We performed a multicenter study to validate the concept that a simple comprehensive geriatric assessment (CGA) can identify elderly, non-fit patients with diffuse large B-cell lymphoma (DLBCL) in whom curative treatment is not better then palliation, and to analyze potential benefits of treatment modulation after further subdividing the non-fit category by CGA criteria. One hundred and seventy-three patients aged > 69 treated with curative or palliative intent by clinical judgement only were grouped according to CGA into fit (46%), unfit (16%) and frail (38%) categories. Two-year overall survival (OS) was significantly better in fit than in non-fit patients (84% vs. 47%; p < 0.0001). Survival in unfit and frail patients was not significantly different. Curative treatment slightly improved 2-year OS in unfit (75% vs. 45%) but not in frail patients (44% vs. 39%). CGA was confirmed as very efficient in identifying elderly patients with DLBCL who can benefit from a curative approach. Further efforts are needed to better tailor therapies in non-fit patients.

Context: Thyroid incidentaloma diagnosed by 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (F-18-FDG-PET/CT) is defined as a thyroid uptake incidentally and newly detected in a patient studied for nonthyroid purpose. In this review, we have comprehensively analyzed the diagnostic and clinical significance of F-18-FDG-PET/CT thyroid incidentalomas revealed during studies performed for an unrelated and nonthyroid purpose. Evidence Acquisition: A comprehensive literature research of the PubMed/MEDLINE databases was conducted to find relevant published articles about the F-18-FDG-PET or F-18-FDG-PET/CT thyroid incidentalomas. Evidence Synthesis: All studies considered in this review have investigated a very large number of patients, achieving overall about 147,505 units. The pooled incidence of thyroid incidentalomas detected by F-18-FDG-PET or PET/CT was 2.46% (95% confidence interval, 1.68–3.39%). The malignancy ratio was 34.6% (95% confidence interval, 29.3–40.2%). Conclusion: F-18-FDG-PET/CT thyroid incidentaloma is a relevant clinical finding; diffuse uptakes and most focal uptakes are commonly caused by benign diseases, whereas about one third of focal uptakes are malignant; the most frequent malignant histological type responsible for F-18-FDG-PET/CT thyroid incidentaloma is papillary thyroid carcinoma.

Background: Several meta-analyses reporting data on the diagnostic performance or prognostic value of positron emission tomography (PET) with different tracers in detecting brain tumors have been published so far. This review article was written to summarize the evidence-based data in these settings. Methods: We have performed a comprehensive literature search of meta-analyses published in the Cochrane library and PubMed/Medline databases (from inception through July 2019) about the diagnostic performance or prognostic value of PET with different tracers in patients with brain tumors. Results: We have summarized the results of 24 retrieved meta-analyses on the use of PET or PET/computed tomography (CT) with different tracers in brain tumors. The tracers included were: fluorine-18 fluorodeoxyglucose (¹⁸F-FDG), carbon-11 methionine (¹¹C-methionine), fluorine-18 fluoroethyltyrosine (¹⁸F-FET), fluorine-18 dihydroxyphenylalanine (¹⁸F-FDOPA), fluorine-18 fluorothymidine (¹⁸F-FLT), and carbon-11 choline (¹¹C-choline). Evidence-based data demonstrated good diagnostic performance of PET with different tracers in detecting brain tumors, in particular, radiolabelled amino acid tracers showed the highest diagnostic performance values. All the PET tracers evaluated had significant prognostic value in patients with glioma. Conclusions: Evidence-based data showed a good diagnostic performance for some PET tracers in specific indications and significant prognostic value in brain tumors.

To systematically review and meta-analyze published data about the diagnostic performance of Fluorine-18-Fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and PET/computed tomography (PET/CT) in patients with chronic inflammatory bowel disease (IBD). A comprehensive computer literature search of studies published through May 2012 regarding (18)F-FDG-PET and PET/CT in patients with IBD was performed. All retrieved studies were reviewed and qualitatively analyzed. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-) and diagnostic odd ratio (DOR) of (18)F-FDG PET and PET/CT in patients with IBD on a per segment-based analysis were calculated. The area under the ROC curve was calculated to measure the accuracy of (18)F-FDG PET and PET/CT in patients with IBD. Nineteen studies comprising 454 patients with suspected IBD were included in the qualitative analysis (systematic review) and discussed. The quantitative analysis (meta-analysis) of seven selected studies (including 219 patients with IBD) provided the following results on a per segment-based analysis: sensitivity was 85% [95% confidence interval (95%CI) 81-88%], specificity 87% (95%CI 84-90%), LR+ 6.19 (95%CI: 2.86-13.41), LR- 0.19 (95%CI: 0.10-0.34), and DOR 44.35 (95%CI: 11.77-167.07). The area under the ROC curve was 0.933. In patients with suspected IBD (18)F-FDG PET and PET/CT demonstrated good sensitivity and specificity, being accurate methods in this setting. Nevertheless, the literature focusing on the use of PET and PET/CT in IBD remains still limited; thus, further large multicenter studies will be necessary to substantiate the diagnostic accuracy of these methods in patients with IBD.