ABSTRACT
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Subject(s)
Humans , Female , Child , Spleen/abnormalities , Spleen , Splenosis , TechnetiumSubject(s)
Spleen/abnormalities , Spleen/diagnostic imaging , Splenosis/diagnostic imaging , Technetium , Child , Erythrocytes , Female , Humans , Radionuclide ImagingABSTRACT
OBJECTIVE: To assess the utility of FDG-PET in the follow-up of patients treated for endometrial cancer and with suspicion of recurrence according to conventional imaging methods (CT, MRI) and/or elevation of serum tumour markers. MATERIALS AND METHODS: Between April 2002 and December 2005, eleven patients underwent 17 FDG-PET studies (six with 2 studies); mean age was 63.4 yrs (range, 52-69 yrs) and time since diagnosis ranged from 11 months to 12 yrs (mean of 56 months). Initially, seven patients were in stage I, three in stage III and one in stage IV (FIGO classification). Histologically, they corresponded to 8 endometrioid carcinomas and 3 non endometrioid carcinomas. RESULTS: FDG-PET showed infradiaphragmatic uptake in 3 patients and disseminated disease in 7 cases. FDG-PET showed no uptake in one patient. CT (n = 7) or MRI (n = 7) detected infradiaphragmatic lesions in 5 patients and visceral lesions in 2. In 11 patients, tumour markers were elevated (CA125, n = 9; CA19.9, n = 2; CA15.3, n = 2). In 7 patients, FDG-PET modified the information yielded by conventional imaging techniques and in 4 patients, the FDG-PET contributed no additional information. In 2 patients, histologic confirmation of the lesions was obtained and in 9 patients, there were clinical follow-up (from 3 to 20 months, mean of 8.7 months) and imaging studies. CONCLUSIONS: FDG-PET is superior to CT and MRI for detecting recurrences in the follow-up of patients with endometrial cancer.
Subject(s)
Carcinoma/diagnostic imaging , Endometrial Neoplasms/diagnostic imaging , Fluorodeoxyglucose F18 , Neoplasm Recurrence, Local/diagnostic imaging , Positron-Emission Tomography , Radiopharmaceuticals , Aged , Female , Follow-Up Studies , Humans , Middle Aged , Retrospective StudiesABSTRACT
Objetivo. Valorar la utilidad de la tomografía de emisión de positrones con 2-[ 18F]fluoro-2-desoxi-D-glucosa (PET-FDG) en el seguimiento del cáncer de endometrio, en pacientes con sospecha de recurrencia por elevación de marcadores tumorales séricos y técnicas convencionales de imagen. Material y métodos. Se revisaron retrospectivamente 17 estudios PET-FDG, realizados entre abril de 2002 y diciembre de 2005, a 11 pacientes previamente diagnosticadas de cáncer de endometrio (6 pacientes se hicieron dos estudios), con una edad media de 63,4 años (rango 52-69), y entre 11 meses y 12 años (media: 56 meses) de evolución desde el diagnóstico. Inicialmente, 7 casos estaban en estadio I, 3 en estadio III y 1 en estadio IV (clasificación FIGO). Histológicamente, correspondían a 8 carcinomas endometrioides y 3 no endometrioides. Resultados. La PET-FDG presentó captación infradiafragmática en 3 pacientes, y enfermedad diseminada en 7 casos. En 1 paciente la PET-FDG fue negativa. La tomografía axial computarizada (TAC) (n = 7) o la resonancia magnética (RM) (n = 7) detectaron lesiones infradiafragmáticas en 5 pacientes y viscerales en 2. En 11 pacientes existió elevación de marcadores tumorales séricos (CA125, n = 9; CA19.9, n = 2; CA15.3, n = 2). En 7 pacientes la PET-FDG modificó la información proporcionada por las técnicas convencionales de imagen, y en 4 no aportó información adicional. En 2 pacientes se obtuvo confirmación histológica de las lesiones y en 9 se realizó seguimiento clínico (3-20 meses, media 8,7 meses) y con técnicas de imagen. Conclusiones. La PET-FDG es superior a la TAC y la RM en la detección de recurrencias en el seguimiento de pacientes con cáncer de endometrio
