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1.
J Comput Assist Tomogr ; 45(2): 330-336, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33661151

RESUMO

OBJECTIVE: The aim of the study was to evaluate computed tomography (CT) findings of pulmonary NUT midline carcinoma. METHODS: We assessed clinical and CT features of pulmonary NUT carcinoma in 10 consecutive patients (M:F, 7:3; mean, 39 years). RESULTS: The primary tumors (size range, 15-65 mm) manifested as either a peripheral tumor (5/10) or a central tumor (5/10). All tumors showed relatively low-attenuation at contrast-enhanced CT (mean net enhancement, 26 HU). Associated CT findings were metastatic hilar or mediastinal lymphadenopathy (8/10), ipsilateral pleural seeding with malignant pleural effusion (2/10), and distant metastasis (2/10). Five patients with low tumor-node-metastasis stages after optimal treatment showed no evidence of disease (50%) for 6 to 35 months. CONCLUSIONS: Pulmonary NUT carcinoma presented as a peripheral or a central lung mass showing mild degree of contrast enhancement, frequent metastatic regional lymphadenopathy, affecting relatively young adults. Although known to be highly aggressive, an early diagnosis in low TNM stages can lead to a favorable prognosis.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Adolescente , Adulto , Carcinoma de Células Escamosas/terapia , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
3.
BMJ Case Rep ; 14(1)2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33500301

RESUMO

A 75-year-old man was hospitalised for bronchoscopy with biopsy due to a suspicious pulmonary mass at chest tomography. He had significant dyspnoea, constipation, nausea, vomiting, anorexia and a 33% loss of weight in the past 3 months. Biopsy revealed a pulmonary squamous cell carcinoma, which was inoperable. Tramadol used at home for 3 months was replaced by morphine on admission. The patient remained constipated despite prokinetics and laxatives, leading to the diagnostic hypothesis of paraneoplastic motility disorder and opioid-induced constipation. Abdominal tomography ruled out the possibility of mechanical obstruction. As complications, the patient presented superior vena cava syndrome and opioid (morphine) intoxication. The patient died a few days later. The management of this case highlights the importance of multidisciplinary care and the challenges of palliative oncology care. Paraneoplastic motility disorder must always be considered among the mechanisms of intestinal dysfunction in patients with advanced oncological disease.


Assuntos
Carcinoma de Células Escamosas/complicações , Constipação Intestinal/etiologia , Gastroparesia/etiologia , Neoplasias Pulmonares/complicações , Síndromes Paraneoplásicas do Sistema Nervoso/etiologia , Idoso , Antieméticos/uso terapêutico , Carcinoma de Células Escamosas/diagnóstico por imagem , Constipação Intestinal/diagnóstico , Constipação Intestinal/tratamento farmacológico , Constipação Intestinal/fisiopatologia , Fármacos Gastrointestinais/uso terapêutico , Gastroenteropatias/diagnóstico , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/etiologia , Gastroenteropatias/fisiopatologia , Motilidade Gastrointestinal , Gastroparesia/diagnóstico , Gastroparesia/tratamento farmacológico , Gastroparesia/fisiopatologia , Glicerol/uso terapêutico , Humanos , Lactulose/uso terapêutico , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Metoclopramida/análogos & derivados , Metoclopramida/uso terapêutico , Morfina/efeitos adversos , Constipação Induzida por Opioides/diagnóstico , Cuidados Paliativos , Síndromes Paraneoplásicas do Sistema Nervoso/diagnóstico , Síndromes Paraneoplásicas do Sistema Nervoso/fisiopatologia , Tramadol/efeitos adversos
4.
Cancer Imaging ; 21(1): 2, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407915

RESUMO

BACKGROUND: To determine the predictive CT imaging features for diagnosis in patients with primary pulmonary mucoepidermoid carcinomas (PMECs). MATERIALS AND METHODS: CT imaging features of 37 patients with primary PMECs, 76 with squamous cell carcinomas (SCCs) and 78 with adenocarcinomas were retrospectively reviewed. The difference of CT features among the PMECs, SCCs and adenocarcinomas was analyzed using univariate analysis, followed by multinomial logistic regression and receiver operating characteristic (ROC) curve analysis. RESULTS: CT imaging features including tumor size, location, margin, shape, necrosis and degree of enhancement were significant different among the PMECs, SCCs and adenocarcinomas, as determined by univariate analysis (P < 0.05). Only lesion location, shape, margin and degree of enhancement remained independent factors in multinomial logistic regression analysis. ROC curve analysis showed that the area under curve of the obtained multinomial logistic regression model was 0.805 (95%CI: 0.704-0.906). CONCLUSION: The prediction model derived from location, margin, shape and degree of enhancement can be used for preoperative diagnosis of PMECs.


