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1.
Ann Nucl Med ; 36(5): 450-459, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35275345

RESUMO

PURPOSE: [18F] fluorodeoxyglucose positron emission tomography/computed tomography ([18F] FDG-PET/CT) is used for diagnosis, staging, response assessment and prognosis prediction in different tumors, but its role in esophageal cancer is still debated. The aim of this study was to evaluate the role of semiquantitative baseline PET parameters as possible prognostic and predictive factors in a series of esophageal carcinomas treated with combined modalities. METHODS: 43 patients with esophageal carcinoma were treated with chemoradiotherapy (CRT) followed by surgery in 20 cases and underwent pre-treatment 18F-FDG-PET/CT. Semiquantitative PET parameters were evaluated including Standardized Uptake Value (SUVmax e SUVmean), Metabolic Tumor Volume (MTV) and Total Lesion Glycolysis (TLG) with isocontour of 41 and 50%. Further variables analyzed were gender, primary tumor site, histological type, use of surgery, achievement of a radical resection and the type of chemotherapy regimen. The correlation of all variables with treatment response, loco-regional control (LR), Overall survival (OS) and Disease-Free Survival (DFS) was evaluated. RESULTS: SUVmax, SUVmean50 and SUVmean41 were significantly higher in node-positive cases and in squamous cell carcinomas. With respect to prognostic factors, MTV was found to be correlated with OS: patients with MTV41 < 11.32 cm3 and MTV50 < 8.07 cm3 (both p values = 0.04) showed better 3-year OS rates (33 vs. 20%). Further factors predicting a better prognosis were the use of surgery and radical resection (R0) (both p values < 0.01). CONCLUSIONS: Pre-treatment MTV values were significant prognostic factors for OS, together with the use of surgery and R0 resection in esophageal cancers treated with multimodal therapies.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Esofágicas , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/terapia , Fluordesoxiglucose F18 , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Prognóstico , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Carga Tumoral
2.
Artigo em Inglês | MEDLINE | ID: mdl-35238518

RESUMO

BACKGROUND: The aim of the present study is to evaluate the reliability of a 18F-Fluorodeoxyglucose ([18F]FDG) PET adaptive threshold segmentation (ATS) algorithm, previously validated in a preclinical setting on several scanners, for the biological target volume (BTV) delineation of head and neck radiotherapy planning. METHODS: [18F]FDG PET ATS algorithm was studied in treatment plans of head and neck squamous cell carcinoma on a dedicated workstation (iTaRT, Tecnologie Avanzate, Italy). BTVs segmented by the present ATS algorithm (BTVATS) were compared with those manually segmented for the original radiotherapy treatment planning (BTVVIS). We performed a qualitative and quantitative volumetric analysis with a comparison tool within the ImSimQA TM software package (Oncology Systems Limited, UK -OSL, www.imismqa.com-). We reported figures of merit (FOMs) to convey complementary information: Dice Similarity Coefficient, Sensitivity Index, and Inclusiveness Index. RESULTS: The study was conducted on 32 treatment plans. Median BTVATS was 11 cm3 while median BTVVIS was 14 cm3. The median Dice Similarity Coefficient, Sensitivity Index, Inclusiveness Index were 0.72, 63%, 88%, respectively. Interestingly, the median volume and the median distance of the voxels that are over contoured by ATS were respectively 1 cm3 and 1 mm. CONCLUSIONS: ATS algorithm could be a smart and an independent operator tool when implemented for [18F] FDG-PET-based tumour volume delineation. Furthermore, it might be relevant in case of BTV-based dose painting.

3.
Diagnostics (Basel) ; 11(11)2021 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-34829505

RESUMO

Sarcopenia is a skeletal muscle disorder characterized by reduced muscle mass, strength, and performance. Muscle ultrasound can be helpful in assessing muscle mass, quality, and architecture, and thus possibly useful for diagnosing or screening sarcopenia. The objective of this study was to evaluate the reliability of ultrasound assessment of tibialis anterior muscle in sarcopenia diagnosis. We included subjects undergoing total or partial hip replacement, comparing measures with a healthy control group. We measured the following parameters: tibialis anterior muscle thickness, echogenicity, architecture, stiffness, skeletal muscle index (SMI), hand grip strength, and sarcopenia related quality of life evaluated through the SarQoL questionnaire. We included 33 participants with a mean age of 54.97 ± 23.91 years. In the study group we found reduced tibialis anterior muscle thickness compared to the healthy control group (19.49 ± 4.92 vs. 28.94 ± 3.63 mm, p < 0.05) with significant correlation with SarQoL values (r = 0.80, p < 0.05), dynamometer hand strength (r = 0.72, p < 0.05) and SMI (r = 0.76, p < 0.05). Moreover, we found reduced stiffness (32.21 ± 12.31 vs. 27.07 ± 8.04 Kpa, p < 0.05). AUC measures of ROC curves were 0.89 predicting reduced muscle strength, and 0.97 predicting reduced SMI for tibialis anterior muscle thickness, while they were 0.73 and 0.85, respectively, for muscle stiffness. Our findings showed that ultrasound assessment of tibialis anterior muscle might be considered a reliable measurement tool to evaluate sarcopenia.

