ABSTRACT
PURPOSE: The Region of Southern Denmark (RSD), covering 1.2 of Denmark's 5.6 million inhabitants, established a task force to (1) retrieve literature evidence for the clinical use of positron emission tomography (PET)/CT and provide consequent recommendations and further to (2) compare the actual use of PET/CT in the RSD with these recommendations. This article summarizes the results. METHODS: A Work Group appointed a professional Subgroup which made Clinician Groups conduct literature reviews on six selected cancers responsible for 5,768 (62.6 %) of 9,213 PET/CT scans in the RSD in 2012. Rapid Evidence Assessment was applied, using the methodology of systematic reviews with predefined limitations to search PubMed, Embase and the Cochrane Library for articles published in English/Danish/Swedish/Norwegian since 2002. PICO questions were defined, data recorded and quality appraised and rated with regard to strength and evidence level. Consequent recommendations for applications of PET/CT were established. The actual use of PET/CT was compared with these, where grades A and B indicated "established" and "useful" and grades C and D "potentially useful" and "non-recommendable" indications, respectively. RESULTS: Of 11,729 citations, 1,729 were considered for review, and 204 were included. The evidence suggested usefulness of PET/CT in lung, lymphoma, melanoma, head and neck, and colorectal cancers, whereas evidence was sparse in gynaecological cancers. The agreement between actual use of PET/CT and literature-based recommendations was high in the first five mentioned cancers in that 96.2 % of scans were made for grade A or B indications versus only 22.2 % in gynaecological cancers. CONCLUSION: Evidence-based usefulness was reported in five of six selected cancers; evidence was sparse in the sixth, gynaecological cancers. Actual use of PET/CT agreed well with recommendations.
Subject(s)
Fluorodeoxyglucose F18 , Multimodal Imaging/statistics & numerical data , Neoplasms/diagnostic imaging , Positron-Emission Tomography/statistics & numerical data , Practice Guidelines as Topic , Radiopharmaceuticals , Tomography, X-Ray Computed/statistics & numerical data , Denmark , HumansABSTRACT
It is important to recognize that patients with chest pain and a family history of cardiac diseases along with obvious risk factors might suffer from acute myocardial infarction. Even young females can be affected. We present a history of a 22-year-old woman who was predisposed to cardiac atherosclerosis. Her father and her brother had atherosclerotic changes in coronary arteries. Her BMI was 35 kg/m2 and she was a smoker. Her young age misled the physicians to conclude, with fatal consequence, that her symptoms with chest pain and heavy feeling in both arms were explained by spasms of the cardia.
Subject(s)
Myocardial Infarction/diagnosis , Coronary Artery Disease/complications , Coronary Artery Disease/diagnosis , Coronary Artery Disease/genetics , Coronary Artery Disease/pathology , Fatal Outcome , Female , Genetic Predisposition to Disease , Humans , Myocardial Infarction/etiology , Myocardial Infarction/genetics , Myocardial Infarction/pathology , Risk Factors , Young AdultABSTRACT
In this literature review, an update is provided on the role of [(18)F]fluorodeoxyglucose PET/computed tomography in different clinical settings of the 4 most frequent female-specific cancer types: breast, endometrial, ovarian, and cervical cancer. The most recent knowledge regarding primary diagnosis, staging, response evaluation, prognostic and predictive values, recurrence detection, and radiotherapy planning is evaluated, including, when clinically relevant, considerations with respect to the epidemiology, treatment, and course of the diseases.