Assuntos
Adenocarcinoma/diagnóstico por imagem , Carcinoma Mucoepidermoide/diagnóstico por imagem , Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adenocarcinoma/patologia , Adulto , Idoso , Carcinoma Mucoepidermoide/patologia , Carcinoma de Células Escamosas/patologia , Diagnóstico Diferencial , Feminino , Humanos , Modelos Logísticos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos
5.
Clin Nucl Med ; 46(1): e13-e15, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32701799

RESUMO

Constrictive pericarditis refers to focal or global thickening of pericardium causing impedance to diastolic filling and increased systemic venous pressure. We discuss a case of thymic carcinoma presenting as constrictive pericarditis. A 70-year-old man experiencing shortness of breath underwent Doppler echocardiography for further evaluation. Echocardiography was suggestive of thickened nodular pericardium with minimal pericardial effusion, and Doppler features were suggestive of constrictive pericarditis. F-FDG PET/CT done to exclude malignancy reveals locally advanced thymic carcinoma spreading along the pericardial sheath with metabolically active rib metastases.


Assuntos
Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico por imagem , Fluordesoxiglucose F18 , Pericardite Constritiva/complicações , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias do Timo/complicações , Neoplasias do Timo/diagnóstico por imagem , Idoso , Carcinoma de Células Escamosas/patologia , Ecocardiografia , Humanos , Masculino , Neoplasias do Timo/patologia
6.
Magn Reson Imaging ; 75: 100-106, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33096226

RESUMO

OBJECTIVE: To test the performance of free-breathing Dynamic Contrast-Enhanced MRI (DCE-MRI) using a radial volumetric interpolated breath-hold examination (VIBE) sequence combined with diffusion-weighted imaging (DWI) for quantitative solitary pulmonary nodule (SPN) assessment. METHODS: A total of 67 SPN cases receiving routine MRI routine scans, DWI, and dynamic-enhanced MRI in our hospital from May 2017 to November 2018 were collected. These cases were divided into a malignant group and a benign group according to the characteristics of the SPNs. The quantitative DCE-MRI parameters (Ktrans, Kep, Ve) and apparent diffusion coefficient (ADC) values of the nodules were measured. RESULTS: The Ktrans and Kep values in the malignant group were higher than those in the benign group, while the ADC values in the malignant group were lower than those in the benign group. Furthermore, the Ktrans value of adenocarcinoma was higher than that of squamous cell carcinoma and small cell carcinoma (P < 0.05). The Ve value was significantly different between non-small cell carcinoma and small cell carcinoma (P < 0.05). With an ADC value of 0.98 × 10-3 mm2/s as the threshold, the specificity and sensitivity to diagnose benign and malignant nodules was 90.6% and 80%, respectively. CONCLUSION: High-temporal-resolution DCE-MRI using the r-VIBE technique in combination with DWI could contribute to pulmonary nodule analysis and possibly serve as a potential alternative to distinguish malignant from benign nodules as well as differentiate different types of malignancies.


Assuntos
Suspensão da Respiração , Imagem de Difusão por Ressonância Magnética , Processamento de Imagem Assistida por Computador , Nódulo Pulmonar Solitário/diagnóstico por imagem , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/fisiopatologia , Adulto , Idoso , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/fisiopatologia , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Nódulo Pulmonar Solitário/fisiopatologia
7.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(12): 1071-1076, 2020 Dec 12.
Artigo em Chinês | MEDLINE | ID: mdl-33333642

