RESUMO
Advanced imaging techniques, including diffusion tensor imaging (DTI), perfusion-weighted imaging (PWI), and magnetic resonance spectroscopy (MRS) can provide more information than that regarding anatomy. These techniques have been commonly used in the clinical field and recently been shown useful in diagnosing brain tumors, especially in cases difficult to specify using conventional imaging. Differentiation requires more than attention to each advanced image. Diagnostic accuracy improves by combining information from MRS with that from other sequences, such as maps of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) generated from DTI and of cerebral blood volume (CBV) generated from PWI. We show clinical applications of advanced imaging techniques, combined MRS, for brain tumor.
Assuntos
Neoplasias Encefálicas/patologia , Espectroscopia de Ressonância Magnética/métodos , Anisotropia , Encéfalo/patologia , Meios de Contraste , Imagem de Difusão por Ressonância Magnética/métodos , Humanos , Aumento da Imagem/métodosRESUMO
PURPOSE: To evaluate (18)F-fluorodeoxyglucose (FDG) uptake and the pathological risk category of gastrointestinal stromal tumors (GISTs), and to investigate the possibility of determining the pathological risk category by positron emission tomography/computed tomography (PET/CT). PATIENTS AND METHODS: We undertook 29 PET/CT studies in 20 patients with GISTs. Eleven of the 20 patients underwent PET/CT prior to therapy, with three of these also undergoing follow-up PET/CT after operation or imatinib therapy. RESULTS: All eleven lesions imaged before treatment were FDG-positive on PET/CT. Seven of these eleven primary lesions were categorized as high risk and the other four primary lesions were categorized as low or intermediate risk. There was a significant difference between the maximum standardized uptake value (SUVmax) of the primary lesions categorized as high risk (11.8±3.15) and that of the primary lesions categorized as low and intermediate risk (2.88±0.47) (p<0.001). Recurrent tumors were also shown as FDG-positive. CONCLUSION: Primary GISTs and recurrent tumors can be detected by PET/CT. Our study suggests that the degree of FDG uptake is a useful indicator of risk category. In addition, PET/CT is probably useful for follow-up examinations of GIST after operation or imatinib therapy. J. Med. Invest. 57: 270-274, August, 2010.
Assuntos
Fluordesoxiglucose F18 , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Benzamidas , Feminino , Tumores do Estroma Gastrointestinal/terapia , Humanos , Mesilato de Imatinib , Técnicas In Vitro , Masculino , Pessoa de Meia-Idade , Piperazinas/uso terapêutico , Tomografia por Emissão de Pósitrons , Pirimidinas/uso terapêutico , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: Radiographic film is generally used for inspection of dose distribution in intensity modulated radiation therapy (IMRT) at many institutions. However, the distribution of filmless systems can be expected to be used increasingly in the future. Therefore, we confirmed the utility of radiochromic film by comparing it with radiographic film that does not need an automatic processor. RESULT: Difference in does measured by radiographic film and radiochromic film tended to increase in the low does area, but it was limited in a range of 1.5%. CONCLUSION: When the dose distribution was verified in a highly accurate radiation therapy such as IMRT, the results suggested that radiochromic film can be useful in addition to radiographic film.
Assuntos
Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada , Filme para Raios X , Radioterapia de Intensidade Modulada/instrumentaçãoRESUMO
Unlike other reproductive organs, the uterus and ovaries are known to undergo dynamic morphologic changes according to various physiologic states. It is vitally important for radiologists when diagnosing gynecologic disorders to understand how normal female reproductive organs appear on magnetic resonance (MR) images for a given physiologic state. The authors focused on the effects of the menstrual cycle, pregnancy, and aging on MR images of normal female reproductive organs. During menstruation, the zonal architecture of the uterine corpus may be indistinct and the ovarian stroma may shrink and have lower signal intensity on both T2- and diffusion-weighted (DW) images. During periovulation, the ovarian stroma may be reach its maximum size and have high signal intensity on both T2- and DW images. Functional cysts may often be seen in ovaries of reproductive age and usually spontaneously shrink, whereas surface-epithelial inclusion cysts may be commonly seen in postmenopausal ovaries. Pregnancy-related changes, such as decidual changes in ectopic endometrial tissue and hyperreactio luteinalis in ovaries, may mimic gynecologic tumors and must be correctly diagnosed to avoid unnecessary and excessive surgical intervention. The authors offer some clues that may be helpful for making the differential diagnosis when evaluating MR images of female reproductive organs. Radiologists should, as much as practicably possible, check the physiologic states of patients before interpreting MR images.
