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1.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1096-1099, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018177

RESUMO

Simultaneously resting brain glucose metabolism and intrinsic functional activity, by integrated PET/MRI scans, both reflect nerve actions. Studies showed that there existed relevance between two phenotypes of neuros in normal human brains. However, whether the relevance will change in cognitive dysfunction (CD) brains is still unknown. The aim of this study therefore is to explore the relevance between voxel-wise glucose metabolism and functional connectivity in Chinese CD people. The dataset in this study included two imaging modalities and clinical information of 21 healthy control (HC) individuals and 15 CD patients, from Xuanwu hospital, Beijing, China. Firstly, we calculated the standardized uptake value rate (SUVR) from positron emission tomography (PET), and three parameters for intrinsic functional activity from functional magnetic resonance imaging (fMRI), including amplitude of low frequency fluctuations (ALFF), fractional amplitude of low frequency fluctuations (fALFF) and regional homogeneity (ReHo). Second, the two sample t-test was used to compare each parameter between HC and CD groups respectively. Third, the relevance between SUVR and the three fMRI parameters were measured by Spearman's rank correlation. The results of t-test showed that glucose metabolism consumption decreased in Default Mode Network (DMN) (p < 0.01), and the damage of functional connection also happened DMN area in CD group. The correlation between glucose metabolism and functional activity in CD group was lower than that in HC group in DMN. Especially, the correlation between SUVR and ReHo was significantly reduced (p < 0.05). Above results promoted a deeper understanding on the pathogenesis of cognitive impairment, and providing new biomarkers to discriminate CD and HC subjects.


Assuntos
Disfunção Cognitiva , Tomografia por Emissão de Pósitrons , Encéfalo/diagnóstico por imagem , China , Disfunção Cognitiva/diagnóstico por imagem , Glucose , Humanos , Imagem por Ressonância Magnética
2.
Fortschr Neurol Psychiatr ; 88(9): 609-619, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32957144

RESUMO

The present work provides an overview of the various nuclear medicine methods in the diagnosis of neurodegenerative parkinsonian syndromes and their respective evidence and is intended to enable practical decision-making aids in the application and interpretation of the methods and findings. The value of the procedures differs considerably in relation to the two relevant diagnostic questions. On the one hand, it is the question of whether there is a neurodegenerative parkinsonian syndrome at all, and on the other hand the question of which one. While the DAT-SPECT is undisputedly the method of choice for answering the first question (taking certain parameters into account), this method is not suitable for answering the second question. To categorise parkinsonian syndromes into idiopathic (i. e. Parkinson´s disease) or atypical, various procedures are used in everyday clinical practice including MIBG scintigraphy, and FDG-PET. We explain why FDG-PET currently is not only the most suitable of these methods to differentiate an idiopathic parkinsonian syndrome, from an atypical Parkinson's syndrome, but also enables sufficiently valid to distinguish the various atypical neurodegenerative Parkinson's syndromes (i. e. MSA, PSP and CBD) from each other and therefore should be reimbursed by health insurances.


Assuntos
Transtornos Parkinsonianos/classificação , Transtornos Parkinsonianos/diagnóstico , Diagnóstico Diferencial , Humanos , Doença de Parkinson/diagnóstico , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada de Emissão de Fóton Único
3.
Artigo em Japonês | MEDLINE | ID: mdl-32963141

RESUMO

PURPOSE: The aim of this study was to clarify the artifacts that occurred in the non-activity signal with computed tomography (CT)-based attenuation correction (CTAC) error due to image misregistration. METHODS: We used a cylindrical phantom containing a test tube with a diameter of 15 mm as the non-activity signal part. Positron emission tomography (PET) images were acquired for 30 minutes using the phantom with water in the non-activity signal part and 18F-fluoro-2-deoxy-d-glucose (18F-FDG) (5.3 kBq/ml) in the background area. CT scanning was performed by replacing the water with contrast agents at different dilutions to obtain arbitrary CT numbers (-1000 to 1000). The PET images were attenuation-corrected individually by the CT images in which the CT number of the non-activity signal part had changed. The relationship between the CT numbers and the CTAC artifact was determined by measuring the PET value in the non-activity signal part of the PET images and comparing Ci. RESULTS: As the CT number of the CT images increased, Ci of the artifact increased. The CT number and Ci had a correlation of y=1.48x+2.86×103 (R2 =0.99) when CTAC was performed in units of CT numbers above 0 for PET data of water (0 HU) and a correlation of y=3.15x+6.26×103 (R2 =0.97) when CTAC was performed in units of CT numbers below 0 for PET data of air (-1000 HU). Although the original CT image was air, the artifacts due to CTAC errors with different Hounsfield units showed larger changes. In particular, positive artifacts were recognized in the PET images after CTAC depending on the Hounsfield units. CONCLUSIONS: When the CT number was different from the original in CTAC, the PET value was different. CTAC should be performed with caution as there may be image misregistration.


