ABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Choristoma/pathology , Choristoma/surgery , Breast Neoplasms/surgery , Breast Neoplasms , Fluorodeoxyglucose F18/analysis , Positron-Emission Tomography/methods , Carcinoma, Ductal, Breast , Choristoma , Biopsy, Large-Core Needle , Prognosis , Chemotherapy, Adjuvant , Lymph Node Excision/methodsABSTRACT
We report a case of a 44-year-old man with neurological symptoms and MRI findings, which were unable to differentiate between glioma and lymphoma. Metabolic characterization by means of PET imaging with F-FDG and C-methionine is proposed to determine the benign or tumor (high- and low-grade) origin of brain lesions. In this case, the MRI lesion corresponded with an inconclusive metabolic pattern of intense F-FDG uptake and no significant C-methionine uptake. Pathological study revealed a false-negative case of C-methionine due to lymphoma.
Subject(s)
Central Nervous System Neoplasms/diagnostic imaging , Glioma/diagnostic imaging , Lymphoma/diagnostic imaging , Positron-Emission Tomography , Adult , Carbon Radioisotopes , False Negative Reactions , Fluorodeoxyglucose F18 , Humans , Magnetic Resonance Imaging , Male , Methionine , RadiopharmaceuticalsABSTRACT
Renal cell carcinoma (RCC) is resistant to chemotherapy and radiotherapy in most cases, and surgery is the preferred option in patients with local tough advanced disease. Even in metastatic RCC, patient survival has been reported to improve after surgery. Considering the importance of angiogenesis in RCC pathogenesis, new inhibitors of vascular endothelial growth factor pathway show promising results. Imaging monitoring with F-FDG PET/CT may allow selecting the appropriateness and right time to implement these drugs, according to disease outcome.
Subject(s)
Carcinoma, Renal Cell/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Positron-Emission Tomography , Tomography, X-Ray Computed , Adult , Angiogenesis Inhibitors/therapeutic use , Carcinoma, Renal Cell/drug therapy , Carcinoma, Renal Cell/pathology , Female , Fluorodeoxyglucose F18 , Humans , Kidney Neoplasms/drug therapy , Kidney Neoplasms/pathology , Middle Aged , Multimodal Imaging , Neoplasm Metastasis , RadiopharmaceuticalsABSTRACT
Antiandrogen therapy alone or combined with radical therapy is the first choice in diagnosis and recurrence of patients with metastatic prostate cancer. However, patients on androgen deprivation frequently show treatment resistance. In recent years, new treatments for metastatic castration-resistant prostate cancer have been developed. Clinical studies with docetaxel have shown its usefulness for first-line therapy, and different therapeutic algorithms with second-line drugs like abiraterone or cabazitaxel have also been proposed. Sequential metabolic study with PET/CT imaging with ¹¹C-choline may be important for assessing the right moment for administration each one of the therapeutic options.
