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1.
Säo Paulo med. j ; 140(3): 454-462, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1377387

ABSTRACT

ABSTRACT BACKGROUND: Clinical assessment of head and neck cancers is highly challenging owing to the complexity of regional anatomy and wide range of lesions. The diagnostic evaluation includes detailed physical examination, biopsy and imaging modalities for disease extent and staging. Appropriate imaging is done to enable determination of precise tumor extent and involvement of lymph nodes, and detection of distant metastases and second primary tumors. OBJECTIVE: To evaluate the initial staging discrepancy between conventional contrasted computed tomography (CT) and 18F-fluorodeoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) and its impact on management plans for head and neck malignancies. DESIGN AND SETTING: Prospective cross-sectional study in two tertiary-level hospitals. METHODS: This study included 30 patients with primary head and neck malignant tumors who underwent contrasted computed tomography and whole-body 18F-FDG PET/CT assessments. The staging and treatment plans were compared with the incremental information obtained after 18F-FDG PET/CT. RESULTS: 18F-FDG PET/CT was found to raise the stage in 33.3% of the cases and the treatment intent was altered in 43.3% of them, while there was no management change in the remaining 56.7%. 18F-FDG PET/CT had higher sensitivity (96% versus 89.2%) and accuracy (93% versus 86.7%) than conventional contrast-enhanced computed tomography. CONCLUSION: Our study demonstrated that 18F-FDG PET/CT had higher sensitivity and accuracy for detecting head and neck malignancy, in comparison with conventional contrast-enhanced computed tomography. 18F-FDG PET/CT improved the initial staging and substantially impacted the management strategy for head and neck malignancies.


Subject(s)
Humans , Positron Emission Tomography Computed Tomography/methods , Head and Neck Neoplasms/therapy , Head and Neck Neoplasms/diagnostic imaging , Cross-Sectional Studies , Prospective Studies , Sensitivity and Specificity , Radiopharmaceuticals , Fluorodeoxyglucose F18 , Positron-Emission Tomography , Neoplasm Staging
3.
Rev. méd. Chile ; 150(2): 199-205, feb. 2022. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1389644

ABSTRACT

BACKGROUND: 18F-fluorodesoxyglucose positron emission tomography/ computed tomography (PET-CT) has a high sensitivity and specificity to detect medullary and extramedullary lesions in multiple myeloma (MM). AIM: To describe the findings of PET-CT in extramedullary multiple myeloma (EMM) at diagnosis and at relapse, and correlate its results with clinical variables, response to treatment and survival. MATERIALS AND METHODS: Review of medical records and PET-CT reports of 39 patients with multiple myeloma (MM) who had at least one PET-CT study, treated between January 1, 2015, and January 1, 2019 at a clinical hospital. RESULTS: The Standard Uptake Values for each hypermetabolic lesion were not described in PET-CT reports. Fifteen patients had an EMM and in eight, without a previous clinical suspicion, PET-TC lead to the diagnosis. The mortality rate in the 39 patients with MM was 46%. Sixty seven percent of deaths occurred in patients with EMM. CONCLUSIONS: PET-TC was useful to diagnose EMM. However, a standardization in PETCT reports would be required to unify criteria. As previously reported, EMM had a greater aggressiveness and lower survival.


Subject(s)
Humans , Positron Emission Tomography Computed Tomography/methods , Multiple Myeloma/drug therapy , Multiple Myeloma/diagnostic imaging , Radiopharmaceuticals , Fluorodeoxyglucose F18 , Positron-Emission Tomography/methods , Neoplasm Recurrence, Local
4.
ABC., imagem cardiovasc ; 35(2): eabc264, 2022. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1400505

ABSTRACT

Embora a avaliação da viabilidade miocárdica seja comum na prática do cardiologista, muitos médicos têm dúvidas a respeito dos resultados dos métodos diagnósticos. A medicina nuclear tem papel importante nos estudos de viabilidade, mas os laudos precisam ser interpretados num contexto clínico e fisiopatológico. Este artigo teve o objetivo de revisar a origem e a evolução do conceito da viabilidade miocárdica. São expostos os métodos diagnósticos com ênfase na medicina nuclear com uma explicação funcional sobre cada tipo de exame. A partir disso, são mostradas imagens como exemplos e é proposta uma maneira de atuar nesses casos baseada na clínica, na porcentagem de miocárdio acometido e na topografia das lesões coronarianas (proximais ou distais). (AU)


Although assessing myocardial viability is a common cardiology practice, many physicians question the results of diagnostic methods. Nuclear medicine plays an important role in viability studies, but the reports require interpretation in a clinical and pathophysiological context. this article was aimed at reviewing the origin and evolution of myocardial viability. Here we present diagnostic methods by emphasizing nuclear medicine and provide a functional explanation of each test type using example images. We also propose how to act in these cases based on clinic examination findings, the percentage of affected myocardium, and coronary lesion topography (proximal or distal).(AU)


