RESUMO
Although they have proven effectiveness, radiofrequency and microwave ablation techniques have a high rate of partial responses. Diagnostic studies that anticipate the changes in morphology are essential for earlier detection of residual viable tumor tissue or local recurrences to identify patients who will benefit from a new treatment. Our study has determined the diagnostic yield of PET/CT studies at baseline and follow-up and adequate time between them and the ablation intervention. Seven patients with single tumor lesion with a total of 8 ablations were included. CT and PET/CT studies were performed at baseline and follow-up after ablation. Average times between PET studies at baseline and follow-up and the ablative therapy were 1.8 and 3.4 months, respectively. Mean scores in metabolic activities of the PET at baseline and follow-up were 7.6 and 4.3g/ml of SUVmax, respectively. The Dual Time Point technique helped to identify viable tissue after ablation in 3 cases. Follow-up PET/CT studies have conditioned the various treatment strategies adopted by clinical oncologists. The high yield of the PET/CT study including the Dual Time Point technique may be considered as a study replacement of initial and follow-up Contrast-Enhanced CT before and after treatment with RFA and AMO, this achieving considerable reduction in the exposure to high radiation levels. We propose conducting the first PET/CT follow-up study at 3 months of the RFA and AMO.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Imagem Multimodal , Recidiva Local de Neoplasia/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/metabolismo , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Ablação por Cateter , Eletrocoagulação , Radioisótopos de Flúor , Fluordesoxiglucose F18 , Seguimentos , Humanos , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Micro-Ondas/uso terapêutico , Neoplasia Residual/diagnóstico por imagem , Cuidados Paliativos , Cuidados Pós-Operatórios , Estudos Prospectivos , Compostos Radiofarmacêuticos , Resultado do TratamentoRESUMO
The use of (18)F-FDG-PET/CT has changed the management of patients with lymphoma for the last two decades. This technique improves initial staging of the disease, making a prognostic approach and appropriate treatment planning, as well as monitoring therapy response of lymphoma. However, there are still controversial issues in medical literature that impact on daily clinical practice. This comprehensive literature review summarizes the current information regarding the potential use of (18)F-FDG-PET/CT in patients with lymphoma, highlighting the main applications and the current dilemmas for the nuclear medicine physicians at the time of the evaluation of these studies, trying to standardize criteria for its assessment, particularly in restaging and therapy monitoring.
Assuntos
Radioisótopos de Flúor , Fluordesoxiglucose F18 , Linfoma/diagnóstico por imagem , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X , Adulto , Anticorpos Monoclonais Murinos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bleomicina/administração & dosagem , Medula Óssea/diagnóstico por imagem , Transplante de Medula Óssea , Meios de Contraste , Ciclofosfamida/administração & dosagem , Progressão da Doença , Doxorrubicina/administração & dosagem , Etoposídeo/administração & dosagem , Reações Falso-Positivas , Feminino , Seguimentos , Humanos , Linfoma/classificação , Linfoma/tratamento farmacológico , Linfoma/patologia , Linfoma/cirurgia , Estadiamento de Neoplasias , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Prednisona/administração & dosagem , Procarbazina/administração & dosagem , Estudos Retrospectivos , Rituximab , Transplante Autólogo , Resultado do Tratamento , Vincristina/administração & dosagemRESUMO
We present a case of encephalitis caused by Herpes Simplex Virus in a 57 year old woman. The acute picture was suggestive of viral infection without associated neurological symptoms. Due to the posterior appearance of neurological focality, cerebral spinal fluid (CSF) was analyzed. It showed pleocytosis and lymphocytosis, inflammatory process data, and serological test with positivity for Simple Herpes Virus (SHV) subtypes I and II. During admission, other complementary tests were performed: EEG, CT, MRI, cerebral perfusion SPECT; the later supplied significant data regarding anatomical neuroimaging (CT, MRI) in regards to bihemispheral extension of the encephalic condition. Furthermore, after clinical discharge, persistent metabolic abnormality was demonstrated in temporal cortex, responsible for concomitant mixed aphasia.
