ABSTRACT
Aim. To assess dual time point 2-deoxy-2-[18F]fluoro-d-glucose 18FFDG PET-CT accuracy in nodal staging and in detection of extra-axillary involvement.M aterial and methods. Dual time point [18F] FDG PET/CT scan was performed in 75 patients. Visual and semiquantitative assessment of lymph nodes was performed. Semiquantitative measurement of SUV and ROC-analysis were carried out to calculate SUVmax cut-off value with the best diagnostic performance. Axillary and extra-axillary lymph node chains were evaluated.Results. Sensitivity and specificity of visual assessment was 87.3% and 75%, respectively. SUVmax values with the best sensitivity were 0.90 and 0.95 for early and delayed PET, respectively. SUVmax values with the best specificity were 1.95 and 2.75, respectively. Extra-axillary lymph node involvement was detected in 26.7%.Conclusion. FDG PET/CT detected extra-axillary lymph node involvement in one-fourth of the patients. Semiquantitative lymph node analysis did not show any advantage over the visual evaluation (AU)
Objetivo. Valorar la precision diagnóstica de la PET-CT con 2-deoxi-2-[18F]fluor-d-glucosa [18F] FDG en doble fase en la estadificación ganglionar y en la detección de afectación extra-axilar. Material y métodos. Se realizó una [18F] FDG PET-TC en doble fase a 75 pacientes. Se valoraron los ganglios linfáticos de forma visual y semicuantitativa. Se realizaron medidas del SUV y análisis ROC para calcular el valor de SUV max con la mejor precisión diagnóstica. Se evaluaron los niveles axilares y extra-axilares.Resultados. La sensibilidad y especificidad del análisis visual fue del 87.3% y 75% respectivamente. Los valores de SUVmax con la mejor sensibilidad fueron de 0.90 y 0.95 para el PET en fase precoz y tardía respectivamente. Los valores de SUV max con la mejor especificidad fueron de 1.95 y 2.75 respectivamente. Se detectó afectación ganglionar extra-axilar en el 26.7%.Conclusión. La PET-TC con FDG detectó afectación ganglionar extra-axilar en una cuarta parte de las pacientes. El análisis semicuantitativo no pareció aportar ninguna ventaja sobre la valoración visual (AU)
Subject(s)
Humans , Female , Positron-Emission Tomography/instrumentation , Positron-Emission Tomography/methods , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography/instrumentation , Positron Emission Tomography Computed Tomography/methods , Positron Emission Tomography Computed Tomography , Fluorodeoxyglucose F18 , Breast Neoplasms/diagnosis , Neoplasm Staging/instrumentation , Neoplasm Staging/methods , Neoplasm Staging , Castleman Disease/diagnosis , Sensitivity and Specificity , Nuclear Medicine/methods , Nuclear Medicine/organization & administrationABSTRACT
AIM: To assess dual time point 2-deoxy-2-[(18)F]fluoro-D-glucose (18)(F)FDG PET-CT accuracy in nodal staging and in detection of extra-axillary involvement. MATERIAL AND METHODS: Dual time point [(18)F] FDG PET/CT scan was performed in 75 patients. Visual and semiquantitative assessment of lymph nodes was performed. Semiquantitative measurement of SUV and ROC-analysis were carried out to calculate SUV(max) cut-off value with the best diagnostic performance. Axillary and extra-axillary lymph node chains were evaluated. RESULTS: Sensitivity and specificity of visual assessment was 87.3% and 75%, respectively. SUV(max) values with the best sensitivity were 0.90 and 0.95 for early and delayed PET, respectively. SUV(max) values with the best specificity were 1.95 and 2.75, respectively. Extra-axillary lymph node involvement was detected in 26.7%. CONCLUSION: FDG PET/CT detected extra-axillary lymph node involvement in one-fourth of the patients. Semiquantitative lymph node analysis did not show any advantage over the visual evaluation.
Subject(s)
Breast Neoplasms/diagnostic imaging , Carcinoma, Ductal, Breast/secondary , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Lymphatic Metastasis/diagnostic imaging , Multimodal Imaging/methods , Neoplasm Staging/methods , Positron-Emission Tomography/methods , Radiopharmaceuticals , Tomography, X-Ray Computed/methods , Adult , Aged , Axilla , Biopsy, Fine-Needle , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/diagnostic imaging , Carcinoma, Ductal, Breast/pathology , Female , Humans , Middle Aged , Predictive Value of Tests , Prospective Studies , ROC Curve , Sensitivity and Specificity , Sentinel Lymph Node Biopsy , ThoraxABSTRACT
BACKGROUND: Venous thromboembolism (VTE) is one of the most common complications in cancer patients. It is not only associated with both reduced survival and a high number of recurrences, but an idiopathic VTE also increases the likelihood of a cancer diagnosis. METHODS: Between January 2000 and October 2005 we reviewed the medical history of 88 patients who were admitted to a tertiary hospital and presented both a diagnosis of VTE and any type of tumour. The information collected included the type of tumour, the temporal association between tumour diagnosis and VTE, anticoagulation treatment applied and percentage of recurrences. RESULTS: Ten patients (11.4%) presented the VTE prior to the cancer diagnosis; only half of them underwent a posterior tumour screening routine. Fifteen patients (17%) were diagnosed simultaneously and 71% presented the VTE after the tumour was detected. In 47 patients (53.4%) no risk factors for VTEs were detected. Twenty-nine patients (31.7%) presented a recurrent VTE, mainly during chemotherapy treatment (66%). Less than half of the patients (47.57%) were receiving treatment with low-molecular- weight heparins (LMWH). CONCLUSIONS: Idiopathic VTEs may be the first manifestation of an occult neoplasia, but tumour screening is scheduled in only a few patients. Regarding the high incidence of recurrent VTE in cancer populations, a high percentage is attributed to the underuse of LMWH, whose efficacy in preventing recurrent phenomena is superior to oral dicumarinics (AU)
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