare, Victoria, Australia.
| | - Sarah Chang
- University of Melbourne, Parkville 3052, Victoria, Australia
| | - Lauren Hicks
- The Royal Women's Hospital, 20 Flemington Rd, Parkville 3052, Victoria, Australia; Julia Argyrou Endometriosis Centre, Epworth HealthCare, Victoria, Australia
| | - Samantha Mooney
- Julia Argyrou Endometriosis Centre, Epworth HealthCare, Victoria, Australia; Gynaecology Research Centre, The Royal Women's Hospital, Victoria, Australia; Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Victoria, Australia
| | - Peter A W Rogers
- Gynaecology Research Centre, The Royal Women's Hospital, Victoria, Australia; Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Victoria, Australia
| | - Rodney J Hicks
- Department of Medicine, St Vincent's Hospital, University of Melbourne, Victoria, Australia; Melbourne Theranostic Innovation Centre, Victoria, Australia
| | - Kate Tyson
- Julia Argyrou Endometriosis Centre, Epworth HealthCare, Victoria, Australia
| | - Sarah J Holdsworth-Carson
- Julia Argyrou Endometriosis Centre, Epworth HealthCare, Victoria, Australia; Gynaecology Research Centre, The Royal Women's Hospital, Victoria, Australia; Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Victoria, Australia
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3
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Sebastiano J, Rodriguez C, Samuels ZV, Pepin K, Zeglis BM. Molecular Imaging in Gynecology: Beyond Cancer. J Nucl Med 2024; 65:998-1003. [PMID: 38871386 PMCID: PMC11218728 DOI: 10.2967/jnumed.124.267546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Abstract
Gynecological pathologies account for approximately 4.5% of the overall global disease burden. Although cancers of the female reproductive system have understandably been the focus of a great deal of research, benign gynecological conditions-such as endometriosis, polycystic ovary syndrome, and uterine fibroids-have remained stubbornly understudied despite their astonishing ubiquity and grave morbidity. This historical inattention has frequently become manifested in flawed diagnostic and treatment paradigms. Molecular imaging could be instrumental in improving patient care on both fronts. In this Focus on Molecular Imaging review, we will examine recent advances in the use of PET, SPECT, MRI, and fluorescence imaging for the diagnosis and management of benign gynecological conditions, with particular emphasis on recent clinical reports, areas of need, and opportunities for growth.
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Affiliation(s)
- Joni Sebastiano
- Department of Chemistry, Hunter College, City University of New York, New York, New York
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Ph.D. Program in Biochemistry, Graduate Center of City University of New York, New York, New York
| | - Cindy Rodriguez
- Department of Chemistry, Hunter College, City University of New York, New York, New York
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Ph.D. Program in Chemistry, Graduate Center of City University of New York, New York, New York
| | - Zachary V Samuels
- Department of Chemistry, Hunter College, City University of New York, New York, New York
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Ph.D. Program in Chemistry, Graduate Center of City University of New York, New York, New York
| | - Kristen Pepin
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York; and
| | - Brian M Zeglis
- Department of Chemistry, Hunter College, City University of New York, New York, New York;
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Ph.D. Program in Biochemistry, Graduate Center of City University of New York, New York, New York
- Ph.D. Program in Chemistry, Graduate Center of City University of New York, New York, New York
- Department of Radiology, Weill Cornell Medical College, New York, New York
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4
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Saunders PTK, Whitaker LHR, Horne AW. Endometriosis: Improvements and challenges in diagnosis and symptom management. Cell Rep Med 2024; 5:101596. [PMID: 38897171 PMCID: PMC11228648 DOI: 10.1016/j.xcrm.2024.101596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/08/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024]
Abstract
Endometriosis is a chronic disorder with debilitating symptoms that is difficult to diagnose and treat. Advances in imaging technologies and strategies for the management of symptoms are improving the quality of life of patients by reducing the time taken for diagnosis and offering a more balanced approach to therapy.
