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1.
Clin Radiol ; 76(4): 247-261, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33423761

RESUMO

The last decade has seen a paradigm shift in medical oncology treatment with the rise of novel systemic agents, principally molecular targeted therapy and immunotherapy. These new groups of anti-cancer treatment have revolutionised the prognostic landscape for certain patient cohorts with advanced disease, and it is hoped that through ongoing extensive clinical research, significant survival benefits may be demonstrated in the majority of tumour types. However, radiological response assessment of these new agents has become more nuanced for radiologists, as the behaviour of both responding and progressing tumour burden can be more diverse than with conventional chemotherapy. Additionally, radiologists need to be aware of adverse events associated with these treatments as some side effects carry a high morbidity/mortality and may manifest radiologically before they become clinically apparent. This review discusses radiological response assessment and adverse events associated with these novel agents, which have become fundamental aspects of systemic oncological therapy.


Assuntos
Imunoterapia/efeitos adversos , Terapia de Alvo Molecular/efeitos adversos , Neoplasias/diagnóstico por imagem , Neoplasias/terapia , Progressão da Doença , Hemorragia/diagnóstico por imagem , Hemorragia/etiologia , Humanos , Metástase Neoplásica/diagnóstico por imagem , Neoplasias/patologia , Tomografia Computadorizada por Raios X , Carga Tumoral
2.
Clin Radiol ; 75(12): 903-913, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32782128

RESUMO

Prostate-specific membrane antigen (PSMA)-based positron-emission tomography (PET)-computed tomography (CT) has shown great promise in prostate cancer imaging. This technique has demonstrated particular utility in the staging of high-risk primary cancer and in the localisation of recurrent disease. The use of fluorine-18 PSMA-1007 is advantageous, as it is excreted via the hepatobiliary system rather than urinary and the longer half-life of fluorine-18 compared to gallium tracers, allows for PSMA imaging in centres without a gallium generator. However, imaging with this tracer is not without flaws and areas of ambiguity remain. In this article, the biodistribution, clinical indications, and pearls of 18F-PSMA-1007 PET-CT in patients with prostate cancer will be discussed, as well as the potential pitfalls in the reporting of these studies.


Assuntos
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Próstata/diagnóstico por imagem , Radioisótopos de Flúor , Humanos , Masculino , Estadiamento de Neoplasias , Antígeno Prostático Específico , Neoplasias da Próstata/patologia , Compostos Radiofarmacêuticos
5.
Clin Radiol ; 74(9): 655-662, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31178067

RESUMO

Pulmonary veno-occlusive disease (PVOD) is a rare subtype of pulmonary arterial hypertension (PAH) characterised by preferential remodelling of the pulmonary venules. Differentiation from other subtypes of PAH is essential as the management can differ significantly; for example, initiation of vasodilator therapy may cause fatal pulmonary oedema in a patient with PVOD misdiagnosed with idiopathic PAH. PVOD also carries a substantially worse prognosis. Lung biopsy is required for definitive diagnosis, but this is hazardous, and ideally, should be avoided in pulmonary hypertension. Computed tomography (CT) may suggest the diagnosis, directing the patient towards specialist review. Potential distinguishing CT features between PVOD and other subtypes of PAH include interlobular septal thickening, mediastinal lymphadenopathy, and centrilobular ground-glass opacities. No evidence-based medical therapy exists for PVOD at present and lung transplantation remains the definitive treatment for eligible patients. Therefore, early radiological identification of this challenging diagnosis facilitates timely referral for transplant.


Assuntos
Pneumopatia Veno-Oclusiva/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Biópsia , Diagnóstico Diferencial , Humanos , Prognóstico
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