Subject(s)
Antineoplastic Agents/therapeutic use , Multimodal Imaging , Positron-Emission Tomography , Prostatic Neoplasms, Castration-Resistant/diagnostic imaging , Tomography, X-Ray Computed , Aged , Algorithms , Antineoplastic Agents/administration & dosage , Carbon Radioisotopes , Choline , Humans , Male , Neoplasm Metastasis , Prostatic Neoplasms, Castration-Resistant/drug therapy , Prostatic Neoplasms, Castration-Resistant/pathology , RadiopharmaceuticalsABSTRACT
PURPOSE: The aim of this study was to assess dual-phase 11C-choline PET/computed tomography (CT) for differentiating benign from malignant lesions in patients with biochemical recurrence of prostate cancer. MATERIALS AND METHODS: We prospectively studied 56 patients with prostate cancer treated by surgery (n=22) or radiotherapy (n=34) who had hypermetabolic foci on 11C-choline PET/CT determined for biochemical recurrence (prostate-specific antigen 1.23-9.9 ng/ml). We used the dual-phase technique, calculating the standardized uptake value (SUV) for early (SUVearly) and late (SUVdelay) acquisitions and the difference between the two (SUVvariation) to determine whether tracer uptake remained stable or increased (accumulative pattern) or decreased (washout pattern). We used t-tests to compare mean and receiver operating characteristic curve analysis (SUVearly/SUVdelay/SUVvariation vs. benign/malignant). RESULTS: We identified 106 hypermetabolic foci (34 local, 10 inguinal, 34 infradiaphragmatic, 14 supradiaphragmatic, and 14 in bone). We identified 34 local foci (eight after prostatectomy and 26 after radiotherapy). The eight postsurgical foci had an accumulative pattern and recurrence was confirmed (three histology, five follow-up). Of the 26 postradiotherapy foci, three had a washout pattern and follow-up ruled out recurrence; 23 had an accumulative pattern and recurrence was confirmed (14 histology, nine follow-up). The 10 inguinal foci had a washout pattern and were reactive (three histology, seven follow-up). The 34 infradiaphragmatic foci had an accumulative pattern and were malignant (34 follow-up). Of the 14 supradiaphragmatic foci, the three with a washout pattern were benign (three histology) and the 11 with an accumulative pattern were malignant (11 histology). Of the 14 foci in bone, two had a washout pattern and corresponded with signs of spondyloarthropathy. On the receiver operating characteristic curve analysis, SUVvariation best discriminated benign from malignant lesions [area under the curve (AUC)=0.993], followed by SUVdelay (AUC=0.933) and finally SUVearly (AUC=0.665). CONCLUSION: Dual-phase PET/CT with 11C-choline is technically feasible despite this tracer's short physical half-life and is useful for discriminating benign from malignant lesions. SUVvariation accurately discriminated between benign and malignant lesions.
Subject(s)
Choline , Multimodal Imaging , Positron-Emission Tomography , Prostatic Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Aged , Carbon Radioisotopes , Choline/metabolism , Feasibility Studies , Half-Life , Humans , Male , Prostatic Neoplasms/radiotherapy , Prostatic Neoplasms/surgery , RecurrenceABSTRACT
No disponible
Subject(s)
Humans , Male , Aged, 80 and over , Electrodes, Implanted/adverse effects , Defibrillators, Implantable/adverse effects , Prosthesis-Related Infections , Tomography, X-Ray ComputedSubject(s)
Defibrillators, Implantable/adverse effects , Prosthesis-Related Infections/diagnostic imaging , Aged, 80 and over , Defibrillators, Implantable/microbiology , Escherichia coli Infections/diagnostic imaging , Escherichia coli Infections/etiology , Fluorodeoxyglucose F18 , Humans , Male , Positron-Emission TomographyABSTRACT
The main indication for C-choline PET/CT in prostate cancer patients is the early localization of biochemical recurrence after radical treatment. However, any C-choline uptake should be assessed in terms of physiological distribution and patterns of tumor spread. Therefore, tracer-avid lesions in unexpected sites should be carefully addressed because the diagnosis of other malignancies has important therapeutic implications. We present a patient with biochemical recurrence of prostate cancer treated with radiotherapy. C-choline PET/CT showed local recurrence and inguinal lymph node uptake. Because of its location beyond typically prostatic lymphatic spread, resection was performed. Histology confirmed a diffuse large B-cell lymphoma.