Subject(s)
Humans , Echocardiography/methods , Myocardial Stunning/diagnosis , Myocardial Stunning/physiopathology , Ventricular Dysfunction, Left/therapy , Nuclear Medicine/instrumentation , Rubidium/administration & dosage , Thallium/administration & dosage , Tomography, Emission-Computed, Single-Photon/methods , Clinical Diagnosis , Echocardiography, Stress/methods , Positron-Emission Tomography/methods , Dobutamine/administration & dosage , Myocardial Revascularization/methods
5.
Chinese Journal of Oncology ; (12): 555-561, 2022.
Article in Chinese | WPRIM | ID: wpr-940922

ABSTRACT

Objective: Solid and micropapillary pattern are highly invasive histologic subtypes in lung adenocarcinoma and are associated with poor prognosis while the biopsy sample is not enough for the accurate histological diagnosis. This study aims to assess the correlation and predictive efficacy between metabolic parameters in (18)F-fluorodeoxy glucose positron emission tomography/computed tomography ((18)F-FDG PET-CT), including the maximum SUV (SUV(max)), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and solid and micropapillary histological subtypes in lung adenocarcinoma. Methods: A total of 145 resected lung adenocarcinomas were included. The clinical data and preoperative (18)F-FDG PET-CT data were retrospectively analyzed. Mann-Whitney U test was used for the comparison of the metabolic parameters between solid and micropapillary subtype group and other subtypes group. Receiver operating characteristic (ROC) curve and areas under curve (AUC) were used for evaluating the prediction efficacy of metabolic parameters for solid or micropapillary patterns. Univariate and multivariate analyses were conducted to determine the prediction factors of the presence of solid or micropapillary subtypes. Results: Median SUV(max) and TLG in solid and papillary predominant subtypes group (15.07 and 34.98, respectively) were significantly higher than those in other subtypes predominant group (6.03 and 10.16, respectively, P<0.05). ROC curve revealed that SUV(max) and TLG had good efficacy for prediction of solid and micropapillary predominant subtypes [AUC=0.811(95% CI: 0.715~0.907) and 0.725(95% CI: 0.610~0.840), P<0.05]. Median SUV(max) and TLG in lung adenocarcinoma with the solid or micropapillary patterns (11.58 and 22.81, respectively) were significantly higher than those in tumors without solid and micropapillary patterns (4.27 and 6.33, respectively, P<0.05). ROC curve revealed that SUV(max) and TLG had good efficacy for predicting the presence of solid or micropapillary patterns [AUC=0.757(95% CI: 0.679~0.834) and 0.681(95% CI: 0.595~0.768), P<0.005]. Multivariate logistic analysis showed that the clinical stage (Stage Ⅲ-Ⅳ), SUV(max) ≥10.27 and TLG≥7.12 were the independent predictive factors of the presence of solid or micropapillary patterns (P<0.05). Conclusions: Preoperative SUV(max) and TLG of lung adenocarcinoma have good prediction efficacy for the presence of solid or micropapillary patterns, especially for the solid and micropapillary predominant subtypes and are independent factors of the presence of solid or micropapillary patterns.


Subject(s)
Adenocarcinoma of Lung/diagnostic imaging , Fluorodeoxyglucose F18/metabolism , Humans , Lung Neoplasms/pathology , Multimodal Imaging/methods , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography/methods , Prognosis , Radiopharmaceuticals , Retrospective Studies , Tomography, X-Ray Computed/methods , Tumor Burden
6.
Article in Chinese | WPRIM | ID: wpr-939766

ABSTRACT

PET/CT imaging can reflect the physiological metabolic process in living body which is the model experiment incapable to simulate. Animal experiment may be considered for systematic validation of PET/CT products. The obtained research data can be used to evaluate the feasibility, effectiveness and safety of PET/CT products, and be submitted as supporting documents for research data or clinical evaluation data when doing product registration or alteration registration. In this study, the functions and advantages of animal experiments were expounded, and relevant research cases were given as well as the issues that should be paid attention to. It can be a reference for the validation and review of PET/CT products.


