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1.
World J Surg Oncol ; 19(1): 262, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34470640

RESUMO

BACKGROUND: This study aimed to investigate the correlation between miRNA-216b expression in patients with non-small cell lung cancer (NSCLC) and 18F-fluorodeoxyglucose (FDG) uptake by PET/CT and to explore the clinical application value of 18F-FDG PET/CT in miRNA-216b based on therapy for NSCLC. METHODS: Eighty patients with NSCLC and 40 healthy subjects were enrolled in our study. The SUVmax of the lesion area by PET/CT imaging was calculated. SUVmax represented the highest concentration of 18F-FDG in the lesion. The expression of miRNA-216b in the plasma and fiber bronchoscopic puncture of NSCLC patients was detected by RT qPCR. Then Pearson correlation analysis was used to analyze the correlation between miRNA-216b expression and 18F-FDG uptake in patients with different types of NSCLC. RESULTS: Compared with healthy subjects, SUVmax of early adenocarcinoma and advanced adenocarcinoma were increased. Compared with healthy subjects, SUVmax of early squamous and advanced squamous were increased. And the SUVmax content of advanced adenocarcinoma and squamous cell carcinoma was higher than that of early adenocarcinoma and squamous cell carcinoma. Compared with healthy subjects, the expression of miRNA-216b in the plasma of patients with early and advanced adenocarcinoma was reduced, and the expression of miRNA-216b in the plasma of patients with early and advanced squamous cell carcinoma was reduced. Compared with adjacent tissues, the expression of miRNA-216b in early adenocarcinoma tissues and advanced adenocarcinoma tissues was reduced, and the expression in early squamous cell carcinoma and advanced squamous cell carcinoma was reduced. Pearson correlation analysis showed a negative correlation between SUVmax and miRNA-216b (plasma and tissue) in patients with four types of NSCLC. CONCLUSION: miRNA-216b expression was negatively correlated with 18F-FDG uptake in NSCLC. miRNA-216b could be used for the classification and staging of non-small cell lung cancer. 18F-FDG PET/CT may be used to evaluate the therapeutic response in application of miRNA-216b-based cancer treatment.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Fluordesoxiglucose F18/farmacocinética , Neoplasias Pulmonares , MicroRNAs , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/genética , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/genética , MicroRNAs/genética , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Prognóstico , Compostos Radiofarmacêuticos
2.
Medicine (Baltimore) ; 100(35): e27189, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477179

RESUMO

ABSTRACT: Histiocytic necrotizing lymphadenitis (HNL) is a rare, benign, and self-limiting inflammatory disease that mainly involves the lymph nodes. There is a lack of large sample studies concerning the clinical manifestations and imaging features of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of HNL.The clinical symptoms, laboratory examination results, 18F-FDG PET/CT imaging features, and treatment outcome were investigated in this retrospective study.A total of 40 HNL patients were recruited. The onset age was between 14 and 65 years, with a median of 25 years. The white blood cell count was 3.9 (2.9, 7.1) × 109/L, C-reactive protein level was 20.2 (6.6, 63.8) mg/L, erythrocyte sedimentation rate was 29.0 (18.0,45.0) mm/h, and ferritin was 616.5 (205.6, 2118.1) ng/mL. An abnormal liver function was observed in 23 patients. 18F-FDG PET-CT showed that an abnormal lymph node metabolism was observed in 38 patients, among which the highest 18F-FDG maximal standard uptake value (SUVmax) of the lymph nodes ranged between 3.4 and 41.9; the nodes were mainly distributed in the neck and axilla regions. Meanwhile, a total of 2502 lymph nodes (721 lymph nodes with a short axis greater than 10 mm) were found in the 38 patients, including 1837 lymph nodes with an 18F-FDG SUVmax ≥ 2.5. The 18F-FDG SUVmax of the spleen ranged from 2.5 to 9.2 in 20 patients, while that of central and peripheral bone marrow ranged from 2.7 to 36.0 in 30 patients. After follow-up for an average period of 1 month, the symptoms improved after prednisone treatment.HNL often occurs in adolescents. Scanning with 18F-FDG PET/CT showed that most patients had multiple involved lymph nodes that were hypermetabolic, and only few lymph nodes are enlarged. Besides, the spleen or central and peripheral bone marrow could sometimes be hypermetabolic. Glucocorticoid treatment for the HNL patients is effective.


