Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.443
Filtrar
1.
Medicine (Baltimore) ; 98(39): e17328, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574868

RESUMO

INTRODUCTION: Gastric leiomyosarcoma (LMS) is a rare malignancy with minimal therapeutic options and has poor prognosis once metastasis develops. PATIENT CONCERNS: A case of gastric LMS with multiple metastases, pain, and progressive anemia 13 months after the initial diagnosis in a 43-year-old woman. DIAGNOSIS: Gastric LMS with liver metastases and multiple retroperitoneal lymphatic metastases. INTERVENTIONS: Minimally invasive therapies of repeated tetrahydropalmatine and oxaliplatin-based transarterial chemoembolization and high-intensity focused ultrasound treatment were performed. OUTCOMES: The treatments resulted in significant pain relief (numerical rating scale from 8-2 points) after the initial treatment, improvement in performance status and quality of life, and a progression-free survival of 4 months after treatment. CONCLUSION: This combined modality palliative treatment approach was well tolerated with noticeable pain relief.


Assuntos
Quimioembolização Terapêutica/métodos , Tratamento por Ondas de Choque Extracorpóreas/métodos , Leiomiossarcoma/patologia , Manejo da Dor/métodos , Dor , Qualidade de Vida , Neoplasias Gástricas/patologia , Adulto , Terapia Combinada/métodos , Feminino , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/fisiopatologia , Neoplasias Hepáticas/secundário , Imagem Multimodal/métodos , Estadiamento de Neoplasias , Dor/diagnóstico , Dor/etiologia , Dor/psicologia , Medição da Dor/métodos , Cuidados Paliativos/métodos , Intervalo Livre de Progressão , Resultado do Tratamento
2.
Cancer Radiother ; 23(6-7): 761-764, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31471254

RESUMO

The arrival of new hybrid radiotherapy machines with MRI or PET is announced as a milestone in radiotherapy management. Based on recent literature, we will describe the contribution of each of these modalities and the technological challenges that have already been or are still to be addressed.


Assuntos
Desenho de Equipamento , Imagem por Ressonância Magnética Intervencionista/instrumentação , Imagem Multimodal/métodos , Aceleradores de Partículas , Tomografia por Emissão de Pósitrons/instrumentação , Radioterapia Guiada por Imagem/instrumentação , Humanos , Imagem por Ressonância Magnética Intervencionista/tendências , Imagem Multimodal/tendências , Tomografia por Emissão de Pósitrons/tendências , Radioterapia Guiada por Imagem/tendências
3.
Medicine (Baltimore) ; 98(35): e16841, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464910

RESUMO

RATIONALE: Multiple primary central nervous system lymphoma (MPCNSL) is a rare disease with differential diagnosis and treatment. As the underlying pathogenesis is not yet clarified, the early-stage clinical manifestations are occult and atypical. Also, the imaging manifestations are not specific, which is challenging for the clinical diagnosis and treatment. Therefore, additional clinical research is essential to understand the etiology of the disease. PATIENT CONCERNS: A 63-year-old male patient suffered from MPCNSLs but without typical clinical manifestations. The findings of the imaging examination were as follows. Magnetic resonance imaging (MRI) showed long T1 and T2 signal shadows in the right frontal lobe, right hippocampus, right cerebellar hemisphere, and the left occipital lobe. In addition, patchy T1-enhanced signal shadows were observed in the right frontal lobe and around the midline. Frontal lesions were detected in the magnetic resonance spectroscopy (MRS), Cho peak increased, and N-acetylaspartate (NAA) peak decreased. On the other hand, in the diffusion weighted imaging (DWI), apparent dispersion coefficient (ADC) showed low-value changes and high signal changes. The positron emission tomography-computed tomography (PET-CT) displayed radioactive accumulation in the right frontal lobe. DIAGNOSIS: Multiple primary central nervous system lymphoma. INTERVENTIONS: The patient received some conservative medical treatment, but his condition continued to worsen. Finally, he received a pathological biopsy, and refused further treatment after the result was reported. OUTCOMES: The patient died 1 week after biopsy, and the course of disease was about 100 days. LESSONS: PCNSL is a primary intracranial malignancy with low incidence and a high degree of malignancy and specificity in clinical manifestations. To facilitate early clinical treatment and improve the long-term survival of patients, it is necessary to master the imaging diagnostic methods and its features. The comprehensive application of multiple imaging examinations, such as CT, MRI, PET/CT, and PET/MRI, as well as, cerebrospinal fluid cytology can greatly improve the diagnosis of PCNSL.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Linfoma não Hodgkin/diagnóstico por imagem , Imagem Multimodal/métodos , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Cerebelo/diagnóstico por imagem , Cerebelo/patologia , Imagem de Difusão por Ressonância Magnética , Evolução Fatal , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Humanos , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/patologia , Lobo Occipital/diagnóstico por imagem , Lobo Occipital/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons
4.
Cancer Radiother ; 23(6-7): 753-760, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31427076

