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1.
Eur Radiol ; 25(7): 2015-24, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25680716

RESUMEN

OBJECTIVES: We evaluated the ability of dual-phase (18)F-FDG PET/CT to predict the histological response after neoadjuvant chemotherapy (NAC) in osteosarcoma. METHODS: Thirty-one patients with osteosarcoma treated with NAC and surgery were prospectively enrolled. After injection of (18)F-FDG, both early (~60 min) and delayed (~150 min) PET were acquired before and after the completion of NAC. SUVmax, early/delayed SUVmax change (RImax), and early/delayed SUVmean change (RImean) of tumour were measured before (SUV1, RImax1, and RImean1) and after NAC (SUV2, RImax2, and RImean2). Then, we calculated the percentage changes between SUV1 and SUV2 (%SUV). RESULTS: Twelve patients (39%) exhibited good histological response after NAC. SUVmax, RImax, and RImean significantly decreased after NAC. Before NAC, only RImean1 predicted good histological response with the optimal criterion of < 10%, sensitivity of 92%, specificity of 57%, and accuracy of 71%. After NAC, %SUV, SUV2, and RImax2 predicted histological response. By using combined criterion of %SUV and RImax2 or SUV2 and RImean1 or SUV2 and RImax2, accuracies were 81%, 77%, and 77%, respectively. CONCLUSIONS: The histological response after NAC could be predicted by using RImean1 before the initiation of NAC in osteosarcoma. The combined use of SUV and RI values may provide a better prediction. KEY POINTS: • Pretreatment dual-phase FDG-PET was useful to predict histological response in osteosarcoma. • A combination of early and delayed PET may increase the predictive value. • Early/delayed SUV change of tumours significantly decreased after neoadjuvant chemotherapy.


Asunto(s)
Neoplasias Óseas/tratamiento farmacológico , Osteosarcoma/tratamiento farmacológico , Adolescente , Neoplasias Óseas/diagnóstico por imagen , Quimioterapia Adyuvante/métodos , Femenino , Fluorodesoxiglucosa F18 , Humanos , Masculino , Imagen Multimodal/métodos , Terapia Neoadyuvante/métodos , Osteosarcoma/diagnóstico por imagen , Tomografía de Emisión de Positrones/métodos , Curva ROC , Radiofármacos , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Adulto Joven
2.
J Med Assoc Thai ; 97 Suppl 2: S115-22, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25518184

RESUMEN

OBJECTIVE: To study 18F-FDG PET/CT findings in endometrial cancer patients, to analyze the correlation between the maximum standardized uptake value (SUVmax) and clinicopathologic tumor characteristics. MATERIAL AND METHOD: Retrospective study included 33 endometrial cancer patients who underwent pre-operative 18F-FDG PET/CT and abdominal CT or MRI from June 2005 to October 2009. Pattern of FDG uptake was classified as focal and diffuse uptake. SUVmax was measured at primary tumor in endometrial cavity and correlated with maximum tumor size, menopausal state, histological grade, depth of myometrial invasion and nodal metastasis. The diagnostic performance of 18F-FDG PET/CT was assessed for primary tumor and lymph node metastasis and correlated with those of CT/MRI. RESULTS: Sensitivity of 18F-FDG PET/CT in primary tumor detection was slightly higher, without significant difference, than that of either CT or MRI (93.9% vs. 87.9%, p = 0.625). The overall SUVmax mean ofthe primary tumor was 8.24 +/- 5.38. The focal FDG uptake pattern was more common than the diffuse uptake pattern (71.0% and 29.0%, respectively), but the SUVmax was higher in the diffuse uptake pattern (diffuse pattern 12.10 +/- 7.47 vs. focal pattern 6.66 +/- 3.33, p = 0.008). There was significant association between the SUVmax of the primary tumor and maximum tumor size (p = 0.001), but not between the SUVmax of the primary tumor and menopause state, histological grade, depth of myometrial invasion and nodal metastasis (p = 0.522, 0.622, 0.694 and 0.601, respectively). For lymph node detection, the sensitivity of 18F-FDG PET/CT were also higher without statistically significant difference, than those of CT/MRI (on patient basis; 80.0% vs. 40.0%, p = 0.500; on nodal basis 64.7% vs. 47.1%, p = 0.453, respectively). CONCLUSION: 18F-FDG PET/CThad slightly higher diagnostic sensitivity than CT/MRIin both primary tumor and lymph node detection. The finding focal uptake pattern is more common, but the diffuse uptake pattern shows higher FDG uptake. The SUVmax of primary tumors was associated with the maximum tumor size, but not associated with menopause state, histologic grade, depth of myometrial invasion and nodal metastasis.


