ABSTRACT
AIM: We assessed in this study the influence of contrast-enhanced CT (ceCT) on PET/CT interpretation and PET/CT on ceCT interpretation in patients with lymphoma, before and after chemotherapy. METHODS: Fifty patients with Hodgkin disease (N.=17) or non-Hodgkin lymphomas (N.=33) were assessed before and after chemotherapy. PET/CT were performed 60 minutes after injection of FDG. Iopamidol was then injected and followed, 50 seconds later, by another CT. PET images were successively reconstructed using non-enhanced CT (PET-) and ceCT (PET+). Four nuclear physicians rated PET- and PET+ in random order. Three radiologists initially rated ceCT alone and then ceCT along with PET+. RESULTS: Before chemotherapy, global agreement (GA) was 99% (k=0.96) when PET- was compared to PET+. Nine (5%) lesions were discordant, 5 according to PET- and 4 to PET+. After chemotherapy, GA was 99% (k=0.91). Eight (15%) lesions were discordant, 3 according to PET- and 5 to PET+. Before chemotherapy, GA was 97% (k=0.91) when ceCT was compared to ceCT with PET+. Twenty-one (12%) lesions were discordant, 16 when ceCT were analyzed alone and 5 when ceCT was analyzed with PET+. After chemotherapy, GA was 95% (k=0.76). All 30 (35%) discordant lesions were positive according to ceCT alone. A significant difference between the 2 procedures was found in the pelvis and in the groin (P<0.05). CONCLUSION: PET+ did not differ from PET-, before and after chemotherapy. Fewer abnormalities were observed, when ceCT was analyzed with PET+, particularly after chemotherapy, due to residual masses that are better analyzed with functional imaging.
Subject(s)
Lymphoma/diagnostic imaging , Adult , Aged , Contrast Media , Female , Hodgkin Disease/diagnostic imaging , Hodgkin Disease/drug therapy , Humans , Lymphoma/drug therapy , Lymphoma, Non-Hodgkin/diagnostic imaging , Lymphoma, Non-Hodgkin/drug therapy , Male , Middle Aged , Nuclear Medicine , Observer Variation , Positron-Emission Tomography , Radiographic Image Interpretation, Computer-Assisted , Radiology , Tomography, X-Ray ComputedABSTRACT
OBJECTIVES: Assessment of prognostic value of pretherapeutic (18)F-FDG PET/CT (PET). PATIENTS AND METHODS: Retrospective study of 53 patients with invasive uterine cervix carcinoma. Each patient has been evaluated with pretherapeutic whole-body FDG PET/CT and pelvic MRI. Minimal follow-up lasted for 1 year. On PET/CT, we have visually analyzed metabolism of primary tumor, pelvic and para-aortic lymph nodes in comparison with surrounding structures. We have compared prognostic factors as pretherapeutic haemoglobin rate, FIGO staging, MRI and PET/CT data using Mann-Whitney univariate analysis and Cox multivariate analysis. RESULTS: Para-aortic lymph node abnormal uptake on PET/CT was the only independent predictor of progression-free survival. Pelvic lymph node involvement on PET/CT was the only independent predictor of overall survival. MRI did not provide any additional information. DISCUSSION AND CONCLUSION: Lymph node involvement visually assessed by (18)F-FDG PET/CT was the most significant prognostic factor for overall and progression-free survival.
Subject(s)
Adenocarcinoma, Mucinous/diagnostic imaging , Carcinoma, Squamous Cell/diagnostic imaging , Positron-Emission Tomography/methods , Uterine Cervical Neoplasms/diagnostic imaging , Adenocarcinoma, Mucinous/mortality , Adenocarcinoma, Mucinous/pathology , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Disease-Free Survival , Female , Fluorodeoxyglucose F18 , Humans , Lymph Nodes/diagnostic imaging , Lymphatic Metastasis , Magnetic Resonance Imaging , Middle Aged , Prognosis , Radiopharmaceuticals , Retrospective Studies , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/pathologyABSTRACT
The pseudotumoral feature of radial scar cause considerable diagnostic problems mammographically and at the extemporaneous examination. From a series of 28 cases, the authors confront their experience with classical mammographic data and emphasize: the difficulty in analysing the central area of the radiating structure, the possibility of glandular retraction, the relationship between spicules and radiolucent linear structures. These radiological criterias do not allow us to affirm the diagnosis. Extraction with histological examination of the operatory fragment is the only attitude.
Subject(s)
Breast Diseases/diagnostic imaging , Breast Neoplasms/diagnostic imaging , Mammography , Adult , Aged , Breast Diseases/pathology , Breast Neoplasms/pathology , Diagnosis, Differential , Female , Humans , Middle Aged , Retrospective StudiesABSTRACT
Granular cell tumors are rarely localized in the breast gland because of diagnosis is difficult compared to breast skin lesions. Clinically and radiologically, pseudo-neoplastic aspect can be encountered. Differential diagnosis with an invasive carcinoma can be difficult on frozen section. But final histological analysis easily confirms the diagnosis. The treatment consists in local excision of the tumor. Today we can admit that granular cell tumors are derived from schwann cells.
Subject(s)
Breast Neoplasms/pathology , Neoplasms, Muscle Tissue/pathology , Adult , Breast Neoplasms/diagnostic imaging , Carcinoma/pathology , Diagnosis, Differential , Female , Humans , Middle Aged , Neoplasms, Muscle Tissue/diagnostic imaging , RadiographyABSTRACT
15 stellar types breast lesions were reviewed and classified according their etiology (fibrosing adenosis, dysplasia, dystrophy, radial scar of Aschoff, fat necrosis). Radio-anatomical confrontation allowed to understand the images given by the varying appearances of the connective skeleton surrounded by adipose lobules. The authors study the diagnosis of the stellar breast lesions and recall the determinant role of connective tissue in the genesis of mammographic stellar images.