Assuntos
Artefatos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X
4.
Medicine (Baltimore) ; 99(35): e20932, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871859

RESUMO

BACKGROUND: Accurate clinical staging of patients with cholangiocarcinoma (CCA) has a significant impact on treatment decisions. In this study, we aimed to compare the diagnostic value of magnetic resonance imaging (MRI) and 18-fludeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) for staging of CCA. METHODS: We performed comprehensive systematic search in Web of Science (including MEDLINE) and Excerpta Medica Database for relevant diagnostic studies in accordance with the preferred reporting items for systematic reviews and meta-analysis statement. Based on data extracted from patient-based analysis, we calculated the pooled sensitivity and specificity with the 95% confidence intervals (CIs). In addition, the publication bias was assessed by Deek funnel plot of the asymmetry test. The potential heterogeneity was explored by threshold effect analysis and subgroup analyses. RESULTS: Thirty-two studies with 1626 patients were included in present analysis. In T stage, the pooled sensitivity and specificity of MRI were 0.90 (95% CI 0.86-0.93), 0.84 (95% CI 0.73-0.91) respectively. The pooled sensitivity and specificity of F-FDG PET/CT were 0.91 (95% CI 0.83-0.95) and 0.85 (0.64-0.95) respectively. In N stage, the pooled sensitivity and specificity of MRI were 0.64 (95% CI 0.52-0.74) and 0.69 (95% CI 0.51-0.87) respectively. The pooled sensitivity and specificity of PET/CT were 0.52 (95% CI 0.37-0.66) and 0.92 (95% CI 0.79-0.97) respectively. In M stage, the pooled sensitivity and specificity of F-FDG PET/CT were 0.56 (95% CI, 0.42-0.69) and 0.95 (95% CI, 0.91-0.97) respectively. The Deek test revealed no significant publication bias. No threshold effect was identified. The subgroup analyses showed that pathological type (extrahepatic cholangiocarcinoma vs hilar cholangiocarcinoma/intrahepatic cholangiocarcinoma), country (Asia vs non-Asia) and type of MRI (1.5T vs. 3.0T) were potential causes for the heterogeneity of MRI studies and country (Asia vs non-Asia) was a potential source for F-FDG PET/CT studies. CONCLUSION: The analysis suggested that both modalities provide reasonable diagnostic accuracy in T stage without significant differences between them. We recommend that both modalities be considered based on local availability and practice for the diagnosis of primary CCA tumors. In N stage, the diagnosis of lymph node metastasis (N) of CCA is still limited by MRI and F-FDG PET/CT, due to unsatisfactory diagnostic accuracy of both. Nevertheless, F-FDG PET/CT can be used to confirm lymph node metastasis while a negative result may not rule out metastasis. Furthermore, F-FDG PET/CT have a low sensitivity and a high specificity for detection of distant metastasis.


Assuntos
Neoplasias dos Ductos Biliares/patologia , Colangiocarcinoma/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Tomografia por Emissão de Pósitrons/métodos , Idoso , Colangiocarcinoma/epidemiologia , Feminino , Fluordesoxiglucose F18/administração & dosagem , Humanos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Estadiamento de Neoplasias/métodos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/métodos
5.
Artigo em Russo | MEDLINE | ID: mdl-32929924