4.
Blood Adv ; 5(21): 4504-4514, 2021 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-34597375

RESUMO

The role of consolidation radiotherapy (RT) for bulky lesions is controversial in patients with advanced-stage Hodgkin lymphoma who achieve complete metabolic response (CMR) after doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD)-based chemotherapy. We present the final results of the Fondazione Italiana Linfomi HD0801 trial, which investigated the potential benefit of RT in that setting. In this phase 3 randomized study, patients with a bulky lesion at baseline (a mass with largest diameter ≥5 cm) who have CMR after 2 and 6 ABVD cycles were randomly assigned 1:1 to RT vs observation (OBS) with a primary endpoint of event-free survival (EFS) at 2 years. The sample size was calculated estimating an EFS improvement for RT of 20% (from 60% to 80%). The secondary end point was progression-free survival (PFS). One hundred sixteen patients met the inclusion criteria and were randomly assigned to RT or OBS. Intention-to-treat (ITT) analysis showed a 2-year EFS of 87.8% vs 85.8% for RT vs OBS (hazard ratio [HR], 1.5; 95% confidence interval [CI], 0.6-3.5; P = .34). At 2 years, ITT-PFS was 91.3% vs 85.8% (HR, 1.2; 95% CI, 0.5-3; P = .7). Patients in CMR randomly assigned to OBS had a good outcome, and the primary end point of a 20% benefit in EFS for RT was not met. However, the sample size was underpowered to detect a benefit of 10% or less, keeping open the question of a potential, more limited role of RT in this setting. This trial was registered at www.clinicaltrials.gov as #NCT00784537.


Assuntos
Doença de Hodgkin , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bleomicina , Dacarbazina/uso terapêutico , Doxorrubicina/uso terapêutico , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/radioterapia , Humanos , Estadiamento de Neoplasias , Vimblastina/uso terapêutico
5.
Eur J Radiol ; 141: 109821, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34139575

RESUMO

PURPOSE: To assess the prognostic role of different inter and intralesional expression (heterogeneity) of oestrogen receptor (ER) in bone metastases, as identified by the combined use of [18F]FES PET/CT and [18F]FDG PET/CT in patients with oestrogen receptor-positive (ER+) metastatic breast cancer (BC). METHODS: We analysed patients with a new diagnosis of bone metastases who were candidates for first-line systemic endocrine therapy. Before starting therapy, patients underwent baseline [18F]FES PET/CT and [18]FDG PET/CT. Semi-quantitative evaluation of whole-body bone metabolic burden (WB-B-MB) was performed on [18F]FES and [18F]FDG PET/CT in order to evaluate disease extent, tumour metabolism and ER heterogeneity. We used time-to-event analyses (Kaplan-Meier and Cox proportional-hazards methods) to estimate progression-free (PFS) and overall survival (OS), in order to assess the independent prognostic value of [18F]FES PET/CT and [18F]FDG PET/CT, alone and in combination. RESULTS: According to our criteria, we enrolled 49 patients. Over a median follow-up of 44.7 months, 35 patients suffered disease progression (71.4 %) and 15 died of disease (30.6 %). When the risk of disease progression was calculated by means of the Cox model, only [18F]FDG WB-B-MB was independently and directly associated to PFS (p = 0.02). On analysing the association between all prognostic parameters and survival, the Cox model showed that the only parameter associated with OS was the WB-B-MB FES/FDG ratio (p = 0.01). CONCLUSION: The combined use of [18F]FES-PET/CT and [18F]FDG-PET/CT can identify ER heterogeneity in BC bone metastases. This heterogeneity is significantly associated with survival. Moreover, the extension of the FDG-avid component correlates with the risk of disease progression.


