Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 8 de 8
Filtrar
1.
Eur J Nucl Med Mol Imaging ; 39(1): 13-26, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21932120

RESUMO

PURPOSE: The aim of this study was to evaluate the clinical usefulness of [(11)C]choline positron emission tomography (PET)/CT in comparison with bone scintigraphy (BS) in detecting bone metastases (BM) of patients with biochemical progression after radical treatment for prostate cancer (PCa). METHODS: Seventy-eight consecutive patients with biochemical progression of PCa (mean prostate-specific antigen 21.1 ng/ml, range 0.2-500.0 ng/ml) referred for both [(11)C]choline PET/CT and BS for restaging purposes were retrospectively analysed. The diagnostic accuracy of [(11)C]choline PET/CT and BS was assessed by using morphological imaging and/or follow-up as standards of reference. As equivocal findings were found, the accuracy analysis was performed twice, once including them as positive and once as negative. A separate analysis was also performed in hormone-resistant patients and data compared with those of patients who did not receive anti-androgenic treatment. RESULTS: Equivocal findings occurred in 1 of 78 (1%) cases in [(11)C]choline PET/CT and in 21 of 78 (27%) cases in BS. Depending on their attribution as either positive or negative, the ranges of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for [(11)C]choline PET/CT were 89-89%, 98-100%, 96-100%, 94-96% and 95-96%, respectively. For BS they were 100-70%, 75-100%, 68--100%, 100-86% and 83-90%, respectively. Concordant findings between [(11)C]choline PET/CT and BS occurred in 55 of 78 (71%) cases. The accuracy of [(11)C]choline PET/CT did not significantly (p = 0.30) differ between hormone-resistant patients (97%) and those who did not receive anti-androgenic treatment (95%). CONCLUSION: In clinical practice, [(11)C]choline PET/CT may not replace BS because of its lower sensitivity. However, for its high specificity, [(11)C]choline PET/CT positive findings may accurately predict the presence of BM. Equivocal findings are more frequent in BS than [(11)C]choline PET/CT.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Osso e Ossos/diagnóstico por imagem , Colina , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/patologia , Tomografia Computadorizada por Raios X , Idoso , Idoso de 80 Anos ou mais , Radioisótopos de Carbono , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/sangue , Neoplasias da Próstata/terapia , Estudos Retrospectivos , Sensibilidade e Especificidade
3.
Drug Des Devel Ther ; 9: 2189-99, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25931813

RESUMO

BACKGROUND: A prospective, multicenter trial was undertaken to assess the activity, safety, and quality of life of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) as second-line chemotherapy in HER2-negative, taxane-pretreated metastatic breast cancer (MBC). PATIENTS AND METHODS: Fifty-two women with HER2-negative MBC who were candidates for second-line chemotherapy for the metastatic disease were enrolled and treated at three centers in Northern Italy. All patients had previously received taxane-based chemotherapy in the adjuvant or first-line metastatic setting. Single-agent nab-paclitaxel was given at the dose of 260 mg/m(2) as a 30-minute intravenous infusion on day 1 each treatment cycle, which lasted 3 weeks, in the outpatient setting. No steroid or antihistamine premedication was provided. Treatment was stopped for documented disease progression, unacceptable toxicity, or patient refusal. RESULTS: All of the enrolled patients were evaluable for the study endpoints. The objective response rate was 48% (95% CI, 31.5%-61.3%) and included complete responses from 13.5%. Disease stabilization was obtained in 19 patients and lasted >6 months in 15 of them; the overall clinical benefit rate was 77%. The median time to response was 70 days (range 52-86 days). The median progression-free survival time was 8.9 months (95% CI, 8.0-11.6 months, range 5-21+ months). The median overall survival point has not yet been reached. Toxicities were expected and manageable with good patient compliance and preserved quality of life in patients given long-term treatment. CONCLUSION: Our results showed that single-agent nab-paclitaxel 260 mg/m(2) every 3 weeks is an effective and well tolerated regimen as second-line chemotherapy in HER2-negative, taxane-pretreated MBC patients, and that it produced interesting values of objective response rate and progression-free survival without the concern of significant toxicity. Specifically, the present study shows that such a regimen is a valid therapeutic option for that 'difficult to treat' patient population represented by women who at the time of disease relapse have already received the most active agents in the adjuvant and/or metastatic setting (ie, conventional taxanes).


Assuntos
Albuminas/administração & dosagem , Albuminas/uso terapêutico , Antineoplásicos Fitogênicos/efeitos adversos , Antineoplásicos Fitogênicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Paclitaxel/administração & dosagem , Paclitaxel/uso terapêutico , Qualidade de Vida , Receptor ErbB-2/genética , Taxoides/uso terapêutico , Adulto , Idoso , Albuminas/efeitos adversos , Neoplasias da Mama/patologia , Neoplasias da Mama/psicologia , Progressão da Doença , Intervalo Livre de Doença , Determinação de Ponto Final , Feminino , Humanos , Pessoa de Meia-Idade , Nanopartículas , Paclitaxel/efeitos adversos , Cooperação do Paciente , Estudos Prospectivos
4.
Ann Nucl Med ; 28(7): 683-7, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24658773

RESUMO

A 35-year-old woman affected by a well-differentiated papillary thyroid carcinoma was referred to our hospital to perform a (131)Iodine ((131)I) whole body scintigraphy for restaging purpose. The patient had been previously treated with total thyroidectomy and three subsequent doses of (131)I for the ablation of a remnant jugular tissue and a suspected metastatic focus at the superior left hemi-thorax. In spite of the previous treatments with (131)I, planar and tomographic images showed the persistence of an area of increased uptake at the superior left hemi-thorax. This finding prompted the surgical resection of the lesion. Histological examination of the surgical specimen showed the presence of a pulmonary tissue consistent with pulmonary sequestration. Even though rare, pulmonary sequestration should be included in the potential causes of false-positive results of radioiodine scans.


