ABSTRACT
ABSTRACT: We present a case of a 75-year-old woman with clinical suspicion of stroke whose cranial CT showed ischemic changes in right precentral region, without visible vascular occlusion, and a right vagal lesion suggestive of paraganglioma. Two weeks later, 68Ga-DOTATOC PET/CT with IV iodine-based contrast administration (Biograph 6 True Point equipment; Siemens) was performed for characterization of this lesion and staging. Intraparenchymal 68Ga-DOTATOC uptake was visualized in right frontal lobe suggestive of hemorrhagic transformation of the previous stroke.
Subject(s)
Neuroendocrine Tumors , Organometallic Compounds , Paraganglioma , Stroke , Aged , Female , Humans , Octreotide/analogs & derivatives , Paraganglioma/complications , Paraganglioma/diagnostic imaging , Positron Emission Tomography Computed Tomography , Stroke/complications , Stroke/diagnostic imagingABSTRACT
BACKGROUND: Lung involvement in patients with coronavirus disease 2019 (COVID-19) undergoing PET-CT has been previously reported. However, FDG uptake outside lung parenchyma was poorly characterized in detail. We evaluated the extra-parenchymal lung involvement in asymptomatic cancer patients with COVID-19 pneumonia through 18F-FDG PET-CT. METHODS: A total of 1079 oncologic 18F-FDG PET-CT were performed between February 2 and May 18, 2020. Confirmed COVID-19 pneumonia was defined as characteristic ground-glass bilateral CT infiltrates and positive genetic/serologic tests. Nonmetastatic extra-parenchymal lung PET-CT findings were evaluated through qualitative (visual), quantitative (measurements on CT), and semiquantitative (maximum standardized uptake value: SUVmax on PET) interpretation. Clinical data, blood tests, and PET-CT results were compared between patients with and without COVID-19 pneumonia. RESULTS: A total of 23 18F-FDG PET-CT scans with pulmonary infiltrates suggestive of COVID-19 and available laboratory data were included: 14 positive (cases) and 9 negative (controls) for COVID-19 infection, representing a low prevalence of COVID-19 pneumonia (1.3%). Serum lactate dehydrogenase and D-dimers tended to be increased in COVID-19 cases. Extra-parenchymal lung findings were found in 42.9% of patients with COVID-19, most frequently as mediastinal and hilar nodes with 18F-FDG uptake (35.7%), followed by incidental pulmonary embolism in two patients (14.3%). In the control group, extra-pulmonary findings were observed in a single patient (11.1%) with 18F-FDG uptake located to mediastinal, hilar, and cervical nodes. Nasopharyngeal and hepatic SUVmax were similar in both groups. CONCLUSION: In cancer patients with asymptomatic COVID-19 pneumonia, 18F-FDG PET-CT findings are more frequently limited to thoracic structures, suggesting that an early and silent distant involvement is very rare. Pulmonary embolism is a frequent and potentially severe finding raising special concern. PET-CT can provide new pathogenic insights about this novel disease.
Subject(s)
COVID-19/diagnostic imaging , Fluorodeoxyglucose F18/administration & dosage , Lung/diagnostic imaging , Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Radiopharmaceuticals/administration & dosage , COVID-19/complications , COVID-19/epidemiology , COVID-19 Testing , Common Bile Duct Neoplasms , Female , Humans , Male , Pneumonia/complications , Pneumonia/diagnostic imaging , SARS-CoV-2ABSTRACT
Cancer patients require a careful clinical follow-up during the coronavirus disease 2019 (COVID-19) pandemic. Although hybrid fluorine-18 Fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT) is not routinely used in the management of COVID-19 patients, it could play a complementary role of other laboratory and radiological data in selected cases. We describe an asymptomatic cancer patient derived to 18F-FDGPET/CT with simultaneous findings of COVID-19 pneumonia and pulmonary thrombus, discussing its possible mechanisms and prognostic implications.
ABSTRACT
Se describen las experiencias en el entrenamiento de un panel descriptivo para degustación de carne vacuna. El adiestramiento constó de cuatro pasos: entrevista persona, selección, entrenamiento y evaluación del desempeño. Previo al entrenamiento se evaluaron 37 bistés por los siete candidatos potenciales de un grupo de 12 que fueron los que asistieron regularmente a sesiones preliminares de degustación. Luego se entrevistaron todos los 12 candidatos potenciales. Para medir su habilidad natural durante la selección se realizaron pruebas de triángulo que permitieron la selección de diez candidatos. Durante el entrenamiento el líder instruyó las técnicas de degustación y se uniformizaron criterios en la asignación de puntuaciones. Una vez entrenados, se realizó una primera prueba de desempeño, de 12 sesiones distribuidas en 4 días, con 3 sesiones por día, 3 muestras por sesión para un total de 9 muestras diferentes. Se calculó el valor F con un análisis de varianza por panelista, para medir la habilidad de los panelistas en acertar y ser consistentes en las puntuaciones de las nueve muestras, durante las 4 repeticiones, para cada atributo. Los resultados fueron satisfactorios; en la primera prueba de desempeño se descartaron 2 candidatos con los menores valores F, quedando el panel constituido por 8 catadores. Después de 300 pruebas de degustación se realizó una segunda prueba de desempeño para conocer su nivel de mejora, obteniéndose cambios en el ordenamiento por habilidad de los panelistas y una mayor uniformidad del panel en sus evaluaciones. El efecto panelista fue detectado antes (P<0.05) y después (P<0.001) del entrenamiento con muestras de longissimus (N=37 y N=40, respectivamente). Sin embargo, las medidas para panelistas entrenados fueron menos variables y sólo difirieron en décimas dentro de una escala de ocho puntos para cinco diferentes atributos. Los resultados validan las metodologías utilizadas para entrenamiento y la adecuación del panel para la evaluación sensorial de carnes no procesadas