Assuntos
Neoplasias da Mama , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Mama/diagnóstico por imagem , Feminino , Fluordesoxiglucose F18 , Humanos , Prognóstico , Compostos Radiofarmacêuticos , Receptores de Estrogênio
6.
EJNMMI Phys ; 8(1): 35, 2021 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-33825058

RESUMO

BACKGROUND: Time-of-flight (TOF) PET technology determines a reduction in the noise and improves the reconstructed image quality in low count acquisitions, such as in overweight patients, allowing a reduction of administered activity and/or imaging time. However, international guidelines and recommendations on the 18F-fluoro-2-deoxyglucose (FDG) activity administration scheme are old or only partially account for TOF technology and advanced reconstruction modalities. The aim of this study was to optimize FDG whole-body studies on a TOF-PET/CT scanner by using a multivariate approach to quantify how physical figures of merit related to image quality change with acquisition/reconstruction/patient-dependent parameters in a phantom experiment. METHODS: The NEMA-IQ phantom was used to evaluate contrast recovery coefficient (CRC), background variability (BV) and contrast-to-noise ratio (CNR) as a function of changing emission scan duration (ESD), activity concentration (AC), target internal diameter (ID), target-background activity ratio (TBR) and body mass index (BMI). The phantom was filled with an average concentration of 5.3 kBq/ml of FDG solution and the spheres with TBR of 21.2, 8.8 and 5.0 in 3 different sessions. Images were acquired at varying background activity concentration from 5.1 to 1.3 kBq/ml, and images were reconstructed for ESD of 30-151 s per bed position with and without point spread function (PSF) correction. The parameters were all considered in a single analysis using multiple linear regression methods. RESULTS: As expected, CRC depended only on sphere ID and on PSF application, while BV depended on sphere ID, ESD, AC and BMI of the phantom, in order of decreasing relevance. Noteworthy, ESD and AC resulted as the most significant predictors of CNR variability with a similar relevance, followed by the BMI of the patient and TBR of the lesion. CONCLUSIONS: AC and ESD proved to be effective tools in modulating CNR. ESD could be increased rather than AC to improve image quality in overweight/obese patients to fulfil ALARA principles.

7.
Clin Rheumatol ; 39(4): 1277-1281, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31713732

RESUMO

Giant cell arteritis (GCA) is characterized by two subsets: cranial GCA and large-vessel GCA (LV-GCA); positron emission tomography (PET) is an essential tool in the diagnosis of LV-GCA. In this study, we aimed to investigate its potential prognostic value in the stratification of relapse risk. We retrospectively revised all the clinical records of patients who received a diagnosis of GCA at an immuno-rheumatology clinic of a University Hospital along 6 years and who underwent to a PET-CT examination at diagnosis. Clinical, laboratory, and imaging data were collected. Relapses were recorded. The study population included 19 patients (10 females, 52.6%; median age 74.0 [65.5-76.0] years), 12 with typical cranial GCA (63%) and 7 (37%) with LV-GCA. Based on PET findings, a diagnosis of aortitis was made in 15/19 patients, including 8/12 patients with a classical cranial GCA (58%). Along a median follow-up of 15 months [4.5-26.5], 4 relapses were observed. All relapsers were male; indeed, the difference in gender distribution was the only variable reaching statistical difference between relapsers and non-relapsers. Specifically, aortitis was not more frequent among relapsers. Our study confirms PET as a valid tool in the identification of LV-GCA with no cranial involvement. We failed to demonstrate a role for PET in the prognostic stratification of GCA, while male gender is suggested as a potential risk factor for GCA relapse.Key Points• A significant proportion of patients with GCA presents with non-cranial disease, the identification of which requires imaging studies, among which PET is particularly useful.• Aortitis might be detected also in patients with the classical, cranial GCA type but does not seem to have prognostic implications, at least in terms of relapse risk.• Male gender is suggested as a risk factor for relapse in GCA.