Subject(s)
Animal Experimentation , Animals , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Tomography, X-Ray Computed
7.
Article in Chinese | WPRIM | ID: wpr-939659

ABSTRACT

OBJECTIVES@#To study the early clinical efficacy of combined therapy of stage 4 neuroblastoma.@*METHODS@#A retrospective analysis was performed on the medical data and follow-up data of 14 children with stage 4 neuroblastoma who were diagnosed in Hong Kong University-Shenzhen Hospital from January 2016 to June 2021.@*RESULTS@#The median age of onset was 3 years and 7.5 months in these 14 children. Among these children, 9 had positive results of bone marrow biopsy, 4 had N-Myc gene amplification, 13 had an increase in neuron-specific enolase, and 7 had an increase in vanilmandelic acid in urine. Based on the results of pathological examination, differentiated type was observed in 6 children, undifferentiated type in one child, mixed type, in one child and poorly differentiated type in 6 children. Of all the children, 10 received chemotherapy with the N7 regimen (including 2 children receiving arsenic trioxide in addition) and 4 received chemotherapy with the Rapid COJEC regimen. Thirteen children underwent surgery, 14 received hematopoietic stem cell transplantation, and 10 received radiotherapy. A total of 8 children received Ch14.18/CHO immunotherapy, among whom 1 child discontinued due to anaphylactic shock during immunotherapy, and the other 7 children completed Ch14.18/CHO treatment without serious adverse events, among whom 1 child was treated with Lu177 Dotatate 3 times after recurrence and is still undergoing chemotherapy at present. The median follow-up time was 45 months for all the 14 children. Four children experienced recurrence within 2 years, and the 2-year overall survival rate was 100%; 4 children experienced recurrence within 3 years, and 7 achieved disease-free survival within 3 years.@*CONCLUSIONS@#Multidisciplinary combined therapy is recommended for children with stage 4 neuroblastoma and can help them achieve better survival and prognosis.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Child , Child, Preschool , Combined Modality Therapy , Humans , Infant , Neuroblastoma/drug therapy , Positron-Emission Tomography , Radionuclide Imaging , Retrospective Studies , Treatment Outcome
8.
Article in Chinese | WPRIM | ID: wpr-935815

ABSTRACT

Occupational pneumoconiosis is one of the main occupational diseases in China. Progressive massive fibrosis in pneumoconiosis should be distinguished from lung cancer for their similar imaging features which is often identified by (18)F-FDG PET-CT in clinic. Here we reported two cases of pneumoconiosis. Both of them were suspected of carrying malignant tumors by preoperative PET-CT exam, however, nodules in these two patients were all proved to be benign by intraoperative pathology which suggested that there is false-positive possibility in the distinguishment of pneumoconiosis nodules by (18)F-FDG PET-CT.


Subject(s)
Fibrosis , Fluorodeoxyglucose F18 , Humans , Lung Neoplasms/pathology , Pneumoconiosis/pathology , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography/methods
9.
Chinese Journal of Hematology ; (12): 316-322, 2022.
Article in Chinese | WPRIM | ID: wpr-935088

ABSTRACT

Objective: To analyze the value of (11)C-PiB PET/MRI for evaluating organ involvement in patients with primary light chain amyloidosis (pAL) . Methods: The clinical data of 20 patients with pAL and 3 healthy volunteers from January 2019 to October 2021 were retrospectively analyzed. The correlation between the organ involvement evaluated by clinical standards and PET/MRI was compared. The relationship between cardiac-related biological indicators, disease stage, and the maximum standardized uptake value (SUVmax) were analyzed. The relationship between 24-hour urinary protein quantification and kidney SUVmax was analyzed. Results: ①In 20 patients (18 newly diagnosed patients and 2 non-newly diagnosed patients) ,(11)C-PiB positive uptake was observed in the heart (15 patients, 75%) , lung (8 patients, 40%) , bone marrow (10 patients, 50%) , muscle (10 patients, 50%) , tongue muscle (7 patients, 35%) , thyroid (6 patients, 30%) , salivary gland (4 patients, 20%) , spleen (2 patients, 10%) , and stomach wall (1 patient, 5%) . ②Organ involvement on (11)C-PiB PET/MRI showed good correlations with the clinical evaluation criteria for the heart and bone marrow. The positive rate of PET/MRI evaluation in the lung, spleen, gland, muscle, and tongue muscle was significantly higher than the clinical criteria. However, (11)C-PiB PET/MRI has limitations in the evaluation of the nervous system and fat tissue. ③To analyze the relationship between cardiac-related biological indexes and the SUVmax of the heart in 13 newly diagnosed patients. Patients with left ventricular ejection fraction (LVEF) <50% and interventricular septal thickness (ISV) ≥1.2 cm showed a higher SUVmax than patients with LVEF ≥50% and ISV<1.2 cm (P<0.05) .There are significant differences in the SUVmax of the heart between the Mayo2004 stage and the Mayo2012 stage. The later the disease stage, the higher the SUVmax (P<0.05) . The SUVmax of the heart was positively correlated with cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) (P<0.01) .There was no significant correlation between renal SUVmax and 24-hour urine protein (P>0.05) . Conclusion: Whole body (11)C-PiB PET/MRI, as a visualization system of amyloid protein, is used to qualitatively evaluate organ involvement, which can improve the level of early non-invasive diagnosis. Whole body (11)C-PiB PET/MRI can be used to perform quantitative evaluation of organ levels, especially the heart, which is expected to evaluate organ function and predict disease prognosis more accurately.


