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1.
Br J Radiol ; 94(1119): 20200710, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33571012

RESUMO

OBJECTIVE: To determine its ability of in-phase (IP) and out-of-phase (OOP) chemical shift imaging (CSI) to distinguish non-neoplastic marrow lesions, benign bone tumours and malignant bone tumours. METHODS: CSI was introduced into our musculoskeletal tumour protocol in May 2018 to aid in characterisation of suspected bone tumours. The % signal intensity (SI) drop between IP and OOP sequences was calculated and compared to the final lesion diagnosis, which was classified as non-neoplastic (NN), benign neoplastic (BN) or malignant neoplastic (MN). RESULTS: The study included 174 patients (84 males; 90 females: mean age 44.2 years, range 2-87 years). Based on either imaging features (n = 105) or histology (n = 69), 44 lesions (25.3%) were classified as NN, 66 (37.9%) as BN and 64 (36.8%) as MN. Mean % SI drop on OOP for NN lesions was 36.6%, for BN 3.19% and for MN 3.24% (p < 0.001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of CSI for differentiating NN from neoplastic lesions were 65.9%, 94.6%, 80.6%, 89.1%% and 87.4% respectively, and for differentiating BN from MN were 9.1%, 98.4%, 85.7%, 51.2 and 53.1% respectively. CONCLUSION: CSI is accurate for differentiating non-neoplastic and neoplastic marrow lesions, but is of no value in differentiating malignant bone tumours from non-fat containing benign bone tumours. ADVANCES IN KNOWLEDGE: CSI is of value for differentiating non-neoplastic marrow lesions from neoplastic lesions, but not for differentiating benign bone tumours from malignant bone tumours as has been previously reported.


Assuntos
Neoplasias da Medula Óssea/diagnóstico por imagem , Neoplasias Ósseas/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Medula Óssea/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
2.
Br J Radiol ; 94(1120): 20201234, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33565896

RESUMO

OBJECTIVE: To determine the sensitivity, specificity and accuracy of CT-guided needle biopsy (CT-NB) for distinguishing benign and malignant lesions in children with suspected primary bone tumours, and to assess the correlation between imaging diagnosis and final diagnosis. METHODS: Retrospective review of children who underwent CT-NB of a suspected primary bone tumour between October 2016 and October 2019. Data collected included anatomical location, imaging diagnosis, type of needle, type of biopsy sample, CT-NB diagnosis, final diagnosis and post-procedural complications. The final diagnosis was established based on surgical histology or clinical/imaging follow-up. RESULTS: 125 patients met the inclusion criteria (68M, 57F: mean age 11 years; range 10 months-18 years). Biopsy was performed using a 10 cm Jamshidi needle (10G n = 96; 13 G n = 8); 14G Tru-Cut needle (n = 18); 14G Temno needle (n = 3). The commonest anatomical locations were the femur (n = 40), tibia (n = 25) and humerus (n = 16), while the commonest diagnoses were osteosarcoma (n = 35), CRMO (n = 15) and LCH (n = 14). A benign tumour was correctly identified on imaging in 100% of cases, and a malignant tumour in 95.8%. Sensitivity, specificity and diagnostic accuracy of CT-NB for distinguishing malignant from benign lesions were 98%, 100 and 99%. Of 24 indeterminate biopsy results, all that had a non-aggressive radiological appearance were benign. No immediate complications were recorded. CONCLUSION: CT-NB represents a safe and very effective tool for differentiating benign and malignant lesions in children presenting with a suspected primary bone tumour. Suspected radiological diagnosis plays a pivotal role in the management of indeterminate biopsy results. ADVANCES IN KNOWLEDGE: Paediatric bone tumours pose a significant diagnostic and therapeutic challenge. The interpretation of the imaging findings is essential for the successful management of indeterminate histological results.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Radiografia Intervencionista/métodos , Tomografia Computadorizada por Raios X/métodos , Adolescente , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Biópsia Guiada por Imagem , Lactente , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
3.
Br J Radiol ; 94(1120): 20210043, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33571003