RESUMO

Objective: To explore the clinical manifestations, imaging features, pathological features, diagnosis and treatment of pulmonary mucosal-associated lymphoid tissue(MALT)lymphoma concurrent with lung squamous cell carcinoma, and to improve the understanding of this disease. Methods: Using "Pulmonary mucosa-associated lymphoid tissue, squamous cell carcinoma" as the search term, from January 1, 1983 to August 31, 2020, a total of 3 cases were retrieved in the PubMed database. In the Wanfang database, using "Lung mucosa-associated lymphoid tissue, lung squamous cell carcinoma" as the search term, from January 1, 1990 to August 31, 2020, a total of 1 related document was retrieved. In the CNKI database, "(lung) mucosa-associated lymphoid tissue lymphoma, (lung) squamous cell carcinoma" was used as the search term, and no relevant case reports were retrieved. Results: A 64-year-old man was admitted to the hospital because of chest tightness and shortness of breath for 10 days, cough and fever for one day. Enhanced CT of the chest showed a soft tissue mass shadow in the right lower hilar area, with obstruction of the adjacent bronchus, and local mild enhancement, suggesting of right lower lung cancer. In addition, the CT scan also showed consolidated shadows in the lower lobes of both lungs, scattered nodules, multiple lymphadenopathy in the mediastinum, and a small amount of pleural effusion on the right. Under bronchoscopy, a cauliflower-like neoplasm was seen at the opening of the lower right basal section, about 7 mm×8 mm, and biopsy showed that part of the mucosal structure was destroyed, with disappearance of the squamous epithelial layer, and the nuclei were large and deeply stained, and some were distributed in nests, with poor keratinization and a small amount of necrosis, and fibrous tissue reaction. Immunostaining revealed that the tumor was positive for p40, CK5/6 and EGFR and negative forTTF-1, NapsinA, PD-L1, p53, with about 30% Ki-67 positive cells. A puncture biopsy of the right lower lobe showed that the alveolar cavity was filled with nested lymphoid cells, consisting of small lymphocytes, central cell-like cells and monocyte-like cells, with occasionally large cells. Immunostaining revealed CD20+, CD79a+, scattered CD3+, Bcl2+, SMA vascular+, Bcl6-, CK-, CD10-, CyclinD1-, with about 3% Ki-67 positive cells. The histopathological examinations confirmed the diagnosis of mucosal-associated lymphoid tissue extranodal marginal zone lymphoma(MALT lymphoma),and lung squamous cell carcinoma. Conclusions: Pulmonary mucosa-associated lymphoid tissue lymphoma complicated with lung squamous cell carcinoma is rare and easy to be missed and misdiagnosed. Chest CT imaging shows single or multiple nodules, mass shadows or consolidation, often accompanied by air-bronchial signs in the lesion, bronchiectasis, ground glass density around the lesion, hilar and mediastinal lymphadenopathy. Occasionally, pleural effusion can be seen. Lung biopsy is the gold standard for diagnosis.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Pulmonares/patologia , Pulmão/diagnóstico por imagem , Linfadenopatia/diagnóstico por imagem , Linfoma de Zona Marginal Tipo Células B/patologia , Biópsia , Broncoscopia , Carcinoma de Células Escamosas/diagnóstico por imagem , Tosse/etiologia , Dispneia/etiologia , Febre/etiologia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Linfoma de Zona Marginal Tipo Células B/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
8.
PLoS One ; 15(12): e0244250, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33332452

RESUMO

OBJECTIVES: Residual cysts are relatively rare inflammatory cysts of the jaws. They are essentially radicular cysts without the presence of the offending dentition. These lesions have the ability to destroy bone within the jaws without any symptoms. Moreover, they can mimic more aggressive cysts and tumours on radiographs. The aim of this study was to describe the clinico-pathological features of residual cysts in order to discern them from other cystic lesions as well as analyse their management and recurrence patterns. MATERIALS AND METHODS: Sixty-four histopathologically confirmed residual cysts were analysed based on their clinical, radiological and histopathological features. Their management and follow-up were also noted. RESULTS: The majority of lesions presented in elderly (46.8%), edentulous patients (60.9%) and were most commonly found in the posterior regions of the mandible (51.6%). Clinico-pathological features that aided in their diagnosis included long-standing history with slow growing swelling and presence of well-defined, unilocular cystic lesion associated with previously extracted dentition. Enucleation was a successful method in the management of residual cysts with very low recurrence rate (1.6%). Two patients (3.1%) developed squamous cell carcinoma from the cyst lining. CONCLUSION: Residual cysts should be high on the list of differential diagnosis when elderly, edentulous patients present with cystic lesions in the jaws compared to dentate patients (P<0.01). All lesions should by biopsied and sent for histopathological examination along with radiological correlation as they have the potential to transform into primary intra-osseous squamous cell carcinoma with devastating consequences to the patient.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Maxilomandibulares/patologia , Cisto Radicular/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/diagnóstico por imagem , Criança , Feminino , Seguimentos , Humanos , Neoplasias Maxilomandibulares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Prognóstico , Cisto Radicular/diagnóstico por imagem , Radiografia , Estudos Retrospectivos , Adulto Jovem
9.
Zhonghua Zhong Liu Za Zhi ; 42(8): 665-669, 2020 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-32867459