Subject(s)
Amyloidosis/diagnostic imaging , Aniline Compounds , Humans , Magnetic Resonance Imaging , Positron-Emission Tomography , Retrospective Studies , Stroke Volume , Ventricular Function, Left
10.
Article in Chinese | WPRIM | ID: wpr-928691

ABSTRACT

OBJECTIVE@#To investigate the characteristics of 18F-FDG PET/CT images of multiple myeloma secondary extramedullary infiltration in order to improve recognition.@*METHODS@#Twenty-one patients with multiple myeloma secondary extramedullary infiltration confirmed by pathology or follow-up from January 2012 to October 2020 in the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed. All the patients underwent 18F-FDG PET/CT imaging before treatment, and the PET/CT characteristics of extramedullary infiltration and bone marrow were analyzed.@*RESULTS@#Twenty-one patients included 12 males and 9 females, aged from 41 to 77 years old, with an average of 58.3±10.0; 9 cases of extramedullary infiltration involving lymph nodes; lung, stomach, spleen, and kidney were involved respectively in 2 cases; retroperitoneal, right auricle, subcutaneous nodule, and spinal meninges involvement were reported in each one case respectively. The maximum SUVmax value of extra-medullary lesions was 21.2, the minimum value was 2.1, and mean was 7.7±5.3. The maximum SUVmax value of bone marrow was 33.5, the minimum was 2.4, and mean was 6.6±3.6. There was no statistically significant difference in SUVmax value between extra-medullary lesions and bone marrow (Z=-1.195, P=0.232).@*CONCLUSION@#18F-FDG PET/CT not only has a good diagnostic value for multiple myeloma, but also a good evaluation value for secondary extramedullary infiltration, which provides reference for clinical treatment and prognosis.


Subject(s)
Adult , Aged , Female , Fluorodeoxyglucose F18 , Humans , Male , Middle Aged , Multiple Myeloma/diagnostic imaging , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Retrospective Studies
11.
Article in Chinese | WPRIM | ID: wpr-928682

ABSTRACT

OBJECTIVE@#To investigate the influencing factors of maximum standard uptake value (SUVmax) of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and nuclear antigen Ki-67 in non-Hodgkin lymphoma (NHL) and their correlation.@*METHODS@#The relationship between SUVmax, Ki-67 and gender, age, maximum lesion diameter, extranodal involvement, superficial and deep lymph node involvement, malignancy, B symptoms, clinical stage, lactate dehydrogenase (LDH) and international prognostic index (IPI) scores and their correlation were reviewed.@*RESULTS@#Among 185 NHL patients, 99 cases were aggressive B-cell NHL, 43 cases were indolent B-cell NHL, and 43 cases were T-cell NHL, respectively. Obviously, the SUVmax and Ki-67 of aggressive B-cell NHL were higher than those of indolent B-cell NHL and T-cell NHL (P<0.05), while indolent B-cell NHL were lower than those of T-cell NHL (P<0.05). SUVmax and Ki-67 were closely related to maximum lesion diameter, extranodal involvement, malignancy, LDH, and IPI scores (P<0.05). SUVmax was positively correlated with Ki-67 expression (r=0.615). According to the analysis of receiver operating characteristic (ROC), the results showed that the SUVmax and Ki-67 could reflect the aggressiveness of NHL accurately, with an AUC of 0.871 and 0.968.@*CONCLUSION@#SUVmax and Ki-67 are not affected by age, sex, B symptoms, clinical stage and so on, and are relatively objective quantitative parameters. SUVmax is positively correlated with Ki-67 expression in NHL. SUVmax and Ki-67 have certain value in clinical diagnosis of malignant degree of NHL.


Subject(s)
Fluorodeoxyglucose F18 , Humans , Ki-67 Antigen , Lymphoma, Non-Hodgkin , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Retrospective Studies
12.
Chinese Medical Journal ; (24): 591-597, 2022.
Article in English | WPRIM | ID: wpr-927512

