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1.
Orv Hetil ; 162(15): 595-600, 2021 04 02.
Artigo em Húngaro | MEDLINE | ID: mdl-33798105

RESUMO

Összefoglaló. A lateralis cysticus nyaki terimék két leggyakoribb oka a branchiogen cysta és a cysticus nyaki áttét. Az átfedo lokalizáció (a leggyakrabban a IIA nyaki régióban), a betegek életkora és az esetenként hirtelen kezdet alapján a két leggyakoribb ok differenciáldiagnózisa nagy kihívást jelenthet. Egy hirtelen fellépo fájdalmas, bal oldali nyaki duzzanattal, dysphagiával és lázzal jelentkezo 72 éves férfi esetét ismertetjük. A nyak komputertomográfiás vizsgálata egy 6 cm legnagyobb átméroju, vastag falú, többrekeszes cysticus terimét igazolt. Infektív branchiogen cysta lehetoségére gondolva az elváltozást eltávolítottuk. A szövettan azonban p16-pozitív laphámrákot igazolt. A primer tumort végül az ipsilateralis tonsilla palatina állományában sikerült azonosítani. A beteg definitív radioterápiában részesült, és 18 hónappal a diagnózis után tumormentes. A nyaki cystákon, az infektív nyaki cystákon és a cysticus metastasisokon kívül a humán papillómavírussal összefüggo szájgarati laphámrákok infektív cysticus vagy necroticus metastasisait is figyelembe kell venni a lateralis cysticus nyaki terimék differenciáldiagnózisában. Orv Hetil. 2020; 162(15): 595-600. Summary. Branchial cleft cysts and cystic neck metastases are the two most common causes of cystic lateral neck masses. Based on the overlapping location (neck level IIA), patient age at onset and the occasionally sudden onset, their differential diagnosis is challenging. We present a 72-year-old male presenting with a suddenly emerging painful, left-sided neck swelling, dysphagia and fever. Computed tomography showed a 6 cm thick-walled multicystic mass. With the suspected diagnosis of an infected branchial cleft cyst, the lesion was removed. Histology confirmed p16 positive squamous cell carcinoma. Primary tumor was identified in the ipsilateral palatine tonsil. Definive radiotherapy was performed and the patient is free of disease at the 18-month follow-up. Beyond pure and infected branchial cleft cysts and pure cystic metastases, infected cystic or necrotic metastasis of human papillomavirus associated oropharyngeal squamous cell carcinoma should be included in the differential diagnosis of cystic lateral neck lesions. Orv Hetil. 2021; 162(15): 595-600.


Assuntos
Neoplasias de Cabeça e Pescoço , Inflamação , Idoso , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Inflamação/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X
2.
Br J Radiol ; 94(1120): 20200026, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33684314

RESUMO

OBJECTIVES: Mandible osteoradionecrosis (ORN) is one of the most severe toxicities in patients with head and neck cancer (HNC) undergoing radiotherapy (RT). The existing literature focuses on the correlation of mandible ORN and clinical and dosimetric factors. This study proposes the use of machine learning (ML) methods as prediction models for mandible ORN incidence. METHODS: A total of 96 patients (ORN incidence ratio of 1:1) treated between 2011 and 2015 were selected from the local HNC toxicity database. Demographic, clinical and dosimetric data (based on the mandible dose-volume histogram) were considered as model variables. Prediction accuracy (measured using a stratified fivefold nested cross-validation), sensitivity, specificity, precision and negative predictive value were used to evaluate the prediction performance of a multivariate logistic regression (LR) model, a support vector machine (SVM) model, a random forest (RF) model, an adaptive boosting (AdaBoost) model and an artificial neural network (ANN) model. The different models were compared based on their prediction accuracy and using the McNemar's hypothesis test. RESULTS: The ANN model (77% accuracy), closely followed by the SVM (76%), AdaBoost (75%) and LR (75%) models, showed the highest overall prediction accuracy. The RF model (71%) showed the lowest prediction accuracy. However, based on the McNemar's test applied to all model pair combinations, no statistically significant difference between the models was found. CONCLUSION: Based on our results, we encourage the use of ML-based prediction models for ORN incidence as has already been done for other HNC toxicity end points. ADVANCES IN KNOWLEDGE: This research opens a new path towards personalised RT for HNC using ML to predict mandible ORN incidence.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Aprendizado de Máquina , Mandíbula/efeitos da radiação , Osteorradionecrose/diagnóstico , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Incidência , Masculino , Mandíbula/diagnóstico por imagem , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
3.
Medicine (Baltimore) ; 100(8): e24955, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33663135

