Does 18F-FDG PET/CT play a role in the differential diagnosis of parotid masses.

AIM: The aim of the present study was to assess the accuracy of an hybrid PET/CT scanner in the evaluation of newly diagnosed parotid masses, comparing the results with those reported in the literature with using PET scanners only. METHODS: The potential role of 18F-FDG PET/CT in distinguishing benign from malignant parotid masses in 14 consecutive patients was investigated. All patients were preoperatively evaluated by means of ultrasound (US), US-guided fine needle aspiration (FNA) cytology, computed tomography (CT) scan, magnetic resonance imaging (MRI) and 18F-FDG PET/CT. For To interpreting FDG PET findings, the right to left parotid (R/L) SUV max ratio was calculated in a group of 54 patients without evidence of parotideal disease (mean+/-SD = 1+/-0.2; range = 0.8-1.2); considering the R/L SUV max ratio, focal or diffuse uptakes <0.8 or >1.2 were considered as potentially pathological. RESULTS: Imaging data were compared with surgical and histopathological findings. At FDG PET/CT, 9 false positive cases were found (8 Warthin's tumours, 1 pleomorphic adenoma), 1 false negative (acinar cell carcinoma), 4 true negative (1 Warthin's tumour, 1 pleomorphic adenoma, 1 lymph epithelial cyst, 1 parotid inflammation) whereas there was no case of true positive. The global accuracy of FGD PET/CT was rather low = at 29%. CONCLUSIONS: In agreement with other preliminary reports in which the FDG PET without CT fusion imaging was used, in our experience 18F-FDG PET/CT did not prove to play a significant role in differential diagnosis (benign vs malignant) of parotid masses. Further studies collecting larger groups of patients are needed to further elucidate this observation.

[Laminaria in induction of abortion in the 2d trimester. Case of uterine rupture]. / La laminaria nell'induzione d'aborto al 2no trimestre. Caso di rottura d'utero.

PIP: A 32 year old patient in her 25th week of gestation was hospitalized for endouterine fetal death. The sample patient in previous years had 2 cesarean sections, both times for early detachment of the placenta with consequent fetal death. Cervical dilatation was induced with a Hagar dilator and with laminaria tents, sudden spontaneous and strong contractions led to echography which showed uterine rupture. Laparotomy and hysterectomy were then performed. The use of laminaria followed by surgical evacuation is considered almost free of side effects in the first half of 2nd trimester pregnancy, while prostaglandins are preferred in the 2nd half. According to recent studies laminaria can provoke strong contractions in about 30% of cases and especially if the patient is nulliparous. This last risk factor negatively influenced the outcome of uterine evacuation in the case presented here since the uterine wall had already been weakened by 2 preceding cesarean sections.^ieng