RESUMO

Imaging provides the basis for radiotherapy. Multi-modality images are used for target delineation (primary tumor and nodes, boost volume) and organs at risk, treatment guidance, outcome prediction, and treatment assessment. Next to anatomical information, more and more functional imaging is being used. The current paper provides a brief overview of the different applications of imaging techniques used in the radiotherapy process, focusing on uncertainties and QA. The paper mainly focuses on PET and MRI, but also provides a short discussion on DCE-CT. A close collaboration between radiology, nuclear medicine and radiotherapy departments provides the key to improve the quality of radiotherapy. Jointly developed imaging protocols (RT position setup, immobilization tools, lasers, flat table…), and QA programs are mandatory. For PET, suitable windowing in consultation with a Nuclear Medicine Physician is crucial (differentiation benign/malignant lesions, artifacts…). A basic knowledge of MRI sequences is required, in such a way that geometrical distortions are easily recognized by all members the RT and RT physics team. If this is not the case, then the radiologist should be introduced systematically in the delineation process and multidisciplinary meetings need to be organized regularly. For each image modality and each image registration process, the associated uncertainties need to be determined and integrated in the PTV margin. When using functional information for dose painting, response assessment or outcome prediction, collaboration between the different departments is even more important. Limitations of imaging based biomarkers (specificity, sensitivity) should be known.


Assuntos
Imagem por Ressonância Magnética/métodos , Imagem Multimodal/métodos , Neoplasias/diagnóstico por imagem , Neoplasias/radioterapia , Garantia da Qualidade dos Cuidados de Saúde , Planejamento da Radioterapia Assistida por Computador/métodos , Incerteza , Artefatos , Humanos , Imagem por Ressonância Magnética/normas , Imagem Multimodal/normas , Estadiamento de Neoplasias , Neoplasias/patologia , Imagens de Fantasmas , Tomografia por Emissão de Pósitrons/métodos , Tomografia por Emissão de Pósitrons/normas , Tomografia Computadorizada por Raios X/métodos
5.
Cancer Radiother ; 23(6-7): 765-772, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31451358

RESUMO

Image-guided brachytherapy is crucial in the management of locally advanced cervical cancers and has benefited from advances in imaging over recent decades. The recommendations of the European Brachytherapy - European Society for Radiation Oncology (GEC-ESTRO) have resulted in harmonized practices and improved clinical outcomes in terms of efficacy and toxicity. Post-implant magnetic resonance imaging (MRI) has become the reference imaging modality to guide brachytherapy. There is an increasing interest for other multimodal imaging in these patients. The metabolic information provided by Positrons Emission Tomography/computed tomodensitometry (PET/CT) is also very promising approach to guide personalized dose escalation strategies. The prognostic values of MRI and PET scanner before brachytherapy make it possible to consider personalizing the dose delivered in brachytherapy and to propose a dose escalation to patients who really need it and to possibly consider a deescalation strategy in patients with a very good prognosis. However, further studies are needed to confirm this approach.


Assuntos
Braquiterapia/métodos , Imagem por Ressonância Magnética Intervencionista/métodos , Imagem Multimodal/métodos , Órgãos em Risco/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Radioterapia Guiada por Imagem/métodos , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/radioterapia , Feminino , Humanos , Neoplasias do Colo do Útero/patologia
6.
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
7.
Presse Med ; 48(7-8 Pt 1): 816-824, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31439443

RESUMO

Diagnosis of mature B cell malignancies is highly multidisciplinary. Biological tools provide diagnostic, prognostic and theranostic information. Biological hematology allows considering mature B cell diseases from two perspectives : cellular and molecular approaches. Cytomorphology and flow cytometry are tools from cell hematology. Conventional cytogenetics, FISH and molecular biology are tools from molecular hematology. NGS is a new technique that could dramatically change diagnostic and therapeutic management of B cell malignancies in the near future. Integration of clinical, pathological and biological data allows for personalized management of these diseases.