RESUMO

ABSTRACT: To investigate the feasibility of arterial spin labeling (ASL) blood flow (BF) and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPLH).Sixty-three stage T1 NPC patients and benign NPLH patients underwent ASL on a 3.0-T magnetic resonance imaging system. BF histogram parameters were derived automatically, including the mean, median, maximum, minimum, kurtosis, skewness, and variance. Absolute values were obtained for skewness and kurtosis (absolute value of skewness [AVS] and absolute value of kurtosis [AVK], respectively). The Mann-Whitney U test, receiver operating characteristic curve, and multiple logistic regression models were used for statistical analysis.The mean, maximum, and variance of ASL BF values were significantly higher in early-stage NPC than in NPLH (all P < 0.0001), while the median and AVK values of early-stage NPC were also significantly higher than those of NPLH (all P < 0.001). No significant difference was found between the minimum and AVS values in early-stage NPC compared with NPLH (P = 0.125 and P = 0.084, respectively). The area under the curve (AUC) of the maximum was significantly higher than those of the mean and median (P < 0.05). The AUC of variance was significantly higher than those of the other parameters (all P < 0.05). Multivariate analysis showed that variance was the only independent predictor of outcome (P < 0.05).ASL BF and its histogram analysis could distinguish early-stage NPC from NPLH, and the variance value was a unique independent predictor.


Assuntos
Circulação Cerebrovascular , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Carcinoma Nasofaríngeo/diagnóstico por imagem , Estudos de Casos e Controles , Detecção Precoce de Câncer/métodos , Estudos de Viabilidade , Feminino , Humanos , Hiperplasia/diagnóstico por imagem , Doenças Linfáticas/diagnóstico por imagem , Masculino , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade
4.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33526526

RESUMO

Pilomatrixoma is a benign subcutaneous tumour arising from the sebaceous glands. Mutation in the CTNNB1 gene is seen, suggesting beta-catenin misregulation may be the cause of pilomatrixoma. The preoperative diagnosis may be improved by the awareness of the fact that pilomatrixoma is a common and benign skin tumour of the head and neck region. It presents as a well-defined mass, which may be firm to hard in consistency, usually attached to the skin, but not to the underlying tissue. The colour of overlying skin appears a reddish-brown tinge, indicating that it could be a case of pilomatrixoma. Here, we report a case of pilomatrixoma of the cheek in a woman along with the CT findings and histopathological appearances. Dental surgeons should consider it as one of the differential diagnosis in superficial head and neck swelling with calcification.


Assuntos
Calcinose/diagnóstico por imagem , Doenças do Cabelo/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Pilomatrixoma/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Adulto , Calcinose/patologia , Feminino , Doenças do Cabelo/patologia , Doenças do Cabelo/cirurgia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Pilomatrixoma/patologia , Pilomatrixoma/cirurgia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Tomografia Computadorizada por Raios X
6.
Artigo em Chinês | MEDLINE | ID: mdl-33541006

RESUMO

Radiomics refers to extract advanced quantitative features in radiological images in a high-throughput way, to invert the features into extensible data with the help of mathematical algorithms, and to establish descriptive and predictive models of tumors. It has important value in the diagnosis, treatment and prognosis of tumors. As an entirely new field, radiomics becomes the research hotspot of clinical medicine and biomedical engineering because of its objective, holistic, non-invasive characteristics. Head and neck squamous cell cancer is one of the common malignant tumors. Radiomics is gradually applied to the study of head and neck squamous cell cancer. This article reviews the research progress of radiomics and its application in head and neck cancer.


Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Prognóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem
7.
West Afr J Med ; 38(2): 131-136, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33641147