Assuntos
Fluordesoxiglucose F18 , Linfadenite Histiocítica Necrosante/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Adolescente , Adulto , Idoso , Anti-Inflamatórios/administração & dosagem , Feminino , Linfadenite Histiocítica Necrosante/tratamento farmacológico , Linfadenite Histiocítica Necrosante/patologia , Humanos , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Estudos Retrospectivos , Adulto Jovem
3.
Urologiia ; (4): 41-46, 2021 Sep.
Artigo em Russo | MEDLINE | ID: mdl-34486273

RESUMO

AIM: to perform a comparative analysis of the results of morphofunctional and morphoanatomical studies for the clinical assessment of the viability of the renal parenchyma. MATERIALS AND METHODS: Based on a random sampling method, the results of whole-body PET/CT scan with 18F-FDG glucose in 134 patients with various non-urological disorders were analyzed. However, 13.3% of the participants had concomitant chronic kidney diseases without exacerbation. At the same time, the morphological and anatomical manifestations of chronic kidney disease were studied in 32 patients of the same age and sex in order to evaluate the severity of structural changes in nephron. RESULTS: It was found that among individuals undergone to whole-body PET/CT scan with 18F-FDG glucose for various diseases without a urological history and patients with chronic kidney disease, the parenchyma tropism to energy-intensive labeled glucose molecules had certain differences that correlated with morphoanatomical manifestations of structural changes in the nephron in chronic kidney disease. CONCLUSIONS: The modern morphofunctional PET/CT study of the whole-body viability with 18F-FDG glucose, including the kidneys, is an advanced diagnostic tool that may supplement the results of morphoanatomical studies and monitor the efficiency of treatment.


Assuntos
Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Glucose , Humanos , Rim/diagnóstico por imagem , Imagem Corporal Total
4.
Medicine (Baltimore) ; 100(35): e26961, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477126

RESUMO

BACKGROUND: The quantification of heterogeneity for the striatum and whole brain with F-18 FP-CIT PET images will be useful for diagnosis. The index obtained from texture analysis on PET images is related to pathological change that the neuronal loss of the nigrostriatal tract is heterogeneous according to the disease state. The aim of this study is to evaluate various heterogeneity indices of F-18 FP-CIT PET images in the diagnosis of Parkinson's disease (PD) patients and to access the diagnostic accuracy of the indices using machine learning (ML). METHODS: This retrospective study included F-18 FP-CIT PET images of 31 PD and 31 age-matched health controls (HC). The volume of interest was delineated according to iso-contour lines around standardized uptake value (SUV) 3.0 g/ml for each region of the striatum by PMod 3.603. One hundred eight heterogeneity indices were calculated using CGITA to find indices from which the PD and HC were classified using statistical significance. PD group was classified by constructing a 2-dimensional or 3-dimensional phase space quantifier using these heterogeneity indices. We used 71 heterogeneity indices to classify PD from HC using ML for dimensional reduction. RESULTS: The heterogeneity indices for classifying PD from HC were size-zone variability, contrast, inverse difference-moment, and homogeneity in the order of low P value. Three-dimensional quantifiers composed of normalized-contrast, code-similarity, and contrast were more clearly classified than 2-dimensional ones. After 71-dimensional reduction using PCA, classification was possible by logistic regression with 91.3% accuracy. The 2 groups were classified with an accuracy of 85.5% using the support vector machine and 88.4% using the random forest. The classification accuracy using the eXtreme Gradient Boosting was 95.7%, and feature importance was highest in order of SUV bias-corrected kurtosis, size-zone-variability, intensity-variability, and high-intensity-zone-variability. CONCLUSION: It was confirmed that PD patients is more clearly classified than the conventional 2-dimensional quantifier by introducing a 3-dimensional phase space quantifier. We observed that ML can be used to classify the 2 groups in an easy and explanatory manner. For the discrimination of the disease, 24 heterogeneity indices were found to be statistically useful, and the major cut-off values of 3 heterogeneity indices were size-zone variability (1906.44), intensity variability (129.21), and high intensity zone emphasis (800.29).


Assuntos
Doença de Parkinson/diagnóstico , Tomografia por Emissão de Pósitrons/estatística & dados numéricos , Idoso , Feminino , Fluordesoxiglucose F18/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Neuroimagem/métodos , Neuroimagem/estatística & dados numéricos , Doença de Parkinson/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Estudos Retrospectivos
5.
BMJ Case Rep ; 14(9)2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34489256

RESUMO

An 82-year-old woman admitted following a 4-week history of feeling unwell, abdominal pain and constipation. Initial investigations revealed severe hypercalcaemia with suppressed parathyroid hormone and elevated 1,25-dihydroxycholecalciferol. ACE was also raised. CT scans of the head, chest, abdomen and pelvis were normal. Fluorodeoxyglucose-positron emission tomography scan showed metabolically active right axillary lymphadenopathy which when biopsied under ultrasound guidance confirmed sarcoidosis. The patient was started on high-dose prednisolone with resolution of symptoms within 2 weeks. Isolated lymph node sarcoidosis is uncommon, and the reported usual sites are lymph nodes in the head and neck. Rarely has it been reported in the axillary lymph nodes.