Assuntos
Aortite/diagnóstico por imagem , Arterite de Células Gigantes/complicações , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Idoso , Efeitos Psicossociais da Doença , Feminino , Fluordesoxiglucose F18 , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Compostos Radiofarmacêuticos , Recidiva , Estudos Retrospectivos
8.
Phys Med ; 68: 146-154, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31786482

RESUMO

PURPOSE: The aim of this multicenter study was to evaluate the performance of the upgraded version of the Ingenuity TF PET/CT scanner, according to the NEMA NU-2 2012 standards. METHODS: Spatial resolution, sensitivity, count rate response, scatter fraction, image quality and accuracy were evaluated on three Ingenuity TF scanners installed in Italian hospitals. Furthermore, energy and timing resolution were measured. A detailed image quality phantom analysis was performed to evaluate the effect of different clinical reconstruction parameters, including the application of PSF correction. RESULTS: Results show an average spatial resolution of 4.7 mm and an average absolute system sensitivity of 7.9 cps/kBq. The average maximum NECR was 119.83 kcps at 20.67 kBq/ml, while the maximum true event rate was 322.62 kcps at the concentration of 24.51 kBq/ml. The average maximum bias below NECR peak was 12.58%. All the results of NEMA tests were in agreement with the values declared by the manufacturer. The estimated average energy and timing resolution were 10.83% and 536.2 ps, respectively. Image quality phantom analysis obtained with different reconstruction settings showed that PSF correction was the parameter that affected mainly on contrast recovery coefficient, while the iteration number and amplitude of Gaussian filter had no significant effect. Of relevance, the application of PSF correction never led to recovery coefficient values higher than 100% and to Gibbs or edge artifacts. CONCLUSIONS: The new Ingenuity TF model shows physical performance similar to other scanners of the latest generation for all standard NEMA NU2-2012 measurements.


Assuntos
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/instrumentação , Humanos , Processamento de Imagem Assistida por Computador , Controle de Qualidade , Fatores de Tempo
9.
Artigo em Inglês | MEDLINE | ID: mdl-29451027

RESUMO

We describe a 64-year-old woman, suffering from late-onset obsessive-compulsive disorder (OCD) from the age of 57, who developed dysarthria and dysphagia, spastic diplegic, and proximal muscles weakness. Needle electromyography showed no active denervation. Neuropsychological evaluation showed intact cognitive functioning. We diagnosed upper motor neuron disease (MND), with no known genetic correlates. Brain magnetic resonance (MRI) detected bilateral hippocampal atrophy with sclerosis of right hippocampus. 18F-FDG positron emission tomography (PET) showed moderate right temporal cortex thinning. Six months later, motor and behavioral symptoms worsened. Neuropsychological examination revealed long-term memory deficit and executive dysfunction. MRI and PET evidenced severe worsening of atrophy in temporal and frontal lobes. Four years later a definitive diagnosis of primary lateral sclerosis (PLS) and FTD was made. To our knowledge, this is the first report of PLS and FTD with OCD at onset.


Assuntos
Encéfalo/diagnóstico por imagem , Demência Frontotemporal/complicações , Doença dos Neurônios Motores/complicações , Transtorno Obsessivo-Compulsivo/complicações , Progressão da Doença , Feminino , Fluordesoxiglucose F18 , Demência Frontotemporal/diagnóstico por imagem , Demência Frontotemporal/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Doença dos Neurônios Motores/diagnóstico por imagem , Transtorno Obsessivo-Compulsivo/diagnóstico por imagem , Tomografia por Emissão de Pósitrons
10.
Radiol Med ; 121(7): 537-45, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27033474

RESUMO

OBJECTIVES: The aim of this study was to compare the accuracy of retrospective image fusion of PET/MRI-DWI with that of PET/CT and MRI-DWI alone in detecting metastatic lymph nodes in patients with cervical and endometrial carcinoma. MATERIALS AND METHODS: Twenty-seven patients with endometrial (n = 14) and cervical (n = 13) cancer who had undergone preoperative MRI-DWI and PET/CT for staging were retrospectively evaluated. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PET/CT, MRI-DWI, and PET/MRI-DWI image fusion were calculated on a per-patient basis and on a per-node basis. Histopathological and follow-up imaging results were used as the gold standard. RESULTS: On a per-patient basis PET/MRI-DWI had the same sensitivity (87.5 %), specificity (84.2 %), diagnostic accuracy (85.1 %), PPV (70 %), and NPV (94.1 %) as PET-CT, but on a per-node basis PET/MRI-DWI showed better sensitivity (89 vs 70.2 %), specificity (91.6 vs 90.5 %), diagnostic accuracy (91.2 vs 87 %), PPV (68.7 vs 60.4 %), and NPV (97.6 vs 93.6 %) than PET-CT. Comparison of the areas under the ROC curves for the detection of metastatic lymph nodes demonstrated a non-significant difference (p = 0.055) between PET/CT and fused PET/MRI-DWI. CONCLUSION: PET/MRI-DWI may be a valuable technique for N-staging patients with endometrial and cervical cancer, but more studies are needed to investigate its potential clinical utility.