Asunto(s)
Neoplasias Endometriales/diagnóstico , Fluorodesoxiglucosa F18 , Tomografía de Emisión de Positrones , Radiofármacos , Neoplasias Endometriales/diagnóstico por imagen , Neoplasias Endometriales/patología , Femenino , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patología , Metástasis Linfática , Imagen por Resonancia Magnética , Menopausia , Persona de Mediana Edad , Estudios Retrospectivos , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X
3.
Acta Radiol ; 52(2): 181-90, 2011 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-21498347

RESUMEN

BACKGROUND: Autologous periosteal grafting is used as treatment for cartilage defects. PURPOSE: To assess the role of MR imaging and ultrasonography in the evaluation of the post-graft repair process with imaging and histologic correlation. MATERIAL AND METHODS: Periosteal grafts obtained from the tibia of eight dogs were transplanted to the experimental cartilage defects in the femoral condyles (15 knees). The control group was comprised of three dogs (five knees). MR imaging using 4.7T and ultrasonography of the grafted specimens was performed at one, two, four, eight, and 16 weeks after transplantation. The animals were sacrificed at the time of imaging at the previously specified intervals. Histologic analysis with imaging correlation was subsequently performed. RESULTS: All specimens taken from one to 16 weeks demonstrated periosteal proliferation in the graft. At one week, experimental cartilage defects were no longer present on MR imaging. Area of high signal intensity (SI) in the defect was present which corresponded to hemorrhage, edema, and fibrosis on histology. At two, four, and eight weeks, all but two graft demonstrated heterogeneous high SI on T2-weighted image, consistent with immature cartilage. At 16 weeks, all grafts showed heterogeneous isointense to adjacent cartilage on all sequences, which corresponded to dominant mature cartilage. The repair tissue near the exposed subchondral bone revealed heterogeneous high SI on T2-weighted images. This corresponded to the fibrosis with vascular penetration and edema. In the control group, no cartilage repair was noted within cartilage defects. The serial MR features of the grafted area correlated well with the histologic findings. Serial sonographic findings were not sufficient to provide the regenerated cartilage maturity. CONCLUSION: MR imaging is capable of depicting the repair characteristics following periosteal grafting for articular cartilage defects. MR imaging may provide useful information in the assessment of the graft appearance with definite implications regarding the degree and success of incorporation.


Asunto(s)
Cartílago Articular/diagnóstico por imagen , Cartílago Articular/patología , Imagen por Resonancia Magnética/métodos , Periostio/trasplante , Trasplante Autólogo/métodos , Animales , Cartílago Articular/cirugía , Modelos Animales de Enfermedad , Perros , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/patología , Articulación de la Rodilla/cirugía , Masculino , Ultrasonografía
4.
AJR Am J Roentgenol ; 194(4): 1095-8, 2010 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-20308517

RESUMEN

OBJECTIVE: This study aimed to evaluate the reproducibility of a new grading system for lumbar foraminal stenosis. MATERIALS AND METHODS: Four grades were developed for lumbar foraminal stenosis on the basis of sagittal MRI. Grade 0 refers to the absence of foraminal stenosis; grade 1 refers to mild foraminal stenosis showing perineural fat obliteration in the two opposing directions, vertical or transverse; grade 2 refers to moderate foraminal stenosis showing perineural fat obliteration in the four directions without morphologic change, both vertical and transverse directions; and grade 3 refers to severe foraminal stenosis showing nerve root collapse or morphologic change. A total of 576 foramina in 96 patients were analyzed (from L3-L4 to L5-S1). Two experienced radiologists independently assessed the sagittal MR images. Interobserver agreement between the two radiologists and intraobserver agreement by one reader were analyzed using kappa statistics. RESULTS: According to reader 1, grade 1 foraminal stenosis was found in 33 foramina, grade 2 in six, and grade 3 in seven. According to reader 2, grade 1 foraminal stenosis was found in 32 foramina, grade 2 in six, and grade 3 in eight. Interobserver agreement in the grading of foraminal stenosis between the two readers was found to be nearly perfect (kappa value: right L3-L4, 1.0; left L3-L4, 0.905; right L4-L5, 0.929; left L4-L5, 0.942; right L5-S1, 0.919; and left L5-S1, 0.909). In intraobserver agreement by reader 1, grade 1 foraminal stenosis was found in 34 foramina, grade 2 in eight, and grade 3 in seven. Intraobserver agreement in the grading of foraminal stenosis was also found to be nearly perfect (kappa value: right L3-L4, 0.883; left L3-L4, 1.00; right L4-L5, 0.957; left L4-L5, 0.885; right L5-S1, 0.800; and left L5-S1, 0.905). CONCLUSION: The new grading system for foraminal stenosis of the lumbar spine showed nearly perfect interobserver and intraobserver agreement and would be helpful for clinical study and routine practice.