Assuntos
Sarcoidose , Idoso de 80 Anos ou mais , Axila , Diagnóstico Diferencial , Feminino , Fluordesoxiglucose F18 , Humanos , Linfonodos/diagnóstico por imagem , Sarcoidose/diagnóstico , Sarcoidose/tratamento farmacológico
6.
J Coll Physicians Surg Pak ; 31(9): 1102-1104, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34500530

RESUMO

Cardiac lymphomas, either primary or secondary, are mostly of B-cell lineage; among which, diffuse large B-cell lymphoma (DLBCL) is the most common. Secondary involvement of the heart is usually a late manifestation of disseminated lymphoma. Patients may be asymptomatic or may have non-specific symptoms, particularly when cardiac involvement is not extensive. A 22-year male patient presented with four months' history of progressive enlargement of left cervical lymph nodes with intermittent fever along with dysphagia and left ear pain. Positron-emission tomography (PET)/computed tomography (CT) scan revealed abnormal fluorodeoxyglucose (FDG) uptake in multiple systemic locations including inferior wall of the myocardium. Subsequently, cardiac MRI showed left ventricular posterolateral wall abnormal area of delayed enhancement, corresponding to the FDG uptake on PET CT scan. Patient had remission after completion of standard chemotherapy protocol for the management of DLBCL with acceptable toxicity. Key Words: Diffuse large B-cell lymphoma (DLBCL), Secondary, Heart, Chemotherapy.


Assuntos
Linfoma Difuso de Grandes Células B , Compostos Radiofarmacêuticos , Fluordesoxiglucose F18 , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Imageamento por Ressonância Magnética , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons
7.
Acta Oncol ; 60(9): 1122-1129, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34402368

RESUMO

BACKGROUND: The incidence of primary cardiac lymphoma (PCL) is increasing, but the optimal management approach remains unclear. We assessed the clinical characteristics of a single-centre cohort with the goal of determining the optimal management approach. The treatment outcomes and prognostic factors are reported. MATERIAL AND METHODS: All PCL patients were diagnosed via biopsy guided by whole-body imaging (positron emission tomography/computed tomography [PET/CT] and/or contrast-enhanced CT]. Curative therapy involved either surgery or prephase steroids followed by definitive immunochemotherapy, depending on the histological type. The primary outcomes were overall survival (OS) and progression-free survival (PFS); the secondary outcome was the treatment response. RESULTS: Twenty-two PCL patients (14 males, 8 females; age: 59.5 ± 14.7 years [mean ± S.D.]) were histologically confirmed to have diffuse large B-cell lymphoma (DLBCL; n = 17 [77.3%]), fibrin-associated DLBCL (FA-DLBCL) (n = 4 [18.2%]) and Burkitt lymphoma (n = 1 [4.5%]). Seven patients underwent cardiotomy (three for biopsy, four with curative intent). The median and longest follow-up periods were 16.3 and 180.0 months, respectively. The 16 patients who received curative therapy (complete response [CR], n = 15 [93.8%]; partial response [PR], n = 1 [6.2%]) showed better survival than those who did not (5-year OS: 83.0 ± 11.3% vs. 0%; hazard ratio [HR]: 0.025[95% confidence interval, CI: 0.003-0.187], p < 0.001); 5-year PFS: 78.7 ± 11.0% vs. 0%, HR= 0.010[0.001-0.093], p < 0.001). The left ventricular ejection fractions (LVEF) before and after definitive treatment was 63.6 ± 2.4% and 64.6 ± 4.5%, respectively (p = 0.275, power = 0.318). Extrapericardial lesions were associated with poorer survival (5-year OS: 40.0 ± 29.7% vs. 100%, p = 0.027; 5-year PFS:40.0 ± 21.9% vs. 100%, p = 0.010). CONCLUSIONS: Whole-body imaging is essential for diagnosis and prognosis. Curative therapy provided reasonable outcomes and survival; extrapericardial lesions were associated with a poorer treatment response.