Assuntos
Técnicas de Laboratório Clínico/métodos , Leucemia de Células B/diagnóstico , Linfoma de Células B/diagnóstico , Integração de Sistemas , Hibridização Genômica Comparativa/métodos , Citodiagnóstico/métodos , Análise Citogenética/métodos , Análise Mutacional de DNA/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Imunofenotipagem/métodos , Hibridização in Situ Fluorescente/métodos , Leucemia de Células B/genética , Leucemia de Células B/patologia , Linfoma de Células B/genética , Linfoma de Células B/patologia , Técnicas de Diagnóstico Molecular/métodos , Imagem Multimodal/métodos , Imagem Multimodal/tendências
8.
Am Surg ; 85(7): 742-746, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31405420

RESUMO

Insulinomas are rare endocrine malignancies of the pancreas that require surgical resection but can be difficult to localize preoperatively. We sought to review and improve the accuracy of preoperative localization techniques at our institution. We retrospectively reviewed all insulinomas that underwent resection at our institution between 1998 and 2016. Localization techniques include selective arterial calcium stimulation (CaStim), CT, MRI, angiography, and somatostatin receptor scintigraphy. Thirty-eight patients had pathologically proven insulinomas on surgical resection. Localization accuracies of CaStim, CT, and MRI were 89 per cent (31/35), 67 per cent (22/33), and 46 per cent (11/24), respectively. When compared with CT alone and CaStim alone, the combination of these two modalities resulted in 100 per cent preoperative localization (30/30), whereas the use of CaStim alone resulted in 80 per cent (4/5) localization and the use of CT alone resulted in 66 per cent (2/3) localization. Four of our patients had both negative CT and MRI. Among these patients, CaStim was 100 per cent localizing and the only positive modality for these patients. These data confirm that CaStim is accurate in preoperatively identifying single and multiple insulinomas; and when combined with CT, this accuracy is increased to 100 per cent. Based on these data, we propose that a dual imaging approach is a superior means of preoperative localization.


Assuntos
Insulinoma/diagnóstico por imagem , Imagem Multimodal/métodos , Neoplasias Pancreáticas/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Insulinoma/cirurgia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pancreatectomia , Neoplasias Pancreáticas/cirurgia , Cuidados Pré-Operatórios/métodos , Cintilografia/métodos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
9.
Br J Radiol ; 92(1103): 20190517, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31322919

RESUMO

Intramammary lymph nodes (IMLN) are one of the most common benign findings at screening mammography. However, abnormal IMLN features, such as diminished or absent hilum, thickened cortex, not circumscribed margins, increased size or interval change, warrants additional follow-up or pathologic analysis to exclude malignancy. Some benign inflammatory conditions may be associated with imaging-detected suspected abnormal IMLN, such as reactive hyperplasia and silicone-induced lymphadenopathy. In patients with known breast cancer, IMLN are a potential site of locoregional spread, which can change the prognosis and management. In some cases, initial breast carcinomas can also mimic IMLN. Breast radiologists must also be aware of the typical and atypical characteristics of IMLN to suggest further investigation when it is necessary.


Assuntos
Linfadenite/diagnóstico , Imagem Multimodal/métodos , Neoplasias da Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Metástase Linfática , Imagem por Ressonância Magnética/métodos , Mamografia/métodos , Prognóstico
10.
Biomater Sci ; 7(9): 3609-3613, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31361290

RESUMO

Development of versatile phototheranostics is highly desirable for cancer theranostics. Herein, a novel organic conjugated polymer (named DPP-TT) with excellent optical properties was designed and prepared. Based on single-component DPP-TT, single DPP-TT NPs as versatile phototheranostics were developed by a simple nanoprecipitation method. The obtained NPs exhibited good water solubility, excellent biocompatibility, outstanding photostability, strong NIR-I light absorption, and appropriate NIR-II fluorescence emission. Importantly, such NPs presented high photothermal conversion efficiency. From the investigations performed in vitro and in vivo, it was observed that DPP-TT NPs show remarkable performance for cancer theranostics, benefiting from single 808 nm laser-induced tri-modal (NIR-II fluorescence/photoacoustic/thermal) imaging-guided photothermal therapy.


