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2.
Cancer Radiother ; 24(1): 38-43, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-31992518

RESUMO

PURPOSE: The aim of this work is to evaluate the anatomical changes of the glandular structures during the NPC IMRT and to study their dosimetric impacts. PATIENTS AND METHODS: Twenty patients receiving IMRT for NPC were included. For each patient, a second dosimetric CT was performed at a dose of 38Gy, which was fused with the initial planning dosimetric CT. We calculated the volume percent change, the positional and dosimetric variation between the 2 scanners for the glandular structures (parotid, submaxillary, thyroid and pituitary). RESULTS: We observed a decrease in the volume of right and left parotids (-27.9% and -27.54%). It was correlated with the initial dose planned at its level. For the sub maxillary glands, the decrease was -36.1% on the right and -27.28% on the left. The value of reduction of the thyroid gland was -18.01%. A medial supra-millimeter migration of 2 and 1.15mm was found for right and left parotid glands respectively, correlated with GTV N reduction volume. We found a significant increase in mean doses for the parotid glands. It was 1.8±2.3Gy for the right and 1.5±2.7Gy for the left. For the right sub maxillary gland, the increase was about 0.35±2Gy and 3.79±5.2Gy for the thyroid. CONCLUSION: The modifications observed for glandular structures during NPC IMRT can explain the different toxicities caused by radiation. It seems also that a careful adaptation of the treatment plan should be considered during therapy.


Assuntos
Neoplasias Nasofaríngeas/radioterapia , Órgãos em Risco , Radioterapia de Intensidade Modulada , Carcinoma/diagnóstico por imagem , Carcinoma/radioterapia , Humanos , Neoplasias Nasofaríngeas/diagnóstico por imagem , Glândula Parótida/efeitos da radiação , Hipófise/efeitos da radiação , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Glândula Submandibular/efeitos da radiação , Glândula Tireoide/efeitos da radiação , Tomografia Computadorizada por Raios X
3.
World Neurosurg ; 133: 302-307, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31629149

RESUMO

Choroid plexus carcinoma (CPC) is a rare intraventricular neoplasm originating from choroid plexus. CPC is the most aggressive choroid plexus tumor. Almost all the CPCs are detected in children, and the preferred location is the lateral ventricle. We reviewed the literature to evaluate the state of the art concerning the management of CPC in adults and report the first case described of the extremely rare localization into the third ventricle. A 38-year-old woman presented a medical history of Parinaud syndrome and occasional facial weakness. Brain magnetic resonance imaging revealed a mass lesion in the pineal region and posterior part of the third ventricle with obstructive hydrocephalus. She underwent subtotal resection through a supracerebellar infratentorial approach. After the histopathological diagnosis of CPC, the patient underwent a second surgery with gross total resection and adjuvant radiotherapy. CPC in adults, given its extreme rarity, does not have a standardized treatment. Gross total resection should be the first step of the treatment: however, according to the literature, gross total resection is achieved only in 40-75% of cases in CPC as opposed to 95% in choroid plexus papilloma, mainly due to the difficulty in managing a highly vascularized tumor in such a deep location. Chemotherapy has not an established role and adjuvant treatment is based on radiotherapy. In the case described hereby the gross total resection associated with surgical treatment of hydrocephalus and adjuvant radiotherapy has achieved a good clinical and radiological outcome.


Assuntos
Carcinoma/cirurgia , Neoplasias do Plexo Corióideo/cirurgia , Terceiro Ventrículo/cirurgia , Adulto , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Neoplasias do Plexo Corióideo/diagnóstico por imagem , Neoplasias do Plexo Corióideo/patologia , Feminino , Humanos , Procedimentos Neurocirúrgicos , Terceiro Ventrículo/diagnóstico por imagem , Terceiro Ventrículo/patologia , Resultado do Tratamento
7.
Int Braz J Urol ; 45(6): 1270-1274, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808417

RESUMO

Bladder cancer is a common cancer that may present as superficial, invasive, or metastatic disease. Non-muscle-invasive bladder cancer (NMIBC) represents the majority of bladder cancer diagnoses, but represents a spectrum of disease with a variable clinical course, notably for significant risk of recurrence and potential for progression. NMIBC metastasis to distant organs without local invasion or regional metastasis is a very rare occurrence, so there are limi-ted case reports about early metastasis in the literature.


