Subject(s)
Carcinoid Tumor/diagnostic imaging , Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Multiple Pulmonary Nodules/diagnostic imaging , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Carcinoid Tumor/metabolism , Carcinoid Tumor/pathology , Fluorodeoxyglucose F18/pharmacokinetics , Humans , Lung Neoplasms/metabolism , Lung Neoplasms/pathology , Male , Middle Aged , Multiple Pulmonary Nodules/metabolism , Multiple Pulmonary Nodules/pathology , Radiopharmaceuticals/pharmacokineticsSubject(s)
Adenocarcinoma of Lung/diagnostic imaging , Adenocarcinoma of Lung/radiotherapy , Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/radiotherapy , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Humans , Middle Aged , Positron Emission Tomography Computed Tomography/methods , Treatment OutcomeSubject(s)
Bone Neoplasms/diagnostic imaging , Carbon Radioisotopes , Choline , Hyperparathyroidism, Secondary/complications , Positron Emission Tomography Computed Tomography , Prostatic Neoplasms/diagnostic imaging , Radiopharmaceuticals , Aged , Bone Neoplasms/metabolism , Choline/pharmacokinetics , Clavicle/diagnostic imaging , Clavicle/metabolism , Humans , Kidney Failure, Chronic/diagnostic imaging , Kidney Failure, Chronic/metabolism , Male , Prostatic Neoplasms/metabolism , Radiopharmaceuticals/pharmacokinetics , Tibia/diagnostic imaging , Tibia/metabolismABSTRACT
AIM: To compare bone scan (BS) with (11)C-Choline PET/CT for the detection of bone metastases in patients with biochemical recurrence of prostate cancer (PC). MATERIAL AND METHODS: A total of 169 patients with biochemical recurrence of PC(PSA:2.4-58 ng/ml) who were referred for both exams (0-15 days-in-between) were included. Lesion-detection-rate per patients and lesions were analyzed for both BS and (11)C-Choline PET/CT. Metastasis diagnosis was reached by: biopsy, CT/(18)F-Fluoride PET/MRI confirmation, or evidence of progression in subsequent imaging procedures. RESULTS: A total of 91 lesions were found to be active in BS and/or (11)C-choline PET/CT (40 patients), with 78 of which were metastatic. BS detected 38 blastic, 2 lytic and 10 non-CT-evident lesions. (11)C-Choline PET/CT detected 41 blastic, 4 lytic and 29 non-CT-evident lesions. BS and (11)C-Choline PET/CT sensitivities were 65.4% and 96.1%; specificities ere 38.5 and 92.3% (χ(2) 8.27, p<0.04). Both imaging techniques were negative in 118 patients. Tracer avid lesions were found in 51 patients: with 30/51 being BS and (11)C-Choline PET/CT concordant; in 21/51 patients had discordant lesions (kappa 0.712, p=0.00). Lesions were absolutely discordant in 10/19 patients,: 5 FN BS, 2 FP BS (degenerative changes; dysplasia), 1 FN (11)C-Choline PET/CT (blastic), 1 FP (11)C-Choline PET/CT (degenerative), 1 out of field-of-view lesion with (11)C-Choline PET/CT (tibia alone). (11)C-Choline PET/CT showed extraosseous involvement in 26/51 patients with bone metastases: 9 local recurrences, 5 infra-diaphragmatic-lymph-nodes, 2 supra-diaphragmatic, 5 local and infra-diaphragmatic, 4 infra- and supra-diaphragmatic, 1 supra-diaphragmatic and lung metastases. CONCLUSION: (11)C-Choline PET/CT yielded better sensitivity and specificity than BS for the detection of bone involvement in patients with biochemical recurrence of PC and allowed extraosseous restaging, with an impact in the clinical management of these patients.