Asunto(s)
Vértebras Lumbares/patología , Imagen por Resonancia Magnética/métodos , Estenosis Espinal/patología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad
5.
Skeletal Radiol ; 39(8): 807-13, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20383495

RESUMEN

OBJECTIVE: The aim of this study was to introduce gamma correction pinhole bone scan (GCPBS) to depict specific signs of knee occult fractures (OF) on (99m)Tc-hydroxydiphosphonate (HDP) scan. MATERIALS AND METHODS: Thirty-six cases of six different types of knee OF in 27 consecutive patients (male = 20, female = 7, and age = 18-86 years) were enrolled. The diagnosis was made on the basis of a history of acute or subacute knee trauma, local pain, tenderness, cutaneous injury, negative conventional radiography, and positive magnetic resonance imaging (MRI). Because of the impracticability of histological verification of individual OF, MRI was utilized as a gold standard of diagnosis and classification. All patients had (99m)Tc-HDP bone scanning and supplementary GCPBS. GCPBS signs were correlated and compared with those of MRI. The efficacy of gamma correction of ordinary parallel collimator and pinhole collimator scans were collated. RESULTS: Gamma correction pinhole bone scan depicted the signs characteristic of six different types of OF. They were well defined stuffed globular tracer uptake in geographic I fractures (n = 9), block-like uptake in geographic II fractures (n = 7), simple or branching linear uptake in linear cancellous fractures (n = 4), compression in impacted fractures (n = 2), stippled-serpentine uptake in reticular fractures (n = 11), and irregular subcortical uptake in osteochondral fractures (n = 3). All fractures were equally well or more distinctly depicted on GCPBS than on MRI except geographic II fracture, the details of which were not appreciated on GCPBS. Parallel collimator scan also yielded to gamma correction, but the results were inferior to those of the pinhole scan. CONCLUSIONS: Gamma correction pinhole bone scan can depict the specific diagnostic signs in six different types of knee occult fractures. The specific diagnostic capability along with the lower cost and wider global availability of bone scanning would make GCPBS an effective alternative.


Asunto(s)
Difosfonatos , Fracturas Cerradas , Articulación de la Rodilla , Compuestos de Organotecnecio , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Fracturas Cerradas/clasificación , Fracturas Cerradas/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
6.
Neuroimage ; 47(1): 50-5, 2009 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-19073268

RESUMEN

OBJECTIVES: This study aimed to determine whether regional cerebral blood flow (rCBF) is abnormal in patients who have Transient Global Amnesia (TGA). METHODS: We obtained noninvasive rCBF measurements using Tc-99m-ethyl cysteinate diamer Single Photon Emission Computed Tomography (SPECT) in 7 patients diagnosed with TGA within 4 days of onset of the amnestic episode while the patients were still symptomatic and in 17 age-matched healthy control subjects. We assessed memory functioning using the Hopkins's Verbal Learning Test (HVLT) and Statistical Parametric Mapping to compare rCBF across diagnostic groups. RESULTS: The patients with TGA were significantly impaired in their performance on the 20-minute delayed recall of the HVLT. They also exhibited significantly decreased rCBF on their SPECT scans in the inferior and middle frontal gyrus bilaterally, with more prominent left-sided reductions in the superior temporal, precentral, and postcentral gyri, as well as increased rCBF primarily in the right hemisphere within the middle temporal, superior temporal, and inferior frontal gyri, cerebellum, and thalamus, compared with the normal control group. CONCLUSION: These findings suggest that lateralized abnormalities in brain functioning are an important component of the pathophysiology of TGA. Lateralized abnormalities may disrupt functions that are relatively specific to the left hemisphere, including receptive language, symbolic representation, and the processing of local features in the environment, while preserving anterograde memory processes. Increased flow to the right hemisphere centered on regions that subserve the functions of expressive language and visuospatial processing, and may represent processes that compensate for flow reductions to the left hemisphere.


Asunto(s)
Amnesia Global Transitoria/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Circulación Cerebrovascular , Anciano , Amnesia Global Transitoria/psicología , Encéfalo/irrigación sanguínea , Mapeo Encefálico , Cisteína/análogos & derivados , Femenino , Humanos , Masculino , Recuerdo Mental , Persona de Mediana Edad , Pruebas Neuropsicológicas , Compuestos de Organotecnecio , Tomografía Computarizada de Emisión de Fotón Único
7.
Ann Nucl Med ; 23(2): 131-6, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19225935