Assuntos
Imageamento por Ressonância Magnética/métodos , Menstruação/fisiologia , Ovário/anatomia & histologia , Ovário/fisiologia , Ovulação/fisiologia , Útero/anatomia & histologia , Útero/fisiologia , Envelhecimento/patologia , Envelhecimento/fisiologia , Feminino , HumanosRESUMO
OBJECTIVE: We evaluated the feasibility of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurement in differentiating benign and malignant ovarian tumors. METHODS: Surgically proven 49 ovarian tumors (39 malignant/borderline malignant and 10 benign) were examined. RESULTS: The solid portion of all 39 malignant tumors showed homogeneous or heterogeneous high intensity on DWI, whereas only 3 of the 10 benign tumors (3 thecomas) showed high intensity. The mean (SD) ADC value in the 39 malignant tumors (1.03 [0.19]) was significantly lower than that in 10 benign tumors (1.38 [0.30]). A relatively low ADC (1.08-1.20) in the 3 thecomas may reflect their abundant cellular nature, and the presence of low intensity on T2-weighted images was suggestive for benign fibrous tumor. CONCLUSIONS: Low intensity on DWI with high ADC may suggest benign lesions; however, it may be occasionally difficult to differentiate benign and malignant lesions only on the basis of DWI.
Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Neoplasias Ovarianas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Estatísticas não ParamétricasRESUMO
OBJECTIVE: The purpose of this study was to introduce a novel customized intraoral mold treatment for maxillary gingival carcinoma (UGC). STUDY DESIGN: Two patients with UGC were treated as salvage therapy using this technique. The mold was designed to keep normal soft tissues adjacent to the tumor away from the radioactive source as much as possible, and it was shielded by lead. The radiation dose on the buccal mucosa and tongue was measured at the inner and outer surfaces of the intraoral mold before starting high-dose-rate brachytherapy by the remote afterloading system, and was reduced to almost one tenth. RESULTS: The patient had no recurrence and no severe adverse effects on the normal soft tissue adjacent to the tumor until the end of the follow-up period. CONCLUSION: High-dose-rate brachytherapy using the novel customized intraoral mold might be a treatment option of not only salvage therapy, but definitive therapy of UGC.
Assuntos
Braquiterapia/instrumentação , Carcinoma de Células Escamosas/radioterapia , Neoplasias Gengivais/radioterapia , Terapia de Salvação/instrumentação , Idoso , Idoso de 80 Anos ou mais , Fracionamento da Dose de Radiação , Feminino , Humanos , Maxila , Proteção Radiológica/instrumentaçãoRESUMO
PURPOSE: The aim of this study was to evaluate distortion of the tabletop in a diagnostic positron emission tomography-computed tomography (PET-CT) system to determine its suitability for planning radiotherapy positioning. MATERIALS AND METHODS: Distortion of the tabletop was compared among PET-CT, lineac CT, and CT simulator systems. A phantom or angiography catheter was fixed to the tabletop and imaged after iron plate weight loading. The acquired images were analyzed using radiotherapy planning software. Distortion of the tabletop was measured based on the displayed coordinates. RESULTS: Sinking represented the greatest distortion of the tabletop in all systems. Using the same baseline, the maximum sinking were -0.4, -0.2, and +0.4 cm, respectively. The distortion of the tabletop in the PET-CT system was more similar to that in the lineac CT than in the CT simulator system. CONCLUSION: Distortion of the tabletop in a diagnostic PET-CT system may be within the acceptable range to allow its use for planning radiotherapy positioning.