Assuntos
Carcinoma/secundário , Neoplasias de Cabeça e Pescoço/patologia , Metástase Linfática/patologia , Neoplasias da Bexiga Urinária/patologia , Idoso , Carcinoma/diagnóstico por imagem , Evolução Fatal , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Metástase Linfática/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X , Ultrassonografia , Neoplasias da Bexiga Urinária/diagnóstico por imagem
8.
Acta Cir Bras ; 34(10): e201901001, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31826147

RESUMO

PURPOSE: To examine the effects of Arrabidaa chica (Bignoniacea) extract, a native plant of the Amazon known as crajiru, on a 7,12-dimethyl-1,2-benzanthracene (DMBA)-induced breast cancer model in Wistar rats. METHODS: We compared the response of breast cancer to the oral administration of A. chica extract (ACE) for 16 weeks, associated or not with vincristine. Groups: normal control; DMBA (50mg/kg v.o,) without treatment; DMBA+ACE (300 mg/kg); DMBA+vincristine. 500µg/kg injected i.p; DMBA+ACE+Vincristine 250µg/kg i.p. Imaging by microPET and fluorescence, biochemistry, oxidative stress, hematology and histopathology were used to validate the treatments. RESULTS: All animals survived. A gradual weight gain in all groups was observed, with no significant difference (p>0.05). The oral administration of ACE and ACE+vincristine 50% significantly reduced breast tumors incidence examined with PET-18FDG and fluorescence (p<0.001). Significant reduction of serum transaminases, oxidative stress and hematological toxicity were observed in these groups. Antioxidant enzyme levels in breast tissue were significantly higher compared to the DMBA and DMBA+vincristine groups. CONCLUSION: These results demonstrate for the first time that ACE positively influences the treatment of DMBA-induced breast cancer in animal model, inducing a reduction in oxidative stress and chemotherapy toxicity, meaning that ACE may have clinical implication in further studies.


Assuntos
Antineoplásicos/farmacologia , Bignoniaceae/química , Neoplasias da Mama/tratamento farmacológico , Carcinoma/tratamento farmacológico , Neoplasias Experimentais/tratamento farmacológico , Extratos Vegetais/farmacologia , 9,10-Dimetil-1,2-benzantraceno , Animais , Antineoplásicos/uso terapêutico , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinógenos , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Catalase/análise , Feminino , Fluordesoxiglucose F18 , Glutationa Peroxidase/análise , Neoplasias Experimentais/diagnóstico por imagem , Neoplasias Experimentais/patologia , Imagem Óptica/métodos , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/uso terapêutico , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Ratos Wistar , Reprodutibilidade dos Testes , Superóxido Dismutase/análise , Fatores de Tempo , Resultado do Tratamento , Vincristina/farmacologia , Vincristina/uso terapêutico
9.
Medicine (Baltimore) ; 98(51): e18416, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31861007