RESUMO

OBJECTIVE: A new Bayesian penalized likelihood reconstruction algorithm for positron emission tomography (PET) (Q.Clear) is now in clinical use for fludeoxyglucose (FDG) PET/CT. However, experience with non-FDG tracers and in special patient populations is limited. This pilot study aims to compare Q.Clear to standard PET reconstructions for 18F sodium fluoride (18F-NaF) PET in obese patients. METHODS: 30 whole body 18F-NaF PET/CT scans (10 patients with BMI 30-40 Kg/m2 and 20 patients with BMI >40 Kg/m2) and a NEMA image quality phantom scans were analyzed using ordered subset expectation maximization (OSEM) and Q.Clear reconstructions methods with B400, 600, 800 and 1000. The images were assessed for overall image quality (IQ), noise level, background soft tissue, and lesion detectability, contrast recovery (CR), background variability (BV) and contrast-to-noise ratio (CNR) for both algorithms. RESULTS: CNR for clinical cases was higher for Q.Clear than OSEM (p < 0.05). Mean CNR for OSEM was (21.62 ± 8.9), and for Q.Clear B400 (31.82 ± 14.6), B600 (35.54 ± 14.9), B800 (39.81 ± 16.1), and B1000 (40.9 ± 17.8). As the ß value increased the CNR increased in all clinical cases. B600 was the preferred ß value for reconstruction in obese patients. The phantom study showed Q.Clear reconstructions gave lower CR and lower BV than OSEM. The CNR for all spheres was significantly higher for Q.Clear (independent of ß) than OSEM (p < 0.05), suggesting superiority of Q.Clear. CONCLUSION: This pilot clinical study shows that Q.Clear reconstruction algorithm improves overall IQ of 18F-NaF PET in obese patients. Our clinical and phantom measurement results demonstrate improved CNR and reduced BV when using Q.Clear. A ß value of 600 is preferred for reconstructing 18F-NaF PET/CT with Q.Clear in obese patients. ADVANCES IN KNOWLEDGE: 18F-NaF PET/CT is less susceptible to artifacts induced by body habitus. Bayesian penalized likelihood reconstruction with18F-NaF PET improves overall IQ in obese patients.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Radioisótopos de Flúor , Interpretação de Imagem Assistida por Computador/métodos , Obesidade/complicações , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Fluoreto de Sódio , Algoritmos , Teorema de Bayes , Neoplasias Ósseas/complicações , Neoplasias Ósseas/secundário , Osso e Ossos/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Imagem Corporal Total/métodos
4.
AJR Am J Roentgenol ; 216(3): 824-834, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33474986

RESUMO

OBJECTIVE. The purpose of this study is to comprehensively implement a patient-informed organ dose monitoring framework for clinical CT and compare the effective dose (ED) according to the patient-informed organ dose with ED according to the dose-length product (DLP) in 1048 patients. MATERIALS AND METHODS. Organ doses for a given examination are computed by matching the topogram to a computational phantom from a library of anthropomorphic phantoms and scaling the fixed tube current dose coefficients by the examination volume CT dose index (CTDIvol) and the tube-current modulation using a previously validated convolution-based technique. In this study, the library was expanded to 58 adult, 56 pediatric, five pregnant, and 12 International Commission on Radiological Protection (ICRP) reference models, and the technique was extended to include multiple protocols, a bias correction, and uncertainty estimates. The method was implemented in a clinical monitoring system to estimate organ dose and organ dose-based ED for 647 abdomen-pelvis and 401 chest examinations, which were compared with DLP-based ED using a t test. RESULTS. For the majority of the organs, the maximum errors in organ dose estimation were 18% and 8%, averaged across all protocols, without and with bias correction, respectively. For the patient examinations, DLP-based ED was significantly different from organ dose-based ED by as much as 190.9% and 234.7% for chest and abdomen-pelvis scans, respectively (mean, 9.0% and 24.3%). The differences were statistically significant (p < .001) and exhibited overestimation for larger-sized patients and underestimation for smaller-sized patients. CONCLUSION. A patient-informed organ dose estimation framework was comprehensively implemented applicable to clinical imaging of adult, pediatric, and pregnant patients. Compared with organ dose-based ED, DLP-based ED may overestimate effective dose for larger-sized patients and underestimate it for smaller-sized patients.