Objective. To assess the utility of FDG-PET in the follow-up of patients treated for endometrial cancer and with suspicion of recurrence according to conventional imaging methods (CT, MRI) and/or elevation of serum tumour markers. Materials and methods. Between April 2002 and December 2005, eleven patients underwent 17 FDG-PET studies (six with 2 studies); mean age was 63.4 yrs (range, 52-69 yrs) and time since diagnosis ranged from 11 months to 12 yrs (mean of 56 months). Initially, seven patients were in stage I, three in stage III and one in stage IV (FIGO classification). Histologically, they corresponded to 8 endometrioid carcinomas and 3 non endometrioid carcinomas. Results. FDG-PET showed infradiaphragmatic uptake in 3 patients and disseminated disease in 7 cases. FDG-PET showed no uptake in one patient. CT (n = 7) or MRI (n = 7) detected infradiaphragmatic lesions in 5 patients and visceral lesions in 2. In 11 patients, tumour markers were elevated (CA125, n = 9; CA19.9, n = 2; CA15.3, n = 2). In 7 patients, FDG-PET modified the information yielded by conventional imaging techniques and in 4 patients, the FDG-PET contributed no additional information. In 2 patients, histologic confirmation of the lesions was obtained and in 9 patients, there were clinical follow-up (from 3 to 20 months, mean of 8.7 months) and imaging studies. Conclusions. FDG-PET is superior to CT and MRI for detecting recurrences in the follow-up of patients with endometrial cancer
Subject(s)
Female , Middle Aged , Aged , Humans , Tomography, Emission-Computed/methods , Endometrial Neoplasms/diagnosis , Biomarkers, Tumor/analysis , Follow-Up Studies , Retrospective Studies , Fluorodeoxyglucose F18 , Neoplasm Recurrence, Local/diagnosis , Uterine Neoplasms/diagnosisABSTRACT
No disponible
Subject(s)
Male , Middle Aged , Humans , Femoral Neck Fractures , Femoral Neck Fractures/surgery , Erdheim-Chester DiseaseABSTRACT
Se presenta el caso clínico de una mujer de 47 años de edad afectada de miosotis osificante, en evolución con calcificaciones musculares. La gammagrafía ósea mostró aumento de actividad polifocal así como depósitos de distinta intensidad en tejidos blandos. La gammagrafía ósea permite una identificación precoz de áreas de osificación en tejidos blandos, pudiendo incluso detectar lesiones de forma más temprana que las observadas con otras técnicas de imagen, considerándose de gran utilidad en el diagnóstico y establecimiento de la extensión del proceso, así como en su control evolutivo
-47 year old woman affected by myositis ossificans, with muscular calcifications in her evolution. Bone scintigraphy showed increased polyfocal activity as well as uptake of different intensity in soft tissues. The bone scintigraphy allows for early identification of ossification areas in soft tissues, as it can even detect injuries earlier than that observed with other image techniques. It is considered to be very useful in the diagnosis and establishment of the extension of the process, as well as follow-up
Subject(s)
Female , Humans , Calcinosis , Myositis Ossificans/pathology , Myositis Ossificans , Scoliosis/etiology , Ankylosis/etiology , Calcinosis/pathology , Disease Progression , Early DiagnosisABSTRACT
47 year old woman affected by myositis ossificans, with muscular calcifications in her evolution. Bone scintigraphy showed increased polyfocal activity as well as uptake of different intensity in soft tissues. The bone scintigraphy allows for early identification of ossification areas in soft tissues, as it can even detect injuries earlier than that observed with other image techniques. It is considered to be very useful in the diagnosis and establishment of the extension of the process, as well as follow-up.