RESUMO

Objective: To investigate the CT features and dynamic changes of new developed lung cancer in patients with connective tissue disease-related interstitial lung disease (CTD-ILD). Methods: A series of chest CT images of 58 CTD-ILD patients during follow-up were collected. The CT features of interstitial lung disease, the initial appearance time of lung cancer, the time of diagnosis of lung cancer, the morphological characteristics (location, shape, size) of lung cancer lesions and the dynamic changes of CT features were analyzed. Results: Among 58 patients, rheumatoid arthritis was the most common (31 cases). Chest CT images showed coexistence of two or more interstitial CT signs. During the follow-up, a total of 59 lung cancer lesions were found. The median time of lung cancer lesion occurred was 289 days. The median delay in diagnosis was 43 days. There were 44 cases of non-small cell lung cancer (including 23 cases of squamous cell carcinoma and 19 cases of adenocarcinoma), 12 cases of small cell lung cancer. Forty-three (72.9%) lesions were located in the lower lobes and 41 (69.5%) lesions were located in the area of pulmonary interstitial fibrosis. According to CT morphological characteristics of lung cancer, nodular type (37 cases), inflammatory consolidation (12 cases) and intra-honeycomb type (10 cases) were identified. Conclusions: The chest CT features of patients with CTD-ILD are complex. New developed lung cancer is easily missed or misdiagnosed in the early stage. Pay attention to the special CT characteristics of CTD-ILD with lung cancer is helpful for early diagnosis.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma de Células Escamosas/diagnóstico por imagem , Doenças do Tecido Conjuntivo/complicações , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Neoplasias Pulmonares/complicações , Tomografia Computadorizada por Raios X/métodos , Doenças do Tecido Conjuntivo/diagnóstico por imagem , Humanos , Neoplasias Pulmonares/diagnóstico por imagem
10.
Cancer Imaging ; 20(1): 63, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912310

RESUMO

BACKGROUND: Postoperative pathologic risk factors (PRFs) could increase the recurrence rate in early-stage uterine cervical squamous cancer (ECSC). Our study intended to explore the efficiency of 18F-FDG PET/CT for assessing the pathologic risk status (PRS) in ECSC patients. METHODS: This retrospective study was performed in 240 ECSC patients with stage IA2-IIA2 (FIGO 2009), who underwent preoperative PET/CT scans and subsequent radical surgery between January 2010 and July 2015. Intermediate-risk (tumour diameter ≥ 4 cm, stromal invasion depth ≥ 1/2, lymphovascular space invasion (LVSI)), and high-risk factors (parametria involvement, positive surgery margin, pelvic lymph node metastasis) were confirmed by postoperative pathology. Patients with none of these PRFs were at a low risk for relapse. One of these PRFs was defined as positive risk. The relationship between each PRF and 18F-FDG uptake was analysed by t-test. Chi-square tests and logistic regression analyses were used to determine the efficiency of PET/CT parameters for assessing the PRS. The area under the curve (AUC) was used as an indicator for predictive efficiency. RESULTS: Patients with higher SUVmax (p < 0.001), MTV (p < 0.001) and TLG (p < 0.001) had larger tumour sizes and deeper stromal invasion. Further multivariate analyses showed SUVmax and TLG were independent predictors for positive- and intermediate-risk status. In high-risk group, MTV and TLG were associated with pelvic lymph node metastasis and parametria involvement. However, only MTV was a significant indicator. CONCLUSIONS: Preoperative 18F-FDG PET/CT had an independent predictive value for PRS in ECSC.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Linfonodos/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Neoplasias do Colo do Útero/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Feminino , Fluordesoxiglucose F18 , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/normas , Valor Preditivo dos Testes , Compostos Radiofarmacêuticos , Neoplasias do Colo do Útero/patologia
11.
Cancer Imaging ; 20(1): 64, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912319