RESUMO

BACKGROUND: Intracranial extensions of Head and Neck region tumours are a result of direct spread, into the brain and meninges, of tumours arising in the pharynx, paranasal sinuses, orbit, middle ear, scalp, skull and neck tissues. Presenting features may resemble those of an intracranial mass, or the contiguous structure of origin, or both. Delayed diagnosis is not uncommon when patients are not able to afford diagnostic imaging or when the possibility of an intracranial extension is not readily considered in the evaluation of patients with head and neck lesions. AIM: To highlight the important histologic entities in the head and neck region presenting as intracranial mass lesions. METHODS: This was a retrospective database study of tumours in the head and neck region with extension into the cranial cavity. RESULTS: We present 13 patients with intracranial extension of tumours from contiguous structures. There were 7 males and 6 females. Age ranged from 16 to 80 years. Mean age of the patients was 48.92 ± 19.13 years. Specific histologic entities included: nasopharyngeal carcinoma, olfactory neuroblastoma, squamous cell carcinoma, rhabdomyosarcoma and adenoid cystic carcinoma, amongst others CONCLUSION: Early and accurate diagnosis requires a raised awareness of tumours in the head and neck region; their likelihood to invade the cranial cavity; and a familiarity with the likely presentation. Multidisciplinary approach is needed when clinical and radiological features are suggestive of mass lesions breaching the skull and invading the brain from adjacent structures. Confirmation of clinical suspicion by histology is essential.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Rabdomiossarcoma , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
8.
West Afr J Med ; 38(1): 24-27, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33463703

RESUMO

BACKGROUND: There is uncertainty surrounding the choice of a better imaging modality to detect metastases in cervical lymph nodes. The aim of this study is to examine the role of Ultrasound in the diagnosis of metastatic cervical lymph nodes in orofacial malignancies in a resource limited environment and the effect of the radiologist's experience in interpretation of the results. METHODS: Sixty patients with various histologically diagnosed orofacial malignancies and clinical evidence of cervical lymph nodes metastases were examined with ultrasound by a consultant and a trainee radiologist. Affected lymph nodes were subsequently biopsied and examined histologically. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 19 (SPSS Inc., Chicago, IL, USA) and Microsoft Excel 2010 (Microsoft, Redmond, WA, USA). Test of statistical significance was set at 0.05. RESULTS: Ultrasonography examination by the consultant radiologist recorded a sensitivity of 80.0%, specificity of 57.1%, PPV of 77.5%, NPV of 60.0%, accuracy of 71.7% and a P value of 0.004. The trainee radiologist recorded a sensitivity of 69.2%, specificity 38.1%, PPV of 67.5%, NPV of 40.0%, accuracy of 58.3% and a P value of 0.566. CONCLUSION: Ultrasonography is useful in the diagnosis of metastatic cervical lymph nodes in orofacial malignancies and the interpretation and reliability of the results depend on the experience of the radiologist. Examination of patients should therefore be done and interpreted by an experienced radiologist.


Assuntos
Neoplasias de Cabeça e Pescoço , Linfonodos , Metástase Linfática , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Linfonodos/diagnóstico por imagem , Metástase Linfática/diagnóstico por imagem , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Ultrassonografia
9.
HNO ; 69(2): 157-168, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33416910

RESUMO

Tumoral lesions in the head and neck region represent a diagnostic and therapeutic challenge in otorhinolaryngologic routine. High-resolution ultrasound is usually able to guide diagnosis. Nevertheless, a definite differentiation between benign and malignant lesions can only be achieved by tissue biopsy. The various options for obtaining samples for histopathological or cytological examination-from minimally invasive ultrasound-guided fine-needle biopsy to punch biopsy and open surgical biopsy-will be discussed in the first part along with the associated advantages and disadvantages. In the second part of this CME article, minimally invasive ultrasound-guided therapeutic options in the head and neck region which can be performed on an outpatient basis are depicted.


Assuntos
Neoplasias de Cabeça e Pescoço , Cabeça , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Pescoço/diagnóstico por imagem , Ultrassonografia , Ultrassonografia de Intervenção
10.
Cancer Imaging ; 21(1): 10, 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33436095

RESUMO

Marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALToma) arises in extranodal sites in the head and neck. Chronic inflammatory, infectious or autoimmune conditions are implicated in its pathogenesis. Within the head and neck, MALToma is often multifocal and indolent and the imaging appearances may be mistaken for non-malignant disease in the head and neck. The aim of this article is to illustrate the varied radiological and clinical features of MALToma in the head and neck, an awareness of which is needed for timely and correct diagnosis to guide subsequent disease management.


Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Linfoma de Zona Marginal Tipo Células B/diagnóstico por imagem , Diagnóstico Diferencial , Diagnóstico por Imagem , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Linfoma de Zona Marginal Tipo Células B/patologia , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X , Ultrassonografia
11.
Clin Imaging ; 69: 82-90, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32693228

RESUMO

PURPOSE: The emerge of improved personalized treatment adaptations and outcome prediction is accompanied with increasing non-invasive assessments in early treatment phase, leading to increased patient burden. This study assessed the adherence of patients with head and neck squamous cell carcinoma (HNSCC) to undergo pretreatment and research-related intratreatment imaging, and assessed which factors caused drop-out. METHOD: Between 2013 and 2019, advanced-staged HNSCC patients were prospectively included, underwent (chemo) radiotherapy with curative intent and planned for both pre-treatment and intratreatment sequential 18F-FDG-PET/CT, 18F-FDG-PET/MRI and thereafter MRI (including DWI/DCE). Drop-out-factors were described as healthcare-related (logistics and imaging-system defects) and patient-related (psychological, physical, not-specified). Common Toxicity Criteria (CTC) were routinely scored by radiation/medical oncologists throughout the first 3 weeks, and compared between patient drop-outs and who complete imaging. RESULTS: Ninety-seven patients (mean age 61 ± 6.8 years) were included; 95 patients (97.9%) underwent pretreatment imaging and 63 (64.9%) intratreatment imaging. For 18F-FDG-PET/CT, 18F-FDG-PET/MRI and MRI pretreatment drop-outs were 2, 10 and 3 patients and for intratreatment drop-outs were 34, 39 and 35 patients, respectively. Patient-related drop-out-factors were physical (n = 16, e.g. dysphagia), psychological (n = 6, e.g. claustrophobia) and non-specified (n = 12). Healthcare-related drop-out-factors were logistics (n = 6) and 18F-FDG-PET/CT-/MRI-system defects (n = 2). The CTC mucosal toxicity was significantly higher (p = 0.023) at week 2 of (chemo)radiotherapy in patient drop-outs than with complete imaging. CONCLUSIONS: The drop-out frequency of advanced-staged HNSCC patients for imaging during (chemo)radiotherapy in a research-setting was high and mainly patient-related. Treatment of patient-related inconveniences, communication of rationale and healthcare-related imaging protocol efficiency improvements may contribute to improved adherence.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Idoso , Quimiorradioterapia/efeitos adversos , Fluordesoxiglucose F18 , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Carcinoma de Células Escamosas de Cabeça e Pescoço
12.
Facial Plast Surg ; 36(6): 727-736, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33368129

RESUMO

Reconstructive procedures in the head and neck can be a surgical challenge owing to the complex anatomical and physiological structure. Different locoregional and microvascular flaps are used for various defects to improve both function and cosmesis. Subjective clinical findings have been the mainstay for perfusion monitoring; however, areas of borderline perfusion are much more difficult to assess clinically. Multiple technologies that offer objective perfusion assessment have been developed to improve surgical outcomes. Indocyanine green (ICG) angiography has gained popularity owing to its minimal invasiveness and increased sensitivity and specificity in assessing flap perfusion particularly in the head and neck. It has been extensively used in free flaps, pedicled flaps (including nasal reconstruction), facelift procedures, random flaps, skull base reconstruction, and pharyngocutaneous fistula prediction. Its perioperative use has provided valuable qualitative and quantitative data that aid our understanding of flap hemodynamics. Clinically, this impacted decision-making in flap design, harvest, inset, and precocious salvage interventions. Though increased cost and intraoperative time could be limitations, cost-effectiveness studies have supported its use, particularly in high-risk individuals. Limitations include the lack of standardized dosing and consistent methodology agreement for data analysis. Future studies should involve larger cohorts and multi-institute studies to overcome such limitations.


Assuntos
Retalhos de Tecido Biológico , Neoplasias de Cabeça e Pescoço , Procedimentos Cirúrgicos Reconstrutivos , Angiografia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Verde de Indocianina , Estudos Retrospectivos
13.
Cient. dent. (Ed. impr.) ; 17(3): 221-224, sept.-dic. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-198605

RESUMO

INTRODUCCIÓN: El quiste óseo solitario representa el 1% de todos los quistes maxilares. Es una lesión ósea benigna que aparece de forma fortuita en una radiografía de control en la primera/segunda década de la vida, aunque la lesión carezca de trascendencia en la vida del paciente requiere de abordaje quirúrgico para confirmar el diagnóstico. CASO CLÍNICO: Se presenta un caso clínico de una paciente mujer de 11 años de edad y raza negra, remitida al Servicio de Cirugía Bucal del Hospital Virgen de la Paloma tras observarse imagen radiotransparente apical a nivel de 43 y 44. Una vez realizada la exploración clínica y radiológica se propone cirugía exploratoria ante diagnóstico de presunción de quiste óseo solitario. Bajo anestesia local se procedió al abordaje quirúrgico observándose cavidad vacía en maxilar inferior sin contenido alguno, legrándose profusamente las paredes de la cavidad e introduciendo plasma rico en plaquetas obtenido previamente de la paciente. CONCLUSIONES: La cirugía exploratoria confirma el diagnóstico de presunción de quiste óseo solitario vacío al no poderse mandar a analizar a anatomía patológica