Assuntos
Neoplasias do Endométrio/patologia , Metástase Linfática/diagnóstico por imagem , Imagem Multimodal , Neoplasias do Colo do Útero/patologia , Adulto , Idoso , Meios de Contraste , Imagem de Difusão por Ressonância Magnética , Feminino , Fluordesoxiglucose F18 , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Valor Preditivo dos Testes , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Sensibilidade e Especificidade
11.
J Clin Oncol ; 34(12): 1376-85, 2016 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-26884559

RESUMO

PURPOSE: The clinical impact of positron emission tomography (PET) evaluation performed early during first-line therapy in patients with advanced-stage Hodgkin lymphoma, in terms of providing a rationale to shift patients who respond poorly onto a more intensive regimen (PET response-adapted therapy), remains to be confirmed. PATIENTS AND METHODS: The phase II part of the multicenter HD0801 study involved 519 patients with advanced-stage de novo Hodgkin lymphoma who received an initial treatment with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and who underwent an early ifosfamide-containing salvage treatment followed by stem-cell transplantation if they showed a positive PET evaluation after two cycles of chemotherapy (PET2). The primary end point was 2-year progression-free survival calculated for both PET2-negative patients (who completed a full six cycles of ABVD treatment) and PET2-positive patients. Overall survival was a secondary end point. RESULTS: In all, 103 of the 512 evaluable patients were PET2 positive. Among them, 81 received the scheduled salvage regimen with transplantation, 15 remained on ABVD (physician's decision, mostly because of minimally positive PET2), five received an alternative treatment, and two were excluded because of diagnostic error. On intention-to-treat analysis, the 2-year progression-free survival was 76% for PET2-positive patients (regardless of the salvage treatment they received) and 81% for PET2-negative patients. CONCLUSION: Patients with advanced-stage Hodgkin lymphoma for whom treatment was at high risk of failing appear to benefit from early treatment intensification with autologous transplantation, as indicated by the possibility of successful salvage treatment in more than 70% of PET2-positive patients through obtaining the same 2-year progression-free survival as the PET2-negative subgroup.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Substituição de Medicamentos , Doença de Hodgkin/terapia , Tomografia por Emissão de Pósitrons , Transplante de Células-Tronco , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Progressão da Doença , Intervalo Livre de Doença , Feminino , Doença de Hodgkin/diagnóstico por imagem , Doença de Hodgkin/mortalidade , Humanos , Itália , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Seleção de Pacientes , Valor Preditivo dos Testes , Medição de Risco , Fatores de Risco , Terapia de Salvação , Transplante de Células-Tronco/efeitos adversos , Transplante de Células-Tronco/mortalidade , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
12.
Radiol Med ; 121(6): 502-9, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26754293

RESUMO

OBJECTIVES: The purpose of our study was to assess the diagnostic value of multi-modal imaging through co-registration of short tau inversion recovery (STIR) and diffusion-weighted imaging (DWI) MRI with (18)FDG-PET/CT in T and N staging of head and neck tumours. MATERIALS AND METHODS: 25 patients with head and neck squamous cell carcinoma who had undergone MRI and PET/CT before treatment were retrospectively evaluated. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PET/CT, MRI and their combined use were assessed in T and N staging. Histopathology and follow-up imaging results were used as the gold standard. RESULTS: In assessing trans-compartmental extensions, PET-MRI showed 93 % sensitivity, 88 % specificity, 94 % PPV, and 88 % NPV, as compared to the 94 and 53 % sensitivity, 75 and 75 % specificity, 89 and 82 % PPV, and 86 and 43 % demonstrated by MRI and PET, respectively. In the identification of pathological lymph nodes, PET-MRI showed 92 % sensitivity, 89 % specificity, 96 % PPV, and 89 % NPV, whereas PET/CT displayed 72 % sensitivity, 89 % specificity, 95 % PPV and 53 % NPV. The corresponding figures for DWI and STIR sequences were 84 and 100 % sensitivity, 67 and 56 % specificity, 88 and 86 % PPV, and 60 and 100 % NPV, respectively. CONCLUSIONS: Multi-modal imaging assessment of co-registered MRI and PET/CT images provides more accurate results for trans-compartmental extensions in T and N staging than the individual techniques alone.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/patologia , Adulto , Idoso , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Metástase Linfática/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
13.
Gastroenterol Res Pract ; 2015: 104794, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26798331