RESUMO

BACKGROUND: Patients with esophageal cancer (EC) undergo endoscopic ultrasound and CT based cancer staging. Recent technical developments allow improved MRI quality with diminished motion artifact that may allow MRI to compare favorable to CT for noninvasive staging. Hence the purpose of the study was to assess image quality and diagnostic accuracy of 3 T MRI versus CT and EUS for preoperative T-staging of potentially resectable esophageal cancer. METHODS: Between October-2014 and December-2017, esophageal cancer patients with T-staging by EUS were enrolled in this prospective study. Post-operative histopathologic T-staging was the reference standard. All participants underwent MRI [T2- multi-shot turbo spin echo sequence (msTSE), diffusion-weighted imaging (DWI), and 3D gradient-echo based sequence (3D-GRE)] and CT [non-contrast and multiphase contrast-enhanced CT scanning] 5.6 + 3.6 days after endoscopy. Surgery was performed within 3.6 + 3.5 days after imaging. Two blinded endoscopists (reader 1 and 2) and radiologists (reader 3 and 4) independently evaluated EUS and CT/MRI, respectively. Considering the clinical relevance, patients were dichotomized into early (T1 and T2) vs late (T3 and T4) stage cancer before assessment. For statistical purpose, the binary decision was defined as the ability of the imaging technique to diagnose early stage/not early stage esophageal cancer. Diagnostic performance of EUS, MRI and CT was compared using McNemar's test with Bonferroni correction; kappa values were assessed for reader performance. RESULTS: 74 study participants (60 ± 8 yrs.; 56 men) with esophageal cancer were evaluated, of whom 85%(63/74) had squamous cell carcinoma, 61%(45/74) were at early stage and 39%(29/74) were at late stage cancer, as determined by histopathology. Intra- and Inter-reader agreement for pre-operative vs post-operative T-staging was excellent for all imaging modalities. Compared to CT, MRI showed significantly higher accuracy for both the readers (reader3: 96% vs 82%, p = 0.0038, reader4: 95% vs 80%, p = 0.0076, for MRI vs CT, respectively). Further, MRI outperformed EUS with higher specificity (reader 1 vs 3: 59% vs 93%, p = 0.0015, reader 2 vs 4: 66% vs 93%, p = 0.0081, for EUS vs MRI respectively), and accuracy (reader 1 vs 3: 81% vs 96%, p = 0.0022, reader 2 vs 4: 85% vs 95%, p = 0.057, for EUS vs MRI, respectively). CONCLUSION: For resectable esophageal cancer, MRI had better diagnostic performance for tumor staging compared to CT and EUS. TRIAL REGISTRATION: ChiCTR, ChiCTR-DOD, Registered 2nd October 2014, http://www.chictr.org.cn/showproj.aspx?proj=9620.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Endossonografia/normas , Neoplasias Esofágicas/diagnóstico por imagem , Imagem por Ressonância Magnética/normas , Tomografia Computadorizada por Raios X/normas , Adulto , Idoso , Carcinoma de Células Escamosas/patologia , Endossonografia/métodos , Neoplasias Esofágicas/patologia , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Tomografia Computadorizada por Raios X/métodos
12.
Yonsei Med J ; 61(10): 895-900, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32975065

RESUMO

The purpose of this study was to evaluate the diagnostic performance of magnetic resonance (MR) radiomics-based machine learning algorithms in differentiating squamous cell carcinoma (SCC) from lymphoma in the oropharynx. MR images from 87 patients with oropharyngeal SCC (n=68) and lymphoma (n=19) were reviewed retrospectively. Tumors were semi-automatically segmented on contrast-enhanced T1-weighted images registered to T2-weighted images, and radiomic features (n=202) were extracted from contrast-enhanced T1- and T2-weighted images. The radiomics classifier was built using elastic-net regularized generalized linear model analyses with nested five-fold cross-validation. The diagnostic abilities of the radiomics classifier and visual assessment by two head and neck radiologists were evaluated using receiver operating characteristic (ROC) analyses for distinguishing SCC from lymphoma. Nineteen radiomics features were selected at least twice during the five-fold cross-validation. The mean area under the ROC curve (AUC) of the radiomics classifier was 0.750 [95% confidence interval (CI), 0.613-0.887], with a sensitivity of 84.2%, specificity of 60.3%, and an accuracy of 65.5%. Two human readers yielded AUCs of 0.613 (95% CI, 0.467-0.759) and 0.663 (95% CI, 0.531-0.795), respectively. The radiomics-based machine learning model can be useful for differentiating SCC from lymphoma of the oropharynx.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Neoplasias Orofaríngeas/diagnóstico por imagem , Orofaringe/diagnóstico por imagem , Algoritmos , Biópsia , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Aumento da Imagem/métodos , Linfoma/patologia , Aprendizado de Máquina , Neoplasias Orofaríngeas/patologia , Orofaringe/patologia , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Resultado do Tratamento
13.
Oncology (Williston Park) ; 34(9): 370-376, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-32965669