RESUMO

OBJECTIVE: To investigate the variations in 11C-methionine uptake in the intact brain tissue and in glial brain tumors of different types. MATERIAL AND METHODS: Forty patients (21 men, 19 women) with gliomas, Grade I-IV, underwent 11C-methionine PET-CT and contrast-enhanced MRI. Standardized uptake value (SUV), tumor-to-normal (T/N) ratios and tumor volume were analyzed. RESULTS: The high inter-subject variability was detected in the intact brain tissue (SUV in the frontal lobe (FL) varies from 0.47 to 1.73). Amino acid metabolism was more active in women than in men (FL SUV 1.32±0.22 and 1.05±0.24, respectively). T/N ratio better differentiates gliomas by the degree of anaplasia compared to SUV. Gliomas of Grade III (T/N=2.64±0.98) were significantly different (p<0.05) from those of Grade IV (T/N=3.83±0.75). The lowest level of methionine uptake was detected in diffuse astrocytomas (T/N=1.52±0.57), which was lower than with anaplastic astrocytomas (T/N=2.34±0.77, p<0.05). CONCLUSIONS: 11C-methionine PET-CT was informative in the high/low degree of malignancy differentiation (T/N 1.66±0.71 for Grade I-II and 3.18±1.06 for Grade III-IV, p<0.05). The method was also useful in separating astrocytomas of Grade II and III. The considerable variation of SUV in the intact brain tissue as well as the difference in uptake between selected areas of the brain were revealed.


Assuntos
Neoplasias Encefálicas , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Radioisótopos de Carbono , Feminino , Humanos , Masculino , Metionina , Tomografia por Emissão de Pósitrons
8.
Rev Prat ; 70(2): 152-155, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32877125

RESUMO

Alzheimer's disease: a biological disorder? Alzheimer's disease often begins clinically with memory problems progressively followed by aphasia, apraxia, agnosia and behavioral disturbances. Recent studies of biological markers of cerebrospinal fluid or amyloid and tau PET imaging have shown that abnormalities can begin one to two decades before the onset of symptoms. This clinically silent phase is a biological phase where neurons fight the toxic effects of amyloid and tau accumulations as well as neuroinflammation. An ATN biological classification has been proposed (A: amyloid, T tau, N: neurodegeneration). The discovery of blood or other biomarkers should allow detection of this silent phase leading to the setup of therapeutic trials when brain lesions are minimal and neurons less affected, to be able to prevent the late cognitive decline of this disease.


Assuntos
Doença de Alzheimer , Amiloidose , Disfunção Cognitiva , Peptídeos beta-Amiloides , Biomarcadores , Humanos , Tomografia por Emissão de Pósitrons , Proteínas tau
9.
Medicine (Baltimore) ; 99(31): e21524, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756195

RESUMO

RATIONALE: Sporadic inclusion body myositis (sIBM) is a chronic progressive idiopathic inflammatory myopathy, with characteristic rimmed vacuoles and sarcoplasmic abnormal tau protein deposits. THK5317, an F-labelled positron emission tomography (PET) marker, targets tau protein deposits, which are expressed in the brain of patients with Alzheimer's disease (AD). It is assumed that THK5317 PET/MRI may also depict tau protein in the skeletal muscles of patients with sIBM. Here we introduced a novel application of tau PET in diagnosis of sIBM in a rare case. PATIENT CONCERNS: We presented a 46-year-old woman who suffered from progressive lower limb weakness for one and a half year. DIAGNOSES: Needle electromyography showed myogenic damage. Characteristic myopathological changes of sIBM were discovered, and abnormal tau protein deposits were identified by tau immunostaining. Genetic testing ruled out the GNE myopathy, a hereditary distal myopathy with rimmed vacuoles. The patient was finally diagnosed as sIBM. INTERVENTIONS: We performed [F] THK5317 PET/MRI on the patient. OUTCOMES: There were significantly increased tau uptake levels in the quadriceps muscles of sIBM patient. The uptake levels of tau in the quadriceps were significantly higher than that in the posterior group of thigh muscles, which was consistent with the distribution characteristics of involved muscle groups. LESSONS: [F] THK5317 PET can reveal muscular tau deposition in vivo, which provides a new and noninvasive diagnostic method for sIBM and offers the opportunity to monitor the progression of tau pathology along with muscle impairment.


Assuntos
Miosite de Corpos de Inclusão/diagnóstico , Tomografia por Emissão de Pósitrons/métodos , Compostos de Anilina , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Feminino , Radioisótopos de Flúor , Humanos , Pessoa de Meia-Idade , Miosite de Corpos de Inclusão/diagnóstico por imagem , Quinolinas
10.
Radiol Clin North Am ; 58(5): 951-963, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32792126

RESUMO

Up to 8% of renal cancers are thought to have a hereditary component. Several hereditary renal cancer syndromes have been identified over the last few decades. It is important for the radiologist to be aware of findings associated with hereditary renal cancer syndromes to detect tumors early, enroll patients in appropriate surveillance programs, and improve outcomes for the patient and affected family members. This review discusses from a radiologist's perspective well-known hereditary renal cancer syndromes and emerging genetic mutations associated with renal cancer that are less well characterized, focusing on imaging features and known associations.


