title: Contrast-Enhanced Ultrasound in the Assessment of Patients with Indeterminate Abdominal Findings at Positron Emission Tomography Imaging.
abstract: Widespread use of fluorodeoxyglucose-positron emission tomography (PET) in cancer imaging may result in a number of indeterminate and false-positive findings. We investigated the role of contrast-enhanced ultrasound (CEUS) as a second-level option after inconclusive PET. We reviewed CEUS images acquired over 4 y, selecting the examinations performed specifically to better assess an unclear PET image. Final diagnosis was confirmed by biopsy, surgery, further imaging or follow-up. Seventy CEUS examinations were performed after a PET scan (44 PET examinations, 19 PET-computer tomography [CT] examinations and 7 PET-CECT examinations). The target organ was the liver in 54 cases, spleen in 12, gallbladder in 2 and pancreas and kidney in one each. In 6 of 70 cases, CEUS was performed because of a negative PET (no uptake) despite an abnormal finding on the CT images of the PET-CT study; CEUS allowed a correct diagnosis in all of these. In 20 of 70 cases, the PET findings were categorized as indeterminate and non-specific (non-specific fluorodeoxyglucose uptake in PET report with no standardized uptake value given); CEUS reached a correct diagnosis in 19 of the 20 cases with one false negative. In 34 of 70 cases, PET was indeterminate, but specific (fluorodeoxyglucose uptake with a standardized uptake value provided); CEUS reached a correct diagnosis in 30 of these 34 cases. In 10 of 70 cases, PET was categorized as determinate but to be investigated because of discrepancy with clinical or imaging findings; CEUS a definitive diagnosis in 9 of 10 cases. CEUS proved to be effective option in the assessment of cancer patients with indeterminate PET findings.
authors: Department of Radiology, National Cancer Institute, Fondazione Pascale, Naples, Italy. Electronic address: o.catalano@istitutotumori.na.it.
authors: Orlando
authors: O
authors: Catalano
authors: Department of Radiology, National Cancer Institute, Fondazione Pascale, Naples, Italy.
authors: Fabio
authors: F
authors: Sandomenico
authors: Department of Radiology, National Cancer Institute, Fondazione Pascale, Naples, Italy.
authors: Paolo
authors: P
authors: Vallone
authors: Department of Radiology, National Cancer Institute, Fondazione Pascale, Naples, Italy.
authors: Sergio Venanzio
authors: SV
authors: Setola
authors: Department of Radiology, National Cancer Institute, Fondazione Pascale, Naples, Italy.
authors: Vincenza
authors: V
authors: Granata
authors: Department of Radiology, National Cancer Institute, Fondazione Pascale, Naples, Italy.
authors: Roberta
authors: R
authors: Fusco
authors: Department of Nuclear Medicine, National Cancer Institute, Fondazione Pascale, Naples, Italy.
authors: Secondo
authors: S
authors: Lastoria
authors: Department of Nuclear Medicine, Second University of Naples, Naples, Italy.
authors: Luigi
authors: L
authors: Mansi
authors: Department of Radiology, National Cancer Institute, Fondazione Pascale, Naples, Italy.
authors: Antonella
authors: A
authors: Petrillo
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Abdomen; Cancer; Contrast-enhanced sonography; Focal liver lesions; Positron emission tomography