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Affiliation(s)
- Philippa T K Saunders
- Centre for Reproductive Health, Institute of Regeneration and Repair, The University of Edinburgh, Edinburgh EH16 4UU, UK.
| | - Lucy H R Whitaker
- Centre for Reproductive Health, Institute of Regeneration and Repair, The University of Edinburgh, Edinburgh EH16 4UU, UK
| | - Andrew W Horne
- Centre for Reproductive Health, Institute of Regeneration and Repair, The University of Edinburgh, Edinburgh EH16 4UU, UK
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5
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Zhu HY, Cheng Y, Wang SY, Shao D. Urinary Endometriosis Misdiagnosed as Ureteral Malignant Tumor by PET/CT: A Case Study. Clin Nucl Med 2024; 49:e129-e130. [PMID: 38271236 DOI: 10.1097/rlu.0000000000005045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
ABSTRACT Endometriosis is a chronic inflammatory estrogen-dependent benign disease. It is defined as the endometrium growing outside the uterine cavity and the myometrium. It usually has low FDG uptake but rarely occurs in the ureters. We reported a case of a 47-year-old woman's left ureteral nodule originally misdiagnosed as a ureteral malignant tumor by PET/CT and finally pathologically confirmed as endometriosis.
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Affiliation(s)
| | - You Cheng
- Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Si-Yun Wang
- Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Dan Shao
- Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
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Trachsel B, Imobersteg S, Valpreda G, Singer G, Grabherr R, Ormos M, Burger IA, Kubik-Huch RA, Schibli R, Vogel V, Béhé M. Relaxed fibronectin: a potential novel target for imaging endometriotic lesions. EJNMMI Res 2024; 14:17. [PMID: 38340184 DOI: 10.1186/s13550-024-01070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Endometriosis is characterized by the ectopic occurrence of endometrial tissue. Though considered benign, endometriotic lesions possess tumor-like properties such as tissue invasion and remodeling of the extracellular matrix. One major clinical hurdle concerning endometriosis is its diagnosis. The diagnostic modalities ultrasound and MRI are often unable to detect all lesions, and a clear correlation between imaging and clinical symptoms is still controversial. Therefore, it was our aim to identify a potential target to image active endometriotic lesions. RESULTS For our studies, we employed the preclinical radiotracer [111In]In-FnBPA5, which specifically binds to relaxed fibronectin-an extracellular matrix protein with key functions in homeostasis that has been implicated in the pathogenesis of diseases such as cancer and fibrosis. We employed this tracer in biodistribution as well as SPECT/CT studies in mice and conducted immunohistochemical stainings on mouse uterine tissue as well as on patient-derived endometriosis tissue. In biodistribution and SPECT/CT studies using the radiotracer [111In]In-FnBPA5, we found that radiotracer uptake in the myometrium varies with the estrous cycle of the mouse, leading to higher uptake of [111In]In-FnBPA5 during estrogen-dependent phases, which indicates an increased abundance of relaxed fibronectin when estrogen levels are high. Finally, immunohistochemical analysis of patient samples demonstrated that there is preferential relaxation of fibronectin in the proximity of the endometriotic stroma. CONCLUSION Estrous cycle stages characterized by high estrogen levels result in a higher abundance of relaxed fibronectin in the murine myometrium. This finding together with a first proof-of-concept study employing human endometriosis tissues suggests that relaxed fibronectin could be a potential target for the development of a diagnostic radiotracer targeting endometriotic lesions. With [111In]In-FnBPA5, the matching targeting molecule is in preclinical development.
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Affiliation(s)
- Belinda Trachsel
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen, Switzerland
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zurich, 8093, Zurich, Switzerland
| | - Stefan Imobersteg
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen, Switzerland
| | - Giulia Valpreda
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen, Switzerland
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zurich, 8093, Zurich, Switzerland
| | - Gad Singer
- Kantonsspital Baden, 5404, Baden, Switzerland
| | | | - Mark Ormos
- Kantonsspital Baden, 5404, Baden, Switzerland
| | | | | | - Roger Schibli
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen, Switzerland
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zurich, 8093, Zurich, Switzerland
| | - Viola Vogel
- Laboratory of Applied Mechanobiology, Institute of Translational Medicine, Department of Health Sciences and Technology, ETH Zurich, 8093, Zurich, Switzerland
| | - Martin Béhé
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen, Switzerland.
