ABSTRACT
Resumen: El tomógrafo por emisión de positrones (PET, por sus siglas en inglés [positron emission tomography]) es una poderosa herramienta no invasiva para el diagnóstico clínico e investigación in vivo por medio de imágenes empleada en humanos y animales de laboratorio. Se han desarrollado equipos exclusivos para los diversos modelos animales con los beneficios de esta técnica para el estudio de diferentes enfermedades.
Abstract: The positron emission tomography , PET scan (Positron Emission Tomography) is a powerful noninvasive tool for clinical diagnosis and research in vivo by means of images used in humans and laboratory animals. We have developed exclusive equipment for the various animal models with the benefits of this technique for the study of different diseases.
ABSTRACT
Non-Hodgkin lymphoma comprises a heterogeneous group of haematological malignancies, classified according to their clinic, anatomic-pathological features and, lately, to their molecular biomarkers. Despite the therapeutic advances, nearly half of the patients will die because of this disease. The new diagnostic tools have been the cornerstone to design recent therapy targets, which must be included in the current treatment guidelines of this sort of neoplasms by means of clinical trials and evidence-based medicine. In the face of poor diagnoses devices in most of the Mexican hospitals, we recommend the present diagnose stratification, and treatment guidelines for non-Hodgkin lymphoma, based on evidence. They include the latest and most innovative therapeutic approaches, as well as specific recommendations for hospitals with limited framework and therapy resources.
Subject(s)
Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/therapy , Humans , MexicoABSTRACT
BACKGROUND: Of women between 15 and 29 years of age, 13.6% will die from breast cancer. For women between 30 and 64 years of age, 19% will die from breast cancer. METHODS: We studied 1728 oncological patients and 295 patients were included, 293 with breast cancer (17%) and two patients with primary breast lymphoma (0.1%). RESULTS: There were 98% females and 2% males. SUVmax for the primary tumor was 4.2 +/- 2.6 SD. Mean SUVmax for patients with primary breast lymphoma were 3.2 and 1.4. Sites of metastases were lymph nodes in the neck (4.4% SUVmax 2.7), internal mammary lymph nodes (5% SUVmax 5.3), mediastinum (8.3% SUVmax 5.0), retroperitoneal (6 % SUVmax 5.4), ipsilateral axilla (94% SUVmax 4.5), contralateral axilla (4.4% SUVmax 2.8), pectoral muscle (10.2% SUVmax 2.6), pleura (4.4% SUVmax 3.9), lung (32.3% SUVmax 2.9), liver (19.1% SUVmax 4.5), bone (36.7%), adrenal gland (4.4% SUVmax 2.4), brain (4.4%), spleen and contralateral breast, one case each. One patient presented thymic hyperplasia after chemotherapy. Mean SUVmax for blastic lesions was 5.4 +/- 2.9 SD, for lytic lesions it was 6.7 +/- 2.4 SD and for lesions not apparent on the CT it was 4.6 +/- 2.4 SD. The incidence of a second primary was 4.7%, 2.1% ovarian, 1.4% lung, 0.3% lymphoma, 0.3% endometrium, 0.3% pancreas and 0.3% thyroid. CONCLUSIONS: Mean SUVmax for the primary tumor was similar to that reported in the literature. Values for metastatic bone lesions are higher in this study. Inclusion of PET/CT in the followup of breast lesions is cost efficient.