RESUMEN

OBJECTIVE: In poorly differentiated thyroid cancer originating from thyroid follicular cells, the ability to concentrate iodine is lost. This makes recurrence undetectable by (131)I whole-body scan. In this situation, other radiopharmaceuticals, such as (18)F-fluorodeoxyglucose ((18)F-FDG) and technetium-99m-methoxyisobutylisonitrile ((99m)Tc-MIBI), are used to evaluate recurrence or metastasis. Some reports suggest that (18)F-FDG uptake is increased by thyroid-stimulating hormone (TSH) stimulation. This study aimed to determine the influence of TSH on (18)F-FDG and (99m)Tc-MIBI uptake in human poorly differentiated thyroid cancer cells in vitro. MATERIALS AND METHODS: The cells were stimulated with 1000 muU/ml of recombinant human thyroid-stimulating hormone (rhTSH) for 1 day, 3 days, and 5 days. Each cell was incubated with 0.5 MBq/ml-1 MBq/ml of (18)F-FDG or 0.5 MBq/ml-1 MBq/ml of (99m)Tc-MIBI for 1 h at 37 degrees C. The uptake of each radiopharmaceutical in the cells was quantified as a percent of whole radioactivity per total viable cell number. The quantification of glucose transporter 1, 2, 3 and 4 mRNA expression was measured using RT-PCR. RESULTS: TSH stimulation increased (18)F-FDG uptake in a time-dependent manner. Following 5 days of rhTSH stimulation, (18)F-FDG uptake was approximately 2.2 times that of the control. The increase in (18)F-FDG uptake following rhTSH stimulation was correlated to the increase in GLUT4 mRNA level. The GLUT1 mRNA level was unchanged. An increased uptake of (99m)Tc-MIBI was observed with a pattern similar to that of (18)F-FDG. The (99m)Tc-MIBI uptake was approximately 1.5 times that of the control 5 days later. CONCLUSIONS: These results suggest that TSH stimulates (18)F-FDG and (99m)Tc-MIBI uptake in poorly differentiated papillary thyroid cancer, and therefore (18)F-FDG-PET or (99m)Tc-MIBI scans under TSH stimulation may be more accurate than under suppression.


Asunto(s)
Adenocarcinoma Folicular/metabolismo , Fluorodesoxiglucosa F18/farmacocinética , Tecnecio Tc 99m Sestamibi/farmacocinética , Neoplasias de la Tiroides/metabolismo , Tirotropina/administración & dosificación , Adenocarcinoma Folicular/diagnóstico por imagen , Adenocarcinoma Folicular/patología , Diferenciación Celular , Humanos , Tasa de Depuración Metabólica/efectos de los fármacos , Cintigrafía , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/patología , Células Tumorales Cultivadas
8.
J Nucl Med ; 48(1): 15-21, 2007 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17204694

RESUMEN

UNLABELLED: Small pulmonary nodules with little or no perceptible (18)F-FDG uptake are relatively common findings on combined PET/CT images of patients with nonthoracic malignancies. Interpreting such nodules is often a diagnostic challenge, and this study aimed to evaluate the clinical significance of the nodules. METHODS: Patients with pulmonary nodules < or =1 cm in diameter showing no (18)F-FDG uptake or uptake less than the mediastinal background were included. Nodules with clearly benign or metastatic findings on CT were excluded. One hundred twenty-one patients had either tissue confirmation or clinical follow-up with additional chest images. The subjects were studied by 3 variables: (i) solitary versus multiple nodules, (ii) presence of accompanying benign lung lesion versus absence, and (iii) imperceptible (18)F-FDG uptake versus faint (18)F-FDG uptake. The malignancy rates were calculated for each variable. RESULTS: Of the 121 patients, 24 had malignancy, with a strong possibility of pulmonary metastasis (19.8%). Six of the 44 patients with solitary nodules (13.6%) and 18 of the 77 patients with multiple nodules (23.4%) had malignancies, though there was no statistically significant difference in the incidences of malignancy between the solitary and multiple groups. On the other hand, there was a statistically significant difference (P = 0.040) between the accompanying lung lesion present (8.3%) and absent (24.7%) groups. No statistically significant difference was noted between the (18)F-FDG uptake imperceptible group and faint (18)F-FDG uptake group (20.7% vs. 17.2%). CONCLUSION: For patients with incidental lung nodules of indeterminate nature with no (18)F-FDG uptake or uptake less than that of the mediastinum on PET/CT images, >19% of the cases turned out to be malignant. The nodule was more likely to be malignant when no other benign pulmonary lesions could be identified elsewhere in the lung field. Thus, regardless of the number of nodules and (18)F-FDG uptake, tissue confirmation or close imaging follow-up is necessary when small nodules with imperceptible or faint (18)F-FDG activity are present on the PET/CT images, especially in the absence of accompanying benign lung lesions.


Asunto(s)
Fluorodesoxiglucosa F18/farmacocinética , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/diagnóstico , Pulmón/diagnóstico por imagen , Neoplasias/diagnóstico por imagen , Neoplasias/diagnóstico , Tomografía de Emisión de Positrones/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Femenino , Humanos , Pulmón/patología , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Metástasis de la Neoplasia , Estudios Retrospectivos
9.
Korean J Radiol ; 8(6): 458-65, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-18071275

RESUMEN

OBJECTIVE: The purpose of this study was to objectively assess the efficacy of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery using Technetium (Tc)-99m-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) in patients who underwent STA-MCA bypass surgery. MATERIALS AND METHODS: Brain perfusion SPECT images obtained at baseline and after the administration of acetazolamide were reconstructed using statistical parametric mapping in 23 patients, both before and after STA-MCA bypass surgery. The clinical outcomes of the surgery were also recorded and compared with the hemodynamic changes. A voxel with an uncorrected p-value of less than 0.001 was considered to be statistically significant. RESULTS: SPECT images of the territory supplied by the bypass graft showed an increase in both cerebrovascular flow and reserve at baseline, and the increase was significantly higher following the administration of acetazolamide. All patients showed improvement of clinical symptoms and increased blood flow to the left temporal, parietal, and frontal cortices as well as the thalamus. CONCLUSION: Brain SPECT effectively and objectively demonstrated the improved outcomes of STA-MCA bypass surgery, and thus may be used in postoperative analyses.