Subject(s)
Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , Multimodal Imaging , Positron-Emission Tomography , Prostate-Specific Antigen/blood , Prostatic Neoplasms/diagnosis , Tomography, X-Ray Computed , Aged , Carbon Radioisotopes , Choline , Humans , Incidental Findings , Lymphoma, Large B-Cell, Diffuse/pathology , Male , RadiopharmaceuticalsABSTRACT
OBJECTIVE: The aim of this study was to develop a protocol for normalizing blood glucose levels in diabetic patients by subcutaneously administering rapid-acting insulin before administering (18)F-fluorodeoxyglucose ((18)F-FDG) without hindering the quality of PET/computed tomography (CT) studies. MATERIALS AND METHODS: The study included 120 patients, who were divided into four groups: Group I: This group comprised 30 diabetic patients with blood glucose levels lower than 160 mg/dl at the time of arrival at our center; in these patients, (18)F-FDG was injected without prior administration of subcutaneous rapid-acting insulin. Group II: This group comprised 30 diabetic patients with blood glucose levels ranging from 168 to 260 mg/dl; in these patients, subcutaneous rapid-acting insulin was administered and then (18)F-FDG was injected when blood glucose levels dropped below 160 mg/dl (30-115 min). Group III: This group included 30 diabetic patients with blood glucose levels ranging from 192 to 324 mg/dl; in these patients, subcutaneous rapid-acting insulin was administered and then (18)F-FDG was injected 4 h later. Blood glucose levels dropped below 160 mg/dl (range, 58-159 mg/dl) in all patients. CONTROL GROUP: This group included 30 nondiabetic patients with normal blood glucose levels (72-104 mg/dl). We calculated the mean standardized uptake value (SUV) of muscle from the maximum SUV in five consecutive axial slices in the proximal middle third of the rectus femoris muscle of the right thigh. RESULTS: The quality of the PET-CT studies was considered suboptimal when muscle uptake was more than 2 SDs greater than the mean muscle uptake in the control group (1.15±0.2). The mean SUV of muscle was as follows: Group I, 1.09 (σ=0,26); group II, 1.98 (σ=0,32); group III, 1.98 (σ=1,13); and control group IV, 1.15 (σ=0,2). The quality of PET-CT studies was considered suboptimal in 18 patients in group II (60%) and in four patients (13%) in group I. The quality was optimal in all studies conducted in group III patients. CONCLUSION: Subcutaneous administration of rapid-acting insulin normalizes blood glucose levels without compromising the quality of PET-CT studies when (18)F-FDG is administered not earlier than 4 h later.
Subject(s)
Fluorodeoxyglucose F18 , Insulin, Short-Acting/administration & dosage , Insulin, Short-Acting/pharmacology , Multimodal Imaging/methods , Positron-Emission Tomography/methods , Tomography, X-Ray Computed/methods , Adult , Aged , Aged, 80 and over , Blood Glucose/metabolism , Diabetes Mellitus/blood , Diabetes Mellitus/diagnostic imaging , Female , Humans , Injections, Subcutaneous , Male , Middle Aged , Quality ControlABSTRACT
Bone scintigraphy has been used extensively in prostate cancer patients to detect bone involvement. (11)C-choline PET/CT is indicated when a biochemical recurrence is suspected, as this procedure is able to detect local recurrence, lymph-node infiltration, and metastases.In cases where the results of these 2 procedures do not coincide, MRI is then usually performed. (18)F-fluoride may become an alternative to MRI for bone imaging.In our patient series, all bone lesions with (11)C-choline uptake were metastases. (18)F-Fluoride did not increase specificity of (11)C-choline but increased sensitivity of bone scintigraphy. CT helped in the interpretation of osteoarthritis and trauma lesions.