RESUMO

Background. The purpose of this study was to compare the accuracy of whole-body MRI with diffusion-weighted sequences (WB-DW-MRI) with that of (18)F-FDG-PET/CT in the staging of patients with primary gastrointestinal lymphoma. Methods. This retrospective study involved 17 untreated patients with primary abdominal gastrointestinal lymphoma. All patients underwent (18)F-FDG-PET/CT and WB-DW-MRI. Histopathology findings or at least 6 months of clinical and radiological follow-up was the gold standard. The Musshoff-modified Ann Arbor system was used for staging, and diagnostic accuracy was evaluated on a per-node basis. Results. WB-DW-MRI exhibited 100% sensitivity, 96.3% specificity, and 96.1% and 100% positive and negative predictive values (PPV and NPV), respectively. The sensitivity, specificity, and PPV and NPV of PET/CT were 95.9%, 100%, and 100% and 96.4%, respectively. There were no statistically significant differences between the two techniques (p = 0.05). The weighted kappa agreement statistics with a 95% confidence interval were 0.97 (0.95-0.99) between the two MRI readers and 0.87 (0.82-0.92) between the two methods. Conclusions. WB-DW-MRI appears to have a comparable diagnostic value to (18)F-FDG-PET/CT in staging patients with gastrointestinal lymphoma.

14.
Arch. bronconeumol. (Ed. impr.) ; 48(11): 423-424, nov. 2012. ilus
Artigo em Espanhol | IBECS | ID: ibc-106636

RESUMO

Los tumores primarios del timo son excepcionales, pero se han descrito unos pocos casos de tumores secundarios. Describimos el caso de una paciente con metástasis exclusivas en el timo a partir de un adenocarcinoma de pulmón resecado por completo 3 años antes. La duda diagnóstica aumentó porque la lesión tímica no se asociaba a la recidiva del síndrome paraneoplásico y a un aumento de los valores de antígeno carcinoembrionario (ACE) documentados en el momento del tratamiento del tumor primario. La lesión se diagnosticó y trató al mismo tiempo mediante timectomía transcervical. Al año de seguimiento, la paciente sigue viva y libre de la enfermedad(AU)


Primary thymic tumors are rare, but secondary ones are exceptionally uncommon. We report the case of a single metastasis within the thymic gland from a lung adenocarcinoma that had been completely resected 3 years before. There was high diagnostic doubt because the thymic lesion was not associated with the recurrence of the paraneoplastic syndrome or the increased CEA levels described at the moment of the treatment of the primary tumor. The lesion was diagnosed and treated at the same time by transcervical thymectomy. At the one-year follow-up, the patient is alive and disease-free(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Carcinoma Pulmonar de Células não Pequenas/complicações , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/patologia , Neoplasias do Timo/complicações , Pneumonectomia/métodos , Neoplasias Pulmonares/fisiopatologia , Neoplasias Pulmonares , Carcinoma Pulmonar de Células não Pequenas , Metástase Neoplásica/fisiopatologia , Timo/patologia , Timo , Neoplasias Primárias Múltiplas/complicações , Neoplasias Primárias Múltiplas/cirurgia , /métodos
15.
Arch Bronconeumol ; 48(11): 423-4, 2012 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22341302

RESUMO

Primary thymic tumors are rare, but secondary ones are exceptionally uncommon. We report the case of a single metastasis within the thymic gland from a lung adenocarcinoma that had been completely resected 3 years before. There was high diagnostic doubt because the thymic lesion was not associated with the recurrence of the paraneoplastic syndrome or the increased CEA levels described at the moment of the treatment of the primary tumor. The lesion was diagnosed and treated at the same time by transcervical thymectomy. At the one-year follow-up, the patient is alive and disease-free.


Assuntos
Adenocarcinoma/secundário , Carcinoma Pulmonar de Células não Pequenas/secundário , Neoplasias Pulmonares/cirurgia , Neoplasias do Timo/secundário , Adenocarcinoma/sangue , Adenocarcinoma/complicações , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/cirurgia , Antineoplásicos Alquilantes/uso terapêutico , Biomarcadores Tumorais/sangue , Antígeno Carcinoembrionário/análise , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Quimioterapia Adjuvante , Feminino , Humanos , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/complicações , Pessoa de Meia-Idade , Compostos Organoplatínicos/uso terapêutico , Síndromes Paraneoplásicas/etiologia , Indução de Remissão , Timectomia , Neoplasias do Timo/tratamento farmacológico , Neoplasias do Timo/cirurgia
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