Assuntos
Linfoma Difuso de Grandes Células B , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Fluordesoxiglucose F18 , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prognóstico , Intervalo Livre de Progressão , Estudos Retrospectivos
8.
Yonsei Med J ; 62(9): 814-821, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34427067

RESUMO

PURPOSE: To evaluate whether vascular uptake on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) during the clinically inactive state of Takayasu arteritis (TAK) is associated with disease relapse. MATERIALS AND METHODS: Patients with TAK who underwent 18F-FDG PET/CT during the clinically inactive state of the disease between 2006 and 2019 were included. Clinically inactive disease was defined as a status not fulfilling the National Institutes of Health (NIH) criteria for active disease in TAK. Relapse was defined as recurrence of clinically active disease after a clinically inactive period, requiring change in the treatment regimen. Vascular uptake on 18F-FDG PET/CT was assessed using target/background ratio (TBR), calculated as arterial maximum standardized uptake value (SUV)/mean SUV in venous blood pool. Multivariable Cox regression analysis was performed to identify factors associated with relapse. RESULTS: A total of 33 patients with clinically inactive TAK were included. During a median observation period of 4.5 (0.9-8.1) years, relapse occurred in 9 (27.3%) patients at median 1.3 (0.7-6.9) years. Notably, TBR [1.5 (1.3-1.8) vs. 1.3 (1.1-1.4), p=0.044] was significantly higher in patients who relapsed than in those who did not. On multivariable Cox regression analysis, the presence of NIH criterion 2 [adjusted hazard ratio (HR): 7.044 (1.424-34.855), p=0.017] and TBR [adjusted HR: 11.533 (1.053-126.282), p=0.045] were significantly associated with an increased risk of relapse. CONCLUSION: Vascular uptake on 18F-FDG PET/CT and the presence of NIH criterion 2 are associated with future relapse in patients with clinically inactive TAK.


Assuntos
Fluordesoxiglucose F18 , Arterite de Takayasu , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos Radiofarmacêuticos , Recidiva , Arterite de Takayasu/diagnóstico por imagem
9.
J Pak Med Assoc ; 71(7): 1907-1908, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34410274

RESUMO

"Superscan" features have been described in 18F FDG PET-CT (F18 fluorodeoxyglucose Positron Emission Tomography­Computed Tomography) scan; characterized by significantly increased uptake in one or more organ systems resulting in absent or decreased uptake in the organs which normally show physiological uptake. The importance of the awareness has evolved over the years in order to avoid false interpretation of scan findings as well as in determination of a high tumour burden. We present images of three patients who underwent 18F FDG PET-CT scan showing findings consistent with FDG PET-CT superscan.


Assuntos
Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Humanos , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X , Carga Tumoral
10.
Artigo em Inglês | MEDLINE | ID: mdl-34340958

RESUMO

In recent months, much of the scientific efforts have focused on research on SARSCoV-2 infection and its consequences in humans. Still, many aspects remain unknown. It is known that the damage caused by SARS-CoV-2 is multifactorial and that its extension goes beyond lung inflammation and the acute phase, with the appearance of numerous complications and sequelae. To date, knowledge about the usefulness of 18F-FDG-PET/CT in the acute phase has been limited to the incidental detection of SARS-CoV-2 unsuspected pneumonia. Recent studies have been appearing collecting the findings of 18F-FDG-PET/CT in long COVID-19 or persistent COVID-19 state as well as the alterations caused after mass vaccination of the population in the metabolic studies. This work aims to review the existing literature focusing on these three issues and to briefly present our own preliminary experience.


Assuntos
COVID-19/complicações , COVID-19/diagnóstico por imagem , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos Radiofarmacêuticos , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos
11.
Medicina (Kaunas) ; 57(8)2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34441015

RESUMO

Backgroundand objectives: The clinical assessment of therapeutic response in pyogenic vertebral osteomyelitis (PVO) has been usually performed based on the changes of clinical symptoms and blood inflammatory markers. Recently, 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) has emerged as an alternative independent method. We analyzed the validity of the clinical assessment for detecting residual PVO based on 18F-FDG-PET. Materials and Methods: This study was conducted with 53 patients confirmed as lumbar PVO under retrospective design. All patients underwent clinical assessment using clinical symptoms and C-reactive protein (CRP) for therapeutic response after parenteral antibiotic therapy, which led to the decision of placement in the uncontrolled (group UC) or controlled (group C) group. The validity of clinical assessment was analyzed based on the cut-off values of FDG uptake for detecting residual PVO as references, which are already established in the previous literature. Results: The mean duration of parenteral antibiotic therapy and recurrence rate were 42.19 ± 15.84 (21-89) days and 9.4% (5/53), respectively. 18F-FDG-PETs were performed at 80 rounds of clinical assessment on 37.40 ± 13.15 (21-83) days of parenteral antibiotic therapy and divided: 31 into group UC and 49 into group C, according to the decisions of clinical assessment. Based on the cut-off values of FDG uptake, clinical assessment showed 48.4-58.1% of false positive for residual PVO in group UC. However, 18F-FDG-PET showed 8.2% (4/49) of false negative for residual PVO in group C, which led to recurrences. Conclusions: Clinical assessment using clinical symptoms and CRP for evaluating therapeutic response in PVO is still a useful method in terms of similar recurrence rate compared to 18F-FDG-PET. However, the high rate of false positive for residual PVO can prolong the use of unnecessary antibiotics and overall treatment period.