Subject(s)
Breast Neoplasms/diagnostic imaging , Carcinoma/diagnostic imaging , Positron-Emission Tomography , Tomography, X-Ray Computed , Adult , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/secondary , Breast Neoplasms/epidemiology , Breast Neoplasms, Male/diagnostic imaging , Cost-Benefit Analysis , Female , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Humans , Hyperplasia , Lymphatic Metastasis/diagnostic imaging , Lymphoma, Non-Hodgkin/diagnostic imaging , Male , Mammography , Neoplasms, Multiple Primary/diagnostic imaging , Positron-Emission Tomography/economics , Radiopharmaceuticals , Retrospective Studies , Sensitivity and Specificity , Thymus Gland/diagnostic imaging , Thymus Gland/pathologyABSTRACT
BACKGROUND: Of women between 15 and 29 years of age, 13.6% will die from breast cancer. For women between 30 and 64 years of age, 19% will die from breast cancer. METHODS: We studied 1728 oncological patients and 295 patients were included, 293 with breast cancer (17%) and two patients with primary breast lymphoma (0.1%). RESULTS: There were 98% females and 2% males. SUVmax for the primary tumor was 4.2 +/- 2.6 SD. Mean SUVmax for patients with primary breast lymphoma were 3.2 and 1.4. Sites of metastases were lymph nodes in the neck (4.4% SUVmax 2.7), internal mammary lymph nodes (5% SUVmax 5.3), mediastinum (8.3% SUVmax 5.0), retroperitoneal (6 % SUVmax 5.4), ipsilateral axilla (94% SUVmax 4.5), contralateral axilla (4.4% SUVmax 2.8), pectoral muscle (10.2% SUVmax 2.6), pleura (4.4% SUVmax 3.9), lung (32.3% SUVmax 2.9), liver (19.1% SUVmax 4.5), bone (36.7%), adrenal gland (4.4% SUVmax 2.4), brain (4.4%), spleen and contralateral breast, one case each. One patient presented thymic hyperplasia after chemotherapy. Mean SUVmax for blastic lesions was 5.4 +/- 2.9 SD, for lytic lesions it was 6.7 +/- 2.4 SD and for lesions not apparent on the CT it was 4.6 +/- 2.4 SD. The incidence of a second primary was 4.7%, 2.1% ovarian, 1.4% lung, 0.3% lymphoma, 0.3% endometrium, 0.3% pancreas and 0.3% thyroid. CONCLUSIONS: Mean SUVmax for the primary tumor was similar to that reported in the literature. Values for metastatic bone lesions are higher in this study. Inclusion of PET/CT in the followup of breast lesions is cost efficient.
Subject(s)
Humans , Male , Female , Adult , Carcinoma , Breast Neoplasms , Positron-Emission Tomography , Tomography, X-Ray Computed , Bone Neoplasms , Brain Neoplasms , Cost-Benefit Analysis , Carcinoma , Radiopharmaceuticals , Hyperplasia , Lymphatic Metastasis , Lymphoma, Non-Hodgkin , Mammography , Neoplasms, Multiple Primary , Breast Neoplasms, Male , Breast Neoplasms, Male , Breast Neoplasms/epidemiology , Retrospective Studies , Fluorine Radioisotopes , Sensitivity and Specificity , Thymus Gland , Positron-Emission Tomography/economicsABSTRACT
BACKGROUND: Lung cancer is the most frequent cause of death due to neoplasm in Western populations, with >660,000 new diagnoses of lung cancer per year according to the World Health Organization. METHODS: We undertook this study to emphasize the role of positron emission tomography to all health care professionals involved in lung cancer diagnosis. RESULTS: There are false negatives with PET-(18)FDG in carcinoids and broncheoalveolar carcinoma in almost 40% of the cases. One relatively common cause of false positives is the vocal cord and adjacent muscles contralateral and compensatory to the lung lesion that show an increased uptake of (18)FDG because of lesions in the laryngeal nerve by the tumor or secondary to surgery. It should not be confounded with metastases. CONCLUSIONS: There is sufficient scientific evidence pointing to the usefulness of PET studies and its evolution to PET/CT, especially in patients with lung cancer. This can resolve doubts by the oncologist and patient when there is a suspicious malignant lesion by the following: characterizing solitary pulmonary nodules (benign or malignant), localizing the optimal site for the biopsy, diagnosis of the primary tumor for initial staging, evaluation of mediastinal involvement and distant metastasis, evaluate and restage residual tumor, assessment of recurrence, monitoring response, prognostic prediction and radiotherapy planning.