Asunto(s)
Encéfalo/diagnóstico por imagen , Revascularización Cerebral , Circulación Cerebrovascular , Arteria Cerebral Media/cirugía , Arterias Temporales/cirugía , Tomografía Computarizada de Emisión de Fotón Único/métodos , Acetazolamida , Adulto , Anciano , Mapeo Encefálico/métodos , Estenosis Carotídea/cirugía , Cisteína/análogos & derivados , Femenino , Estudios de Seguimiento , Humanos , Procesamiento de Imagen Asistido por Computador , Arteriosclerosis Intracraneal/cirugía , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Compuestos de Organotecnecio , Valor Predictivo de las Pruebas , Radiofármacos , Resultado del Tratamiento
10.
Clin Nucl Med ; 32(8): 628-30, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17667437

RESUMEN

Osteoid osteoma is a common skeletal neoplasm with distinctive histologic abnormalities that consist of a central core of vascular osteoid tissue and a peripheral sclerotic zone. We report a case of intense F-18 FDG uptake in the nidus of cortical osteoid osteoma of the distal metaphysis of the right tibia.


Asunto(s)
Neoplasias Óseas/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Osteoma Osteoide/diagnóstico por imagen , Tomografía de Emisión de Positrones/métodos , Tibia/diagnóstico por imagen , Tibia/metabolismo , Adulto , Neoplasias Óseas/metabolismo , Fluorodesoxiglucosa F18/farmacocinética , Humanos , Masculino , Osteoma Osteoide/metabolismo , Radiofármacos/farmacocinética
11.
Clin Nucl Med ; 32(9): 711-2, 2007 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-17710025

RESUMEN

A 10-year-old girl presented with a 2-month history of intermittent fever and palpable masses in the right side of the neck. Whole body FDG PET/CT imaging was performed, showing multiple FDG-avid nodular masses in cervical and abdominal lymph nodes. The patient then underwent excision biopsy of the enlarged right cervical nymph nodes, which confirmed the diagnosis of Kikuchi disease. After steroid therapy, fever and cervical lymphadenopathy subsided. After 3 months, follow up FDG PET/CT was done, and there was no abnormality. Kikuchi disease could lead to the wrong initial diagnosis of tuberculosis or even malignant lymphoma.


Asunto(s)
Fluorodesoxiglucosa F18 , Linfadenitis Necrotizante Histiocítica/diagnóstico , Ganglios Linfáticos/diagnóstico por imagen , Linfoma/diagnóstico , Tomografía de Emisión de Positrones/métodos , Tomografía Computarizada por Rayos X/métodos , Niño , Femenino , Humanos , Radiofármacos
12.
Clin Neurophysiol ; 117(3): 637-42, 2006 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-16426890

RESUMEN

UNLABELLED: Functional neuroimaging studies have shown abnormalities of limbic regions in patients with posttraumatic stress disorder (PTSD) during symptom provocation and cognitive activation. OBJECTIVE: The aim of this study was to determine whether PTSD patients without re-exposure to accident-related stimuli would exhibit alterations in cerebral perfusion compared with age-matched normal subjects. METHODS: Brain perfusion SPECT was measured in medication-free 23 PTSD patients and 64 age-matched healthy subjects under resting conditions and analyzed using statistical parametric mapping to compare between the patient and control groups. RESULTS: We found that PTSD patients exhibited increased cerebral blood perfusion in limbic regions and decreased perfusion in the superior frontal gyrus and parietal and temporal regions in comparison with those of the normal controls. CONCLUSIONS: This result indicates that PTSD patients have alterations in cerebral perfusion of limbic regions and the frontal and temporal cortex without re-exposure to accident-related stimuli. SIGNIFICANCE: This finding supports the hypothesis of the involvement of limbic regions, which might be associated with the regulation of emotion and memory, in the pathophysiology of PTSD.


Asunto(s)
Sistema Límbico/irrigación sanguínea , Memoria/fisiología , Trastornos por Estrés Postraumático/fisiopatología , Adulto , Análisis de Varianza , Mapeo Encefálico , Estudios de Casos y Controles , Cognición/fisiología , Femenino , Lateralidad Funcional/fisiología , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Sistema Límbico/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Flujo Sanguíneo Regional , Trastornos por Estrés Postraumático/diagnóstico por imagen , Tomografía Computarizada de Emisión de Fotón Único/métodos
13.
Ann Nucl Med ; 20(4): 311-5, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16856575

RESUMEN

Positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) is useful in cancer diagnosis owing to its sensitivity to the differences in glucose metabolic rate between benign and malignant diseases, especially in the lung. One pitfall in PET imaging of lung disease, however, is the overlap in metabolic rate of inflammatory and neoplastic entities. Paragonimiasis is a food-borne parasitic disease that causes the pulmonary and pleural inflammation. We present two cases of pulmonary paragonimiasis that showed high uptake suggestive of tumor on FDG-PET CT images, both confirmed on histopathology by visualization of Paragonimus westermani eggs in the involved tissues.