Assuntos
Distorção da Percepção/fisiologia , Tomografia por Emissão de Pósitrons/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Processamento de Imagem Assistida por Computador/métodos , Imagens de FantasmasRESUMO
OBJECTIVE: The preoperative evaluation of venous thromboembolism (VTE) is important to avoid complications, because VTE is often induced by orthopedic surgery. We focused on radioisotope venography (RIV) using 99mTc-macroaggregated human serum albumin, examining orthopedic patients. METHODS: We conducted 34 examinations in 33 patients who were referred for RIV and lung perfusion scintigraphy for the pre-orthopedic operative evaluation of VTE. Two board-certified (one nuclear medicine board-certified) radiologists interpreted the images based on the following: (1) flow defect of the lower extremities; (2) interruption of flow; (3) irregular or asymmetric filling of the deep vein (low flow); (4) presence of collateral vessels; and (5) abnormal RI retention on delayed-phase images. Scoring was based on a 5-point scale, and more than 2 points was considered VTE positive. RESULTS: Abnormal findings were noted in 27 of the 34 examinations performed in the 33 patients and normal findings in the other 7 examinations. According to the RI score, 21 patients were classified into the VTE-positive group and 12 into the VTE-negative group. Surgery was canceled because of advanced age and respiratory dysfunction in 2 of the 21 patients in the VTE-positive group. Of the 19 patients who underwent surgery, an IVH filter was placed before surgery in 2 and anticoagulant treatment with heparin and warfarin was initiated on the day of surgery in 12 to prevent postoperative VTE, and only one of the patients receiving anticoagulant treatment developed PTE after surgery. Surgery was canceled due to advanced age and at patient's request in 2 of 12 patients in the VTE-negative group. Anticoagulant treatment with heparin/ warfarin was performed to prevent postoperative VTE in only 3 patients: one with a past medical history of pulmonary infarction, one with atrial fibrillation, and one suspected of having antiphospholipid antibody syndrome. No patient in the VTE-negative group developed VTE after surgery. CONCLUSION: The preoperative identification of patients with VTE by RIV might be useful for perioperative management and the evaluation of preventive measures against postoperative VTE.
Assuntos
Ortopedia , Flebografia/métodos , Radioisótopos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Compostos de Organotecnécio , Albumina Sérica/química , Tromboembolia Venosa/diagnóstico por imagem , Tromboembolia Venosa/cirurgiaRESUMO
Ovarian metastasis from malignant melanoma is rare and usually appears as a solid ovarian mass. We report a case of ovarian metastasis from cutaneous malignant melanoma that proved to be a diagnostic dilemma. The ovarian metastasis exhibited a multilocular cystic appearance on magnetic resonance imaging, mimicking a mucinous ovarian tumor with massive ascites.
Assuntos
Imageamento por Ressonância Magnética , Melanoma Amelanótico/diagnóstico , Melanoma Amelanótico/secundário , Cistos Ovarianos/diagnóstico , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/secundário , Neoplasias Cutâneas/patologia , Adulto , Ascite/etiologia , Diagnóstico Diferencial , Evolução Fatal , Feminino , Gadolínio , Humanos , Melanoma/diagnóstico , Melanoma/secundário , Melanoma Amelanótico/complicações , Melanoma Amelanótico/cirurgia , Cistos Ovarianos/complicações , Cistos Ovarianos/cirurgia , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/cirurgia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia , Fatores de Tempo , Resultado do TratamentoRESUMO
OBJECTIVE: The objective was to determine whether diffusion-weighted imaging (DWI) might be useful in differentiating uterine leiomyomas exhibiting hyperintensity on T2-weighted images from malignant lesions. METHODS: Thirty-four uterine myometrial lesions including 7 malignant tumors and 27 leiomyomas (6 cellular leiomyomas [CLM] and 21 degenerated leiomyomas [DLM]) were evaluated. The apparent diffusion coefficients (ADC) in cellular portions of the lesions were measured (10(-3) mm2/s). RESULTS: All malignant tumors showed high signal intensity on DWI with low ADC (mean [SD], 0.79 [0.26]), which was significantly lower (P < 0.01) than that in benign leiomyomas (1.51 [0.33]). The ADC in CLM (1.18 [0.16]) was significantly lower (P < 0.01) than that in DLM (1.60 [0.30]) and higher (P < 0.05) than that in malignant tumors. CONCLUSIONS: It was difficult to differentiate malignant tumors from leiomyomas on the basis of signal intensity on DWI; however, the ADC measurement may be helpful to distinguish malignant tumors, CLM, and DLM.
Assuntos
Imagem de Difusão por Ressonância Magnética , Imageamento por Ressonância Magnética/métodos , Neoplasias Uterinas/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Leiomioma , Pessoa de Meia-Idade , Estudos Retrospectivos , Estatísticas não Paramétricas , Neoplasias Uterinas/patologiaRESUMO
We evaluated risk factors of radiation pneumonitis (RP) after whole breast irradiation following breast-conserving surgery. Four hundred and seventy-two cases underwent whole breast irradiation with tangential field following breast-conserving surgery in our hospital, between January 2005 and April 2007. Of these cases, we performed statistical analyses for 423 breasts of 413 patients, using a pulmonary dose-volume histogram. Patient characteristics, treatment regimens and irradiation methods were included as variables in the analyses on risk factors of RP. As a result, 89 breasts of 84 cases (21%) were diagnosed with RP. The version 3.0 of the NCI Common Terminology Criteria for Adverse Events was used to evaluate the grade of pneumonitis: 77 cases (18.2%) were diagnosed as Grade 1 RP, 10 cases (2.3%) as Grade 2, and 2 cases (0.5%) as Grade 3. Multivariate analysis indicated that the significant risk factors for RP were central lung distance (CLD) (>1.8 cm) and the short axis length of the radiation field. The incidence of radiation-induced bronchiolitis obliterans organizing pneumonia (BOOP) syndrome significantly correlated only with CLD. The lung volume within the radiation field was shown to be a significant risk factor for RP and radiation-induced BOOP syndrome.