ABSTRACT

BACKGROUND@#Insufficient cerebral perfusion is suggested to play a role in the development of Alzheimer disease (AD). However, there is a lack of direct evidence indicating whether hypoperfusion causes or aggravates AD pathology. We investigated the effect of chronic cerebral hypoperfusion on AD-related pathology in humans.@*METHODS@#We enrolled a group of cognitively normal patients (median age: 64 years) with unilateral chronic cerebral hypoperfusion. Regions of interest with the most pronounced hypoperfusion changes were chosen in the hypoperfused region and were then mirrored in the contralateral hemisphere to create a control region with normal perfusion. 11C-Pittsburgh compound-positron emission tomography standard uptake ratios and brain atrophy indices were calculated from the computed tomography images of each patient.@*RESULTS@#The median age of the 10 participants, consisting of 4 males and 6 females, was 64 years (47-76 years). We found that there were no differences in standard uptake ratios of the cortex (volume of interest [VOI]: P = 0.721, region of interest [ROI]: P = 0.241) and grey/white ratio (VOI: P = 0.333, ROI: P = 0.445) and brain atrophy indices (Bicaudate, Bifrontal, Evans, Cella, Cella media, and Ventricular index, P > 0.05) between the hypoperfused regions and contralateral normally perfused regions in patients with unilateral chronic cerebral hypoperfusion.@*CONCLUSION@#Our findings suggest that chronic hypoperfusion due to large vessel stenosis may not directly induce cerebral β-amyloid deposition and neurodegeneration in humans.


Subject(s)
Aged , Alzheimer Disease/pathology , Amyloid beta-Peptides/metabolism , Arteries , Atrophy , Brain/metabolism , Cerebral Cortex/metabolism , Cerebrovascular Circulation , Constriction, Pathologic/pathology , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Positron-Emission Tomography/methods
13.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 43(5): 510-513, Sept.-Oct. 2021. tab
Article in English | LILACS | ID: biblio-1345479

ABSTRACT

Objective: People with Alzheimer's disease (AD) dementia have impaired sleep. However, the characteristics of sleep in the early stages of AD are not well known, and studies with the aid of biomarkers are lacking. We assessed the subjective sleep characteristics of non-demented older adults and compared their amyloid profiles. Methods: We enrolled 30 participants aged ≥ 60 years, with no dementia or major clinical and psychiatric diseases. They underwent [11C]PiB-PET-CT, neuropsychological evaluations, and completed two standardized sleep assessments (Pittsburgh Sleep Quality Inventory and Epworth Sleep Scale). Results: Comparative analysis of subjective sleep parameters across the two groups showed longer times in bed (p = 0.024) and reduced sleep efficiency (p = 0.05) in individuals with positive amyloid. No differences in other subjective sleep parameters were observed. We also found that people with multiple-domain mild cognitive impairment (MCI) had shorter self-reported total sleep times (p = 0.034) and worse overall sleep quality (p = 0.027) compared to those with single-domain MCI. Conclusions: Older adults testing positive for amyloid had a longer time in bed and lower sleep efficiency, regardless of cognitive status. In parallel, individuals with multiple-domain MCI reported shorter sleep duration and lower overall sleep quality.


Subject(s)
Humans , Aged , Alzheimer Disease/diagnostic imaging , Cognitive Dysfunction/diagnostic imaging , Sleep , Thiazoles , Case-Control Studies , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography , Aniline Compounds
14.
J. health med. sci. (Print) ; 7(3): 201-206, jul.-sept. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1391545

ABSTRACT

Presentamos el caso de un paciente masculino de 40 años de edad, con estreñimiento de un año de evolución y antecedentes de enfermedad por reflujo gastroesofágico, se realiza endoscopia digestiva alta y baja y se realiza diagnóstico sincrónico de adenocarcinoma de estómago, recto y colon descendente, realizamos tomografía por emisión de positrones con tomografía computarizada pre quirúrgico y cirugía como tratamiento primario. Mostramos una descripción del caso y una revisión de la bibliografía.


We present the case of a 40-year-old man with a one year evolution constipation and a history of GERD. An upper and lower digestive endoscopy was performed and a synchronous diagnosis of adenocarcinoma of the stomach, rectum and descending colon was established. A PET-CT pre-surgical was performed and the surgery was carried out as primary treatment. We show a description of the case and a bibliographic review.


Subject(s)
Humans , Male , Adult , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/pathology , Colorectal Neoplasms/epidemiology , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/epidemiology , Prognosis , Tomography, X-Ray Computed , Incidence , Endoscopy, Digestive System/methods , Colon, Descending , Positron-Emission Tomography , Informed Consent , Neoplasm Staging
15.
Int. braz. j. urol ; 47(4): 705-729, Jul.-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286767