Assuntos
Fluordesoxiglucose F18 , Osteomielite , Proteína C-Reativa , Humanos , Osteomielite/diagnóstico por imagem , Osteomielite/tratamento farmacológico , Tomografia por Emissão de Pósitrons , Estudos Retrospectivos
12.
Medicina (Kaunas) ; 57(8)2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34441062

RESUMO

Monoclonal gammopathy of undetermined significance (MGUS) is a highly prevalent condition with the possible risk of progression to multiple myeloma (MM) or a lymphoproliferative neoplasm in a small percentage of patients. Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) or positron emission tomography/magnetic resonance imaging (PET/MRI) are imaging methods increasingly used in patients with MM. The aim of this communication is to underline that, taking into account current evidence-based data, compared to MM the role of 18F-FDG PET/CT or PET/MRI in MGUS is still undetermined and more studies should be performed before suggesting 18F-FDG PET/CT or PET/MRI for evaluation of MM progression in patients with MGUS.


Assuntos
Fluordesoxiglucose F18 , Gamopatia Monoclonal de Significância Indeterminada , Humanos , Imageamento por Ressonância Magnética , Gamopatia Monoclonal de Significância Indeterminada/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons
13.
Kyobu Geka ; 74(9): 720-723, 2021 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-34446630

RESUMO

Primary mediastinal leiomyosarcoma is extremely rare, and few reports in the literature have described the clinical features of this malignancy. We report a case of a small anterior mediastinal leiomyosarcoma that showed rapid growth within a short period. An 85-year-old woman showed a small anterior mediastinal tumor on chest computed tomography (CT), three months prior to presentation. Contrast-enhanced chest CT revealed rapid tumor growth, and positron emission tomography/CT revealed significant 18-fluorodeoxyglucose uptake, suggestive of malignancy. Thoracoscopic tumor resection was performed via the left thoracic approach. In addition to the tumor and surrounding anterior mediastinal tissue, we resected an area of pericardial infiltration. The tumor was diagnosed as a primary mediastinal leiomyosarcoma based on histopathological and immunohistochemical findings.


Assuntos
Leiomiossarcoma , Neoplasias do Mediastino , Idoso de 80 Anos ou mais , Feminino , Fluordesoxiglucose F18 , Humanos , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/cirurgia , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Mediastino/diagnóstico por imagem , Mediastino/cirurgia , Tomografia Computadorizada por Raios X
14.
J Int Med Res ; 49(8): 3000605211035197, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34461767

RESUMO

Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma, but its diagnosis is challenging in some cases. A brain biopsy is the gold standard for diagnosing PCNSL, but its invasiveness can be problematic. Thus, noninvasive imaging examinations have been developed for the pre-surgical diagnosis of PCNSL, including gadolinium-enhanced magnetic resonance imaging (MRI), 123I-N-isopropyl-p-iodoamphetamine single-photon emission computed tomography (123I-IMP SPECT), and positron emission tomography with 18F-fluorodeoxyglucose (18F-FDG PET). Here, we report the case of a 71-year-old woman with negative imaging findings for PCNSL, but who was diagnosed with PCNSL by a brain biopsy and histological analysis. Her imaging results were negative for gadolinium-enhanced cranial MRI, with low uptake in 123I-IMP SPECT and hypometabolism in 18F-FDG PET. However, a stereotactic brain biopsy from an abnormal lesion revealed that many round cells had infiltrated into the brain. Moreover, many infiltrating cells were positive for cluster of differentiation (CD)20 and CD79a, and proliferation marker protein Ki-67-positive cells accounted for nearly 80% of all cells. Based on these results, our final pathological diagnosis was PCNSL. The present case highlights the possibility of a PCNSL diagnosis even when all imaging-related examinations display negative results.


