RESUMEN
OBJECTIVE: To compare the usefulness of MRI and PET/CT in nodal staging (N) of patients with locally advanced rectal cancer (LARC). MATERIAL AND METHODS: Retrospective study of patients with LARC, who completed their initial staging with PET/CT, between January-20 and March-23. Regional nodes were assessed, and N was determined using both techniques according to TNM criteria. Concordance between MRI and PET/CT was analyzed. The accuracy of both techniques was calculated for those patients who underwent direct surgery. Non-regional pelvic lymph nodes were evaluated by both modalities. RESULTS: Among the 73 patients, 48 were ultimately diagnosed with a locally advanced stage. Of these, 39 underwent neoadjuvant treatment (chemoradiotherapy) followed by surgery, and 9 direct surgery. In 25, the PET/CT extension study revealed distant disease, leading to systemic treatment. Weak concordance was observed between MRI and PET/CT in determining N (k=0.286; p<0.005). Out of 73 patients, 31(42%) exhibited concordance, and 42(58%) showed discordance. In 83% of the discordant cases, MRI overstaged compared to PET/CT, with 17 cases indicating nodal involvement (N+) by MRI and N0 by PET/CT. Diagnostic accuracy was 78% for both techniques. Sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 75%, 80%, and 75% for MRI, and 60%, 100%, 100%, and 67%, for PET/CT. PET/CT identified pelvic metastatic adenopathies in 8 patients that were not visible/doubtful by MRI. CONCLUSIONS: In the initial nodal staging of rectal cancer MRI overstages relative to PET/CT. Both modalities are complementary, PET/CT offers higher specificity and MRI higher sensitivity.
Asunto(s)
Metástasis Linfática , Imagen por Resonancia Magnética , Estadificación de Neoplasias , Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias del Recto , Humanos , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/patología , Neoplasias del Recto/terapia , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Imagen por Resonancia Magnética/métodos , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Metástasis Linfática/diagnóstico por imagen , Adulto , Anciano de 80 o más Años , Sensibilidad y Especificidad , Terapia Neoadyuvante , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patologíaRESUMEN
Tumours that produce metastases in the paranasal sinuses or sphenoidal sinus are rare; the carcinomas of kidney and lung being the most frequent with this type of metastasis. Distant metastases from differentiated thyroid carcinoma are rare and, moreover, when they metastasize, they do so into lung and bone. We report a patient who had a papillary thyroid carcinoma with metastases into the sphenoidal sinus.
Asunto(s)
Carcinoma Papilar/secundario , Neoplasias de los Senos Paranasales/secundario , Seno Esfenoidal/patología , Neoplasias de la Tiroides/patología , Carcinoma Papilar/diagnóstico por imagen , Carcinoma Papilar/radioterapia , Carcinoma Papilar/cirugía , Terapia Combinada , Irradiación Craneana , Diplopía/etiología , Femenino , Cefalea/etiología , Humanos , Histerectomía , Radioisótopos de Yodo/uso terapéutico , Leiomioma/cirugía , Imagen por Resonancia Magnética , Persona de Mediana Edad , Neoplasias Primarias Secundarias , Neoplasias de los Senos Paranasales/diagnóstico por imagen , Neoplasias de los Senos Paranasales/radioterapia , Neoplasias de los Senos Paranasales/cirugía , Cintigrafía , Radiofármacos/uso terapéutico , Radioterapia Adyuvante , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Neoplasias Uterinas/cirugíaRESUMEN
Tumours that produce metastases in the paranasal sinuses or sphenoidal sinus are rare; the carcinomas of kidney and lung being the most frequent with this type of metastasis. Distant metastases from differentiated thyroid carcinoma are rare and, moreover, when they metastasize, they do so into lung and bone. We report a patient who had a papillary thyroid carcinoma with metastases into the sphenoidal sinus