No disponible


Assuntos
Humanos , Feminino , Criança , Cistos Ósseos/diagnóstico por imagem , Cistos Ósseos/cirurgia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Cistos Maxilomandibulares/diagnóstico por imagem , Arcada Osseodentária/diagnóstico por imagem , Arcada Osseodentária/patologia , Procedimentos Cirúrgicos Ortognáticos/métodos , Patologia , Radiografia Panorâmica , Cistos Maxilomandibulares/cirurgia
14.
PLoS One ; 15(12): e0244690, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33373394

RESUMO

PURPOSE: The aim of this study was to investigate the correlations of the gamma passing rates (GPR) with the dose-volumetric parameter changes between the original volumetric modulated arc therapy (VMAT) plans and the actual deliveries of the VMAT plans (DV errors). We compared the correlations of the TrueBeam STx system to those of a C-series linac. METHODS: A total of 20 patients with head and neck (H&N) cancer were retrospectively selected for this study. For each patient, two VMAT plans with the TrueBeam STx and Trilogy (C-series linac) systems were generated under similar modulation degrees. Both the global and local GPRs with various gamma criteria (3%/3 mm, 2%/2 mm, 2%/1 mm, 1%/2 mm, and 1%/1 mm) were acquired with the 2D dose distributions measured using the MapCHECK2 detector array. During VMAT deliveries, the linac log files of the multi-leaf collimator positions, gantry angles, and delivered monitor units were acquired. The DV errors were calculated with the 3D dose distributions reconstructed using the log files. Subsequently, Spearman's rank correlation coefficients (rs) and the corresponding p values were calculated between the GPRs and the DV errors. RESULTS: For the Trilogy system, the rs values with p < 0.05 showed weak correlations between the GPRs and the DV errors (rs<0.4) whereas for the TrueBeam STx system, moderate or strong correlations were observed (rs≥0.4). The DV errors in the V20Gy of the left parotid gland and those in the mean dose of the right parotid gland showed strong correlations (always with rs > 0.6) with the GPRs with gamma criteria except 3%/3 mm. As the GPRs increased, the DV errors decreased. CONCLUSION: The GPRs showed strong correlations with some of the DV errors for the VMAT plans for H&N cancer with the TrueBeam STx system.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Radioterapia de Intensidade Modulada , Raios gama , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
15.
Radiol Clin North Am ; 58(6): 1135-1146, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040853

RESUMO

This article is a summary of the most up-to-date applications of radiopharmaceuticals to the diagnosis and therapy of benign and malignant diseases involving endocrine or neuroendocrine organs of the head and neck, focusing on radiotracers approved by the US Food and Drug Administration, such as I-123- and I-131-sodium iodide, F-18-fluorodeoxyglucose, Tc99m-sestamibi, as well as the more recently approved tracers Ga-68 DOTATATE and Lu-177 DOTATATE.


Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Imagem Molecular/métodos , Tumores Neuroendócrinos/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos/farmacologia , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Radioisótopos do Iodo/farmacologia , Masculino , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/terapia , Compostos Organometálicos/farmacologia , Sensibilidade e Especificidade , Estados Unidos , United States Food and Drug Administration
16.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1152-1155, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018191

RESUMO

The purpose of this study was to establish a methodology and technology for the development of an MRI-based radiomic signature for prognosis of overall survival (OS) in nasopharyngeal cancer from non-endemic areas. The signature was trained using 1072 features extracted from the main tumor in T1-weighted and T2-weighted images of 142 patients. A model with 2 radiomic features was obtained (RAD model). Tumor volume and a signature obtained by training the model on permuted survival data (RADperm model) were used as a reference. A 10-fold cross-validation was used to validate the signature. Harrel's C-index was used as performance metric. A statistical comparison of the RAD, RADperm and volume was performed using Wilcoxon signed rank tests. The C-index for the RAD model was higher compared to the one of the RADperm model (0.69±0.08 vs 0.47±0.05), which ensures absence of overfitting. Also, the signature obtained with the RAD model had an improved C-index compared to tumor volume alone (0.69±0.08 vs 0.65±0.06), suggesting that the radiomic signature provides additional prognostic information.


Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias Nasofaríngeas , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Prognóstico , Estudos Retrospectivos
17.
Medicine (Baltimore) ; 99(33): e21741, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872061

RESUMO

RATIONALE: Hemangiomas are usually found in cutaneous or mucosal layers, less than 1% of hemangiomas develop in skeletal muscles. Intramuscular hemangioma (IH) in the head and neck areas is relatively infrequent, accounting for 15% of IH. Most of them are identified as a benign mass, and rapid changes in size or internal bleeding are rare. PATIENT CONCERNS: A 60-year-old female patient presented with a 2-week history of sudden onset posterior neck pain. There was no neurological deficit except limited neck motion due to pain. The palpable mass was noted on the paraspinal muscles of cervicothoracic junction, which was located midline to left side portion with tenderness. DIAGNOSES: Magnetic resonance imaging demonstrated a round shaped, multi-lobulated, and well-defined mass lesion (4.1 × 2.6 × 0.9 cm) embedded from the inter-spinous space of T1-2 to the left paraspinal muscles. The lesion was iso-intense on T2-weighted images (WI), iso- to slightly low-intense on T1-WI, heterogeneous enhancement of intra- and peri-mass lesion on contrast-enhanced T1-WI. Vascular structures presented as signal voids were identified internally and around the mass lesion. Histological examination revealed a mixed-type hemangioma. INTERVENTIONS: The mass was removed completely including some of the surrounding muscles where boundaries were unclear between the mass and surrounding muscles with ligation of peritumoral vessels. Dark-brown colored blood was drained from the ruptured tumor capsule during the dissection. There was no bony invasion. OUTCOMES: The preoperative symptoms improved immediately after the operation. There is no residual or recurrence lesion by the 15-months follow-up. LESSONS: IH with hemorrhagic transformation in the head and neck is extremely rare. In the case of intramuscular tumors accompanied by a sudden onset of severe acute pain, we recommend considering a differential diagnosis of IH with hemorrhagic transformation. Complete resection of the tumor mass including surrounding muscles is required to prevent recurrence.


Assuntos
Neoplasias de Cabeça e Pescoço/patologia , Hemangioma/patologia , Músculos Paraespinais/patologia , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/cirurgia , Hemangioma/complicações , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Hemorragia/etiologia , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Músculos Paraespinais/diagnóstico por imagem , Músculos Paraespinais/cirurgia
18.
Cancer Imaging ; 20(1): 61, 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32811559

RESUMO

BACKGROUND: To evaluate the inter- and intrareader agreement and reproducibility of the NI-RADS scoring system and lexicon with contrast-enhanced computed tomography (CECT) and contrast-enhanced magnetic resonance imaging (CEMRI). METHODS: This retrospective study included 97 CECT and CEMRI scans from 58 treated cases of head and neck squamous cell carcinoma (HNSCC) after the exclusion of head and neck cancers (HNCs) other than SCC and noncontrast and poor quality CT and MRI scans, with a total of 111 primary targets and 124 lymph node (LN) targets. Two experienced readers independently scored the likelihood of residual/recurrence for these targets based on the NI-RADS criteria and filled in report templates for NI-RADS lexicon diagnostic features. Inter- and intraobserver reproducibility was assessed with Cohen's kappa, and the percent agreement was calculated. RESULTS: Almost perfect interreader agreement was found for the final NI-RADS category of the primary lesions and LNs, with K = 0.808 and 0.806, respectively. Better agreement was found for CT than for MRI (K = 0.843 and 0.77, respectively, P value 0.001). There was almost perfect agreement for excluding tissue enhancement (K = 0.826, 95% CI = 0.658-0.993, P value 0.001), with a percent agreement of 96.4%, and substantial agreement for discrete nodular and diffuse mucosal enhancement (K = 0.826, 95% CI = 0.658-0.993, P value 0.001), with a percent agreement of 96.4%. There was fair agreement for focal mucosal nonmass and deep ill-defined enhancement. The intrareader agreement was almost perfect for most of the rated features (K ranging from 0.802 to 1), with the exception of enlarging discrete nodule/mass and focal mucosal nonmass-like enhancement, which had substantial intraobserver agreement (K ranging from 0.768 to 0.786). CONCLUSION: The individual features of NI-RADS show variable degrees of confidence; however, the overall NI-RADS category was not significantly affected.