Assuntos
Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Mastectomia Segmentar/efeitos adversos , Pneumonite por Radiação/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Pneumonia em Organização Criptogênica/etiologia , Relação Dose-Resposta à Radiação , Feminino , Humanos , Pulmão/patologia , Pulmão/efeitos da radiação , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVE: We report the findings of Thallium-201 chloride ((201)TlCl) scintigraphy and consider how to use this technique to evaluate the character of soft tissue lesions. PATIENTS AND METHODS: We enrolled 91 consecutive patients (45 males and 46 females, age range 8-91-years-old). Nineteen patients were malignant and 72 were benign. Patients were scanned 15 minutes (early phase) and 3 hours (delayed phase) after (201)TlCl injection. More intense uptake in the lesion compared to the normal side was considered as 'high', the same degree of uptake was considered 'iso', and decreased uptake was 'low'. The retention index (RI) was calculated in 9 patients in the malignant group and in 16 patients in the benign group. RESULTS: In malignant tumors, 15 of 19 patients showed high uptake in both the early and delayed phases. One malignant fibrous histiocytoma patient was high only in the delayed phase and 1 liposarcoma patient was high only in the early phase. Two liposarcoma patients showed an iso uptake in both phases. One of these patients was pathologically diagnosed as a myxoid type. In benign lesions, no lipoma showed increased uptake. All neurogenic tumors except for 2 demonstrated high uptake. All 3 ganglions of the lower extremities showed iso uptake. Most inflammatory diseases showed increased uptake. Clinically-considered benign patients consisted of tumorous lesions or inflammatory disease. Only 2 patients were considered 'low', and these were diagnosed as intramuscular hematoma and cyst. RI was variable in both malignant and benign lesions and no statistically significant difference was seen between malignant and benign lesions by t-test (p=0.72). CONCLUSIONS: A high (201)TlCl uptake lesion is more frequently seen in malignant tumors, but regardless of whether the tumor is benign or malignant, according to the histopathological variety, the (201)TlCl uptake pattern can not be the only indicator to differentiate malignant from benign tumors. We ultimately need to evaluate the nature of tumors by a combination of several imaging techniques.
Assuntos
Neoplasias de Tecidos Moles/diagnóstico por imagem , Radioisótopos de Tálio , Tálio , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Diagnóstico Diferencial , Feminino , Histiocitoma Fibroso Maligno/diagnóstico , Histiocitoma Fibroso Maligno/diagnóstico por imagem , Humanos , Lipossarcoma/diagnóstico , Lipossarcoma/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cintilografia , Compostos Radiofarmacêuticos , Neoplasias de Tecidos Moles/diagnóstico , Adulto JovemRESUMO
The purpose of this study was to estimate the gamma-aminobutyric acid (GABA) and glutamate plus glutamine (Glx) concentrations in the cortical tubers of patients with tuberous sclerosis complex (TSC) using the MEGA-editing J-difference method and a stimulated echo-acquisition mode with a short echo time, and to determine which abnormality was more dominant between GABA and Glx in patients with TSC with epilepsy. This study included six patients with TSC (mean age, 4.3 years) and seven control subjects (mean age, 4.8 years). Measurements were obtained with a three-Tesla apparatus and postprocessing was conducted with an LCModel. The GABA level in the cortical gray matter (cgGABA) was calculated as a result of segmentation in voxels and from the literature values for gray and white matter ratios for GABA. Increased GABA and myo-inositol (mI) concentrations and a decreased N-acetyl aspartate (NAA) concentration were observed in the cortical tubers. The cgGABA level, and cgGABA/NAA and cgGABA/Glx ratios were also higher in patients with TSC than in control subjects. No significant difference was found in Glx concentration between patients with TSC and control subjects. Although the number of patients with TSC in this study was small, the increase in GABA and no significant change in Glx were consistent with previous neurochemical studies and support the hypothesis that brain GABA plays a key role in the pathophysiology of epilepsy during the process of neuronal development.