Assuntos
Nanopartículas/química , Neoplasias/diagnóstico por imagem , Neoplasias/terapia , Fototerapia/métodos , Animais , Materiais Biocompatíveis/química , Células HeLa , Humanos , Hipertermia Induzida , Camundongos , Imagem Multimodal/métodos , Imagem Óptica/métodos , Técnicas Fotoacústicas/métodos , Polímeros/química , Solubilidade , Nanomedicina Teranóstica
11.
Medicine (Baltimore) ; 98(29): e16313, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335678

RESUMO

We evaluated the relationships among functional imaging modality such as PET-CT and DW-MRI and lung adenocarcinoma pathologic heterogeneity, extent of invasion depth, and tumor cellularity as a marker of tumor microenvironment.In total, 74 lung adenocarcinomas were prospectively included. All patients underwent 18F-fluorodeoxyglucose (FDG) PET-CT and MRI before curative surgery. Pathology revealed 68 stage I tumors, 3 stage II tumors, and 3 stage IIIA tumors. Comprehensive histologic subtyping was performed for all surgically resected tumors. Maximum standardized uptake value (SUVmax) and ADC values were correlated with pathologic grade, extent of invasion, solid tumor size, and tumor cellularity.Mean solid tumor size (low: 1.7 ±â€Š3.0 mm, indeterminate: 13.9 ±â€Š14.2 mm, and high grade: 30.3 ±â€Š13.5 mm) and SUVmax (low: 1.5 ±â€Š0.2, indeterminate: 3.5 ±â€Š2.5, and high grade: 15.3 ±â€Š0) had a significant relationship with pathologic grade based on 95% confidence intervals (P = .01 and P < .01, respectively). SUVmax showed a strong correlation with tumor cellularity (R = 0.713, P < .001), but was not correlated with extent of invasion (R = 0.387, P = .148). A significant and strong positive correlation was observed among SUVmax values and higher cellularity and pathologic grade. ADC did not exhibit a significant relationship with tumor cellularity.Intratumor heterogeneity quantification using a multimodal-multiparametric approach might be effective when tumor volume consists of a real tumor component as well as a non-tumorous stromal component.


Assuntos
Adenocarcinoma de Pulmão , Imagem de Difusão por Ressonância Magnética/métodos , Neoplasias Pulmonares , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Microambiente Tumoral , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/patologia , Adulto , Idoso , Correlação de Dados , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Gradação de Tumores , Invasividade Neoplásica , Estadiamento de Neoplasias , Reprodutibilidade dos Testes , República da Coreia , Carga Tumoral
12.
Med Oncol ; 36(8): 67, 2019 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-31190232

RESUMO

To evaluate the diagnostic performance of a whole-body 18F-choline (FCH) hybrid PET/MRI for prostate cancer patients at biochemical relapse after radical prostatectomy (RP) compared to pelvic multiparametric MRI (mpMRI), one of the standard imaging modality for this patient population. From 2010 to 2016, 58 whole-body FCH PET/MRI studies with mpMRI acquisitions were performed in 53 prostate cancer patients relapsing after curative RP. Median PSA and PSA doubling time (PSA DT) at PET study were 1.5 ng/ml and 6.5 months, respectively. The overall positivity rate of FCH PET/MRI was 58.6% (n = 34), dropping to 44% in patients with a PSA ≤ 2 ng/ml (n = 36). Median PSA values in positive and negative PET/MRI studies were 2.2 ng/ml and 0.8 ng/ml, respectively, with no differences in PSA DT (6.5 vs. 6.6 months). A PSA value ≥ 1.5 ng/ml was a significant predictor of positivity on PET/MRI studies. Compared to PET, mpMRI identified more local relapses (17 vs. 14, p = 0.453) while PET outperformed whole-body Dixon MRI for regional (16 vs. 9, p = 0.016) and distant (12 vs. 6, p = 0.031) metastases. Compared to pelvic mpMRI, the treatment approach turned out to be influenced more frequently using whole-body FCH hybrid PET/MRI studies (58.6% vs. 38%). In prostate cancer patients with biochemical recurrence after RP, whole-body FCH PET/MRI achieved a higher detection rate of nodal/distant metastases compared to pelvic mpMRI alone, increasing the change of treatment strategy by more than 20%.