Assuntos
Sequestro Broncopulmonar/diagnóstico por imagem , Imagem Corporal Total , Adulto , Reações Falso-Positivas , Feminino , Humanos , Radioisótopos do Iodo , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X
5.
Clin Nucl Med ; 39(6): e320-4, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24566409

RESUMO

AIM: The aim of our retrospective study was to assess the usefulness of F-FDG PET/CT in the restaging of clear cell renal cell carcinoma (RCC) patients. PATIENTS AND METHODS: Sixty-nine patients (median age = 62 years; range = 36-86 years) affected by clear cell RCC (TNM at staging: T1, 42 patients; T2, 13 patients; T3, 11 patients; T4, 3 patients; Fuhrman grade: G2, 47 patients; G3, 20 patients; G4, 2 patients) underwent whole-body F-FDG PET/CT to restage the disease after nephrectomy for clinical or radiological suspicion of metastases. Areas of abnormal uptake at PET/CT were classified, taking the liver uptake as reference, as follows: 1 = faint uptake, lower than liver; 2 = moderate uptake, equal to liver; and 3 = high uptake, higher than liver. Validation of F-FDG PET/CT results was established by (1) biopsy (23 patients) and (2) other imaging modalities (addressed BS; c.e.CT; MRI; F-fluoride PET/CT; subsequent F-FDG PET/CT), and/or clinical and radiological follow-up of 12 months (46 patients). RESULTS: F-FDG PET/CT was positive in 42 patients and negative in 27 patients. Sixteen patients presented single lesions and 26 patients presented multiple localizations of the disease. On a patient basis, 40 patients resulted true positive, 2 patient false positive, 23 patients true negative, and 4 patients false negative. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 90%, 92%, 91%, 95%, and 85%, respectively. On a lesion basis, PET/CT detected 114 areas of abnormal uptake in 42 positive patients of which 112 resulted to be true positive. FDG uptake of the true positive lesions resulted to be high in 83 cases, moderate in 17 lesions, and finally faint in 12 lesions. CONCLUSIONS: F-FDG PET/CT demonstrated a good sensitivity in the restaging of clear cell RCC. Most of the lesions showed intense activity. According to our results, it seems that the use of F-FDG PET/CT in the restaging of RCC is feasible because the number of false-negative cases is limited.


Assuntos
Carcinoma de Células Renais/diagnóstico por imagem , Fluordesoxiglucose F18 , Neoplasias Renais/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Estadiamento de Neoplasias
6.
Biomed Pharmacother ; 67(6): 539-42, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23583476

RESUMO

It is well known the useful role of ¹8F-FDG-PET/CT for differential diagnosis between benign and malignant disease, for staging, for monitoring response and for prognosis regarding mesothelioma. Recently, literature was enriched with new interesting studies regarding the potential applications of ¹8F-FDG-PET/CT in this field. The purpose of this review is to evaluate articles published on line (PubMed) from January 2011 until October 2012 in order to obtain an overview of recent progress of molecular imaging in malignant mesothelioma. The main topics concern the use of ¹8F-FDG-PET/CT in radiation therapy planning, monitoring of treatment (surgery/chemotherapy) response and prognosis assessment.


Assuntos
Fluordesoxiglucose F18/administração & dosagem , Neoplasias Pulmonares/diagnóstico por imagem , Mesotelioma/diagnóstico por imagem , Compostos Radiofarmacêuticos/administração & dosagem , Humanos , Neoplasias Pulmonares/patologia , Mesotelioma/patologia , Mesotelioma Maligno , Tomografia por Emissão de Pósitrons/métodos , Prognóstico , Tomografia Computadorizada por Raios X/métodos
7.
Clin Nucl Med ; 38(10): e384-9, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23751832

RESUMO

The combined use of SPECT and CT strongly supports the molecular imaging of neuroendocrine tumors (NETs) with somatostatin receptor radiopharmaceuticals or with meta-iodobenzylguanidine. SPECT/CT fusion images provide potential attenuation correction, higher specificity, and accurate localization for the staging, evaluation of treatment response, and follow-up of NETs.


Assuntos
Tumores Neuroendócrinos/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , Seguimentos , Humanos , Estadiamento de Neoplasias , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/terapia , Resultado do Tratamento
8.
Clin Nucl Med ; 36(2): 134-5, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21220979

RESUMO

The integrated modality positron emission tomography/computed tomography (PET/CT) with C-11 choline is an established diagnostic tool for restaging prostate cancer patients with a biochemical failure after primary treatment. Thymoma is a rare tumor originating in thymus epithelial cells, asymptomatic in one-third to one-half of patients, and often occurring in the fourth and fifth decades of life. In the present case, C-11 choline PET/CT was performed in a prostate cancer patient with a biochemical relapse, to restage the disease. In addition to the detection of local recurrent disease in prostatic fossa, an abnormal C-11 choline increased uptake in mediastinum was reported. The mediastinal finding was initially wrongly interpreted by clinicians as a lymph nodal metastasis from prostate cancer. However, histopathological analysis confirmed the presence of a thymoma. Although rare, thymoma has to be considered as differential diagnosis in case of mediastinal masses presenting C-11 choline PET/CT positive findings, to avoid inappropriate patient management.


Assuntos
Colina , Achados Incidentais , Tomografia por Emissão de Pósitrons , Timoma/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Idoso , Radioisótopos de Carbono , Humanos , Masculino , Timoma/patologia , Timoma/fisiopatologia
SELEÇÃO DE REFERÊNCIAS
Detalhe da pesquisa