Assuntos
Neoplasias do Sistema Nervoso Central , Linfoma não Hodgkin , Linfoma , Idoso , Biópsia , Encéfalo/diagnóstico por imagem , Sistema Nervoso Central , Neoplasias do Sistema Nervoso Central/diagnóstico por imagem , Feminino , Fluordesoxiglucose F18 , Humanos , Linfoma não Hodgkin/diagnóstico por imagem , Imageamento por Ressonância Magnética , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X
15.
Eur J Endocrinol ; 185(4): 553-563, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34342595

RESUMO

Objective: Brown adipose tissue (BAT) controls metabolic rate through thermogenesis. As its regulatory factors during the transition from hyperthyroidism to euthyroidism are not well established, our study investigated the relationships between supraclavicular brown adipose tissue (sBAT) activity and physiological/metabolic changes with changes in thyroid status. Design: Participants with newly diagnosed Graves' disease were recruited. A thionamide antithyroid drug (ATD) such as carbimazole (CMZ) or thiamazole (TMZ) was prescribed in every case. All underwent energy expenditure (EE) measurement and supraclavicular infrared thermography (IRT) within a chamber calorimeter, as well as 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography/magnetic resonance (PET/MR) imaging scanning, with clinical and biochemical parameters measured during hyperthyroidism and repeated in early euthyroidism. PET sBAT mean/maximum standardized uptake value (SUV mean/max), MR supraclavicular fat fraction (sFF) and mean temperature (Tscv) quantified sBAT activity. Results: Twenty-one (16 female/5 male) participants aged 39.5 ± 2.5 years completed the study. The average duration to attain euthyroidism was 28.6 ± 2.3 weeks. Eight participants were BAT-positive while 13 were BAT-negative. sFF increased with euthyroidism (72.3 ± 1.4% to 76.8 ± 1.4%; P < 0.01), but no changes were observed in PET SUV mean and Tscv. Significant changes in serum-free triiodothyronine (FT3) levels were related to BAT status (interaction P value = 0.04). FT3 concentration at hyperthyroid state was positively associated with sBAT PET SUV mean (r = 0.58, P = 0.01) and resting metabolic rate (RMR) (P < 0.01). Conclusion: Hyperthyroidism does not consistently lead to a detectable increase in BAT activity. FT3 reduction during the transition to euthyroidism correlated with BAT activity.


Assuntos
Tecido Adiposo Marrom/metabolismo , Hipertireoidismo/metabolismo , Hipertireoidismo/reabilitação , Tecido Adiposo Marrom/diagnóstico por imagem , Tecido Adiposo Marrom/efeitos dos fármacos , Adulto , Idoso , Antitireóideos/farmacologia , Antitireóideos/uso terapêutico , Composição Corporal/efeitos dos fármacos , Composição Corporal/fisiologia , Carbimazol/uso terapêutico , Metabolismo Energético/efeitos dos fármacos , Metabolismo Energético/fisiologia , Feminino , Fluordesoxiglucose F18 , Doença de Graves/tratamento farmacológico , Doença de Graves/metabolismo , Doença de Graves/reabilitação , Humanos , Hipertireoidismo/diagnóstico , Hipertireoidismo/tratamento farmacológico , Imageamento por Ressonância Magnética , Masculino , Metimazol/uso terapêutico , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons , Indução de Remissão , Singapura , Termogênese/efeitos dos fármacos , Termogênese/fisiologia , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/efeitos dos fármacos , Glândula Tireoide/metabolismo , Glândula Tireoide/fisiologia , Adulto Jovem
16.
Eur J Radiol ; 142: 109874, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34339955

RESUMO

PURPOSE: [18F]-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET/CT) has a central role in the lung nodules' characterization even if, with SUV < 2.5, percutaneous CT-guided Lung Biopsy (CTLB) is needed to assess nodule nature. In that scenario, CT Texture Analysis (CTTA) could be a non-invasive imaging biomarker. Our purpose is to test CTTA ability in differentiating malignant from benign nodules. METHOD: Patients that underwent FDG PET/CT followed by CTLB between January 2013 and December 2018 were retrospectively enrolled. Were included patients with lung nodule SUV < 2.5 and histological diagnosis. EXCLUSION CRITERIA: nodules SUV > 2.5, patients who refused CTLB or received oncological treatment before CTLB, indeterminate pathology report, CT motion artifacts. Two radiologists in consensus performed CTTA, drawing a volumetric Region of Interest of nodule with a dedicated first order TA software with and without spatial scaling filters, on preliminary CT performed for CTLB. Statistics included a comparison between malignant and benign neoplasms distribution (2-tailed T-test or Mann-Whitney test according to normal/non-normal data distribution), P-values < 0.05 were considered statistically significant. CTTA accuracy was tested with Receiver Operating Characteristics (ROC) curve. RESULTS: Form an initial population of 1178, 46 patients encountered inclusion criteria. Pathologist reported 27/46 (59%) malignant and 19/46 (41%) benign nodules. In malignant lesions CTTA showed lower Kurtosis' and higher Skewness' values (all P ≤ 0.0013 and all filtered TA P < 0.024, respectively). ROC curve showed significant Area Under the Curve for Kurtosis and Skewness (0.654 and 0.642, P < 0.001) at medium filtration. CONCLUSIONS: CTTA is a promising radiological tool to characterize benign and malignant lung nodules, even in those cases without an altered glucose metabolism.