RESUMO

RATIONALE: Pulmonary spindle cell carcinoma (PSCC) is a rare subset of pulmonary sarcomatoid carcinoma. PSCC is aggressive and has a poor prognosis. Pulmonary sclerosing pneumocytoma (PSP) is an asymptomatic slow-growing benign tumor, which usually occurs in middle-aged women. PATIENT CONCERNS: Herein, we report a case of solitary PSCC, occurring concomitantly with PSP in a 74-year-old woman. The patient visited our institution with productive purulent cough, dyspnea after activity, and hemoptysis. Enhanced computed tomography revealed an inhomogeneous enhanced mass with central low-attenuation in the right upper lobe (RUL). The mass located in the right lower lobe (RLL) exhibited homogeneous enhancement. DIAGNOSIS: These lesions were subsequently diagnosed as PSCC in the RUL and PSP in the RLL, following postoperative pathological examination. INTERVENTIONS: We performed lobectomy for the RUL and wedge resection for the RLL in one procedure. OUTCOMES: The patient did not experience complications after surgery. No radiological evidence of recurrence was observed on follow-up computed tomography performed within 7 months after the procedure. LESSONS: This case fully reflects the importance of the differential preoperative diagnosis of benign and malignant solitary pulmonary nodules. However, a rare and aggressive malignant tumor may have imaging features typical of a lung abscess, which should be treated carefully.


Assuntos
Carcinoma/patologia , Pulmão/patologia , Neoplasias Primárias Múltiplas/patologia , Hemangioma Esclerosante Pulmonar/patologia , Idoso , Carcinoma/diagnóstico por imagem , Feminino , Humanos , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Hemangioma Esclerosante Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X
11.
Curr Med Sci ; 39(5): 816-819, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31612401

RESUMO

Sometimes endometrial polyps, submucosal myomas, and endometrial cancer show similar findings under ultrasonography. The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensional (3D) power Doppler ultrasonography angiography (PDA) between endometrial cancer and uterine parenchyma lumps. The data of the blood flow indices in 3D-PDA including the vascularization index (VI), flow index (FI), and vascularization flow index (VFI) in 40 patients with endometrial cancer and 41 patients with uterine parenchyma lumps (endometrial polyps and submucosal myomas) were retrospectively analysed and compared utilizing Virtual Organ Computer-aided AnaLysis (VOCAL) software. The results showed that all the blood flow parameters (VI, FI, VFI) were significantly higher in women with endometrial cancer than in those with uterine parenchyma lumps (P<0.001). The area under the curve of ROC of VI, FI, and VFI was 0.98, 0.84, and 0.97, respectively. Thus, the best predictor of endometrial carcinoma was VI with a sensitivity of 97.0% and a specificity of 91.0%. The optimal cutoff value of VI was 4.06%. Our data demonstrated that all of the blood flow signal parameters (including VI, FI, and VFI) in 3D power Doppler ultrasonography had significant antidiastole values between endometrial cancer and uterine parenchyma lumps to assist clinicians in properly diagnosing patients.


Assuntos
Carcinoma/diagnóstico por imagem , Neoplasias do Endométrio/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/estatística & dados numéricos , Mioma/diagnóstico por imagem , Pólipos/diagnóstico por imagem , Adulto , Angiografia/estatística & dados numéricos , Área Sob a Curva , Velocidade do Fluxo Sanguíneo , Carcinoma/irrigação sanguínea , Carcinoma/patologia , Diagnóstico Diferencial , Neoplasias do Endométrio/irrigação sanguínea , Neoplasias do Endométrio/patologia , Endométrio/irrigação sanguínea , Endométrio/diagnóstico por imagem , Endométrio/patologia , Feminino , Humanos , Imagem Tridimensional , Pessoa de Meia-Idade , Mioma/irrigação sanguínea , Mioma/patologia , Pólipos/patologia , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Software , Ultrassonografia Doppler/estatística & dados numéricos
12.
Medicine (Baltimore) ; 98(41): e17446, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593099

RESUMO

RATIONALE: The infiltration of tumor cells to pulmonary lymphatic system, as known as pulmonary lymphangitis carcinomatosis (PLC), is a rare presentation of pulmonary metastases. PATIENT CONCERNS: We reported a case of a 66-year-old man after surgery, chemotherapy, and radiation therapy for colon cancer. Two months after these therapies, the patient complained of nonproductive cough for 1 week. DIAGNOSES: 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) scanning revealed increased FDG uptake along the thickened bronchovascular bundles, in bilaterally scattered ground-glass opacities and in mediastinal lymphadenopathy. The transbronchial biopsy and pathological study confirmed the diagnosis of PLC. INTERVENTIONS: Antineoplastic treatment (cetuximab) were administered after the patient was diagnosed with PLC. OUTCOMES: The patient died of respiratory failure within 3 months after the onset of his symptom. LESSONS: 18F-FDG PET/CT play an important role in identifying PLC, in selecting possible biopsy sites, and in accessing the extent of metastatic disease.