Assuntos
Sistemas de Dados , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Imagem por Ressonância Magnética/normas , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem , Tomografia Computadorizada por Raios X/normas , Idoso , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodos
19.
Cancer Imaging ; 20(1): 56, 2020 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-32771060

RESUMO

BACKGROUND: To determine the usefulness of Diffusion Weighted Imaging (DWI) derived from PET/MRI in discriminating normal from metastatic lymph nodes and the correlation between the metastatic lymph nodes with the grade and the localization of the primary tumor. METHODS: Retrospective study of 90 lymph nodes from 90 subjects; 65 patients who had proven histopathological metastatic lymph nodes from (HNSCC) who had undergone 18F- PET/MRI for clinical staging and assessment and twenty-five lymph nodes were chosen from 25 healthy subjects. Apparent Diffusion Coefficient (ADC) map was generated from DWI with b values (0 and 800 s/mm2). ADC values of the metastatic lymph nodes were calculated and compared to the normal lymph nodes ADC values, ROC was used to determine the best cut-off values to differentiate between the two group. Metastatic lymph nodes ADC mean values were compared to primary tumor grade and localization. RESULTS: ADCmean value of the metastatic lymph nodes in the overall sample (0.899 ± 0.98*10- 3 mm2/sec) was significantly lower than the normal lymph nodes' ADCmean value (1.267 ± 0.88*10- 3 mm2/sec); (P = 0.001). The area under the curve (AUC) was 98.3%, sensitivity and specificity were 92.3 and 98.6%, respectively, when using a threshold value of (1.138 ± 0.75*10- 3 mm2/sec) to differentiate between both groups. Significant difference was found between metastatic lymph nodes (short-axis diameter < 10 mm), ADCmean (0.898 ± 0.72*10- 3 mm2/sec), and the benign lymph nodes ADCmean, (P = 0.001). No significant difference was found between ADCmean of the metastatic lymph nodes < 10 mm and the metastatic lymph nodes > 10 mm, ADCmean (0.899 ± 0.89*10- 3 mm2/sec), (P = 0.967). No significant differences were found between metastatic lymph nodes ADCmean values and different primary tumor grades or different primary tumor localization, (P > 0.05). CONCLUSION: DWI-ADC is an effective and efficient imaging technique in differentiating between normal and malignant lymph nodes, and might be helpful to discriminate sub-centimeters lymph nodes. TRIAL REGISTRATION: The trial is registered in clinical trials under ID: NCT04360993 , registration date: 17/04/2020.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Linfonodos/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem , Adulto , Idoso , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia
20.
J Laryngol Otol ; 134(8): 684-687, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32758307

RESUMO

BACKGROUND: The coronavirus disease 2019 pandemic has necessitated almost exclusive National Health Service focus on emergency work and cancer care. There are concerns that increased hospital and community pressures will lead to decreased referrals and worse outcomes for head and neck cancer patients. METHOD: This is a retrospective review of all cases referred for suspected head and neck cancer to our institution in January and April 2020. RESULTS: There was a 55 per cent decrease in referrals but diagnostic yield rose from 2.9 per cent in January to 8.06 per cent in April. In both months, 100 per cent of patients met the 31- and 62-day targets, with similar 14-day wait time success (97.83 per cent for January vs 98.33 per cent for April). Referrals for laryngopharyngeal reflux rose from 27.5 per cent to 41.9 per cent. Referrals for those aged over 60 years fell from 42 per cent to 26 per cent. CONCLUSION: It is suggested that further research be conducted into the reasons why fewer patients were referred, particularly elderly patients, and why laryngopharyngeal reflux is so prevalent in fast-track referrals.


Assuntos
Infecções por Coronavirus/transmissão , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Refluxo Laringofaríngeo/epidemiologia , Pneumonia Viral/transmissão , Encaminhamento e Consulta/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/isolamento & purificação , Estudos de Casos e Controles , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Refluxo Laringofaríngeo/diagnóstico , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Prevalência , Estudos Retrospectivos , Medicina Estatal/organização & administração , Centros de Atenção Terciária/estatística & dados numéricos , Ultrassonografia/métodos , Reino Unido/epidemiologia
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