Assuntos
Doses de Radiação , Monitoramento de Radiação/métodos , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pontos de Referência Anatômicos/diagnóstico por imagem , Tamanho Corporal , Osso e Ossos/diagnóstico por imagem , Criança , Feminino , Idade Gestacional , Humanos , Fígado/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Imagens de Fantasmas , Gravidez , Padrões de Referência , Estudos Retrospectivos , Fluxo de Trabalho , Adulto Jovem
5.
Methods Mol Biol ; 2230: 217-230, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33197017

RESUMO

The bone is typically studied using traditional histology techniques, that is, serial sectioning and staining. While effective, these techniques are laborious and destructive, as the native 3D environment of the bone is not maintained. Presented here is a bone-clearing methodology, termed Bone CLARITY, which combines published techniques for clearing soft tissues, including delipidation for the removal of light-scattering membranes, hydrogel-embedding for the stabilization of fragile epitopes, heme elution for the reduction of blood-based autofluorescence; as well as specialized steps, including decalcification and progressive refractive index matching, for addressing the unique challenges posed by osseous tissue. This method renders the bone transparent and enables the detailed visualization of an intact tissue specimen at multiple spatial scales.


Assuntos
Osso e Ossos/diagnóstico por imagem , Imageamento Tridimensional/métodos , Imagem Óptica/métodos , Coloração e Rotulagem/métodos , Animais , Osso e Ossos/fisiologia , Heme/química , Humanos , Hidrogéis/farmacologia , Camundongos , Fenótipo , Crânio/diagnóstico por imagem , Crânio/fisiologia
6.
Methods Mol Biol ; 2230: 337-344, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33197023

RESUMO

Immunohistochemistry, or immunolabeling, is a key method for the identification of protein expression and localization. Successful detection relies on a low signal-to-noise ratio, which is affected greatly by antibody specificity as well as the staining protocol. Immunohistochemistry in the mouse is challenging, particularly in adult skeletal tissue, due to the need for long decalcification, high autofluorescence and high levels of endogenous peroxidase. Here, we describe a highly sensitive protocol for protein detection in decalcified paraffin-embedded sections from adult mouse skeletal tissue. By using four levels of amplification, this method allows for the identification of even low-abundance proteins.


Assuntos
Osso e Ossos/ultraestrutura , Técnica de Descalcificação/métodos , Imunofluorescência/métodos , Proteínas/isolamento & purificação , Coloração e Rotulagem/métodos , Animais , Osso e Ossos/diagnóstico por imagem , Humanos , Camundongos , Inclusão em Parafina/métodos , Proteínas/química
7.
Clin Imaging ; 69: 150-157, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32745894

RESUMO

Accidental ingestion of fish bone is a common occurrence in populations that consume unfilleted fish. Although most ingested foreign bodies pass through the gastrointestinal tract uneventfully within a week, less than 1% of patients unfortunately develop gastrointestinal perforation. Occasionally, some patients who are unaware of an episode of fish bone ingestion may present sub-acutely with symptoms mimicking inflammatory conditions or pyrexia of unknown origin. Computed tomography (CT) is the definitive imaging modality in the diagnosis of fish bone foreign body and its complications. This pictorial essay aims to illustrate the various complications related to fish bone ingestion, broadly divided into gastrointestinal related complications and extra-gastrointestinal complications related to migration of fish bone. Radiologists should be familiar with the myriad of possible complications, and take heed that a relevant history of fish bone ingestion is often absent.


Assuntos
Corpos Estranhos , Gastroenteropatias , Animais , Osso e Ossos/diagnóstico por imagem , Ingestão de Alimentos , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico por imagem , Humanos , Masculino , Alimentos Marinhos/efeitos adversos
8.
Clin Nucl Med ; 46(1): 34-37, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33181742

RESUMO

A 64-year-old man with history of renal stones and prostate cancer presented for evaluation of osseous metastatic disease due to elevated prostate-specific antigen (13.7 ng/mL). A Tc-labeled bone scan demonstrated unusual linear uptake projecting over the lower pelvis extending into the scrotum. Follow-up CT confirmed a rare case of inguinoscrotal extraperitoneal herniation of the ureter associated with a partially duplicated left renal collecting system. The left-sided inguinoscrotal uptake was within the herniated ureter, potentially mimicking disease within the pelvis.