RESUMO

In an asymptomatic 77-yearold woman, former 55 packyears smoker, a routine X-ray showed a 45-mm superior left lobe lesion. A chest CT scan confirmed a 36-mm superior left lobe lesion and an aortic-pulmonary lymph node enlargement measuring 42 mm, suspicious for neoplasia. A PET-CT scan showed an elevated uptake in the primary lesion, in the aortic-pulmonary lymph node, and in the left hilar lymph node with a standardized uptake value - 40 and 4.3, respectively. CT-guided lung biopsy showed a lung squamous cell carcinoma. An endobronchial ultrasound-guided transbronchial needle aspiration for lymph-node staging was negative for lymph node spread. Brain MRI was negative. Final staging was determined to be a IIIA (T2bN2) squamous cell carcinoma of the lung.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Carcinoma de Células Escamosas/terapia , Infecções por Coronavirus/diagnóstico , Neoplasias Pulmonares/terapia , Pneumonia Viral/diagnóstico , Pneumonia/diagnóstico , Idoso , Anticorpos Monoclonais/efeitos adversos , Antineoplásicos Imunológicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Betacoronavirus , Carboplatina/administração & dosagem , Carcinoma de Células Escamosas/diagnóstico por imagem , Quimiorradioterapia , Quimioterapia de Consolidação , Diagnóstico Diferencial , Feminino , Humanos , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Paclitaxel/administração & dosagem , Pandemias , Pneumonia/induzido quimicamente
14.
Br J Radiol ; 93(1115): 20200751, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32915647

RESUMO

Objective:The aim of this study was to predict response to neoadjuvant chemotherapy (NAC) in patients with locally advanced hypopharyngeal cancer by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).Methods:A retrospective study enrolled 46 diagnosed locally advanced hypopharyngeal cancer. DCE-MRI were performed prior to and after two cycles of NAC. The volume transfer constant (Ktrans), extracellular extravascular volume fraction (Ve), and plasma volume fraction (Kep) were computed from primary tumors. DCE-MRI parameters were used to measure tumor response according to the Response Evaluation Criteria in Solid Tumors criteria (RECIST).Results:After 2 NAC cycles, 30 out of 46 patients were categorized into the responder group, whereas the other 16 were categorized into non-responder group. Compared with the pretreatment value, the post-treatment Ktrans and Kep was significantly lower (P < 0.05), but no significant change in Ve (P > 0.05). Compared with non-responders, a notably higher pretreatment Ktrans, Kep, lower post-treatment Ktrans, higher ΔKtrans and ΔKep were observed in responders (all P < 0.05). While the pretreatment Ve, post-treatment Ve, and ΔVe did not differ significantly (P>0.05) between the two groups. The receiver operating characteristic curve analysis revealed that pretreatment Ktrans of 0.202/min is the most optimal cut-off in predicting response to chemotherapy, resulting in an AUC of 0.837 and corresponding sensitivity and specificity of 76.7%, and 81.1%, respectively.Conclusion:DCE-MRI especially pretreatment Ktrans can potentially predict the treatment response to neoadjuvant chemotherapy for hypopharyngeal cancer.Advances in knowledge:Few studies of DCE-MRI on hypopharyngeal cancer treated with chemoradiation reported. The results demonstrate that DCE-MRI especially pretreatment Ktrans may be more potential value in predicting the treatment response to neoadjuvant chemotherapy for hypopharyngeal cancer.