Assuntos
Neoplasias Pulmonares , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Biópsia , Fluordesoxiglucose F18 , Humanos , Pulmão , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Estudos Retrospectivos
17.
Theranostics ; 11(16): 7735-7754, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34335961

RESUMO

Rationale: Multiple myeloma (MM) is a multifocal malignancy of bone marrow plasma cells, characterized by vicious cycles of remission and relapse that eventually culminate in death. The disease remains mostly incurable largely due to the complex interactions between the bone microenvironment (BME) and MM cells (MMC). In the "vicious cycle" of bone disease, abnormal activation of osteoclasts (OCs) by MMC causes severe osteolysis, promotes immune evasion, and stimulates the growth of MMC. Disrupting these cancer-stroma interactions would enhance treatment response. Methods: To disrupt this cycle, we orthogonally targeted nanomicelles (NM) loaded with non-therapeutic doses of a photosensitizer, titanocene (TC), to VLA-4 (α4ß1, CD49d/CD29) expressing MMC (MM1.S) and αvß3 (CD51/CD61) expressing OC. Concurrently, a non-lethal dose of a radiopharmaceutical, 18F-fluorodeoxyglucose ([18F]FDG) administered systemically interacted with TC (radionuclide stimulated therapy, RaST) to generate cytotoxic reactive oxygen species (ROS). The in vitro and in vivo effects of RaST were characterized in MM1.S cell line, as well as in xenograft and isograft MM animal models. Results: Our data revealed that RaST induced non-enzymatic hydroperoxidation of cellular lipids culminating in mitochondrial dysfunction, DNA fragmentation, and caspase-dependent apoptosis of MMC using VLA-4 avid TC-NMs. RaST upregulated the expression of BAX, Bcl-2, and p53, highlighting the induction of apoptosis via the BAK-independent pathway. The enhancement of multicopper oxidase enzyme F5 expression, which inhibits lipid hydroperoxidation and Fenton reaction, was not sufficient to overcome RaST-induced increase in the accumulation of irreversible function-perturbing α,ß-aldehydes that exerted significant and long-lasting damage to both DNA and proteins. In vivo, either VLA-4-TC-NM or αvß3-TC-NMs RaST induced a significant therapeutic effect on immunocompromised but not immunocompetent MM-bearing mouse models. Combined treatment with both VLA-4-TC-NM and αvß3-TC-NMs synergistically inhibited osteolysis, reduced tumor burden, and prevented rapid relapse in both in vivo models of MM. Conclusions: By targeting MM and bone cells simultaneously, combination RaST suppressed MM disease progression through a multi-prong action on the vicious cycle of bone cancer. Instead of using the standard multidrug approach, our work reveals a unique photophysical treatment paradigm that uses nontoxic doses of a single light-sensitive drug directed orthogonally to cancer and bone cells, followed by radionuclide-stimulated generation of ROS to inhibit tumor progression and minimize osteolysis in both immunocompetent murine and immunocompromised human MM models.


Assuntos
Mieloma Múltiplo/tratamento farmacológico , Compostos Organometálicos/farmacologia , Osteoclastos/metabolismo , Animais , Apoptose/efeitos dos fármacos , Medula Óssea/metabolismo , Neoplasias Ósseas , Osso e Ossos/metabolismo , Morte Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Fluordesoxiglucose F18/farmacologia , Humanos , Cadeias alfa de Integrinas/efeitos dos fármacos , Cadeias alfa de Integrinas/metabolismo , Camundongos , Mieloma Múltiplo/metabolismo , Compostos Organometálicos/metabolismo , Osteoclastos/efeitos dos fármacos , Osteólise/patologia , Radioisótopos/farmacologia , Compostos Radiofarmacêuticos/uso terapêutico , Espécies Reativas de Oxigênio , Transdução de Sinais/efeitos dos fármacos , Nanomedicina Teranóstica/métodos , Microambiente Tumoral/efeitos dos fármacos , Ensaios Antitumorais Modelo de Xenoenxerto
18.
Curr Cardiol Rep ; 23(9): 130, 2021 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-34363148