Subject(s)
Calcinosis/diagnostic imaging , Myositis Ossificans/diagnostic imaging , Ankylosis/etiology , Calcinosis/pathology , Disease Progression , Early Diagnosis , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Myositis Ossificans/pathology , Radionuclide Imaging , Scoliosis/etiologyABSTRACT
Objetivo: Valorar la utilidad de los estudios con 99mTc-DMSA pre y postcaptopril (imagen gammagráfica y función renal unilateral) para identificar el origen vasculorrenal o renal de la enfermedad en pacientes hipertensos con alta sospecha clínica de hipertensión vasculorrenal. Pacientes y Métodos: Se han estudiado 27 pacientes hipertensos (12 varones, 15 mujeres) de edades comprendidas entre 23 y 65 años (edad media 49 años, DE: 9,46) con alta sospecha clínica de hipertensión vasculorrenal, a los que se les realizó protocolo general analítico, ecográfico y radiológico incluyendo arteriografía renal que se utilizó como gold standard. A todos se les practicaron dos estudios gammagráficos con 99mTc-DMSA, uno basal y otro una hora después de la administración de 50 mg de captopril, con una semana de intervalo entre ambos. Los estudios gammagráficos se obtuvieron a las 4 horas de la administración de 3 mCi (111MBq) de 99mTc-DMSA, obteniéndose imágenes en anterior y posterior, y evaluándose los resultados cualitativamente y cuantitativamente mediante el cálculo de la función renal unilateral porcentual. Se consideraron positivos para hipertensión vasculorrenal los estudios con disminución de 5 puntos porcentuales de la función renal unilateral porcentual o la aparición de un defecto nuevo no existente en el estudio basal. Los resultados gammagráficos fueron comparados con el estudio arteriográfico para determinar la sensibilidad y valores predictivos. Resultados: El estudio arteriográfico demostró la existencia de un 18,5 por ciento de pacientes con estenosis de la arteria renal angiográficamente significativa ( > 50 por ciento de la luz).Los estudios gammagráficos pre y postcaptopril con 99mTcDMSA mostraron una sensibilidad del 60 por ciento, especificidad del 91 por ciento, valor predictivo positivo del 60 por ciento y valor predictivo negativo del 91 por ciento. Se identificaron 3 pacientes con defectos de captación segmentarios compatibles con cicatrices pielonefríticas crónicas. Conclusiones: Los estudios con 99mTc-DMSA basal y tras captopril presentan una alta especificidad y son útiles en pacientes con alta sospecha clínica de hipertensión vasculorrenal, identificando adecuadamente un alto porcentaje de pacientes con estenosis arterial renal significativa. La capacidad del DMSA para identificar la presencia o ausencia de anomalías renales, sobre todo cicatrices pielonefríticas, aporta un valor añadido a los estudios de renograma tras IECAs con otros trazadores pudiendo identificar causas renales de hipertensión diferentes a la estenosis de la arteria renal (AU)
Subject(s)
Middle Aged , Adult , Aged , Male , Female , Humans , Radiopharmaceuticals , Renal Artery Obstruction , Pyelonephritis , Renal Artery , Angiotensin-Converting Enzyme Inhibitors , Angiography , Chronic Disease , Captopril , Cicatrix , Diagnosis, Differential , Hypertension, Renovascular , False Positive Reactions , Predictive Value of Tests , Technetium Tc 99m Dimercaptosuccinic Acid , Kidney Function TestsABSTRACT
AIM: Value the utility of studies with 99mTc-DMSA with captopril (scintigraphy imaging and unilateral renal function) in identifying renovascular disease or renal disease in hypertension patients with high probability of renovascular hypertension. METHODS: We studied 27 hypertension patients (12 males, 15 females) mean age 49 years, SD: 9.46, with high probability of renovascular disease. General analysis and radiology was made to all of them including renal arteriography as gold standard. Two renal scintigraphies with 99mTc-DMSA were made to all of them, baseline study and one hour after administration of 50 mg of captopril, a week between both studies. Renal scintigraphy (anterior and posterior images) was obtained 4 hours after the administration of 111 MBq (3 mCi) of 99mTc-DMSA and results were evaluated quantitatively and qualitatively calculating unilateral renal function. We considered positive for renovascular hypertension studies with decrease of more than five percentual points in unilateral renal function or a new defect absent in baseline study. Scintigraphic results were compared with arteriography to determine sensitivity, specificity and predictive values. RESULTS: Arteriography demonstrated significant renal artery stenosis in 18.5% of patients. Renal scintigraphy with captopril using 99mTc-DMSA demonstrated sensitivity of 60%, specificity of 91%, positive predictive value of 60% and negative predictive value of 91%. We identified 3 patients with segmental defects of uptake consistent with chronic pyelonephritis scarring. CONCLUSIONS: Studies with 99mTc-DMSA using captopril present high specificity and are useful in patients with high probability for renovascular hypertension, identifying high number of patients with significant renal artery stenosis. The utility of DMSA in identify renal abnormalities, as specially pyelonephritis scarring, add value to renal studies with captopril using others tracers. DMSA could identify renal etiologies of renovascular hypertension different to renal artery stenosis.