Assuntos
Carcinoma/diagnóstico por imagem , Neoplasias do Colo/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Linfangite/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Idoso , Carcinoma/secundário , Neoplasias do Colo/complicações , Neoplasias do Colo/patologia , Fluordesoxiglucose F18 , Humanos , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Linfangite/etiologia , Masculino , Compostos Radiofarmacêuticos
13.
J Pak Med Assoc ; 69(9): 1360-1364, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31511725

RESUMO

We report the presentation, management and outcomes of patients operated for hyperparathyroidism at our hospital. Patient sunder going surgery for hyper parathyroidism from 20 05 to 2 015 were retrospectively reviewed. Preoperative biochemistry, diagnostic scans and surgical procedures were studied. Follow up for cure rates, complications and histology were recorded. Out of 72 patients reviewed 54 (75%) were females and the rest males. The mean age was 48.04±15.5 years. Musculoskeletal complains were the most common (76.4%) among the cases reviewed. Asymptomatic hypercalcemia was seen in 13 (18.1%). The mean preoperative PTH level was 658.95 pg/ml and the mean preoperative calcium was 11.9 mg/dl. Bilateral neck exploration was done in 42 (58.3%) while focused unilateral approach was done in 27 (37.5%) cases. Solitary adenoma was the most frequent pathology in 58 (80.5%) patients. Asymptomatic hyperparathyroidism was less frequently detected in our population owing to lack of screening programme. Our patients are younger with a greater severity of the disease both symptomatically and biochemically compared to the West. In almost two decades, preoperative symptoms, calcium and PTH levels have changed marginally. Bilateral explorations are now giving way to focused less invasive procedures.


Assuntos
Adenoma/cirurgia , Carcinoma/cirurgia , Hiperparatireoidismo Primário/cirurgia , Esvaziamento Cervical/métodos , Neoplasias das Paratireoides/cirurgia , Paratireoidectomia/métodos , Adenoma/sangue , Adenoma/diagnóstico por imagem , Adenoma/patologia , Adulto , Doenças Assintomáticas , Cálcio/sangue , Carcinoma/sangue , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Países em Desenvolvimento , Feminino , Humanos , Hiperparatireoidismo Primário/sangue , Hiperparatireoidismo Primário/diagnóstico por imagem , Hiperparatireoidismo Primário/patologia , Hiperplasia , Hipocalcemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical/tendências , Hormônio Paratireóideo/sangue , Neoplasias das Paratireoides/sangue , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/patologia , Paratireoidectomia/tendências , Complicações Pós-Operatórias/epidemiologia , Centros de Atenção Terciária
14.
Fam Cancer ; 18(4): 457-464, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31522335