RESUMO

PURPOSE OF REVIEW: Additional imaging modalities, such as FDG-PET/CT, have been included into the workup for patients with suspected infective endocarditis, according to major international guidelines published in 2015. The purpose of this review is to give an overview of FDG-PET/CT indications and standardized approaches in the setting of suspected infective endocarditis. RECENT FINDINGS: There are two main indications for performing FDG-PET/CT in patients with suspected infective endocarditis: (i) detecting intracardiac infections and (ii) detection of (clinically silent) disseminated infectious disease. The diagnostic performance of FDG-PET/CT for intracardiac lesions depends on the presence of native valves, prosthetic valves, or implanted cardiac devices, with a sensitivity that is poor for native valve endocarditis and cardiac device-related lead infections, but much better for prosthetic valve endocarditis and cardiac device-related pocket infections. Specificity is high for all these indications. The detection of disseminated disease may also help establish the diagnosis and/or impact patient management. Based on current evidence, FDG-PET/CT should be considered for detection of disseminated disease in suspected endocarditis. Absence of intracardiac lesions on FDG-PET/CT cannot rule out native valve endocarditis, but positive findings strongly support the diagnosis. For prosthetic valve endocarditis, standard use of FDG-PET/CT is recommended because of its high sensitivity and specificity. For implanted cardiac devices, FDG-PET/CT is also recommended, but should be evaluated with careful attention to clinical context, because its sensitivity is high for pocket infections, but low for lead infections. In patients with prosthetic valves with or without additional aortic prosthesis, combination with CTA should be considered. Optimal timing of FDG-PET/CT is important, both during clinical workup and technically (i.e., post tracer injection). In addition, procedural standardization is key and encompasses patient preparation, scan acquisition, reconstruction, subsequent analysis, and clinical interpretation. The recommendations discussed here will hopefully contribute to improved standardization and enhanced performance of FDG-PET/CT in the clinical management of patients with suspected infective endocarditis.


Assuntos
Endocardite Bacteriana , Endocardite , Próteses Valvulares Cardíacas , Infecções Relacionadas à Prótese , Endocardite/diagnóstico por imagem , Endocardite Bacteriana/diagnóstico por imagem , Fluordesoxiglucose F18 , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Infecções Relacionadas à Prótese/diagnóstico por imagem , Compostos Radiofarmacêuticos , Padrões de Referência
19.
Radiol Clin North Am ; 59(5): 693-703, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34392913

RESUMO

Precision medicine integrates molecular pathobiology, genetic make-up, and clinical manifestations of disease in order to classify patients into subgroups for the purposes of predicting treatment response and suggesting outcome. By identifying those patients who are most likely to benefit from a given therapy, interventions can be tailored to avoid the expense and toxicity of futile treatment. Ultimately, the goal is to offer the right treatment, to the right patient, at the right time. Lung cancer is a heterogeneous disease both functionally and morphologically. Further, over time, clonal proliferations of cells may evolve, becoming resistant to specific therapies. PET is a sensitive imaging technique with an important role in the precision medicine algorithm of lung cancer patients. It provides anatomo-functional insight during diagnosis, staging, and restaging of the disease. It is a prognostic biomarker in lung cancer patients that characterizes tumoral heterogeneity, helps predict early response to therapy, and may direct the selection of appropriate treatment.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Imagem Molecular/tendências , Tomografia por Emissão de Pósitrons/tendências , Medicina de Precisão/tendências , Fluordesoxiglucose F18 , Humanos , Interpretação de Imagem Assistida por Computador , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/tendências , Compostos Radiofarmacêuticos
20.
Radiol Clin North Am ; 59(5): 705-723, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34392914

RESUMO

Hematologic malignancies are a broad category of cancers arising from the lymphoid and myeloid cell lines. The 2016 World Health Organization classification system incorporated molecular markers as part of the diagnostic criteria and includes more than 100 subtypes. This article focuses on the subtypes for which imaging with positron emission tomography/computed tomography (PET/CT) has become an integral component of the patient's evaluation, that is, lymphoma and multiple myeloma. Leukemia and histiocytic and dendritic cell neoplasms are also discussed as these indications for PET/CT are less common, but increasingly seen in clinic.


Assuntos
Neoplasias Hematológicas/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/tendências , Fluordesoxiglucose F18 , Neoplasias Hematológicas/patologia , Humanos , Compostos Radiofarmacêuticos
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