Assuntos
Carcinoma de Células Renais/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Neoplasias Renais/diagnóstico por imagem , Síndromes Neoplásicas Hereditárias/diagnóstico por imagem , Esclerose Tuberosa/diagnóstico por imagem , Doença de von Hippel-Lindau/diagnóstico por imagem , Humanos , Rim/diagnóstico por imagem , Imagem por Ressonância Magnética , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X
11.
Artigo em Japonês | MEDLINE | ID: mdl-32814734

RESUMO

PURPOSE: This phantom study aimed to determine the optimal acquisition window size for phase-based respiratory gating in silicon photomultiplier (SiPM)-based fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and its acquisition time in respiratory-gated imaging with the optimal window size. METHODS: Images of a moving NEMA IEC Body Phantom SetTM with hot spheres were acquired. First, the tumor volume and the maximum standardized uptake value (SUVmax) of images reconstructed using a different window size were evaluated to define the optimal window size. Second, the quality of the images reconstructed using the optimal window size and different acquisition times was evaluated using the detectability score of the 10-mm hot sphere and physical indices. RESULTS: The volume and the SUVmax of the 10-mm hot sphere were improved when the window size was narrow, and there were no significant differences among images reconstructed using a window size narrower than 20%. To reconstruct an image using the 20% window size, an acquisition time of 5 min was required to visualize the 10-mm hot sphere. CONCLUSIONS: The optimal window size for phase-based respiratory gating is 20%. Further, an acquisition time of 5 min should be taken for respiratory-gated imaging with the 20% window size on SiPM-based FDG-PET/CT.


Assuntos
Fluordesoxiglucose F18 , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Imagens de Fantasmas , Tomografia por Emissão de Pósitrons , Tomógrafos Computadorizados
12.
Nucl Med Commun ; 41(9): 965-976, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32796486

RESUMO

OBJECTIVES: The aim of this study was to characterize national variation in radionuclide calibrator activity response to a single National Institute of Standards and Technology (NIST) traceable reference Ge source used as a surrogate for F at clinical PET centres in England using National Physical Laboratory approved techniques. METHODS: Readings from 20 instruments at 13 centres using local F and Ge factor settings were recorded with the source located in vial and syringe positions. Ten repeat measurements were conducted to investigate repeatability using % coefficient of variability (COV). Comparison ratios to investigate accuracy were made between calibrator responses and decay-corrected NISTref reference activity for syringe and vial position measurements. RESULTS: The maximum %COV was 0.79%, while 90, 95 and 80% of calibrators conformed to 5% accuracy for F syringe, Ge syringe and Ge vial position readings, respectively. We revealed a trend towards reduced bias in measurements using Veenstra devices for F and using Capintec devices for Ge factor settings. CONCLUSIONS: This study demonstrated good repeatability in local device measurements. In total, 70% of English calibrators tested and 88% of all measurements performed achieved 5% accuracy. While statistically significant bias was exhibited between different vendor equipment dependent upon radioisotope selected, our study recommends regular traceability checks for optimum instrument performance conducted within National Metrology Institutes guidelines.


Assuntos
Germânio , Tomografia por Emissão de Pósitrons/normas , Radioisótopos , Compostos Radiofarmacêuticos/análise , Algoritmos , Calibragem , Inglaterra , Radioisótopos de Flúor/análise , Humanos , Imagens de Fantasmas , Padrões de Referência , Reprodutibilidade dos Testes , Seringas
13.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(5): 456-460, 2020 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-32842424

RESUMO

Imaging plays a key role in the diagnosis and decision-making process including pre-treatment planning, surgical strategy, and follow-up. The critical point in diagnosis of presacral recurrent rectal cancer by imaging modalities is to distinguish the recurrent tumor from nonmalignant tissues induced by operation or radiotherapy. The practice guideline recommends CT as surveillance imaging modality for recurrent rectal cancer. MRI shows higher accuracy, sensitivity, and specificity in diagnosis of presacral recurrent rectal cancer compared with CT. If CT or MRI can not make final diagnosis in challenging cases, 18-fluorodeoxyglucose positron emission tomography ((18)FDG PET) is recommended to aid diagnosis with high sensitivity and specificity, though false-positivity and negativity should be considered. If new or enlarging soft tissue are shown in the follow-up examination, tumor recurrence should be suspected. In addition, tumor-related high risk factors, treatment protocol, surgery, quality of specimen and pathological stages should also be considered when presacral recurrent rectal cancer is to be diagnosed.