Subject(s)
Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Choline , Fluorides , Fluorine Radioisotopes , Multimodal Imaging , Positron-Emission Tomography , Prostatic Neoplasms/pathology , Tomography, X-Ray Computed , Bone Neoplasms/pathology , Bone Neoplasms/physiopathology , Carbon Radioisotopes , Humans , MaleABSTRACT
El desarrollo del talento en cualquier organización es un recurso estratégico que opuesto por lo excelencia como valor diferencio/. Generar uno estructuro organizativo que promocione y desarrolle adecuadamente lo capacidad profesional de los trabajadores, a la vez que motive, impulse y refuerce su compromiso corporativo, exige un esfuerzo extraordinario poro cualquier empresa. Definitivamente inmersos en lo ero digital, los Tecnologías de lo Información y de lo Comunicación (TIC) son herramientas perfectamente adecuados poro desarrollar el talento en uno organización. Los TIC han dado lugar o uno sociedad de la información, difundido rápidamente tonto en el medio laboral como en el entorno doméstico, que ha provocado profundos cambios estructurales en todos los ámbitos sociales (AU)
No disponible
Subject(s)
Diagnostic Imaging , Radiology Information Systems , Information Technology , Health Communication , Health Information Management , Knowledge Management , Health Centers , 50230 , Health Sciences, Technology, and Innovation Management , Information Storage and Retrieval , Faculty, Medical , Professional TrainingABSTRACT
La Cirugía Radioguiado consiste en una serie de técnicas exeréticas que implican la utili- zación de radiofármocos administrados al paciente previamente o durante el acto quirúrgico. Se trata, por tanto, de una disciplina a caballo entre la cirugía y la Medicina Nuclear, que requiere una exquisita colaboración entre especialistas en ambas ramos de la moderna medicina. La Cirugía Radioguiada (CRG) no es nueva en la praxis diaria, de hecho se viene utilizando de forma rutinaria desde hace más de una década, por ejemplo en el campo de la biopsia del ganglio centinela (AU)
No disponible
Subject(s)
Sentinel Lymph Node Biopsy , Surgery, Computer-Assisted , Radiopharmaceuticals/administration & dosage , Radiopharmaceuticals , Endocrine Gland Neoplasms/diagnosis , Positron-Emission Tomography , Diagnostic Techniques and ProceduresABSTRACT
Objetivo: Presentación de nuestra experiencia preliminar con la técnica de estudio del cuerpo entero con resonancia magnética (RM) mediante una mesa móvil automática y su aplicación en la extensión ósea del cáncer. Material y métodos: 24 pacientes con neoplasia maligna ya diagnosticada fueron estudiados con gammagrafía ósea y RM de cuerpo entero (1.5T) para cribado de posibles metástasis (MS).Las imágenes de RM fueron realizadas con una mesa móvil automática en tres posiciones (estaciones) anatómicas diferentes y con un tiempo de adquisición de 18 min. En las tres diferentes estaciones se utilizaron secuencias coronales en eco de espín rápido (FSE) T1 y inversión-recuperación de tiempo corto (STIR), y la columna vertebral se visualizó en su totalidad mediante una secuencia sagital FSE T1. El estudio del tórax se completó con un axial STIR. Los hallazgos de la gammagrafía y RM fueron comparados para la existencia o no de MS valorando tanto al paciente globalmente como por regiones óseas. Las lesiones metastásicas se confirmaron por biopsia o seguimiento durante 12 meses. Resultados: En la valoración del paciente globalmente, es decir, si presenta o no metástasis, la RM de cuerpo entero fue superior a la gammagrafía en el cribado de metástasis óseas, con una sensibilidad del 100 por ciento (gammagrafía: 80 por ciento), una especificidad del 93 por ciento (gammagrafía: 71 por ciento) y una fiabilidad (seguridad) del 96 por ciento (gammagrafía: 75 por ciento).En la valoración del paciente por regiones óseas, la RM de cuerpo entero también obtuvo unos resultados superiores a la gammagrafía, con una sensibilidad del 94 por ciento (gammagrafía: 66 por ciento), una especificidad del 99 por ciento (gammagrafía: 95 por ciento) y una fiabilidad del 98 por ciento (gammagrafía: 89 por ciento).Por otra parte la RM de cuerpo entero mostró de forma adicional hallazgos extraóseos relacionados con el tumor, como metástasis pleurales con derrame, metástasis hepáticas, afectación de partes blandas y uropatía obstructiva, que no eran conocidas en el momento de la exploración. Conclusión: La RM de cuerpo entero mediante equipos que dispongan de mesa móvil automática, altos campos magnéticos y gradientes potentes, representa un método eficaz para la estadificación de pacientes afectados de neoplasias malignas, ya que tiene una más alta sensibilidad y especifidad que la gammagrafía ósea para detectar metástasis óseas, y además aporta información sobre lesiones extraóseas (AU)