Assuntos
Meios de Contraste , Neoplasias Hipofaríngeas/diagnóstico por imagem , Neoplasias Hipofaríngeas/tratamento farmacológico , Aumento da Imagem/métodos , Imagem por Ressonância Magnética/métodos , Terapia Neoadjuvante/métodos , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Carcinoma de Células Escamosas/irrigação sanguínea , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/tratamento farmacológico , Quimioterapia Adjuvante/métodos , Cisplatino/administração & dosagem , Feminino , Humanos , Neoplasias Hipofaríngeas/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Paclitaxel/administração & dosagem , Curva ROC , Critérios de Avaliação de Resposta em Tumores Sólidos , Estudos Retrospectivos , Resultado do Tratamento
15.
Clin Imaging ; 67: 198-206, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32866821

RESUMO

Nuclear protein of the testis (NUT) carcinoma (NC) (formerly known as NUT midline carcinoma) is an aggressive pleomorphic squamous cell carcinoma with a dismal prognosis. Primary NC tumors are commonly located in the chest or head and neck regions. Imaging plays an indispensable role in the staging, management, treatment response assessment, and surveillance of NC. Primary pulmonary NC usually presents as a large mass with lymphadenopathy and pleural involvement. Primary head and neck NC presents as a large expansile necrotic mass in the sinonasal region with locoregional destruction and occasional cervical lymph node involvement. These imaging features are relatively non-specific but are consistent among patients. Currently, there are no standardized guidelines for the treatment of NC. Because of its rarity, paucity of reports in the medical literature, and the lack of awareness among radiologists, NUT carcinoma (NC) has been largely underdiagnosed and misdiagnosed. Clinical aggressive features and pleomorphic/undifferentiated squamous cell carcinoma should prompt genetic evaluation for NUT translocation to diagnose NC. In this article, we discuss NC's clinicopathologic and imaging features and treatment options, including emerging new treatments.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Testículo/diagnóstico por imagem , Adulto , Carcinoma de Células Escamosas/patologia , Feminino , Neoplasias de Cabeça e Pescoço , Humanos , Neoplasias Pulmonares/genética , Masculino , Pescoço/patologia , Proteínas Nucleares/genética , Proteínas Nucleares/metabolismo
16.
Br J Radiol ; 93(1112): 20190825, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32520585

RESUMO

OBJECTIVES: High throughput pre-treatment imaging features may predict radiation treatment outcome and guide individualized treatment in radiotherapy (RT). Given relatively small patient sample (as compared with high dimensional imaging features), identifying potential prognostic imaging biomarkers is typically challenging. We aimed to develop robust machine learning methods for patient survival prediction using pre-treatment quantitative CT image features for a subgroup of head-and-neck cancer patients. METHODS: Three neural network models, including back propagation (BP), Genetic Algorithm-Back Propagation (GA-BP), and Probabilistic Genetic Algorithm-Back Propagation (PGA-BP) neural networks were trained to simulate association between patient survival and radiomics data in radiotherapy. To evaluate the models, a subgroup of 59 head-and-neck patients with primary cancers in oral tongue area were utilized. Quantitative image features were extracted from planning CT images, a novel t-Distributed Stochastic Neighbor Embedding (t-SNE) method was used to remove irrelevant and redundant image features before fed into the network models. 80% patients were used to train the models, and remaining 20% were used for evaluation. RESULTS: Of the three supervised machine-learning methods studied, PGA-BP yielded the best predictive performance. The reported actual patient survival interval of 30.5 ± 21.3 months, the predicted survival times were 47.3 ± 38.8, 38.5 ± 13.5 and 29.9 ± 15.3 months using the traditional PCA. Combining with the novel t-SNE dimensionality reduction algorithm, the predicted survival intervals are 35.8 ± 15.2, 32.3 ± 13.1 and 31.6 ± 15.8 months for the BP, GA-BP and PGA-BP neural network models, respectively. CONCLUSION: The work demonstrated that the proposed probabilistic genetic algorithm optimized neural network models, integrating with the t-SNE dimensionality reduction algorithm, achieved accurate prediction of patient survival. ADVANCES IN KNOWLEDGE: The proposed PGA-BP neural network, integrating with an advanced dimensionality reduction algorithm (t-SNE), improved patient survival prediction accuracy using pre-treatment quantitative CT image features of head-and-neck cancer patients.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Redes Neurais de Computação , Neoplasias da Língua/mortalidade , Algoritmos , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Humanos , Aprendizado de Máquina , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Análise de Componente Principal , Probabilidade , Prognóstico , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X , Língua/diagnóstico por imagem , Neoplasias da Língua/diagnóstico , Neoplasias da Língua/diagnóstico por imagem , Neoplasias da Língua/patologia
17.
Brain Tumor Pathol ; 37(3): 118-125, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32488681