ABSTRACT

ABSTRACT Introduction: Prostate cancer (PC) is the second most commonly diagnosed cancer in males. 68Ga-PSMA PET/CT, a non-invasive diagnostic tool to evaluate PC with prostate-specific membrane antigen (PSMA) expression, has emerged as a more accurate alternative to assess disease staging. We aimed to identify predictors of positive 68Ga-PSMA PET and the accuracy of this technique. Materials and methods: Diagnostic accuracy cross-sectional study with prospective and retrospective approaches. We performed a comprehensive literature search on PubMed, Cochrane Library, and Embase database in search of studies including PC patients submitted to radical prostatectomy or radiotherapy with curative intent and presented biochemical recurrence following ASTRO 1996 criteria. A total of 35 studies involving 3910 patients submitted to 68-Ga-PSMA PET were included and independently assessed by two authors: 8 studies on diagnosis, four on staging, and 23 studies on restaging purposes. The significance level was α=0.05. Results: pooled sensitivity and specificity were 0.90 (0.86-0.93) and 0.90 (0.82-0.96), respectively, for diagnostic purposes; as for staging, pooled sensitivity and specificity were 0.93 (0.86-0.98) and 0.96 (0.92-0.99), respectively. In the restaging scenario, pooled sensitivity and specificity were 0.76 (0.74-0.78) and 0.45 (0.27-0.58), respectively, considering the identification of prostate cancer in each described situation. We also obtained specificity and sensitivity results for PSA subdivisions. Conclusion: 68Ga-PSMA PET provides higher sensitivity and specificity than traditional imaging for prostate cancer.


Subject(s)
Humans , Male , Prostatic Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography , Tomography, X-Ray Computed , Cross-Sectional Studies , Prospective Studies , Retrospective Studies , Radiopharmaceuticals , Positron-Emission Tomography
17.
Braz. j. otorhinolaryngol. (Impr.) ; 87(4): 452-456, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1285711

ABSTRACT

Abstract Introduction 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters such as; maximum standardized uptake values, standard metabolic tumor volume and otal lesion glycosis are important prognostic biomarkers in cancers. Objective To investigate the prognostic value of these parameters in patients with head and neck cancers. Methods We performed a retrospective study including 47 patients with head and neck cancer who underwent18F-fluorodeoxyglucose positron emission tomography/computed tomography prior to treatment. Standard metabolic tumor volume, otal lesion glycosis and standardized uptake were measured for each patient. The prognostic value of quantitative 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters and clinicopathologic variables on disease free survival and overall survival were analyzed. Results The median (range) standard metabolic tumor volume and otal lesion glycosis and standardized uptake were 7.63 cm3 (0.6-34.3), 68.9 g (2.58-524.5 g), 13.89 (4.89-33.03 g/mL), respectively. Lymph node metastases and tumour differentiation were significant variables for disease free survival and overall survival, however, all 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters were not associated with disease- free survival and overall survival. Conclusion Pretreatment quantities positron emission tomography parameters did not predict survival in head and neck cancer.


Resumo Introdução Os parâmetros da tomografia por emissão de pósitrons/tomografia computadorizada com 18F-fluordesoxiglicose, como os máximos valores de captação padronizados, o volume metabólico tumoral padrão e a glicólise total da lesão são importantes biomarcadores prognósticos de câncer. Objetivo Investigar o valor prognóstico desses parâmetros em pacientes com câncer de cabeça e pescoço. Método Fizemos um estudo retrospectivo que incluiu 47 pacientes com câncer de cabeça e pescoço e que foram submetidos à tomografia por emissão de pósitrons/tomografia computadorizada com 18F-fluordesoxiglicose antes do tratamento. Volume metabólico tumoral, glicólise total da lesão e valores de captação padronizados foram aferidos em cada paciente. O valor prognóstico de parâmetros quantitativos da tomografia por emissão de pósitrons/tomografia computadorizada com 18F-fluordesoxiglicose e das variáveis clínico-patológicas sobre a sobrevida livre de doença e a sobrevida geral foi analisado. Resultados A média (intervalo) de volume metabólico tumoral e glicólise total da lesão e valores de captação padronizados foram 7,63 cm3 (0,6-34,3), 68,9 g (2,58-524,5) e 13,89 g/mL (4,89-33,03), respectivamente. Metástase nos nódulos linfáticos e diferenciação tumoral foram variáveis significativas de sobrevida livre de doença e sobrevida geral; contudo, nenhum parâmetro da tomografia por emissão de pósitrons/tomografia computadorizada com 18F-fluordesoxiglicose estava associado a sobrevida livre de doença e sobrevida geral. Conclusão As quantidades dos parâmetros da tomografia por emissão de pósitrons pré-tratamento não previram a sobrevida em câncer de cabeça e pescoço.


Subject(s)
Fluorodeoxyglucose F18 , Head and Neck Neoplasms/diagnostic imaging , Prognosis , Retrospective Studies , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography
18.
Rev. méd. Chile ; 149(5): 773-778, mayo 2021. ilus
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1389517

ABSTRACT

Vasculitides are a broad group of diseases that can involve any kind of vessel in any organ. These can be classified according to the size of the affected vessels. The most used classification categorizes them in small, medium, and large vessel vasculitis. Large vessel vasculitis can be further divided in Takayasu arteritis and giant cell arteritis which can sometimes be indistinguishable, even with biopsy. Radiology plays an important role identifying distribution patterns and disease extension18. Fluorine-Fluorodeoxyglucose (FDG) PET-CT shows increased vessel wall FDG uptake in patients with active large vessel vasculitis. Multiple studies show that FDG PET-CT helps to identify the anatomic structures with the disease, as well as evaluate its progression with a high sensibility and specificity in non-treated patients with large vessel vasculitis.