Assuntos
Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias da Próstata/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Colina/análogos & derivados , Radioisótopos de Flúor , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Estadiamento de Neoplasias , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Estudos Prospectivos , Prostatectomia , Neoplasias da Próstata/cirurgia , Compostos Radiofarmacêuticos , Imagem Corporal Total/métodos
13.
Medicine (Baltimore) ; 98(24): e15881, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31192920

RESUMO

INTRODUCTION: Because of its infrequent and the lack of clinical data and image finding, the management of acute infections with the hepatosplenic brucella abscesses is challenging. METHODS: There were 10 serologically diagnosed cases with this brucella infection. All patients had fever, 50% patients had upper abdominal pain. Ninety percent patients lived in an urban environment. The localization of lesions included: 30% hepatosplenic, 30% liver, and 40% spleen. RESULTS: Abdominal computed tomography (CT) scans and magnetic resonance imaging (MRI) demonstrated hepatosplenomegaly, with multiple small abscess lesions of various sizes in the acute stage of brucellosis, with the largest diameter of 1.5 cm in the liver. After contrast-enhanced CT and MRI findings, the arterial phase in which the enhancing area of lesions was thick, revealed multifocal hypodense or hypointense lesions of various sizes. These lesions manifested distinct boundary, which was intensified obviously in portal venous phase. CONCLUSION: Our results indicate that early CT or MRI dynamic contrast enhancement of suspected cases could improve rapid diagnosis. However, diagnostic criteria remain problematic and diagnosis is mostly based on a combination of clinical suspicion, serologic markers, and radiologic findings.


Assuntos
Brucelose/diagnóstico por imagem , Abscesso Hepático/diagnóstico por imagem , Imagem Multimodal/métodos , Esplenomegalia/diagnóstico por imagem , Adolescente , Idoso , Brucelose/tratamento farmacológico , China/etnologia , Doxiciclina/administração & dosagem , Doxiciclina/uso terapêutico , Feminino , Humanos , Abscesso Hepático/tratamento farmacológico , Abscesso Hepático/microbiologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rifampina/administração & dosagem , Rifampina/uso terapêutico , Esplenomegalia/tratamento farmacológico , Esplenomegalia/microbiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
14.
Hematol Oncol ; 37 Suppl 1: 15-18, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31187523

RESUMO

Primary central nervous system lymphoma is a rare subtype of non-Hodgkin lymphoma that is confined to the brain, leptomeninges, or the eye and is associated with a relatively poor prognosis compared to other extranodal diffuse large B-cell lymphomas. However, methotrexate-based induction chemotherapy followed by consolidative chemotherapy or high-dose therapy and autologous stem cell transplantation is associated with improved survival and reduced neurotoxicity. Aberrant activation of B-cell receptor signaling and activation of nuclear factor kappa beta is a frequent genetic alteration and offers opportunities for targeted therapies in this lymphoma subtype.


Assuntos
Neoplasias do Sistema Nervoso Central/terapia , Linfoma/terapia , Neoplasias do Sistema Nervoso Central/diagnóstico , Neoplasias do Sistema Nervoso Central/epidemiologia , Neoplasias do Sistema Nervoso Central/etiologia , Terapia Combinada , Gerenciamento Clínico , Humanos , Incidência , Linfoma/diagnóstico , Linfoma/epidemiologia , Linfoma/etiologia , Imagem Multimodal/métodos , Guias de Prática Clínica como Assunto , Prognóstico , Resultado do Tratamento
15.
Invest Ophthalmol Vis Sci ; 60(6): 2012-2022, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31070670

RESUMO

Purpose: In patients diagnosed with Best vitelliform macular dystrophy (BVMD), quantitative fundus autofluorescence (qAF), near-infrared fundus autofluorescence (NIR-AF), and spectral-domain optical coherence tomography (SD-OCT) were used to elucidate pathogenic mechanisms. Methods: Fourteen patients heterozygous for BEST1 mutations were recruited. qAF was analyzed using short-wavelength fundus autofluorescence (SW-AF) images. Mean gray levels (GL) were determined in nonlesion areas (7 to 9° eccentricity) and adjusted by GL measured in an internal fluorescent reference. NIR-AF images (787 nm; sensitivity of 96) were captured and saved in non-normalized mode. Horizontal SD-OCT images also were acquired and BVMD was staged according to the OCT findings. Results: In the pre-vitelliform stage, NIR-AF imaging revealed an area of reduced fluorescence, whereas in the vitelliruptive stage, puncta of elevated NIR-AF signal were present. In both SW-AF and NIR-AF images, the vitelliform lesion in the atrophic stage was marked by reduced signal. At all stages of BVMD, nonlesion qAF was within the 95% confidence intervals for healthy eyes. Similarly, the NIR-AF intensity measurements outside the vitelliform lesion were comparable to the healthy control eye. SD-OCT scans revealed a fluid-filled detachment between the ellipsoid zone and the hyperreflectivity band attributable to RPE/Bruch's membrane. Conclusions: NIR-AF imaging can identify the pre-vitelliform stage of BVMD. Mutations in BEST1 are not associated with increased levels of SW-AF outside the vitelliform lesion. Elevated SW-AF within the fluid-filled lesion likely reflects the inability of RPE to phagocytose outer segments due to separation of RPE from photoreceptor cells, together with progressive photoreceptor cell impairment.