RESUMO

Individuals at high risk for pancreatic cancer are recommended surveillance and healthy lifestyle behaviours and patient experience with recommendations are understudied. To describe engagement and experience with surveillance, tobacco and alcohol use, health beliefs and motivation (Champion Health Belief Measure) and the relationship with personal, psychosocial (Impact of Event Scale), and familial characteristics. Interest in integrative therapies (complementary therapies) are described. A multi-site cross-sectional survey including individuals at high risk for pancreatic cancer with no diagnosis of pancreatic cancer who have been evaluated at a comprehensive cancer center. Descriptive statistics and Wilcoxon rank sum test and Fisher's exact test were used to assess univariate associations. Of the 132 respondents (72% response rate), 92 (70%) reported undergoing surveillance which was associated with older age (p = 0.001). Of which, 36% and 51% report that magnetic resonance imaging (MRI) or endoscopic ultrasound (EUS), respectively, were uncomfortable; 22% and 30% dread the next MRI or EUS, respectively. Of those who reported alcohol consumption (n = 88); 15% consumed 1 or more drinks daily and no alcohol consumption was associated with higher Impact of Event scale scores (p = 0.024). A total of six participants were currently smoking every day or some days. Participants reported high motivation to engage in heathy behaviours and 92% were interested in integrative therapies. In these select participants, most were engaging in pancreatic cancer surveillance, alcohol intake was moderate, and tobacco intake was minimal. Modifiable factors, such as experience and comfort with surveillance could be addressed. The sample is motivated to engage in behavioural health intervention.


Assuntos
Carcinoma/psicologia , Neoplasias Pancreáticas/psicologia , Adulto , Consumo de Bebidas Alcoólicas , Atitude Frente a Saúde , Carcinoma/diagnóstico por imagem , Carcinoma/prevenção & controle , Estudos Transversais , Endossonografia , Feminino , Predisposição Genética para Doença , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/prevenção & controle , Fatores de Risco , Fatores Socioeconômicos , Uso de Tabaco
15.
BMJ Case Rep ; 12(9)2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31492730

RESUMO

A 46-year-old woman presented with hypertension and renal disease. Investigations showed severe hypercalcaemia due to primary hyperparathyroidism. Imaging demonstrated renal calculi and an incidental left adrenal lesion. Additional biochemistry confirmed adrenocorticotropic hormone-independent hypercortisolism. Ultrasound and sestamibi scan found an enlarged right-sided parathyroid gland and a suspicious right thyroid nodule, biopsy of which suggested papillary carcinoma. The right parathyroid mass, right thyroid lobe and right central compartment tissue along with a segment of the right recurrent laryngeal nerve was resected en-bloc Completion thyroidectomy and left adrenalectomy were performed 6 months later. Histology showed parathyroid cancer, multifocal papillary thyroid cancer and adrenal clear cell cortical adenoma. Genetic tests were normal. There was no evidence of recurrence at 12 months follow-up. Parathyroid cancer should be suspected in the presence of significant hypercalcaemia, very high parathyroid hormone and end organ damage. Suspicious thyroid nodules on imaging should be appropriately investigated.


Assuntos
Neoplasias do Córtex Suprarrenal/diagnóstico por imagem , Adenoma Adrenocortical/diagnóstico por imagem , Carcinoma/diagnóstico por imagem , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias das Paratireoides/diagnóstico por imagem , Câncer Papilífero da Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias do Córtex Suprarrenal/metabolismo , Neoplasias do Córtex Suprarrenal/cirurgia , Adenoma Adrenocortical/metabolismo , Adenoma Adrenocortical/cirurgia , Carcinoma/metabolismo , Carcinoma/cirurgia , Síndrome de Cushing/metabolismo , Feminino , Humanos , Hiperparatireoidismo Primário/diagnóstico , Hiperparatireoidismo Primário/metabolismo , Microscopia Acústica , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/metabolismo , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias das Paratireoides/metabolismo , Neoplasias das Paratireoides/cirurgia , Cintilografia , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Sestamibi , Câncer Papilífero da Tireoide/metabolismo , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/metabolismo , Neoplasias da Glândula Tireoide/cirurgia , Tomografia Computadorizada por Raios X
16.
Clin Lab ; 65(8)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31414757

RESUMO

BACKGROUND: Detection of carcinoembryonic Antigen (CEA) in pleural effusion has good clinical application value in differentiating benign and malignant pleural effusion, but sometimes CEA provides limited help. We report a case of a patient with left lung neoplasms combined with bilateral pleural effusion with increased CEA in the pleural effusion whose thoracoscopy pleural biopsy pathology was negative, mimicking lung carcinoma and ultimately confirmed as pulmonary sarcomatoid carcinoma by CT-guided percutaneous lung biopsy. METHODS: The chest computed tomography (CT) scan, thoracoscopy pleural biopsy, and CT-guided percutaneous lung biopsy were arranged to explore the etiology of pleural effusion. RESULTS: The chest CT scan showed bilateral pleural effusion with left lung neoplasms, pulmonary atelectasis, and left hilar enlargement. Pathology of thoracoscopy biopsy showed pleural inflammation with infiltration of inflammatory cells. Pathology of CT-guided percutaneous lung biopsy confirmed pulmonary sarcomatoid carcinoma. CONCLUSIONS: Elevated pleural effusion CEA is not a specific index of lung cancer. CT-guided percutaneous lung biopsy is appropriate for patients presenting with pleural diseases with lung neoplasms, especially when thoracoscopy pleural biopsy result was negative.


Assuntos
Antígeno Carcinoembrionário/metabolismo , Carcinoma/diagnóstico , Erros de Diagnóstico , Neoplasias Pulmonares/diagnóstico , Pleura/metabolismo , Derrame Pleural/diagnóstico , Idoso , Biópsia , Carcinoma/diagnóstico por imagem , Carcinoma/metabolismo , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pleura/diagnóstico por imagem , Pleura/patologia , Derrame Pleural/metabolismo , Derrame Pleural/patologia , Toracoscopia/métodos , Tomógrafos Computadorizados
17.
BMC Cancer ; 19(1): 827, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438887

RESUMO

BACKGROUND: SMARCB1-deficient sinonasal carcinoma (SDSC) is an aggressive subtype of head and neck cancers that has a poor prognosis despite multimodal therapy. We present a unique case with next generation sequencing data of a patient who had SDSC with perineural invasion to the trigeminal nerve that progressed to a brain metastasis and eventually leptomeningeal spread. CASE PRESENTATION: A 42 year old female presented with facial pain and had resection of a tumor along the V2 division of the trigeminal nerve on the right. She underwent adjuvant stereotactic radiation. She developed further neurological symptoms and imaging demonstrated the tumor had infiltrated into the cavernous sinus as well as intradurally. She had surgical resection for removal of her brain metastasis and decompression of the cavernous sinus. Following her second surgery, she had adjuvant radiation and chemotherapy. Several months later she had quadriparesis and imaging was consistent with leptomeningeal spread. She underwent palliative radiation and ultimately transitioned quickly to comfort care and expired. Overall survival from time of diagnosis was 13 months. Next generation sequencing was carried out on her primary tumor and brain metastasis. The brain metastatic tissue had an increased tumor mutational burden in comparison to the primary. CONCLUSIONS: This is the first report of SDSC with perineural invasion progressing to leptomeningeal carcinomatosis. Continued next generation sequencing of the primary and metastatic tissue by clinicians is encouraged toprovide further insights into metastatic progression of rare solid tumors.


Assuntos
Carcinoma/etiologia , Carcinoma/patologia , Neoplasias dos Seios Paranasais/etiologia , Neoplasias dos Seios Paranasais/patologia , Proteína SMARCB1/deficiência , Adulto , Biomarcadores Tumorais , Carcinoma/diagnóstico por imagem , Progressão da Doença , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Imuno-Histoquímica , Carcinomatose Meníngea/diagnóstico , Carcinomatose Meníngea/secundário , Metástase Neoplásica , Estadiamento de Neoplasias , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Polimorfismo de Nucleotídeo Único , Tomografia Computadorizada por Raios X
18.
Anticancer Res ; 39(8): 4449-4454, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366543