Subject(s)
Humans , Giant Cell Arteritis/diagnostic imaging , Takayasu Arteritis/diagnostic imaging , Tomography, X-Ray Computed , Radiopharmaceuticals , Fluorodeoxyglucose F18 , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography
19.
Rev. colomb. gastroenterol ; 36(supl.1): 78-84, abr. 2021. graf
Article in Spanish | LILACS | ID: biblio-1251552

ABSTRACT

Resumen Introducción: El mejor tratamiento para los tumores neuroendocrinos es la resección completa del tumor, los ganglios, e inclusive en casos seleccionados, las metástasis a distancia. En ocasiones, el tumor primario es pequeño y de difícil localización preoperatoria o sus recaídas pueden ser difíciles de localizar en el terreno de fibrosis por cirugías o tratamientos previos. La cirugía radioguíada ofrece una opción adicional de localización intraoperatoria que hasta ahora no ha sido muy utilizada en tumores neuroendocrinos. Presentación del caso: Paciente de 59 años con antecedente de resección atípica de duodeno y páncreas por tumor neuroendocrino grado 2 del duodeno un año antes. En la tomografía por emisión de positrones/tomografía computarizada (PET/CT) 68Ga-DOTANOC se encontró un ganglio con sobreexpresión de receptores de somatostatina en el mesenterio, sin otras lesiones a distancia. Por los antecedentes quirúrgicos y la dificultad de visualizar la lesión en las imágenes anatómicas (resonancia magnética [RM]) se decidió realizar la cirugía radioguíada. En el preoperatorio se administraron 15 mCi de tecnecio 99 metaestable-hidrazinonicotinilo-Tyr3-octreotida (99mTc-HYNIC-TOC) y se verificó la buena captación en el ganglio. En cirugía, luego de la disección inicial se utilizó la sonda gamma, que detectó una actividad 5 veces mayor en el ganglio, comparado con los tejidos vecinos, lo que permitió su localización y resección. La evolución fue adecuada y un año después no hay evidencia de recaídas. Conclusión: La cirugía radioguíada no ha sido muy utilizada en la localización intraoperatoria de tumores neuroendocrinos, pero es una buena alternativa en casos seleccionados, como el presentado en este artículo, y permite la detección intraoperatoria y su resección completa.


Abstract Introduction: The best treatment for neuroendocrine tumors is complete resection of the tumor, lymph nodes, and even distant metastases in selected cases. Sometimes, the primary tumor is small and difficult to detect before surgery, or its relapses may be difficult to locate in the fibrosis field due to previous surgeries or treatments. Although radioguided surgery allows for additional intraoperative localization, it has yet to be widely used in neuroendocrine tumors. Case report: A 59-year-old patient with a history of atypical resection of duodenum and pancreas due to grade 2 neuroendocrine tumor of the duodenum one year earlier. On 68Ga-DOTANOC PET/CT, a node with somatostatin receptor overexpression was found in the mesentery, with no other distant lesions. Due to the surgical history and the difficulty in visualizing the lesion on anatomical images (MRI), it was decided to perform the radioguided surgery. During the preoperative period, 15 mCi of 99mTc-HYNIC-TOC were administered verifying good uptake in the ganglion. Following the initial dissection, a gamma probe was used, detecting 5 times more activity in the ganglion than in adjacent tissues, allowing for localization and resection. The patient's progress was satisfactory, and one year later there is no evidence of relapse. Conclusion: Although radioguided surgery is not commonly used in the intraoperative location of neuroendocrine tumors, it is a viable option in some situations, such as the one presented here, because it allows for intraoperative detection and full resection.


Subject(s)
Humans , Male , Middle Aged , Somatostatin , Tomography, X-Ray Computed , Neuroendocrine Tumors , Positron-Emission Tomography , Prospecting Probe
20.
Rev. urug. cardiol ; 36(3): e203, 2021. ilus, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1366959