Assuntos
Angiofluoresceinografia/métodos , Imagem Multimodal/métodos , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/métodos , Distrofia Macular Viteliforme/diagnóstico , Adulto , Bestrofinas/genética , Bestrofinas/metabolismo , DNA/genética , Análise Mutacional de DNA , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Distrofia Macular Viteliforme/genética
16.
Eur J Radiol ; 115: 46-52, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31084758

RESUMO

AIM: To examine the performance of 18F-FDG PET/MRI in the loco-regional staging of malignant pleural mesothelioma (MPM). METHODS: Consecutive subjects with MPM undergoing pre-operative staging with 18F-FDG PET/CT who underwent a same day integrated 18F-FDG PET/MRI were prospectively studied. Clinical TNM staging (AJCC 7th edition) was performed separately and in consensus by two readers on the 18F-FDG PET/MRI studies, and compared with staging by 18F-FDG PET/CT, and with final pathological stage, determined by a combination of intra-operative and histological findings. RESULTS: 10 subjects (9 male, mean age 68 years) with biopsy-proven MPM (9 epithelioid tumours, 1 biphasic) were included. One subject underwent neo-adjuvant chemotherapy between imaging and surgery and was excluded from the clinical versus pathological stage analysis. Pathological staging was concordant with staging by 18F-FDG PET/MRI in 67% (n = 6) of subjects, and with 18F-FDG PET/CT staging in 33% (n = 3). Pathological T stage was concordant with 18F-FDG PET/MRI in 78% (n = 7), and with 18F-FDG PET/CT in 33% (n = 3) of subjects. Pathological N stage was concordant with both 18F-FDG PET/MRI and 18F-FDG PET/CT in 78% (n = 7) of cases. No subject had metastatic disease. There was good inter-observer agreement for overall PET/MRI staging (weighted kappa 0.63) with moderate inter-reader agreement for T staging (weighted kappa 0.59). All 6 subjects with prior talc pleurodesis demonstrated mismatch between elevated FDG uptake and restricted diffusion in areas of visible talc deposition. CONCLUSION: Clinical MPM staging by 18F-FDG PET/MRI is feasible, and potentially provides more accurate loco-regional staging than PET/CT, particularly in T staging.


Assuntos
Neoplasias Pulmonares/patologia , Mesotelioma/patologia , Neoplasias Pleurais/patologia , Idoso , Biópsia , Feminino , Fluordesoxiglucose F18 , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Estadiamento de Neoplasias , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Tomografia por Emissão de Pósitrons/métodos , Estudos Prospectivos , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X/métodos
17.
Biochem Soc Trans ; 47(2): 489-508, 2019 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-30952801

RESUMO

Morphometric measurements, such as quantifying cell shape, characterizing sub-cellular organization, and probing cell-cell interactions, are fundamental in cell biology and clinical medicine. Until quite recently, the main source of morphometric data on cells has been light- and electron-based microscope images. However, many technological advances have propelled X-ray microscopy into becoming another source of high-quality morphometric information. Here, we review the status of X-ray microscopy as a quantitative biological imaging modality. We also describe the combination of X-ray microscopy data with information from other modalities to generate polychromatic views of biological systems. For example, the amalgamation of molecular localization data, from fluorescence microscopy or spectromicroscopy, with structural information from X-ray tomography. This combination of data from the same specimen generates a more complete picture of the system than that can be obtained by a single microscopy method. Such multimodal combinations greatly enhance our understanding of biology by combining physiological and morphological data to create models that more accurately reflect the complexities of life.