Assuntos
Osso e Ossos/diagnóstico por imagem , Hérnia/diagnóstico por imagem , Ureter/diagnóstico por imagem , Hérnia/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
9.
Clin Nucl Med ; 46(2): 161-163, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315674

RESUMO

ABSTRACT: A 75-year-old man with suspected prostate cancer underwent a 99mTc-MDP bone scan to exclude the possibility of bone metastasis. Scans revealed areas of increased tracer uptake in a symmetric distribution on both sides of the pelvis. Further SPECT/CT imaging showed focal 99mTc-MDP accumulation within 2 cystic lesions on both sides of the bladder. Subsequent x-ray cystography showed contrast agent filling within both cystic lesions, which suggested double bladder diverticula. Eventually, these 2 cystic lesions were confirmed by surgery and pathology as double congenital bladder diverticula.


Assuntos
Osso e Ossos/diagnóstico por imagem , Divertículo/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Bexiga Urinária/anormalidades , Idoso , Humanos , Masculino , Medronato de Tecnécio Tc 99m , Bexiga Urinária/diagnóstico por imagem
10.
Methods Mol Biol ; 2221: 165-191, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32979204

RESUMO

Our laboratories have used genetically engineered mouse models (GEMMs) to assess genetic contributions to skeletal diseases such as osteoporosis and osteoarthritis. Studies on the genetic contributions to OA are often done by assessing how GEMMs respond to surgical methods that induce symptoms modeling OA. Here, we will describe protocols outlining the induction of experimental OA in mice as well as detailed descriptions of methods for analyzing skeletal phenotypes using micro-computerized tomography and skeletal histomorphometry.


Assuntos
Osso e Ossos , Modelos Animais de Doenças , Osteoartrite , Osteoporose , Animais , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Camundongos , Camundongos Transgênicos , Osteoartrite/diagnóstico por imagem , Osteoartrite/patologia , Osteoporose/diagnóstico por imagem , Osteoporose/patologia
11.
BMC Med Genet ; 21(1): 189, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993552

RESUMO

BACKGROUND: Acroscyphodysplasia has been described as a phenotypic variant of acrodysostosis type 2 and pseudohypoparathyroidism. In acrodysostosis, skeletal features can include brachydactyly, facial hypoplasia, cone-shaped epiphyses, short stature, and advanced bone age. To date, reports on this disorder have focused on phenotypic findings, endocrine changes, and genetic variation. We present a 14-year overview of a patient, from birth to skeletal maturity, with acroscyphodysplasia, noting the significant orthopaedic challenges and the need for a multidisciplinary team, including specialists in genetics, orthopaedics, endocrinology, and otolaryngology, to optimize long-term outcomes. CASE PRESENTATION: The patient presented as a newborn with dysmorphic facial features, including severe midface hypoplasia, malar flattening, nasal stenosis, and feeding difficulties. Radiologic findings were initially subtle, and a skeletal survey performed at age 7 months was initially considered normal. Genetic evaluation revealed a variant in PDE4D and subsequent pseudohypoparathyroidism. The patient presented to the department of orthopaedics, at age 2 years 9 months with a leg length discrepancy, right knee contracture, and severely crouched gait. Radiographs demonstrated cone-shaped epiphyses of the right distal femur and proximal tibia, but no evidence of growth plate changes in the left leg. The child developed early posterior epiphyseal arrest on the right side and required multiple surgical interventions to achieve neutral extension. Her left distal femur developed late posterior physeal arrest and secondary contracture without evidence of schypho deformity, which improved with anterior screw epiphysiodesis. The child required numerous orthopaedic surgical interventions to achieve full knee extension bilaterally. At age 13 years 11 months, she was an independent ambulator with erect posture. The child underwent numerous otolaryngology procedures and will require significant ongoing care. She has moderate intellectual disability. DISCUSSION AND CONCLUSIONS: Key challenges in the management of this case included the subtle changes on initial skeletal survey and the marked asymmetry of her deformity. While cone-shaped epiphyses are a hallmark of acrodysostosis, posterior tethering/growth arrest of the posterior distal femur has not been previously reported. Correction of the secondary knee contracture was essential to improve ambulation. Children with acroscyphodysplasia require a multidisciplinary approach, including radiology, genetics, orthopaedics, otolaryngology, and endocrinology specialties.