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7
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Avery JC, Knox S, Deslandes A, Leonardi M, Lo G, Wang H, Zhang Y, Holdsworth-Carson SJ, Thi Nguyen TT, Condous GS, Carneiro G, Hull ML. Noninvasive diagnostic imaging for endometriosis part 2: a systematic review of recent developments in magnetic resonance imaging, nuclear medicine and computed tomography. Fertil Steril 2024; 121:189-211. [PMID: 38110143 DOI: 10.1016/j.fertnstert.2023.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023]
Abstract
Endometriosis affects 1 in 9 women, taking 6.4 years to diagnose using conventional laparoscopy. Non-invasive imaging enables timelier diagnosis, reducing diagnostic delay, risk and expense of surgery. This review updates literature exploring the diagnostic value of specialist endometriosis magnetic resonance imaging (eMRI), nuclear medicine (NM) and computed tomography (CT). Searching after the 2016 IDEA consensus, 6192 publications were identified, with 27 studies focused on imaging for endometriosis. eMRI was the subject of 14 papers, NM and CT, 11, and artificial intelligence (AI) utilizing eMRI, 2. eMRI papers describe diagnostic accuracy for endometriosis, methodologies, and innovations. Advantages of eMRI include its: ability to diagnose endometriosis in those unable to tolerate transvaginal endometriosis ultrasound (eTVUS); a panoramic pelvic view, easy translation to surgical fields; identification of hyperintense iron in endometriotic lesions; and ability to identify super-pelvic lesions. Sequence standardization means eMRI is less operator-dependent than eTVUS, but higher costs limit its role to a secondary diagnostic modality. eMRI for deep and ovarian endometriosis has sensitivities of 91-93.5% and specificities of 86-87.5% making it reliable for surgical mapping and diagnosis. Superficial lesions too small for detection in larger capture sequences, means a negative eMRI doesn't exclude endometriosis. Combined with thin sequence capture and improved reader expertise, eMRI is poised for rapid adoption into clinical practice. NM labeling is diagnostically limited in absence of suitable unique marker for endometrial-like tissue. CT studies expose the reproductively aged to radiation. AI diagnostic tools, combining independent eMRI and eTVUS endometriosis markers, may result in powerful capability. Broader eMRI use, will optimize standards and protocols. Reporting systems correlating to surgical anatomy will facilitate interdisciplinary preoperative dialogues. eMRI endometriosis diagnosis should reduce repeat surgeries with mental and physical health benefits for patients. There is potential for early eMRI diagnoses to prevent chronic pain syndromes and protect fertility outcomes.
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Affiliation(s)
- Jodie C Avery
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
| | - Steven Knox
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Benson Radiology, Adelaide, Australia
| | - Alison Deslandes
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Mathew Leonardi
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Department of Obstetrics and Gynecology McMaster University, Hamilton, Canada
| | - Glen Lo
- Curtin University Medical School Perth, Australia
| | - Hu Wang
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Australian Institute for Machine Learning, University of Adelaide, Australia
| | - Yuan Zhang
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Australian Institute for Machine Learning, University of Adelaide, Australia
| | - Sarah Jane Holdsworth-Carson
- Julia Argyrou Endometriosis Centre, Epworth HealthCare, Richmond, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Tran Tuyet Thi Nguyen
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Embrace Fertility, Adelaide, Australia
| | - George Stanley Condous
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Omni Ultrasound and Gynaecological Care, Sydney Australia, (j)Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Gustavo Carneiro
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; University of Surrey, Guildford, United Kingdom
| | - Mary Louise Hull
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Embrace Fertility, Adelaide, Australia
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8
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Padilla Bermejo A, García Zoghby L, Pena Pardo FJ, Del Prado Talavera Rubio M, Poblete García VM. 18 F-FDG PET/CT to Spare Malignancy in a Rare Case of Lung Endometriosis. Clin Nucl Med 2023; 48:e472-e473. [PMID: 37586103 DOI: 10.1097/rlu.0000000000004787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
ABSTRACT Lung endometriosis is a rare condition. A 44-year-old woman with known lung endometriosis and radiological follow-up showed progression of bilateral lung affection at control CT, with an enlarged solid nodule with respect to previous control. 18 F-FDG PET/CT was performed to assess that lesion and to guide biopsy. PET images showed the multiple known nodules with pathological tracer uptake.
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Affiliation(s)
- Amanda Padilla Bermejo
- From the Nuclear Medicine Department, Ciudad Real University General Hospital, Ciudad Real, Spain
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9
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Latgé A, Averous G, Gressel A, Faitot F, Leroy-Freschini B. Bilateral Ovarian Metastases of Hepatocellular Carcinoma Diagnosed with 18F-Fluorocholine PET/CT in a Patient with Endometriosis. Nucl Med Mol Imaging 2023; 57:251-253. [PMID: 37720883 PMCID: PMC10504130 DOI: 10.1007/s13139-023-00796-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 09/19/2023] Open
Abstract
A 47-year-old woman with history of hepatocellular carcinoma was referred for 18F-fluorocholine PET/CT evaluation due to elevated alpha-fetoprotein. The examination showed several peritoneal uptakes and two nodular pelvic foci. Coelioscopic exploration allowed confirmation and resection of multiple peritoneal metastases from hepatocellular carcinoma while pelvic biopsies revealed endometriosis and endosalpingiosis. However, alpha-fetoprotein kept rising: subsequent 18F-fluorodesoxyglucose PET/CT exploration found no pelvic uptake, while 18F-fluorocholine PET/CT revealed intense tracer accumulation in the two pelvic masses corresponding to bilateral ovarian metastases of hepatocellular carcinoma. We highlight the importance of 18F-fluorocholine PET/CT in hepatocellular carcinoma especially in patients with confounding comorbidities such as endometriosis.
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Affiliation(s)
- Adrien Latgé
- Department of Nuclear Medicine & Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg, France
| | - Gerlinde Averous
- Department of Pathology, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | - François Faitot
- Hepatobiliary Surgery and Transplantation, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Benjamin Leroy-Freschini
- Department of Nuclear Medicine, Strasbourg Oncologie Libérale, Clinique Sainte-Anne, Strasbourg, France
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10
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Deng Y, Xie H, He L, Ding Z, Zhang W. Umbilical Endometriosis Mimicking Malignancy on 18 F-FDG PET/CT. Clin Nucl Med 2023; 48:56-57. [PMID: 36241029 DOI: 10.1097/rlu.0000000000004459] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACT Umbilical endometriosis is a rare event. A 44-year-old woman complained of a palpable abdominal mass with bloody secretion and chronic abdominal pain for 2 months. 18 F-FDG PET/CT images demonstrated multiple foci of increased tracer uptake indicating malignant tumor with metastases in the region of umbilicus and lower segment of the esophagus. Unexpectedly, the subsequent histology and immunohistochemistry of the umbilical lesion demonstrated endometriosis.
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Affiliation(s)
- Yujiao Deng
- From the Department of Nuclear Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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11
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Advances in Imaging for Assessing Pelvic Endometriosis. Diagnostics (Basel) 2022; 12:diagnostics12122960. [PMID: 36552967 PMCID: PMC9777476 DOI: 10.3390/diagnostics12122960] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
In recent years, due to the development of standardized diagnostic protocols associated with an improvement in the associated technology, the diagnosis of pelvic endometriosis using imaging is becoming a reality. In particular, transvaginal ultrasound and magnetic resonance are today the two imaging techniques that can accurately identify the majority of the phenotypes of endometriosis. This review focuses not only on these most common imaging modalities but also on some additional radiological techniques that were proposed for rectosigmoid colon endometriosis, such as double-contrast barium enema, rectal endoscopic ultrasonography, multidetector computed tomography enema, computed tomography colonography and positron emission tomography-computed tomography with 16α-[18F]fluoro-17β-estradiol.
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12
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Extrauterine Endometrial Stromal Sarcoma Mimicking Colorectal Cancer With Metastases. Clin Nucl Med 2022; 47:982-984. [PMID: 35961634 DOI: 10.1097/rlu.0000000000004366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Extrauterine endometrial stromal sarcoma (EESS) is extremely rare, especially with the colorectum involvement. We describe 18 F-FDG PET/CT findings of EESS in the sigmoid colon and rectum in a 46-year-old woman who complained diarrhea. 18 F-FDG PET/CT revealed multiple hypermetabolic lesions in the abdomen and pelvis, including the sigmoid colon and rectum. Therefore, colorectal cancer with metastases was initially suspected; however, ultimately low-grade EESS was pathologically confirmed. Widespread EESS with intestine involvement revealed by 18 F-FDG PET/CT should be carefully distinguished from colorectal cancer with metastases.
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