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J Nucl Med. 2008; 49 (Supplement 1):43P
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General Clinical Specialties: General Practice-Oncology

General PET-CT and Abdominal Malignancies

18F-FDG activity in a surgical specimen correlates with pathology results: Potential role in evaluating margins in surgical oncology

Nathan Hall1, Edward Martin2, Steven Povoski2, Douglas Murrey2, Jun Zhang1 and Michael Knopp1

1 Radiology; 2 Surgery, The Ohio State University Medical Center, Columbus, Ohio

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Objectives: A major limitation in the surgical management of oncology patients lies in the accuracy of evaluating surgical margins. Intraoperatively, frozen section is used for assessing margins with final pathology results lagging by a few days and often contradicting the initial frozen section report. We report a method for evaluating surgical oncology specimens using 18F-FDG to assess surgical margins in real time while the patient is in surgery.

Methods: Prior to surgery a patient with breast a cancer liver metastasis was injected with 18F-FDG (15 mCi). The specimen was surgically removed and scanned on a 16-slice high resolution PET/CT scanner. The specimen was sliced into 38 similar sized pieces which were re-scanned with the PET/CT, measured in a well counter and then processed by pathology. PET activity from imaging (Bq/g) and well counts (nCi/g) of the pieces was correlated with percent tumor based on final pathologic evaluation of each piece.

Results: Pathology results revealed that of the 38 pieces, 30 were negative for tumor and 8 were positive for tumor cells. Average well count activity (nCi/g +/- st. dev.) for pathology negative and positive samples was 14.6+/-2.2 and 80.8+/-36.7, respectively (p<0.001). Well counts (nCi/g) and 18F-FDG PET counts (Bq/g) per gram correlated well with % tumor in specimen pieces (p<0.01).

Conclusions: 18F-FDG activity in surgical oncology specimens assed with PET/CT and well counts using preoperative 18F-FDG administration correlates very well with presence and burden of tumor in the specimens. This technique may potentially be used to assess margins in surgical oncology specimens intraoperatively and assist in pathology sampling.





This Article
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Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Right arrow Articles by Hall, N.
Right arrow Articles by Knopp, M.
PubMed
Right arrow Articles by Hall, N.
Right arrow Articles by Knopp, M.