Assuntos
Disostoses/terapia , Deficiência Intelectual/terapia , Comunicação Interdisciplinar , Osteocondrodisplasias/terapia , Equipe de Assistência ao Paciente , Pseudo-Hipoparatireoidismo/terapia , Osso e Ossos/anormalidades , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/metabolismo , Subunidade RIalfa da Proteína Quinase Dependente de AMP Cíclico/genética , Nucleotídeo Cíclico Fosfodiesterase do Tipo 4/genética , Disostoses/diagnóstico , Disostoses/genética , Seguimentos , Predisposição Genética para Doença/genética , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/genética , Osteocondrodisplasias/diagnóstico , Osteocondrodisplasias/genética , Pseudo-Hipoparatireoidismo/diagnóstico , Pseudo-Hipoparatireoidismo/genética , Radiografia/métodos , Fatores de Tempo
12.
Nat Commun ; 11(1): 4829, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32973154

RESUMO

The computed tomography angiography (CTA) postprocessing manually recognized by technologists is extremely labor intensive and error prone. We propose an artificial intelligence reconstruction system supported by an optimized physiological anatomical-based 3D convolutional neural network that can automatically achieve CTA reconstruction in healthcare services. This system is trained and tested with 18,766 head and neck CTA scans from 5 tertiary hospitals in China collected between June 2017 and November 2018. The overall reconstruction accuracy of the independent testing dataset is 0.931. It is clinically applicable due to its consistency with manually processed images, which achieves a qualification rate of 92.1%. This system reduces the time consumed from 14.22 ± 3.64 min to 4.94 ± 0.36 min, the number of clicks from 115.87 ± 25.9 to 4 and the labor force from 3 to 1 technologist after five months application. Thus, the system facilitates clinical workflows and provides an opportunity for clinical technologists to improve humanistic patient care.


Assuntos
Angiografia/métodos , Vasos Sanguíneos/diagnóstico por imagem , Cabeça/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Pescoço/diagnóstico por imagem , Rede Nervosa/diagnóstico por imagem , Idoso , Osso e Ossos/diagnóstico por imagem , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
13.
Anticancer Res ; 40(10): 5735-5738, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32988899

RESUMO

BACKGROUND/AIM: Surgical staging is paramount to treatment of primary bone sarcomas. Often, bone scintigraphy and/or positron emission tomography-computed tomography (PET-CT) are used to exclude skeletal metastases; however, skeletal metastases in chondrosarcoma are rare. The purpose of this study was to assess the utility of these staging methods in patients with chondrosarcoma. PATIENTS AND METHODS: We reviewed 138 (87 males, 51 female) patients, mean age 54±20 years, with a chondrosarcoma, who had completed a bone scintigraphy or PET/CT as part of surgical staging. Sensitivity, specificity, and positive/negative predictive value of the scans was calculated. RESULTS: Seventeen (12%) patients had a positive bone scintigraphy or PET-CT for skeletal metastases. In cases of bone scintigraphy (n=11), 6 were benign and 5 were skeletal metastases. In cases of PET-CT, 6 were skeletal metastases, 3 were positive and 3 benign. All positive cases regarded dedifferentiated chondrosarcoma. The overall sensitivity and specificity of a bone scan or PET-CT was 100% and 93.1%; with a positive and negative predictive value of 47.1% and 100%, respectively. CONCLUSION: Skeletal metastases at presentation of chondrosarcoma are rare and associated with dedifferentiated chondrosarcoma. Bone scintigraphy or PET-CT should only be performed in cases of high grade and dedifferentiated histology.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Condrossarcoma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Cintilografia , Neoplasias Ósseas/patologia , Neoplasias Ósseas/secundário , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Condrossarcoma/patologia , Feminino , Fluordesoxiglucose F18/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Tomografia Computadorizada por Raios X
14.
Br J Radiol ; 93(1115): 20200775, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32880475

