ABSTRACT
PURPOSE: The purpose of this study was to evaluate MRI and fluorocholine PET/CT diagnostic performances for the detection of local recurrence following prostate brachytherapy for localised prostate cancer. MATERIAL AND METHODS: In this single-centre study, we retrospectively reviewed data from 21 patients treated by brachytherapy for localised prostate cancer and diagnosed with biochemical recurrence according to Phoenix Criteria, who underwent MRI and fluorocholine PET/CT. We included patients with local relapse suspicion according to imaging exams, with biopsy for the final assessment of local recurrence. Patient analysis data were supplemented by segment analysis using an 8-segment model. RESULTS: The fluorocholine PET/CT was positive for 81% and negative for 19% of patients. The sensitivity and specificity were 92% and 33% with diagnosis accuracy of 67%. The MRI was positive for 57% and negative for 43% of patients. The sensitivity and specificity were 67% and 56% with diagnosis accuracy of 62%. There was no statistically significant difference between fluorocholine PET/CT and MRI accuracy (P=0.63). On a segment-based analysis, the sensitivity and specificity were 44% and 82% for fluorocholine PET/CT with diagnosis accuracy of 78%. For MRI, specificity was 91% diagnosis accuracy was 82%. CONCLUSION: Both MRI and fluorocholine PET/CT permit to highlight local recurrence sites after prostate brachytherapy. Confirmation biopsies are, however, necessary since this accuracy is insufficient.
Subject(s)
Brachytherapy , Magnetic Resonance Imaging/methods , Neoplasm Recurrence, Local/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/radiotherapy , Aged , Biopsy , Choline/analogs & derivatives , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Prostate/diagnostic imaging , Prostate/pathology , Prostatic Neoplasms/pathology , Radiopharmaceuticals , Radiotherapy Dosage , Retrospective Studies , Sensitivity and SpecificityABSTRACT
AIM: To assess the efficacy of venous embolization treatment for the pelvic congestion syndrome (PCS). PATIENTS AND METHODS: Retrospective study of 33 female patients undergoing pelvic venous embolization between January 2008 and May 2012 in Bordeaux. The inclusion criteria were clinical symptoms of PCS documented by transabdominal Doppler ultrasound and/or pelvic magnetic resonance imaging. Patients with pelvic varicose veins feeding saphenous varicose veins were excluded. The efficacy of treatment was assessed on a Visual Analog Scale (VAS). RESULTS: Thirty-three patients were included and the mean follow up period was 26months (3-59months). The VAS was 7.37 (standard deviation: 0.99) before embolization and 1.36 (standard deviation: 1.73) after embolization (P<0.0001). Twenty patients reported that their symptoms had completely disappeared, 11 had partially disappeared and two had gained no improvement. A significant fall was found in the number of patients with dyspareunia (P<0.0001). A single technical embolization failure was reported. CONCLUSION: Our series demonstrates the efficacy of embolization treatment with a significant fall in the VAS in patients with PCS.
Subject(s)
Embolization, Therapeutic , Genital Diseases, Female/therapy , Genitalia, Female/blood supply , Hyperemia/therapy , Pelvic Pain/therapy , Varicose Veins/therapy , Venous Insufficiency/therapy , Adult , Aged , Chronic Disease , Female , Follow-Up Studies , France , Genital Diseases, Female/diagnosis , Humans , Hyperemia/diagnosis , Magnetic Resonance Angiography , Middle Aged , Phlebography , Retrospective Studies , Syndrome , Ultrasonography , Varicose Veins/diagnosis , Venous Insufficiency/diagnosis , Young AdultABSTRACT
Functional imaging of the kidney using radiological techniques has a great potential of development because the functional parameters, which can be approached non-invasively, are multiple. CT can provide measurement of perfusion and glomerular filtration but has the inconvenient to deliver irradiation and potentially nephrotoxicity due to iodine agents in this context. Sonography is able to evaluate perfusion only but quantification remains problematic. Therefore, MR imaging shows the greatest flexibility measuring blood volume and perfusion as well as split renal function. The main applications of perfusion imaging of the kidney are vascular diseases, as renal artery stenosis, renal obstruction and follow-up of renal tumors under antiangiogenic therapy. However, full clinical validation of these methods and the evaluation of their clinical impact are still often worthwhile.
Subject(s)
Kidney Diseases/diagnosis , Magnetic Resonance Imaging , Perfusion Imaging , Tomography, X-Ray Computed , Contrast Media , Humans , Kidney/blood supply , Magnetic Resonance Imaging/methods , Regional Blood Flow , Tomography, X-Ray Computed/methodsABSTRACT
Thermal ablation techniques for renal tumours have become the norm in surgically at-risk patients. These percutaneous treatments are locally effective, particularly for tumours measuring less than 4cm. Larger tumours may be treated by adapting the technique and strategy. Multidisciplinary discussion is essential before any decision, in order to decide on the most appropriate technique. Radiofrequency is simple, effective and inexpensive. Cryotherapy is more complex and should be preferred when the tumour is large or there is vascular or urinary tract contact. Microwaves can be used to treat larger tumours. Morbidity is low, but good knowledge of these techniques and of dissection is required to avoid injury to neighbouring digestive or urinary structures.