Assuntos
Córtex Cerebral/metabolismo , Epilepsia/metabolismo , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Esclerose Tuberosa/metabolismo , Ácido gama-Aminobutírico/análise , Biomarcadores/análise , Córtex Cerebral/patologia , Criança , Pré-Escolar , Epilepsia/complicações , Epilepsia/patologia , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Distribuição Tecidual , Esclerose Tuberosa/complicações , Esclerose Tuberosa/patologiaRESUMO
PURPOSE: This study aimed to compare with bone scintigraphy showed round focal accumulation and Multidetector Row CT (MDCT) findings. METHODS: We obtained 101 patients (mean age 69.2 years; 75 men, 26 women) and 186 diseases. They were examined both MDCT and bone scintigraphy within a month of each other. We classified into two groups (with metastasis and spondylosis) according to their MDCT findings. Bone scintigraphy was estimated on planar image, MDCT was evaluated in three directions with 1 x 1 x 1 mm thickness. RESULTS: We determined 20 metastases cases and 81 of spondylosis. We could not judge abnormal findings on MDCT in 4 patients (1 metastasis, 3 spondylosis); thus, detectability by MDCT was 93.5%. In the spondylosis group, the accumulation lesions were localized on the lower vertebral body in 76 patients (59%), with most showing as osteophytes. In the metastasis group, 11 patients showed more than 1 accumulations, 9 were osteoblastic changes and 10 were lytic. There was a tendency that patients who accumulated more than 1 vertebral bodies (64%) had osteoblastic and irregular distribution and those who accumulated just one body (78%) were lytic and their locations were focused on the lateral side. CONCLUSION: For evaluating bone scintigraphy, MDCT finding was helpful to increase the detectability in bone metastasis. Therefore, we should refer to MDCT finding positively in reading bone scintigraphy.
Assuntos
Neoplasias Ósseas/diagnóstico , Cintilografia , Tomografia Computadorizada por Raios X/métodos , Idoso , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Feminino , Humanos , MasculinoRESUMO
Adenosarcoma of the uterus is a rare tumor containing benign glandular epithelial and malignant mesenchymal elements. Typical adenosarcoma is a low-grade tumor, presents as a large polypoid mass occupying the endometrial cavity, and may protrude into the vaginal cavity. The presence of small hyperintense cysts scattered within the mass on T(2)-weighted imaging, reflecting glandular epithelial components, and relatively low signal intensity on high b-value diffusion-weighted imaging, reflecting its low-grade nature, may be characteristic findings.
Assuntos
Adenossarcoma/diagnóstico , Imageamento por Ressonância Magnética/métodos , Neoplasias Uterinas/diagnóstico , Útero/patologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Clear-cell sarcoma (CCS) is a rare, malignant, soft-tissue tumor, which involves the extremities, particularly the foot and foot joint tendons and aponeuroses. It is morphologically similar to but histochemically distinct from malignant melanoma. CCS arising in the gastrointestinal tract has rarely been reported. The prognosis of CCS is reportedly poor because of the high incidence of metastases at the time of initial diagnosis and the high frequency of recurrence. We report a case of early-stage CCS of the small intestine detected by (18)F-fluoro-2-deoxy D-glucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) during the comprehensive examination of an inflammatory reaction. In this case, FDG-PET/CT clearly visualized the lesion, which was difficult to detect by contrast CT.
Assuntos
Neoplasias Intestinais/diagnóstico por imagem , Sarcoma de Células Claras/diagnóstico por imagem , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Intestinais/cirurgia , Tomografia por Emissão de Pósitrons , Sarcoma de Células Claras/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto JovemRESUMO
(18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET/CT) was performed to evaluate a left femoral subcutaneous mass in a patient with von Recklinghausen's disease (vRd) that gradually enlarged, causing pain and numbness. The left femoral mass showed intense FDG uptake with the maximum standardized uptake value (SUVmax) of 9.0. Other subcutaneous masses considered benign and neurogenic in nature also showed FDG uptake (SUVmax around 3 or less), but the degree of FDG uptake differed considerably from the left femoral mass. This observation suggested that the degree of FDG uptake may be a useful indicator of malignant transformation. Incidentally, PET/CT also showed an asymptomatic large abdominal mass with intense FDG uptake (SUVmax 8.8). The abdominal mass was resected and confirmed as gastrointestinal stromal tumor (GIST) of the small intestine. Three months later, the left femoral mass was operated on and pathologically diagnosed as a malignant peripheral nerve sheath tumor (MPNST). Various malignant diseases are known to occur with high frequency in vRd. Therefore, vRd patients need to have periodical examinations including PET/CT. We present a rare case of a patient with vRd with a MPNST of the left femur and coincidental GIST of the small intestine. February, 2009.