Subject(s)
Adenocarcinoma/secondary , Bone Neoplasms/secondary , Positron Emission Tomography Computed Tomography/methods , Prostatic Neoplasms/blood , Adenocarcinoma/diagnostic imaging , Aged , Bone Neoplasms/diagnostic imaging , Carbon Radioisotopes , Choline , False Negative Reactions , False Positive Reactions , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Prostatic Neoplasms/therapy , Radiopharmaceuticals , Sensitivity and Specificity , Technetium Tc 99m Medronate/analogs & derivativesSubject(s)
Humans , Female , Middle Aged , Hypertrophy , Heart Septal Defects , Heart Septal Defects, Atrial/pathology , Heart Septal Defects, Atrial , Positron-Emission Tomography/methods , Positron-Emission Tomography , Magnetic Resonance Imaging/instrumentation , Magnetic Resonance Imaging/methods , Positron-Emission Tomography/instrumentation , Carcinoma , Fluorodeoxyglucose F18Subject(s)
Adipose Tissue/diagnostic imaging , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Heart Septum/diagnostic imaging , Multimodal Imaging , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray Computed , Adipose Tissue/pathology , Carcinoma/diagnostic imaging , Carcinoma/drug therapy , Carcinoma/radiotherapy , Diagnosis, Differential , Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/drug therapy , Esophageal Neoplasms/radiotherapy , Female , Heart Atria/diagnostic imaging , Heart Atria/pathology , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/secondary , Heart Septum/pathology , Humans , Hypertrophy , Middle AgedABSTRACT
Objetivo. Determinar el impacto de una TAC en inspiración adicional al protocolo convencional de la PET-TAC con 18F-FDG en la detección de nódulos pulmonares de pequeño tamaño. Método. Hemos estudiado consecutivamente 100 pacientes que presentaban uno o varios nódulos pulmonares radiológicos. A todos los pacientes se les practicó un PET/TAC (Gemini, Philips). Los parámetros de adquisición fueron los mismos para la TAC no inspiratoria/fusión y la TAC en inspiración: 120kV, 25mAs. Resultados. Un total de 188 nódulos fueron detectados en la TAC inspiratoria, con tamaño entre 0,3 y 3cm. Resultados. La TAC no inspiratoria no evidenció 20/188 nódulos (10,6%) con tamaño entre 0,3 y 1cm: correspondiendo a 17 pacientes. La localización más frecuente en la que no se evidenciaron nódulos en la TAC fue en lóbulos inferiores. Resultados. La PET visualizó hipercaptación de 18F-FDG en el 83,9% y el 72% de los nódulos >1cm y entre 0,7 y 1cm, respectivamente. Sin embargo, únicamente el 10,5% de los nódulos <0,7cm mostraron aumento de actividad metabólica. Conclusiones. En pacientes seleccionados, la práctica de una TAC inspiratoria adicional al estudio PET/TAC aumenta de forma significativa la detección de pequeños nódulos pulmonares (10,6%), especialmente de los localizados en lóbulos inferiores, debido a los movimientos respiratorios y puede tener un impacto en el manejo del paciente(AU)
Aim. To determine the impact of an additional inspiration CT scan on the conventional 18F-FDG PET-CT protocol in the detection of small pulmonary nodules. Method. One hundred consecutive patients who presented with one or various nodules were studied. Whole-body PET-CT was performed using Gemini (Philips). CT acquisition parameters were 120Kv/25mAs, the same as those for the transmission/fusion CT (mild expiration) and inspiratory CT. Results. A total of 188 nodules were detected in the inspiratory CT with sizes between 0.33cm. Non-inspiratory CT did not show 20/188 nodules (10.6%) with sizes between 0.31cm, this corresponding to 17 patients. The most frequent localization of non-detectable nodules in non-inspiratory CT was the lower lobes.18F-FDG uptake was detected by the PET in 83.9% and 72% of nodules with >1cm and between 0.7 and 1cm, respectively. However, only 10.5% of nodules <0.7cm showed increased metabolic activity. Conclusion. In selected patients, inspiratory CT added to conventional PET-CT significantly improves the detection of small nodules (10.6%), especially in those lesions located in the lower lobes, due to respiratory movements, and may have an impact on patient management(AU)
