RESUMEN
PURPOSE: A pilot study was performed in patients with recurrent back pain after spinal fusion surgery to evaluate the ability of (18)F-NaF PET/CT imaging to correctly identify those requiring surgical intervention and to locate a site amenable to surgical intervention. METHODS: In this prospective study 22 patients with recurrent back pain after spinal surgery and with equivocal findings on physical examination and CT were enrolled for evaluation with (18)F-NaF PET/CT. All PET/CT images were prospectively reviewed with the primary objective of identifying or ruling out the presence of lesions amenable to surgical intervention. The PET/CT results were then validated during surgical exploration or clinical follow-up of at least 15 months. RESULTS: Abnormal (18)F-NaF foci were found in 16 of the 22 patients, and surgical intervention was recommended. These foci were located at various sites: screws, cages, rods, fixation hardware, and bone grafts. In 6 of the 22 patients no foci requiring surgical intervention were found. Validation of the results by surgery (15 patients) or on clinical follow-up (7 patients) showed that (18)F-NaF PET/CT correctly predicted the presence of an abnormality requiring surgical intervention in 15 of 16 patients and was falsely positive in 1 of 16. CONCLUSION: In this initial investigation, (18)F-NaF PET/CT imaging showed potential utility for evaluation of recurrent symptoms after spinal fusion surgery by identifying those patients requiring surgical management.
Asunto(s)
Radioisótopos de Flúor , Imagen Multimodal , Tomografía de Emisión de Positrones , Radiofármacos , Fusión Vertebral , Columna Vertebral/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Anciano , Dolor de Espalda/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fluoruro de Sodio , Columna Vertebral/cirugíaRESUMEN
Os autores fixam os objetivos no manejo do derrame pleural neoplásico associado ao carcinoma brônquico, com ênfase nas medidas que melhoram a qualidade da sobrevida. Discutem a conduta nos casos em que a citologia do líquido pleural e a histopatologia da pelura säo negativas para células malígnas e destacam o papel de talcagem e da tetraciclina intrapleural como paliativos eficientes no controle dos derrames pleurais
Asunto(s)
Humanos , Masculino , Femenino , Carcinoma Broncogénico/complicaciones , Neoplasias Pulmonares/complicaciones , Derrame Pleural/complicacionesRESUMEN
Os autores visam com este trabalho de revisäo de literatura dar noçöes básicas sobre o procedimento; suas indicaçöes, a avaliaçäo nutricional, a técnica de preparo e administraçäo das soluçöes nutritivas e suas complicaçöes