Assuntos
Neoplasias Ósseas/complicações , Tumores do Estroma Gastrointestinal/complicações , Neoplasias Intestinais/complicações , Neoplasias de Bainha Neural/complicações , Osteíte Fibrosa Cística/complicações , Neoplasias Ósseas/diagnóstico por imagem , Fêmur/diagnóstico por imagem , Fluordesoxiglucose F18 , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Humanos , Neoplasias Intestinais/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Neoplasias de Bainha Neural/diagnóstico por imagem , Osteíte Fibrosa Cística/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: Imaging techniques such as CT, MRI and PET/CT have essential pre- and post-treatment roles in detecting tumors and evaluating the extension of malignant pleural mesothelioma (MPM). We sough to evaluate the advantages and limitations on FDG-PET/CT findings. PATIENTS AND METHODS: We performed 13 FDG-PET/CT studies in 9 patients with MPM (8 males, 1 female, aged 51 to 84 years, 9 at the initial diagnosis, 4 follow up studies). We reviewed FDG-PET/CT findings of primary tumors, recurrent tumors, lymph nodes, metastasis. RESULTS: All primary and recurrent tumors were FDG positive. The uptake patterns at initial diagnosis were; diffuse+multi-nodular uptake pattern in 5, diffuse irregular thickened uptake pattern in 2, some focal thickened pattern in one, and a slight diffuse uptake pattern in one. Two of the 3 patients diagnosed as N0 by PET and operated on had negative lymph nodes confirmed pathologically. The other patient diagnosed as N0 by PET, who had one month of time lag between PET/CT examination and surgery, was confirmed as N2 by extrapleural pneumonectomy. In 3 patients, hilar or mediastinal lymph nodes were difficult to distinguish from irregular pleural thickening. One patient had a FDG positive lymph node in the ipsilateral supraclavicular region confirmed as metastasis (N3). One patient had a FDG positive lymph node in the para-aortic region. Lung metastasis was seen in one patient (M1). In another patient, two focal nodular uptakes in the colon were detected and confirmed as colon polyps (pathologically Group 3-4). At restaging, 3 of 4 patients showed diffuse+multi-nodular uptake and one patient showed multi-nodular uptake. CONCLUSIONS: The utility of FDG-PET/CT is limited for evaluation of primary tumor extension and nodal status. FDG-PET/CT is useful for detecting distant metastasis and for evaluating activity in supraclavicular or abdominal lymph nodes. It is also useful for identifying unsuspected diseases.
Assuntos
Mesotelioma/diagnóstico por imagem , Neoplasias Pleurais/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/diagnóstico por imagem , Neoplasias do Colo/secundário , Progressão da Doença , Feminino , Fluordesoxiglucose F18 , Seguimentos , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Metástase Linfática/diagnóstico por imagem , Masculino , Mesotelioma/patologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias Pleurais/patologiaRESUMO
Clear cell adenocarcinoma of the female urethra is a rare malignant tumor arising from urethral diverticulum or paraurethral ducts and glands, and extends to the submucosa surrounding the urethra. In the advanced stage, the tumor may involve adjacent organs such as the vagina, and may mimic gynecologic malignancy. We report 2 cases in which magnetic resonance imaging could reveal their urethral origin by detecting the normal urethra within the mass as targetlike appearance on axial T2-weighted image.
Assuntos
Adenocarcinoma de Células Claras/diagnóstico , Imageamento por Ressonância Magnética/métodos , Neoplasias Uretrais/diagnóstico , Idoso , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Ovarian fibromatosis is a rare benign nonneoplastic condition with ovarian enlargement in young women and characterized by a proliferation of collagen-producing spindle cells surrounding normal ovarian structures. We reported magnetic resonance findings of a case that the affected ovarian parenchyma with follicles was surrounded by very low intense thick fibrous tissue on T2-weighted images such as "black garland" around the ovary. The magnetic resonance findings well reflected the pathological feature of the disease and may be diagnostic.