Assuntos
Tomografia por Raios X/métodos , Humanos , Microscopia Eletrônica , Microscopia de Fluorescência/métodos , Imagem Multimodal/métodos
18.
Sensors (Basel) ; 19(7)2019 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-30974845

RESUMO

In this paper, we perform a systematic study about the on-body sensor positioning and data acquisition details for Human Activity Recognition (HAR) systems. We build a testbed that consists of eight body-worn Inertial Measurement Units (IMU) sensors and an Android mobile device for activity data collection. We develop a Long Short-Term Memory (LSTM) network framework to support training of a deep learning model on human activity data, which is acquired in both real-world and controlled environments. From the experiment results, we identify that activity data with sampling rate as low as 10 Hz from four sensors at both sides of wrists, right ankle, and waist is sufficient in recognizing Activities of Daily Living (ADLs) including eating and driving activity. We adopt a two-level ensemble model to combine class-probabilities of multiple sensor modalities, and demonstrate that a classifier-level sensor fusion technique can improve the classification performance. By analyzing the accuracy of each sensor on different types of activity, we elaborate custom weights for multimodal sensor fusion that reflect the characteristic of individual activities.


Assuntos
Técnicas Biossensoriais , Atividades Humanas , Monitorização Fisiológica/instrumentação , Dispositivos Eletrônicos Vestíveis , Atividades Cotidianas , Algoritmos , Condução de Veículo , Aprendizado Profundo , Humanos , Imagem Multimodal/métodos , Posição Ortostática , Caminhada/fisiologia
19.
Gut ; 68(6): 1115-1126, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30944110

RESUMO

Patients with Crohn's disease commonly develop ileal and less commonly colonic strictures, containing various degrees of inflammation and fibrosis. While predominantly inflammatory strictures may benefit from a medical anti-inflammatory treatment, predominantly fibrotic strictures currently require endoscopic balloon dilation or surgery. Therefore, differentiation of the main components of a stricturing lesion is key for defining the therapeutic management. The role of endoscopy to diagnose the nature of strictures is limited by the superficial inspection of the intestinal mucosa, the lack of depth of mucosal biopsies and by the risk of sampling error due to a heterogeneous distribution of inflammation and fibrosis within a stricturing lesion. These limitations may be in part overcome by cross-sectional imaging techniques such as ultrasound, CT and MRI, allowing for a full thickness evaluation of the bowel wall and associated abnormalities. This systematic literature review provides a comprehensive summary of currently used radiologic definitions of strictures. It discusses, by assessing only manuscripts with histopathology as a gold standard, the accuracy for diagnosis of the respective modalities as well as their capability to characterise strictures in terms of inflammation and fibrosis. Definitions for strictures on cross-sectional imaging are heterogeneous; however, accuracy for stricture diagnosis is very high. Although conventional cross-sectional imaging techniques have been reported to distinguish inflammation from fibrosis and grade their severity, they are not sufficiently accurate for use in routine clinical practice. Finally, we present recent consensus recommendations and highlight experimental techniques that may overcome the limitations of current technologies.


Assuntos
Doença de Crohn/epidemiologia , Obstrução Intestinal/epidemiologia , Intestino Delgado/patologia , Imagem Multimodal/métodos , Comorbidade , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/epidemiologia , Constrição Patológica/patologia , Doença de Crohn/diagnóstico por imagem , Doença de Crohn/patologia , Estudos Transversais , Técnicas de Imagem por Elasticidade/métodos , Feminino , Fibrose/diagnóstico por imagem , Fibrose/epidemiologia , Humanos , Incidência , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/patologia , Intestino Delgado/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Masculino , Prognóstico , Medição de Risco , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia Doppler/métodos
20.
Exp Oncol ; 41(1): 76-79, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30932402

RESUMO

Upper urinary tract urothelial carcinoma is a rare tumor. Data about its correct management are controversial. Investigational technology development made it possible to diagnose asymptomatic small tumors, which can be successfully managed endoscopically. We report the case of bilateral urothelial cancer and hydronephrosis in patient aged 38. After management of acute post-renal kidney insufficiency, the neoadjuvant platinum-based chemotherapy was used followed by the kidney-sparing surgery split in two interventions on both sides. The patient does not have any relapse or further progression after one year of initial treatment with good performance status and high life quality level. We believe that the kidney preserving strategy can be considered as an option even in high-risk patients. The renal function in such cases is a crucial parameter affecting the outcome.


Assuntos
Neoplasias Urológicas/diagnóstico , Neoplasias Urológicas/terapia , Adulto , Biomarcadores , Biópsia , Terapia Combinada , Humanos , Masculino , Imagem Multimodal/métodos , Avaliação de Sintomas , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA