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OBJECTIVE: This study aimed to determine the prognostic role of baseline maximum standardized uptake value (SUVmax) obtained by pretreatment PET/CT and the change in SUVmax (ΔSUVmax [%]) in patients with axillary lymph node-positive breast cancer receiving neoadjuvant chemotherapy (NAC). METHODS: One hundred and eighty patients with baseline SUVmax and 121 patients with SUVmax measurement after treatment were evaluated in the study. The baseline SUVmax value of the breast (SUVmaxBI) and axilla (SUVmaxAI) and the change in the SUVmax of the breast (ΔSUVmaxB) and axilla (ΔSUVmaxA) were measured. The optimal cut-off value of SUVmax and ΔSUVmax were determined by ROC curve analysis. Disease-free survival (DFS) and overall survival (OS) were calculated using Kaplan-Meier curves. RESULTS: ΔSUVmaxB, pCRB, pCRA, and pCR parameters were found to be associated with relapse (p < 0.001, p = 0.033, p = 0.016, and p = 0.013, respectively). ΔSUVmaxB and SUVmaxAI were associated with mortality (p = 0.001 and p = 0.006, respectively). Multiple Cox regression analyses revealed that ΔSUVmaxB value was an independent prognostic factor for relapse and mortality (p = 0.013 and p = 0.010, respectively). CONCLUSION: The results showed that ΔSUVmaxB was an independent prognostic factor for relapse and mortality in patients with axillary lymph node-positive breast cancer who received NAC.
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OBJECTIVE: Our aim is to evaluate if different metabolic parameters obtained by 18F-FDG PET/CT and diffusion weighted magnetic resonance imaging (DW-MRI) can aid in neoadjuvant radiochemotherapy (RCT) response assessment in locally advanced rectal cancer (LARC) patients. METHODS: Out of 20 LARC patients, who were planned to receive neoadjuvant RCT, 19 were included in this prospective study. Patients had 18F-FDG PET/CT and DW-MRI at initial staging, interim (2 weeks after onset of RCT) and after completion of RCT (post-therapy). Standardized uptake value (SUV) parameters (SUVmax, SUVmean, SUVpeak, SULpeak), metabolic tumor volume (MTV) and tumor lesion glycolysis (TLG) detected on PET images and apparent diffusion coefficient (ADC) values (for b=400 and b=1000s/mm2) obtained from DW-MRI were recorded. Postoperative tumor regression grade (TRG) was used as gold-standard, except for 2 patients who were under complete remission with non-operative management 19 months post-therapy and scored as responders. RESULTS: On interim PET/CT, no significant difference was found among PET parameters between responders and non-responders, whereas post-therapy SUVmax, SUVpeak, MTV, SULpeak, TLG (P=0.02, P=0.014, P=0.025, P=0.007, P=0.02, respectively) and initial MTV (P=0.034) were significantly lower in responders. ADC response index (RI) was higher in responders (interim P=0.026; post-therapy: P=0.018) and ROC analysis revealed that a threshold of ADC RI>41.6% for interim MRI and >44.6% for post-therapy MRI had sensitivity and specificity of 75.0% and 90.9%, respectively. CONCLUSIONS: While interim 18F-FDG PET/CT failed to predict therapy response during RCT, post-therapy PET could accurately differentiate responders. DW-MRI was found to be more promising in interim detection of RCT response.
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Objectives: We aimed to analyze the contribution of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging to the diagnosis and management of pancreatic cancer compared with multidetector row computed tomography (MDCT), magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS). Material and methods: We retrospectively scanned the data of 52 patients who were referred for FDG PET/CT imaging for evaluation of pancreatic lesions greater than 10 mm. The diagnostic performances of 4 imaging methods and the impact of PET/CT on the management of pancreatic cancer were defined. Results: Pancreatic adenocarcinoma was diagnosed in 33 of 52 patients (63%), 15 patients had benign diseases of pancreas (29%), and 4 patients were normal (8%). Sensitivity and NPV of EUS and PET/CT were equal (100%) and higher than MDCT and MRI. Specificity, PPV and NPV of PET/CT were significantly higher than MDCT. However, sensitivities of two imaging methods were not significantly different. There was no significant difference between PET/CT and MRI and EUS for these values. When the cut-off value of SUVmax was 3.2, the most effective sensitivity and specificity values were obtained. PET/CT contributed to the management of pancreatic cancer in 30% of patients. Conclusion: FDG PET/CT is a valuable imaging method for the diagnosis and management of pancreatic cancer, especially when applied along with EUS as first line diagnostic tools (AU)
Objetivo: El objetivo fue analizar la contribución de la PET/TC con 18F-FDG (FDG PET/TC) en el diagnóstico y tratamiento del cáncer de páncreas en comparación con la tomografía computarizada multidetector (TCMD), la resonancia magnética (RM) y la ecografía endoscópica (EUS). Material y métodos: Se revisaron retrospectivamente 52 pacientes que fueron remitidos para la evaluación de lesiones pancreáticas mayores de 10 mm mediante FDG PET/TC. Se definieron los hallazgos diagnósticos de los 4 métodos de imagen y el impacto de la FDG PET/TC en el tratamiento del cáncer de páncreas. Resultados: En 33 de los 52 pacientes (63%) se diagnosticó un adenocarcinoma pancreático; 15 pacientes tenían enfermedades benignas del páncreas (29%) y 4 pacientes no mostraron enfermedad pancreática (8%). La sensibilidad y el valor predictivo negativo (VPN) del EUS y la FDG PET/TC fueron iguales (100%) y superior a la TCMD y a la RM. La especificidad, el valor predictivo positivo y el VPN de la FDG PET/TC fueron significativamente mayores que la TCMD; sin embargo, la sensibilidad de 2 métodos de imagen no fue significativamente diferente. No hubo diferencias significativas entre la FDG PET/TC, RM y EUS. Con un punto de corte de SUVmax igual a 3,2 se obtuvieron los valores más efectivos de sensibilidad y de especificidad. La FDG PET/TC contribuyó al manejo clínico del cáncer de páncreas en 30% de los pacientes. Conclusión: La FDG PET/TC es un método de imagen valioso para el diagnóstico y tratamiento del cáncer de páncreas, especialmente cuando se aplica junto con la EUS como primera línea de herramientas de diagnóstico (AU)
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Humanos , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Neoplasias Pancreáticas , Tomografia Computadorizada Multidetectores/métodos , Endossonografia/métodos , Espectroscopia de Ressonância Magnética/métodosRESUMO
OBJECTIVES: We aimed to analyze the contribution of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging to the diagnosis and management of pancreatic cancer compared with multidetector row computed tomography (MDCT), magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS). MATERIAL AND METHODS: We retrospectively scanned the data of 52 patients who were referred for FDG PET/CT imaging for evaluation of pancreatic lesions greater than 10mm. The diagnostic performances of 4 imaging methods and the impact of PET/CT on the management of pancreatic cancer were defined. RESULTS: Pancreatic adenocarcinoma was diagnosed in 33 of 52 patients (63%), 15 patients had benign diseases of pancreas (29%), and 4 patients were normal (8%). Sensitivity and NPV of EUS and PET/CT were equal (100%) and higher than MDCT and MRI. Specificity, PPV and NPV of PET/CT were significantly higher than MDCT. However, sensitivities of two imaging methods were not significantly different. There was no significant difference between PET/CT and MRI and EUS for these values. When the cut-off value of SUVmax was 3.2, the most effective sensitivity and specificity values were obtained. PET/CT contributed to the management of pancreatic cancer in 30% of patients. CONCLUSION: FDG PET/CT is a valuable imaging method for the diagnosis and management of pancreatic cancer, especially when applied along with EUS as first line diagnostic tools.
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Endossonografia , Fluordesoxiglucose F18 , Imageamento por Ressonância Magnética , Tomografia Computadorizada Multidetectores , Imagem Multimodal , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/terapia , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatopatias/diagnóstico , Pancreatopatias/terapia , Estudos RetrospectivosRESUMO
As skin resurfacing has become more common, the number of patients developing post-treatment hypopigmentation has increased. No effective treatment for this complication has been developed. Some hypopigmented disorders, including vitiligo, have been treated with the excimer laser. We used the XeCl excimer laser to successfully treat a 78-year-old woman with perioral leukoderma following CO(2) laser skin resurfacing. The repigmentation was stable for at least 16 months. Larger prospective studies of this new therapeutic intervention are recommended to evaluate its efficacy and long-term stability.
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Técnicas Cosméticas/efeitos adversos , Hipopigmentação/etiologia , Queloide/etiologia , Doenças Labiais/etiologia , Terapia com Luz de Baixa Intensidade/efeitos adversos , Lesões por Radiação/etiologia , Envelhecimento da Pele/efeitos da radiação , Idoso , Feminino , Seguimentos , Humanos , Doença Iatrogênica , Queloide/radioterapia , RetratamentoRESUMO
Hypopigmented skin developed following tattoo removal with the Q-switched Nd:YAG laser. The hypopigmented area remained unchanged for over 4 years, until the use of the 308-nm xenon-chloride excimer laser induced a significant repigmentation in 40 sessions over 14 months. The excimer laser has the potential to influence the reduced activity of the melanocytes, as demonstrated with electron microscopy.