RESUMO

OBJECTIVES: The isotope bone scan (IBS) is the gold-standard imaging modality for detecting skeletal metastases as part of prostate cancer staging. However, its clinical utility for assessing skeletal metastatic burden is limited due to the need for subjective interpretation. We designed and tested a novel custom software tool, the Metastatic Bone Scan Tool (MetsBST), aimed at improving interpretation of IBSs, and compared its performance with that of an established software programme. METHODS: We used IBS images from 62 patients diagnosed with prostate cancer and suspected bone metastases to design and implement MetsBST in MATLAB by defining thresholds used to identify the texture and size of metastatic bone lesions. The results of MetsBST were compared with those of the commercially available automated Bone Scan Index (aBSI) with regression analysis. RESULTS: There was strong agreement between the MetsBST and aBSI results (R2 = 0.9189). In a subregional analysis, MetsBST quantified the extent of metastatic disease in multiple bone sites in patients receiving multimodality therapy (radium-223 and external beam radiotherapy) to illustrate the differences in bone metastatic response to different treatments. CONCLUSION: The results of MetsBST and the commercial software aBSI were highly consistent. MetsBST introduces novel clinical utility by its ability to differentiate between the responses of different bone metastases to multimodality therapies. ADVANCES IN KNOWLEDGE: MetsBST reduces the variability in assessment of tumour burden caused by subjective interpretation. Therefore, it is a useful aid to physicians reporting nuclear medicine scans, and may improve decision-making in the treatment of metastatic prostate cancer.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Osso e Ossos/diagnóstico por imagem , Neoplasias da Próstata/patologia , Design de Software , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/patologia , Neoplasias Ósseas/radioterapia , Ácido Etidrônico , Humanos , Masculino , Pessoa de Meia-Idade , Compostos de Organotecnécio , Neoplasias de Próstata Resistentes à Castração/patologia , Compostos Radiofarmacêuticos , Análise de Regressão , Carga Tumoral , Bexiga Urinária/diagnóstico por imagem
15.
Int J Nanomedicine ; 15: 5825-5838, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32821104

RESUMO

Background and Purpose: The extracellular matrix (ECM) derived from bone marrow mesenchymal stem cells (BMSCs) has been used in regenerative medicine because of its good biological activity; however, its poor mechanical properties limit its application in bone regeneration. The purpose of this study is to construct a three dimensional-printed hydroxyapatite (3D-HA)/BMSC-ECM composite scaffold that not only has biological activity but also sufficient mechanical strength and reasonably distributed spatial structure. Methods: A BMSC-ECM was first extracted and formed into micron-sized particles, and then the ECM particles were modified onto the surface of 3D-HA scaffolds using an innovative linking method to generate composite 3D-HA/BMSC-ECM scaffolds. The 3D-HA scaffolds were used as the control group. The basic properties, biocompatibility and osteogenesis ability of both scaffolds were tested in vitro. Finally, a critical skull defect rat model was created and the osteogenesis effect of the scaffolds was evaluated in vivo. Results: The compressive modulus of the composite scaffolds reached 9.45±0.32 MPa, which was similar to that of the 3D-HA scaffolds (p>0.05). The pore size of the two scaffolds was 305±47 um and 315±34 um (p>0.05), respectively. A CCK-8 assay indicated that the scaffolds did not have cytotoxicity. The composite scaffolds had good cell adhesion ability, with a cell adhesion rate of up to 76.00±6.17% after culturing for 7 hours, while that of the 3D-HA scaffolds was 51.85±4.77% (p<0.01). In addition, the composite scaffold displayed higher alkaline phosphatase (ALP) activity, osteogenesis-related mRNA expression, and calcium nodule formation, thus confirming that the composite scaffolds had good osteogenic activity. The composite scaffolds exhibited good bone repair in vivo and were superior to the 3D-HA scaffolds. Conclusion: We conclude that BMSC-ECM is a good osteogenic material and that the composite scaffolds have good osteogenic ability, which provides a new method and concept for the repair of bone defects.


Assuntos
Durapatita/farmacologia , Matriz Extracelular/metabolismo , Células-Tronco Mesenquimais/citologia , Tecidos Suporte/química , Animais , Regeneração Óssea/efeitos dos fármacos , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/patologia , Adesão Celular/efeitos dos fármacos , Morte Celular/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Matriz Extracelular/efeitos dos fármacos , Hidrodinâmica , Masculino , Células-Tronco Mesenquimais/efeitos dos fármacos , Células-Tronco Mesenquimais/ultraestrutura , Osteogênese/efeitos dos fármacos , Osteogênese/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ratos Sprague-Dawley , Cicatrização/efeitos dos fármacos
17.
Clin Nucl Med ; 45(10): 824-826, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32796243

RESUMO

Osteosarcoma is usually F-FDG-avid. Here we report a case of an 18-year-old young man with widespread osteoblastic and slight osteolytic changes, which had diffusely increased Ga-DOTATATE uptake in the osseous lesions, whereas the F-FDG PET/CT was unrevealing. The final diagnosis is synchronous multifocal osteosarcoma based on the pathological, clinical, and imaging features.