Subject(s)
Lung Neoplasms/diagnosis , Positron-Emission Tomography , Tomography, X-Ray Computed , Diagnosis, Differential , Humans , Neoplasm Metastasis , Neoplasm Staging , Solitary Pulmonary Nodule/diagnosisABSTRACT
BACKGROUND: Fluordeoxyglucose ((18)FDG) is the most common radiotracer used for PET/CT studies. It enters the cell because of the glucose transporter proteins (GLUTs): 1) erythrocytic membrane, skeletal muscle, lymphocytes, ovaries, breast; 2) pancreas, retina, erythrocytes; 3) adipocytes, ovaries, testis; 4) skeletal muscle, adipocytes, ovaries, myocardium; 5) breast, small intestine, testis, kidney, erythrocytes; 6) spleen, leucocytes, brain; 7) liver; 8) testis, brain; 9) liver, kidney; 10) liver, pancreas; 11) heart, muscle; 12) heart, prostate; 13) brain. We undertook this study to expand the knowledge about physiological uptake. Physiological uptake of (18)FDG was in brain, Waldeyer ring (adenoids, palatine tonsils, lingual tonsils), salivary glands (parotids, submandibular), tongue, vocal cords, cricoarythenoid muscle, thyroid, brown fat (supraclavicular, mediastinal, neck, pericardial fat, around kidney, around great vessels in the thorax, subdiaphragmatic, intercostals, paravertebral), myocardium, breast, thymus, contractive muscles, liver, spleen (similar to the liver), stomach, intestine, kidneys, bladder, uterus, ovaries, testes, bone marrow, esophagus, and atherosclerotic inflammatory plaque. DISCUSSION: False positives were as follows: pneumoniae, tuberculosis, sarcoidosis, cryptococcosis, thrombosis, bronchitis, costochondritis, radiation pneumonitis, misregistration for respiratory movements, catheters, thyroid and adrenal adenomas, osteophytes, fractures, abscess, foreign body, surgical wounds, ostomies, prosthesis, degenerative joint diseases, osteomyelitis, amyloidosis, pancreatitis, myositis, gastritis, colitis, herpes zoster. (18)FDG should be injected 4-6 h after insulin administration because it will be concentrated in the muscles. The brown fat raises its uptake 50% in late images. CONCLUSIONS: It is vital to know the most frequent sites of physiological uptake in the (18)FDG PET/CT studies to identify those regions that occasionally present hypermetabolism but that are not related to neoplastic tumors. This must be taken into consideration in the evaluation of PET/CT studies.
Subject(s)
Humans , Radiopharmaceuticals , Radiopharmaceuticals/pharmacokinetics , /pharmacokinetics , Positron-Emission Tomography , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Fluordeoxyglucose ((18)FDG) is the most common radiotracer used for PET/CT studies. It enters the cell because of the glucose transporter proteins (GLUTs): 1) erythrocytic membrane, skeletal muscle, lymphocytes, ovaries, breast; 2) pancreas, retina, erythrocytes; 3) adipocytes, ovaries, testis; 4) skeletal muscle, adipocytes, ovaries, myocardium; 5) breast, small intestine, testis, kidney, erythrocytes; 6) spleen, leucocytes, brain; 7) liver; 8) testis, brain; 9) liver, kidney; 10) liver, pancreas; 11) heart, muscle; 12) heart, prostate; 13) brain. We undertook this study to expand the knowledge about physiological uptake. Physiological uptake of (18)FDG was in brain, Waldeyer ring (adenoids, palatine tonsils, lingual tonsils), salivary glands (parotids, submandibular), tongue, vocal cords, cricoarythenoid muscle, thyroid, brown fat (supraclavicular, mediastinal, neck, pericardial fat, around kidney, around great vessels in the thorax, subdiaphragmatic, intercostals, paravertebral), myocardium, breast, thymus, contractive muscles, liver, spleen (similar to the liver), stomach, intestine, kidneys, bladder, uterus, ovaries, testes, bone marrow, esophagus, and atherosclerotic inflammatory plaque. DISCUSSION: False positives were as follows: pneumoniae, tuberculosis, sarcoidosis, cryptococcosis, thrombosis, bronchitis, costochondritis, radiation pneumonitis, misregistration for respiratory movements, catheters, thyroid and adrenal adenomas, osteophytes, fractures, abscess, foreign body, surgical wounds, ostomies, prosthesis, degenerative joint diseases, osteomyelitis, amyloidosis, pancreatitis, myositis, gastritis, colitis, herpes zoster. (18)FDG should be injected 4-6 h after insulin administration because it will be concentrated in the muscles. The brown fat raises its uptake 50% in late images. CONCLUSIONS: It is vital to know the most frequent sites of physiological uptake in the (18)FDG PET/CT studies to identify those regions that occasionally present hypermetabolism but that are not related to neoplastic tumors. This must be taken into consideration in the evaluation of PET/CT studies.