Asunto(s)
Fluorodesoxiglucosa F18 , Aumento de la Imagen/métodos , Enfermedades Pulmonares/diagnóstico , Paragonimiasis/diagnóstico , Tomografía de Emisión de Positrones/métodos , Técnica de Sustracción , Tomografía Computarizada por Rayos X/métodos , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Persona de Mediana Edad , Radiofármacos
14.
Clin Nucl Med ; 31(4): 221-2, 2006 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16550021

RESUMEN

A case of asymmetric increased fluorodeoxyglucose (FDG) uptake in unilateral pterygomasseter muscles is shown. The authors report an example of intense F-18 FDG uptake in the benign pterygomasseteric muscle complex hypertrophy in a patient with a history of longstanding unilateral chewing.


Asunto(s)
Fluorodesoxiglucosa F18/farmacocinética , Músculos Masticadores/diagnóstico por imagen , Radiofármacos/farmacocinética , Tomografía Computarizada de Emisión , Asimetría Facial , Humanos , Hipertrofia , Masculino , Músculos Masticadores/patología , Persona de Mediana Edad
15.
Ann Nucl Med ; 19(1): 1-7, 2005 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-15770966

RESUMEN

RATIONALE AND OBJECTIVES: The purpose of this study was to evaluate the influence of hydration status upon renogram patterns and renal physiological parameters and clarify the differences between DTPA and MAG3 studies in normal volunteers. MATERIAL AND METHODS: The study populations were 22 kidneys of 11 volunteers with no history of hypertension or renal disease with normal serum creatinine levels. They were 6 men and 5 women aged from 24 to 48 yrs (mean age: 33.4 yrs). Renal scintigraphies with both 185 MBq (5 mCi) of Tc-99m DTPA and Tc-99m MAG3 were performed after dehydration (urine specific gravity > 1.025) and adequate hydration (urine specific gravity < 1.010) in each subject at least with a 5-7-day interval. Renograms were generated from the whole kidney and cortical ROIs. We analyzed the clearance, renogram pattern, mean transit time, time to maximum activity, time from maximum activity to half activity, and residual cortical activity. Paired t-test and Wilcoxon signed rank test were used as statistical analysis methods. Statistical analysis was considered significant at p < 0.05. RESULTS: In the dehydrated state, with Tc-99m DTPA and whole kidney ROI, parameters such as time to maximum activity, time from maximum activity to half activity, residual cortical activity, and mean transit time were delayed as compared to parameters in the adequately hydrated state, but the clearance was not changed. With the cortical ROI, the changes of parameters due to dehydration were partially offset. There were insignificant differences between most parameters of Tc-99m DTPA and Tc-99m MAG3 with the whole kidney and cortical ROIs. CONCLUSIONS: Dehydration may bring about a false positive curve pattern on renograms which can be prevented or minimized by using the cortical ROI. There were insignificant differences between most parameters of Tc-99m DTPA and Tc-99m MAG3.


Asunto(s)
Agua Corporal/diagnóstico por imagen , Agua Corporal/metabolismo , Deshidratación/diagnóstico por imagen , Deshidratación/metabolismo , Renografía por Radioisótopo/métodos , Tecnecio Tc 99m Mertiatida , Pentetato de Tecnecio Tc 99m , Adulto , Femenino , Humanos , Riñón/diagnóstico por imagen , Riñón/metabolismo , Masculino , Tasa de Depuración Metabólica , Persona de Mediana Edad , Radiofármacos , Valores de Referencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Tecnecio Tc 99m Mertiatida/farmacocinética , Pentetato de Tecnecio Tc 99m/farmacocinética
16.
Ann Nucl Med ; 19(6): 479-83, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16248384