Assuntos
Osso e Ossos/diagnóstico por imagem , Progressão da Doença , Fluordesoxiglucose F18 , Compostos Organometálicos , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Adolescente , Humanos , Masculino
18.
J Med Life ; 13(2): 265-268, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32742524

RESUMO

Bone metastases in cholangiocarcinoma are uncommon. We report the case of a patient with disseminated osteolytic lesions who was admitted to the Neurology Department for progressive paraparesis. On the computed tomography examination, specific features for cholangiocarcinoma were described, confirmed later by the histopathological aspect of the bone lesions.


Assuntos
Neoplasias dos Ductos Biliares/complicações , Colangiocarcinoma/complicações , Osteólise/complicações , Paraparesia/complicações , Neoplasias dos Ductos Biliares/patologia , Neoplasias Ósseas/secundário , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Colangiocarcinoma/patologia , Humanos , Masculino , Osteólise/diagnóstico por imagem , Paraparesia/diagnóstico por imagem , Tomografia Computadorizada por Raios X
19.
J Am Acad Orthop Surg ; 28(16): e696-e705, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32769718

RESUMO

Ultrasonography is a valuable tool that can be used in many capacities to evaluate and treat pediatric orthopaedic patient. It has the capability to depict bone, cartilaginous and soft-tissue structures, and provide dynamic information. This technique can be readily applied to a wide range of pediatric conditions, including developmental dysplasia of the hip, congenital limb deficiencies, fracture management, joint effusions, and many other musculoskeletal pathologies. There are many benefits of implementing ultrasonography as a regular tool. It is readily accessible at most centers, and information can be quickly obtained in a minimally invasive way, which limits the need for radiation exposure. Ultrasonography is a safe and reliable tool that pediatric orthopaedic surgeons can incorporate into the diagnosis and management of a broad spectrum of pathology.


Assuntos
Doenças Musculoesqueléticas/diagnóstico por imagem , Pediatria , Ultrassonografia/métodos , Adolescente , Doenças do Desenvolvimento Ósseo/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Cartilagem/diagnóstico por imagem , Criança , Pré-Escolar , Tecido Conjuntivo/diagnóstico por imagem , Fraturas Ósseas/diagnóstico por imagem , Quadril/diagnóstico por imagem , Humanos , Lactente , Reprodutibilidade dos Testes , Segurança
20.
Medicine (Baltimore) ; 99(27): e21047, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629730

RESUMO

Repair of medial meniscus posterior root tear (MMPRT) is considered as an effective early intervention strategy for osteoarthritis. We aimed at evaluating whether or not single-photon emission computed tomography/computed tomography (SPECT/CT) could predict the treatment outcome.Eleven patients with MMPRT who underwent preoperative SPECT/CT were retrospectively enrolled. Clinical symptoms were evaluated based on the knee injury and osteoarthritis outcome score (KOOS) and visual analogue scale (VAS) for pain. The uptake pattern of the medial tibial plateau (MTP) on SPECT/CT was visually assessed. Additionally, the maximum lesion-to-cortical counts ratio (LCRmax) for the anterior and posterior aspects of MTP and anterior-posterior MTP ratio (APR) were quantitatively assessed. Spearman correlation analyses were performed between the change in clinical symptom scores and preoperative SPECT/CT patterns.All patients showed increased radiotracer uptake in MTP. Among them, 8 (73%) showed dominant uptake in the anterior aspect of MTP. The rest 3 (27%) showed posterior-dominant uptake. Patients with anterior-dominant patterns tended to show better outcomes in terms of the postoperative KOOS score (P = .07). Anterior MTP LCRmax showed a negative correlation with the change in VAS (ρ = -0.664, P < .03). APR showed a correlation with the change in the KOOS score (ρ = 0.655, P < .03).Patients with MMPRT with relatively higher uptake in the anterior aspect of MTP could have better clinical outcomes after the repair. The preoperative SPECT/CT pattern may have a predictive value in selecting patients with good postoperative outcomes.


Assuntos
Meniscos Tibiais/patologia , Osteoartrite/cirurgia , Ruptura/cirurgia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Idoso , Osso e Ossos/diagnóstico por imagem , Feminino , Humanos , Traumatismos do Joelho/cirurgia , Articulação do Joelho/diagnóstico por imagem , Meniscectomia/métodos , Pessoa de Meia-Idade , Período Pós-Operatório , Valor Preditivo dos Testes , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento , Escala Visual Analógica
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