Assuntos
Recidiva Local de Neoplasia/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Neoplasias Retais/diagnóstico por imagem , Fluordesoxiglucose F18 , Humanos , Imagem por Ressonância Magnética , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X
14.
Int J Nanomedicine ; 15: 5017-5026, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764933

RESUMO

Background: Molecular imaging is of great benefit to early disease diagnosis and timely treatment. One of the most striking innovations is the development of multimodal molecular imaging technology, which integrates two or more imaging modalities, largely in view of making the best of the advantages of each modality while overcoming their respective shortcomings. Hence, engineering a versatile and easily prepared nanomaterial with integrating multimodal molecular imaging function holds great promise, but is still a great challenge. Materials and Methods: We firstly designed and synthesized a BDT-DPP conjugated polymer and then noncovalent self-assembly with phospholipid-polyethylene glycol endowed BDT-DPP with water solubility and biocompatibility. Followed by [Cu] labeling, the acquired multifunctional nanoparticles (NPs) were studied in detail for the photophysical property. The cytotoxicity and biocompatibility of DPP-BDT NPs were examined through MTT assay and H&E stained analysis. In addition, we investigated the accumulation of the NPs in HepG2 tumor models by positron emission tomography (PET) and photoacoustic (PA) dual-mode imaging. Results and Discussion: The DPP-BDT NPs exhibited excellent optical stability, strong near-infrared (NIR) light absorption as well as fine biocompatibility. After tail vein injection into the living mice, the PA signals in the neoplastic tissues were gradually increased and reached to the maximum at the 4-h post-injection, which was consistent with the PET analysis. Such strong PA and PET signals were attributed to the efficient NPs accumulation resulting from the enhanced permeability and retention (EPR) effect. Conclusion: The biocompatible DPP-BDT NPs demonstrated to be strong NIR absorption property and PAI sensitivity. Besides, these novel DPP-BDT NPs can act not only as a PA imaging contrast agent but also as an imaging agent for PET.


Assuntos
Cetonas/química , Nanopartículas/química , Neoplasias Experimentais/diagnóstico por imagem , Técnicas Fotoacústicas/métodos , Tomografia por Emissão de Pósitrons/métodos , Pirróis/química , Animais , Meios de Contraste/química , Radioisótopos de Cobre/administração & dosagem , Radioisótopos de Cobre/farmacocinética , Feminino , Células Hep G2 , Humanos , Injeções , Camundongos , Camundongos Nus , Imagem Multimodal/métodos , Células NIH 3T3 , Nanopartículas/administração & dosagem , Fosfatidiletanolaminas/química , Polietilenoglicóis/química , Polímeros/química , Compostos Radiofarmacêuticos/administração & dosagem , Compostos Radiofarmacêuticos/química , Ensaios Antitumorais Modelo de Xenoenxerto
15.
Cancer Radiother ; 24(6-7): 635-644, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32859466

RESUMO

Adaptive radiotherapy (ART) corresponds to various replanning strategies aiming to correct for anatomical variations occurring during the course of radiotherapy. The goal of the article was to report the rational, feasibility and benefit of using PET and/or MRI to guide this ART strategy in various tumor localizations. The anatomical modifications defined by scanner taking into account tumour mobility and volume variation are not always sufficient to optimise treatment. The contribution of functional imaging by PET or the precision of soft tissue by MRI makes it possible to consider optimized ART. Today, the most important data for both PET and MRI are for lung, head and neck, cervical and prostate cancers. PET and MRI guided ART appears feasible and safe, however in a very limited clinical experience. Phase I/II studies should be therefore performed, before proposing cost-effectiveness comparisons in randomized trials and before using the approach in routine practice.


