Clinical Significance of Pretreatment FDG PET/CT in MIBG-Avid Pediatric Neuroblastoma / 대한핵의학회잡지

PURPOSE: ¹⁸F-fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging is well known to have clinical significance in the initial staging and response evaluation of the many kinds of neoplasms. However, its role in the pediatric neuroblastoma is not clearly defined. In the present study, the clinical significance of FDG-PET/computed tomography (CT) in ¹²³I- or ¹³¹I-metaiodobenzylguanidine (MIBG)-avid pediatric neuroblastoma was investigated.METHODS: Twenty patients with neuroblastoma who undertook pretreatment FDG PET/CT at our institute between 2008 and 2015 and showed MIBG avidity were retrospectively enrolled in the present study. Clinical information—including histopathology, and serum markers—and several PET parameters—including SUVmax of the primary lesion (Psuv), target-to-background ratio (TBR), metabolic tumor volume (MTV), and coefficient of variation (CV)—were analyzed. The prognostic effect of PET parameters was evaluated in terms of progression-free survival (PFS).RESULTS: Total 20 patients (4.5 ± 3.5 years) were divided as two groups by disease progression. Six patients (30.0 %) experienced disease progression and one patient (5.0 %) died during follow-up period. There were not statistically significant in age, stage, MYCN status, primary tumor size, serum lactate dehydrogenase (LDH), neuron-specific enolase (NSE), and ferritin level between two groups with progression or no progression. However, Psuv (p = 0.017), TBR (p = 0.09), MTV (p = 0.02), and CV (p = 0.036) showed significant differences between two groups. In univariate analysis, PFS was significantly associated with Psuv (p = 0.021) and TBR (p = 0.023).CONCLUSIONS: FDG-PET parameters were significantly related with progression of neuroblastoma. FDG-PET/CT may have the potential as a valuable modality for evaluating prognosis in the patients with MIBG-avid pediatric neuroblastoma.

Radiation dose-rate reduction pattern in well-differentiated thyroid cancer treated with I[-131]

To determine the patterns of dose rate reduction in single and multiple radioiodine [I[-131]] therapies in cases of well differentiated thyroid cancer patients. Analytical series. Department of Nuclear Medicine and Radiation Physics, Multan Institute of Nuclear Medicine and Radiotherapy [MINAR], Multan, Pakistan, from December 2006 to December 2013. Ninety three patients [167 therapies] with well differentiated thyroid cancer treated with different doses of I[-131] as an in-patient were inducted. Fifty four patients were given only single I[-131] therapy dose ranging from 70 mCi [2590 MBq] to 150 mCi [5550 MBq]. Thirty nine patients were treated with multiple I[-131] radioisotope therapy doses ranging from 80 mCi [2960 MBq] to 250 mCi [9250 MBq]. T-test was applied on the sample data showed statistically significant difference between the two groups with p-value [p < 0.01] less than 0.05 taken as significant. There were 68 females and 25 males with an age range of 15 to 80 years. Mean age of the patients were 36 years. Among the 93 cases of first time Radio Active Iodine [RAI] therapy, 59 cases [63%] were discharged after 48 hours. Among 39 patients who received RAI therapy second time or more, most were discharged earlier after achieving acceptable discharge dose rate i.e 25 microSv/hour; 2 out of 39 [5%] were discharged after 48 hours. In 58% patients, given single I[-131] therapy dose, majority of these were discharged after 48 hours without any major complications. For well differentiated thyroid cancer patients, rapid dose rate reduction is seen in patients receiving second or subsequent radioiodine [RAI] therapy, as compared to first time receiving RAI therapy

Klippel-trenaunay syndrome

Klippel-Trenaunay Syndrome [KTS] is a rare, congenital, vascular disorder affecting one or more limbs. Originally, it was defined as a triad including port wine stain, varicose veins and bony and soft tissue hypertrophy. We present a case of a 20-year-old female who walked with a limp. Because of swelling of right leg she was sent for Doppler study which picked up dilated arteries and increased blood flow velocity. The impression of KTS was further strengthened by unique nuclear medicine and radiological findings