RESUMO

Although central nervous system (CNS) metastases are common in advanced cancer, CNS involvement solely by intravascular tumor cells, known as intravascular carcinomatosis, is extremely rare. We report two cases of brain metastasis in which tumor cells were restricted to the vascular lumina without parenchymal involvement, resulting in ischemic lesions. The first patient is a previously healthy young woman who presented with symptoms of community-acquired pneumonia and progressed to respiratory failure. Computed tomography of the brain showed infarcts of differing ages. At autopsy, she was found to have widely metastatic cervical squamous cell carcinoma and cerebral tumor emboli with multifocal infarcts, mainly microinfarcts. The second patient is an elderly man with cognitive impairment and mild Parkinsonism who presented with symptoms of a urinary tract infection. Magnetic resonance imaging of the brain showed atrophy and changes suggestive of chronic microvascular ischemic disease. Postmortem examination demonstrated prostatic adenocarcinoma and cerebral tumor emboli with multifocal infarcts. These cases illustrate that this pattern of intracranial metastasis may rarely be a cause of cerebral ischemic lesions and emphasize the importance of thorough pathologic examination of the brain.


Assuntos
Adenocarcinoma , Encéfalo/irrigação sanguínea , Carcinoma de Células Escamosas , Neoplasias Vasculares , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adulto , Idoso , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Evolução Fatal , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/patologia
18.
Clin Nucl Med ; 45(10): 802-804, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32558719

RESUMO

A 32-year-old woman with a FIGO (International Federation of Gynecology and Obstetrics) stage IIA invasive squamous cell carcinoma of the uterine cervix underwent a clinical FDG PET/CT scan, which revealed intense uptake in the primary. On research F-fluciclovine PET/MRI, the primary showed elevated fluciclovine uptake at 5 and 40 minutes after radiotracer injection, with no evidence of regional or distant metastasis. Fluciclovine PET may have diagnostic value for cervical cancer imaging with a potential advantage over FDG of minimal urinary activity from renal excretion; however, in this patient, the metabolic activity was inferior to that of FDG PET.


Assuntos
Ácidos Carboxílicos , Carcinoma de Células Escamosas/diagnóstico por imagem , Ciclobutanos , Fluordesoxiglucose F18 , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias do Colo do Útero/diagnóstico por imagem , Adulto , Feminino , Humanos , Imagem por Ressonância Magnética
19.
Artigo em Inglês | MEDLINE | ID: mdl-32593620

RESUMO

OBJECTIVE: In oral squamous cell carcinoma (OSCC), 20% of patients experience local recurrences. In this study, the addition of autofluorescence to a standard incandescent light examination was evaluated to enhance detection rates of recurrences in OSCC. STUDY DESIGN: Patients with OSCC who underwent follow-up examinations were included in this prospective cohort study. All patients (with or without recurrences) were examined clinically and with autofluorescence (using VELscope; Mectron, Cologne, Germany) and biopsy was used to examine suspect lesions for recurrences. Variables likely to influence results were analyzed. An analysis of dependencies, a general log-linear analysis, and a binary regression analysis were performed using SPSS version 26 (SPSS Inc., Chicago, IL). RESULTS: The study included 195 patients and in 39 cases a biopsy was performed. Results showed significantly more recurrences with the addition of autofluorescence to the usual clinical examination (P ≥ .5). Sensitivity was 95.2% and specificity was 100%. CONCLUSIONS: This study showed the advantages of adding autofluorescence to routine clinical assessments in OSCC follow-up examinations. CLINICAL TRIAL REGISTRATION: German Clinical Trials Register DRKS-ID: DRKS00004836.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Bucais , Carcinoma de Células Escamosas/diagnóstico por imagem , Chicago , Alemanha , Humanos , Neoplasias Bucais/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Estudos Prospectivos
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