RESUMEN

PURPOSE: Dacryoscintigraphy is widely known to be an effective modality in diagnosing abnormalities of the lacrimal system that cause epiphora (pathological overflow of tear). However, dacryoscintigraphy rarely serves beyond the simple diagnostic use for lacrimal duct obstruction. In our study, dacryoscintigraphy results of patients with functional lacrimal duct obstruction are newly classified into three types, the effects and prognoses of silicone tube intubation are noted according to each type, and the role of dacryoscintigraphy in determining appropriate surgical approaches is evaluated. METHODS: Subjects were 36 eyes of 29 patients complaining of epiphora who had increased tear meniscus, but showed no sign of obstruction on duct syringing. Impression of functional lacrimal duct obstruction was made through dacryoscintigraphy, and silicone tubes were inserted. RESULTS: Patients were classified according to the results of dacryoscintigraphy; those with delayed secretion in the distal nasolacrimal duct were typed as class I; those with delays in the proximal nasolacrimal duct class II; and delayed secretion from the pre-lacrimal sac to the lacrimal sac as class III. All patients had silicone tube intubations together with selective punctoplasty. Symptomatic improvement was observed in all 6 cases of distal nasolacrimal duct obstruction (100%), 14 of 18 proximal obstruction cases (77.8%), and 8 of 12 pre-lacrimal obstructions (66.7%). CONCLUSIONS: Functional lacrimal duct obstruction is easily diagnosed with dacryoscintigraphy. Furthermore, its may be classified by types of obstruction to predict post-operative results of silicone tube insertion. Cases suspicious of pre-lacrimal sac obstructions in particular may achieve better operative results with adjuvant treatments in addition to silicone tube insertion.


Asunto(s)
Dacriocistorrinostomía/métodos , Intubación/métodos , Obstrucción del Conducto Lagrimal/diagnóstico por imagen , Obstrucción del Conducto Lagrimal/terapia , Cuidados Preoperatorios/métodos , Medición de Riesgo/métodos , Cirugía Asistida por Computador/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Aparato Lagrimal/diagnóstico por imagen , Aparato Lagrimal/cirugía , Masculino , Persona de Mediana Edad , Pronóstico , Cintigrafía , Factores de Riesgo , Resultado del Tratamiento
17.
Invest Radiol ; 38(8): 473-81, 2003 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12874513

RESUMEN

RATIONALE AND OBJECTIVES: Acute cyclosporine (CsA) nephrotoxicity cannot be easily differentiated from other renal parenchymal complications, such as acute tubular necrosis (ATN), that cause renal function impairment at the early posttransplantation period. The purpose of this study was to differentiate acute CsA nephrotoxicity from ATN using enalaprilat renal scintigraphy in rats. METHODS: Twenty-six rats were divided into 4 experimental groups: CsA group, who were treated with CsA (50 mg/kg/d) for 2 days; ATN group, who received clamping of both renal arteries for 45 minutes; vehicle group, who were treated with olive oil (1 mL/kg/d) for 2 days; and sham-operated group, who received the same surgical procedure as ATN group without clamping of renal arteries. The baseline study was performed with 300 microCi of technetium-99m diethylenetriaminepentaacetic acid and enalaprilat scintigraphy with 2 mCi of technetium-99m diethylenetriaminepentaacetic acid 5 minutes after intravenous enalaprilat injection (30 microg/kg). The changes of renogram grade and the renal function indices such as T(max), T(1/2), residual cortical activity, and mean transit time between 2 studies were analyzed. Immediately after renal scintigraphy, blood urea nitrogen and serum creatinine levels were measured and renal tissues stained by periodic acid Schiff reaction were examined in each group. RESULTS: Blood urea nitrogen and serum creatinine levels in the CsA and ATN groups were higher than their control groups (P < 0.05). Histologic study revealed severe ischemic necrosis of tubular epithelium in ATN group, but the other groups remained with essentially normal morphology. After enalaprilat injection, renal function indices became improved in CsA group, whereas they deteriorated in ATN group. The renogram grade was decreased in CsA group and increased or unchanged in ATN group after enalaprilat injection. The T(max), residual cortical activity, and mean transit time ratio were statistically different between the 2 groups on enalaprilat study (P < 0.05). CONCLUSIONS: These results suggest that enalaprilat renal scintigraphy could be used clinically in differentiating acute CsA nephrotoxicity from ATN after renal transplantation.


Asunto(s)
Ciclosporina/toxicidad , Trasplante de Riñón , Necrosis Tubular Aguda/diagnóstico por imagen , Nefronas/diagnóstico por imagen , Animales , Nitrógeno de la Urea Sanguínea , Creatinina/sangre , Diagnóstico Diferencial , Modelos Animales de Enfermedad , Enalaprilato , Pruebas de Función Renal , Necrosis Tubular Aguda/inducido químicamente , Necrosis Tubular Aguda/fisiopatología , Masculino , Nefronas/fisiopatología , Cintigrafía , Ratas , Ratas Sprague-Dawley
18.
Biomed Mater Eng ; 24(6): 3091-103, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25227018