ABSTRACT

Introducción: la degeneración valvular protésica es un problema clínico; los métodos de imagen convencionales permiten diagnosticarla en las últimas etapas. La tomografía por emisión de positrones (PET) con 18Ffluoruro puede detectar de manera precoz la degeneración subclínica. Objetivo: correlacionar parámetros de deterioro estructural protésico por PET con parámetros hemodinámicos ecocardiográficos al año de la sustitución valvular aórtica (SVA) por bioprótesis porcina. Métodos: estudio prospectivo ad hoc de un ensayo clínico. Se reclutaron pacientes sometidos a SVA por bioprótesis porcina en dos centros nacionales entre el 01/01/2019 y el 13/02/2020. Se realizaron controles clínicos y ecocardiográficos. Se seleccionaron aleatoriamente 19 sujetos a los que se les realizó PET 18Ffluoruro de sodio con angiotomografía al año de la SVA. Se midió la captación del trazador en la válvula (SUVavV) y aurícula derecha (SUVavA), calculando el índice SUVavV/SUVavA, que se comparó con los gradientes ecocardiográficos medio y máximo al año, mediante análisis de correlación de Spearman. Resultados: de 140 sujetos sometidos a SVA se realizó PET a 19, a los 16,3 meses (15,9-16,9) luego de la SVA. La mediana del índice SUVavV/SUVavA fue de 1,17 (1,11-1,27). Se encontró una correlación negativa moderada entre la captación de 18Ffluoruro y el gradiente medio (coeficiente de correlación -0,516, p = 0,028) y máximo (coeficiente -0,589, p = 0,010) al año. Conclusiones: en el seguimiento de los pacientes en los que se le realizó una sustitución valvular aórtica con bioprótesis, encontramos valores bajos de captación en el PET y gradientes ecocardiográficos normales con una correlación negativa moderada entre estos hallazgos


Introduction: prosthetic valve degeneration is a relevant clinical disorder; conventional imaging methods allow diagnosis in the later stages. 18Ffluoride positron emission tomography (PET) can detect subclinical degeneration earlier. Objective: correlate parameters of prosthetic structural deterioration by PET with echocardiographic hemodynamic parameters one year after aortic valve replacement (AVR) by porcine bioprosthesis. Methods: prospective ad hoc study of a clinical trial. Patients undergoing AVR by porcine bioprosthesis were recruited in two national centers between 01/01/2019 and 02/13/2020. Clinical and echocardiographic controls were carried out. 19 subjects were randomly selected and underwent 18Fsodium fluoride PET with CT angiography one year after AVR. Tracer uptake in the valve (SUVavV) and right atrium (SUVavA) was measured, creating the SUVavV/SUVavA index, which was compared with the mean and maximum gradients at one year, using Spearman's correlation analysis. Results: of a total of 140 subjects, PET was performed on 19 at 16.3 months (15.9-16.9) after the AVR. The median SUVavV/SUVavA ratio was 1.17 (1.11-1.27). A moderate negative correlation was found between. 18Ffluoride uptake and the mean gradient (correlation coefficient -0.516, p = 0.028) and maximum (coefficient of -0.589, p = 0.010) at one year. Conclusions: we found low uptake values in PET, echocardiographic gradients in normal range and no positive correlation between both parameters. It is the first national report with these imaging techniques


Introdução: a degeneração da válvula protética é um problema clínico; os métodos convencionais de imagem permitem o diagnóstico nas fases posteriores. A tomografia por emissão de pósitrons (PET) com fluoreto18F pode detectar a degeneração subclínica precocemente. Objetivo: correlacionar parâmetros de deterioração estrutural protética por PET com parâmetros hemodinâmicos ecocardiográficos após um ano da troca valvar aórtica (SVA) por bioprótese suína. Métodos: estudo ad hoc prospectivo de um ensaio clínico. Pacientes submetidos a SVA por bioprótese suína foram recrutados em dois centros nacionais entre 01/01/2019 e 13/02/2020. Foram realizados controles clínicos e ecocardiográficos. 19 indivíduos foram selecionados aleatoriamente que foram submetidos a PET com fluoreto de sódio 18F com angiotomografia um ano após AVS. A captação do traçador na válvula (SUVavV) e átrio direito (SUVavA) foi medida, criando o índice SUVavV/SUVavA, que foi comparado com os gradientes médio e máximo em um ano, usando a análise de correlação de Spearman. Resultados: de um total de 140 indivíduos submetidos a SVA, PET foi realizado em 19, em 16,3 meses (15,9-16,9) após a SVA. A proporção média de SUVavV/SUVavA foi de 1,17 (1,11-1,27). Uma correlação negativa moderada foi encontrada entre a captação de fluoreto18F e o gradiente médio (coeficiente de correlação -0,516, p = 0,028) e máximo (coeficiente de -0,589, p = 0,010) em um ano. Conclusões: encontramos valores baixos de captação na PET, gradientes ecocardiográficos dentro da normalidade, sem correlação positiva entre os dois parâmetros. É o primeiro trabalho nacional com essas técnicas de imagem


Subject(s)
Humans , Male , Female , Aged , Aortic Valve , Sodium Fluoride/administration & dosage , Bioprosthesis , Prosthesis Failure , Calcinosis/diagnostic imaging , Heart Valve Prosthesis , Echocardiography , Prospective Studies , Follow-Up Studies , Positron-Emission Tomography
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