Subject(s)
Humans , Female , Aged, 80 and over , Technetium Tc 99m Aggregated Albumin/adverse effects , Allergy and Immunology/trends , Histamine H1 Antagonists/therapeutic use , Hypersensitivity/diagnosis , Hypersensitivity/drug therapy , Nuclear Medicine/methods , Sentinel Lymph Node Biopsy , Chromatography/methods , Chromatography/trends , Nuclear Medicine/standards , Nuclear Medicine/trendsABSTRACT
AIM: To determine the impact of an additional inspiration CT scan on the conventional ¹8F-FDG PET-CT protocol in the detection of small pulmonary nodules. METHOD: One hundred consecutive patients who presented with one or various nodules were studied. Whole-body PET-CT was performed using Gemini (Philips). CT acquisition parameters were 120 kV/25 mAs, the same as those for the transmission/fusion CT (mild expiration) and inspiratory CT. RESULTS: A total of 188 nodules were detected in the inspiratory CT with sizes between 0.3-3 cm. Non-inspiratory CT did not show 20/188 nodules (10.6%) with sizes between 0.3-1cm, this corresponding to 17 patients. The most frequent localization of non-detectable nodules in non-inspiratory CT was the lower lobes. ¹8F-FDG uptake was detected by the PET in 83.9% and 72% of nodules with > 1 cm and between 0.7 and 1cm, respectively. However, only 10.5% of nodules <0.7 cm showed increased metabolic activity. CONCLUSION: In selected patients, inspiratory CT added to conventional PET-CT significantly improves the detection of small nodules (10.6%), especially in those lesions located in the lower lobes, due to respiratory movements, and may have an impact on patient management.
Subject(s)
Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Radiopharmaceuticals , Tomography, X-Ray Computed/methods , Adult , Aged , Artifacts , Carcinoma/diagnostic imaging , Carcinoma/secondary , False Negative Reactions , Female , Humans , Inhalation , Lung Neoplasms/secondary , Male , Middle Aged , Movement , Prospective Studies , Radionuclide Imaging , Sensitivity and Specificity , Solitary Pulmonary Nodule/diagnostic imagingSubject(s)
Carcinoma, Hepatocellular/diagnostic imaging , Liver Neoplasms/diagnostic imaging , Adult , Humans , Male , RadiographyABSTRACT
The pregnancy specific beta-1-glycoprotein (SP1) was measured by radioimmunoassay in 854 persons (control group 103, non-tumoral diseases 212, germinal tumors 30, and non-germinal tumors 509). Amounts higher than 2.5 ng/ml (upper normal limit) were observed in 35 cases with non tumoral diseases (specially chronic liver diseases), 97 of the non-germinal tumors (specially mammary, respiratory and digestive tumors), and 10 of the germinal tumors (pure and mixed choriocarcinomas, and embryonic carcinoma with yolk sac component). SP1 rarely is higher than 5 ng/ml in non-tumoral diseases and non-germinal tumors, while it is higher than 5 ng/ml in germinal tumors. SP1 is a good marker for trophoblastic neoplasms and shows a correlation with HCG-beta.
Subject(s)
Neoplasm Proteins/blood , Pregnancy Proteins/blood , Pregnancy-Specific beta 1-Glycoproteins/blood , Trophoblastic Neoplasms/blood , Uterine Neoplasms/blood , Age Factors , Disease/blood , Female , Humans , Neoplasms/blood , Pregnancy , Trophoblastic Neoplasms/diagnosisABSTRACT
Creatine kinase B (CK-B) was evaluated as a tumor marker by radioimmunoassay determination of the isoenzyme in 518 persons (control group, malignant tumors, and several other diseases). Amounts higher than 8 ng/ml (upper normal limit) was observed in 12.6 per 100 of the digestive tumors, 6.1 per 100 of the mammary tumors, 37.7 per 100 of the respiratory tumors, and 22.2 per 100 of the prostatic tumors. A relation exists between CK-B and sigmoid flexure, liver, pancreas and esophagus tumors, between CK-B and acid phosphatase in prostate tumors, and between CK-B and evolution of digestive tumor. The determination of CK-B is useful in the case of tumors lacking known tumor markers, and also as a complementary sign in the diagnosis and evolution of sigmoid flexure and prostate neoplasms.