RESUMEN

This paper aimed to evaluate the prognostic value of maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) of the primary tumor on (18)F-FDG PET/CT scan in early stage non-small cell cancer (NSCLC) patients without lymph node (LN) metastasis. In the experiment, eighty NSCLC patients pathologically staged as T1N0 or T2N0 were included (M:F=50:30; mean age, 64.8 years). All patients had preoperative (18)F-FDG PET/CT scan and curative surgery. FDG uptake in the primary tumor was measured by SUVmax and MTV with various SUV threshold values. SUVmax, MTV of the primary tumor, age, tumor size, histology and differentiation grade were analyzed for association with disease-free survival (DFS). The experimental results showed that the histology types included adenocarcinoma (n=58), squamous cell carcinoma (n=20), and others (n=2); Twenty-two (27.5%) of the 80 patients had a recurrence during follow-up at a median time of 29.1 months; The median SUVmax was 5.26, and the median MTV2.5 was 2.2 cm(3). Univariate analysis showed higher SUVmax (>4), greater MTV (MTV2.5 >4 cm(3)), and non-squamous histology were significantly associated with shorter period DFS (p=0.001, p=0.030 and p<0.001). In multivariate analysis, higher SUVmax (p=0.004) and adenocarcinoma histology (p=0.005) were associated with shorter DFS. Therefore, high SUVmax (>4) of the primary tumor on preoperative (18)F-FDG PET/CT scan is an independent prognostic factor of shorter DFS in early stage of NSCLC.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/metabolismo , Carcinoma de Pulmón de Células no Pequeñas/patología , Fluorodesoxiglucosa F18/farmacocinética , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patología , Tomografía de Emisión de Positrones/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Anciano de 80 o más Años , Supervivencia sin Enfermedad , Femenino , Humanos , Interpretación de Imagen Asistida por Computador/métodos , Metástasis Linfática , Masculino , Tasa de Depuración Metabólica , Persona de Mediana Edad , Imagen Multimodal/métodos , Estadificación de Neoplasias , Pronóstico , Radiofármacos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Carga Tumoral
19.
Biomed Mater Eng ; 24(1): 1173-84, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24212011

RESUMEN

We assessed the role of F-18 FDG PET/CT in evaluating isolated extra-axillary lymph node recurrences in postoperative breast cancer patients and its prognostic value on clinical outcome. We reviewed PET/CT scans of postoperative breast cancer patients performed at our institution between July 2003 and February 2012. We recorded PET/CT findings, clinicopathologic variables and treatment modalities. We analyzed metabolic parameters from PET/CT and clinicopathologic variables with respect to progression free survival (PFS). A total of 3561 PET/CT scans were performed in 1906 postoperative breast cancer patients with a median interval of 43 month from curative surgery. Fifty seven patients (2.99%) demonstrated isolated extra-axillary nodal recurrences (n=85) on PET/CT (internal mammary node recurrences in 28, supraclavicular 24, infraclavicular 4, interpectoral 8, cervical 12, and mediastinal 9).The median SUVmax was 7.8 (range, 1.8~19.0), and the median node size was 15 mm (range, 6~38 mm). All recurrences were nonpalpable. Based on PET/CT findings, 53 out of 57 patients with extra-axillary node recurrences underwent subsequent chemotherapy/radiation therapy. The estimated 3-year PFS rate was 48.6%. Cutoff points of SUVmax 2.7 and size 14 mm were the best discriminative values for predicting clinical outcome. SUVmax and size of extra-axillary nodal recurrences were significantly correlated to PFS on univariate and multivariate analyses (p<0.001 and p=0.019, respectively).


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Fluorodesoxiglucosa F18 , Imagen Multimodal , Radiofármacos , Adulto , Anciano , Anciano de 80 o más Años , Supervivencia sin Enfermedad , Femenino , Glucosa/metabolismo , Humanos , Procesamiento de Imagen Asistido por Computador , Metástasis Linfática , Persona de Mediana Edad , Metástasis de la Neoplasia , Tomografía de Emisión de Positrones , Periodo Posoperatorio , Pronóstico , Recurrencia , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
20.
Nucl Med Mol Imaging ; 46(1): 34-40, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24900030

RESUMEN

PURPOSE: To decrease the risk of recurrence or metastasis in differentiated thyroid cancer (DTC), selected patients receive radioactive iodine ablation of remnant thyroid tissue or tumor. A low iodine diet can enhance uptake of radioactive iodine. We compared the success rates of radioactive iodine ablation therapy in patients who followed two different low iodine diets (LIDs). MATERIALS AND METHODS: The success rates of postsurgical radioactive iodine ablation in DTC patients receiving empiric doses of 150 mCi were retrospectively reviewed. First-time radioactive iodine ablation therapy was done in 71 patients following less strict LID and 90 patients following very strict LID. Less strict LID restricted seafood, iodized salt, egg yolk, dairy products, processed meat, instant prepared meals, and multi-vitamins. Very strict LID additionally restricted rice, freshwater fish, spinach, and soybean products. Radioactive iodine ablation therapy was considered successful when follow-up (123)I whole body scan was negative and stimulated serum thyroglobulin level was less than 2.0 ng/mL. RESULTS: The success rate of patients following less strict LID was 80.3% and for very strict LID 75.6%. There was no statistically significant difference in the success rates between the two LID groups (p = 0.48). CONCLUSIONS: Very strict LID may not contribute to improving the success rate of initial radioactive iodine ablation therapy at the cost of great inconvenience to the patient.

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