RESUMO

BACKGROUND/AIM: Prostate multiparametric magnetic resonance imaging (mpMRI) is the reference imaging modality for extraprostatic extension of disease (EPE) assessment. We aimed to compare the diagnostic accuracy of different abbreviated MRI protocols to the standard prostate mpMRI in the identification of EPE of PCa. PATIENTS AND METHODS: Fifty patients were retrospectively enrolled. Dual-pulse (dpMRI) and biparametric (bpMRI) abbreviated protocols were obtained from mpMRI. The performance of two experienced radiologists and two radiology residents was correlated with a reference standard and compared. Inter and intra-reader agreements were evaluated. RESULTS: All protocols were strongly correlated to the reference standard (p≤0.001). A significant difference was found between dpMRI and mpMRI (p=0.009), no differences emerged between bpMRI and mpMRI (p=0.27). All readers showed moderate agreement (ĸ=0.47, ĸ=0.50 and ĸ=0.53 for dpMRI, bpMRI and mpMRI, respectively). Intra-reader agreement was good (all ĸ values ≥0.70). CONCLUSION: Only bpMRI showed similar diagnostic performance to mpMRI, thus appearing as a feasible alternative to the standard protocol for EPE detection.


Assuntos
Carcinoma/diagnóstico por imagem , Imagem por Ressonância Magnética , Próstata/diagnóstico por imagem , Neoplasias da Próstata/diagnóstico por imagem , Idoso , Carcinoma/complicações , Carcinoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Próstata/patologia , Prostatectomia , Neoplasias da Próstata/complicações , Neoplasias da Próstata/patologia , Estudos Retrospectivos
19.
Medicine (Baltimore) ; 98(33): e16608, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415354

RESUMO

The utility of multimodality molecular imaging for predicting treatment response and survival of patients with hypopharyngeal carcinoma remains unclear. Here, we sought to investigate whether the combination of different molecular imaging parameters may improve outcome prediction in this patient group.Patients with pathologically proven hypopharyngeal carcinoma scheduled to undergo chemoradiotherapy (CRT) were deemed eligible. Besides clinical data, parameters obtained from pretreatment 2-deoxy-2-[fluorine-18]fluoro-D-glucose positron emission tomography/computed tomography (F-FDG PET/CT), dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), and diffusion-weighted MRI were analyzed in relation to treatment response, recurrence-free survival (RFS), and overall survival (OS).A total of 61 patients with advanced-stage disease were examined. After CRT, 36% of the patients did not achieve a complete response. Total lesion glycolysis (TLG) and texture feature entropy were found to predict treatment response. The transfer constant (K), TLG, and entropy were associated with RFS, whereas K, blood plasma volume (Vp), standardized uptake value (SUV), and entropy were predictors of OS. Different scoring systems based on the sum of PET- or MRI-derived prognosticators enabled patient stratification into distinct prognostic groups (P <.0001). The complete response rate of patients with a score of 2 was significantly lower than those of patients with a score 1 or 0 (14.7% vs 58.9% vs 75.7%, respectively, P = .007, respectively). The combination of PET- and DCE-MRI-derived independent risk factors allowed a better survival stratification than the TNM staging system (P <.0001 vs .691, respectively).Texture features on F-FDG PET/CT and DCE-MRI are clinically useful to predict treatment response and survival in patients with hypopharyngeal carcinoma. Their combined use in prognostic scoring systems may help these patients benefit from tailored treatment and obtain better oncological results.


Assuntos
Carcinoma/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/estatística & dados numéricos , Neoplasias Hipofaríngeas/diagnóstico por imagem , Imagem por Ressonância Magnética/estatística & dados numéricos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/estatística & dados numéricos , Adulto , Carcinoma/mortalidade , Carcinoma/patologia , Imagem de Difusão por Ressonância Magnética/métodos , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Hipofaríngeas/mortalidade , Neoplasias Hipofaríngeas/patologia , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Imagem Multimodal/estatística & dados numéricos , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Prognóstico , Compostos Radiofarmacêuticos , Taxa de Sobrevida
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