The Role of Interim PET/CT on Survival in Diffuse Large B Cell Lymphoma.

BACKGROUND: Diffuse large B cell lymphoma is the most frequent aggressive non-Hodgkin lymphoma. Predicting response and estimating prognosis earlier makes management of this heterogeneous lymphoma more satisfying. Interim PET response is established in Hodgkin Lymphoma to tailor the therapy but results for non-Hodgkin Lymphoma is unconvincing. In the current study evaluation of interim PET and survival outcomes of 103 DLBCL patients is performed. PATIENTS AND METHODS: About 103 Patients with DLBCL followed up in a single center between 2009 and 2019 were enrolled the study. All patients received R-CHOP chemoimmunotherapy at first line. Interim PET was performed after at least one or more cycles. All PET scans were performed with 18F-FDG isotope as PET/CT. PET scoring results were evaluated according to the 5-Point Deauville Scoring system defined in the National Comprehensive Cancer Network clinical guidelines for iPET and eotPET. 5-P DS of scores of 1 to 3 were defined as negative scans, and scores of 4 to 5 were considered to be positive scans. RESULTS: Forty-six (44.7%) Female and 57 (55.3%) male aged between 25 and 83 (median 57) years newly diagnosed DLBCL patients were enrolled in the study. Median PFS was 21 (interquartile range 8.5-53.7) months and median OS was 33.5 (interquartile range 12.5-62.9) months for the total cohort. Positive predictive value of interim PET according to Deauville scoring system was 65.4% and negative predictive value was 77.9%. CONCLUSION: Our study showed that according to Deauville 5 point scale (D 5PS) scoring system, interim PET-positive patients have shorter both PFS and OS than iPET-negative patients.

Uptake of an Acrochordon Incidentally Detected on 68Ga Prostate-Specific Membrane Antigen PET/CT.

Ga prostate-specific membrane antigen (PSMA) PET/CT is a promising tool for imaging of prostate cancer. Ga-PSMA PET/CT uptake of prostate cancer and its metastases are reflective of significant overexpression of PSMA. However, PSMA expression of benign neoplasms and nonprostate epithelial malignancies is not very well defined. We report a moderate Ga-PSMA uptake of an acrochordon (skin tag), which was incidentally found in a patient referred for staging prostate cancer. Acrochordon is a frequent, small, soft, skin-colored or hyperpigmented, benign, and usually pedunculated neoplasm of the skin. Nuclear medicine physicians should be aware of it while reporting a Ga-PSMA PET/CT.

Radioiodine therapy in Graves' disease: is it possible to predict outcome before therapy?

OBJECTIVE: To assess the predictability of outcome and evaluate the factors that may lead to treatment failure in patients with Graves' disease who are treated with a single dose of radioiodine. MATERIALS AND METHODS: This is a retrospective study of 123 patients (M: 42; F: 81) with Graves' disease who received radioiodine therapy with a single fixed (10 mCi) dose for hyperthyroidism. Pretreatment age, sex, BMI, type of anti-thyroid drug used, propylthiouracil doses, iodine uptake, uptake ratio (4/24 h radioiodine uptake), and thyroid volume of the patients in whom radioiodine therapy succeeded or failed were compared. RESULTS: Post-therapy follow-up revealed that therapy failed in 22% of the patients. Iodine uptakes and uptake ratios and volumes were found to be significantly higher in patients in whom therapy failed. It was observed that uptake ratio was at least 1 in 25 patients (20%), and therapy failed in 20 (80%) of these patients. Of the 98 patients (80%) in whom uptake ratio was less than 1, therapy was unsuccessful in only seven (7%). CONCLUSION: Uptake ratio is a simple index that may be used to predict the patients in whom therapy may fail or succeed. In patients with Graves' disease who have an uptake ratio of less than 1, radioiodine appears to be an effective dose with high success rates. In contrast, because of the high rates of failure in patients with an uptake ratio of at least 1, use of radioiodine therapy at a dose of 10 mCi does not seem to be appropriate.

Sentinel lymph node biopsy with a gamma probe in patients with high-risk cutaneous squamous cell carcinoma: follow-up results of sentinel lymph node-negative patients.

OBJECTIVE: Lymphoscintigraphy (LS) and sentinel lymph node biopsy have become the standard of care for melanoma and breast cancer. However, the data on patients with cutaneous squamous cell carcinoma (SCC) are limited. We aimed to evaluate and identify the role of LS and sentinel lymph node biopsy in patients with high-risk cutaneous SCC. METHODS: Nineteen patients (13 men, six women; 47-87 years of age, mean age 67.5 ± 12.3) with SCC were included in the study. LS was performed on all patients after intracutaneous injection of Tc-99m nanocolloid. Primary lesions and sentinel lymph nodes (SLNs) were excised with the help of a gamma probe. RESULTS: A total of 26 SLNs and 32 secondary lymph nodes were imaged on LS and were marked. During surgery, 29 SLNs, 21 secondary lymph nodes and three nonactive lymph nodes were excised. In total, 53 lymph nodes were removed surgically. A histopathological study revealed that all lymph nodes were negative for metastasis. Patients were followed up for an average of 41.1 ± 22.2 months (7-80 months). Until the time of data collection, 14 patients were alive and had no regional lymph node or distant metastasis. Local recurrence was seen in only one patient. He was reoperated upon 38 months ago. CONCLUSION: The feasibility of determining SLNs using LS and an intraoperative gamma probe in patients with cutaneous SCC was shown. Unnecessary elective lymph node dissection and possible complications could be avoided in 19 patients.