Assuntos
Imagem por Ressonância Magnética , Neoplasias/radioterapia , Tomografia por Emissão de Pósitrons , Radioterapia Guiada por Imagem/métodos , Estudos de Viabilidade , Feminino , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Neoplasias Pulmonares/radioterapia , Masculino , Neoplasias da Próstata/radioterapia , Neoplasias do Colo do Útero/radioterapia
16.
Cancer Radiother ; 24(6-7): 628-634, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-32861609

RESUMO

Multimodal imaging has become a standard for planning radiation therapy via magnetic resonance imaging (MRI) or positron emission tomography (PET) in many cancers. However, its use is now old, and its impact has not been much discussed in light of technological improvements in imaging and advances in radiotherapy. However, in 20 years, the exclusive functional imaging has been replaced by hybrid imaging (functional and anatomical) with successive improvements (flight time, detector modifications, digitisation, etc.) have enabled us to go from centimetric resolution to the current 3 to 4mm resolution. This article will specifically review PET technology, its latest advances and the potential impact on radiotherapy, particularly head and neck cancers.


Assuntos
Neoplasias/radioterapia , Tomografia por Emissão de Pósitrons/métodos , Radioterapia Assistida por Computador , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos
17.
Ann Hematol ; 99(10): 2385-2392, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32748163

RESUMO

Up to 30% of patients with classical Hodgkin lymphoma (cHL) are not responsive to frontline therapy or relapse after primary treatment. In these cases, autologous hematopoietic stem cell transplantation (AHSCT) is the standard of care. The combination of brentuximab vedotin and bendamustine (BV + B) is an effective salvage regimen in this challenging subpopulation. This nationwide multicenter study investigated the real-world efficacy and safety of the BV + B regimen as a bridge to AHSCT in patients with primary refractory or relapsed cHL. A total of 41 cHL patients underwent AHSCT after receiving at least 1 cycle of BV + B (with brentuximab vedotin given at 1.8 mg/kg on day 1 and bendamustine at 90 mg/m2 on days 1-2 every 4 weeks). After a median of 3 (1-6) cycles of BV + B, the objective response rate was 78%, with 29 (70.7%) patients achieving complete remission. Twelve (29.3%) patients relapsed after AHSCT, 2 (4.9%) of them died, while 2 (4.9%) patients are lost to follow-up. After a median of 17 months of follow-up, the estimated 2-year overall- and progression-free survival after AHSCT was 93 and 62%, respectively. Features of advanced disease at recurrence (p = 0.038) and the presence of stage IV cHL at relapse (p = 0.024) are strong predictor markers of unfavorable outcomes. Twenty-four (58.5%) patients experienced adverse events of any grade, while no grade IV toxicities were reported. BV + B is an effective salvage option with a manageable toxicity profile in cHL. The real-world safety and efficacy of this combination are similar to the observations made on the study population.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante de Células-Tronco Hematopoéticas , Doença de Hodgkin/tratamento farmacológico , Terapia de Salvação , Adolescente , Adulto , Idoso , Antineoplásicos Alquilantes/administração & dosagem , Antineoplásicos Alquilantes/efeitos adversos , Antineoplásicos Imunológicos/administração & dosagem , Antineoplásicos Imunológicos/efeitos adversos , Cloridrato de Bendamustina/administração & dosagem , Cloridrato de Bendamustina/efeitos adversos , Brentuximab Vedotin/administração & dosagem , Brentuximab Vedotin/efeitos adversos , Terapia Combinada , Avaliação de Medicamentos , Resistencia a Medicamentos Antineoplásicos , Feminino , Seguimentos , Doença de Hodgkin/diagnóstico por imagem , Doença de Hodgkin/terapia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto/estatística & dados numéricos , Neutropenia/induzido quimicamente , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Tomografia por Emissão de Pósitrons , Intervalo Livre de Progressão , Estudos Retrospectivos , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
18.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(4): 1189-1196, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32798397

RESUMO

OBJECTIVE: To investigate the prognosis prediction value of PET/CT in DLBCL patients treated with CAR-T therapy. METHODS: The effects of PET/CT were retrospectively explored on 13 R/R DLBCL patients who were treated with CAR-T therapy. Parameters reflecting tumor metabolic burden, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured before and after CAR-T treatment. RESULTS: Patients with larger baseline MTV or longer sum of longest diameters showed shorter overall survival (OS) time than those with low tumor burden. Patients achieved complete remission (CR), partial remission (PR) and minor remission (MR) determined by response evaluation criteria in lymphoma (RECIL) in 12 weeks showed progression-free survival and OS time superior to those of patients with no remission. In addition, it was found that 2 patients with residual masses classified as PR by contrast-enhanced CT of patients were evaluated as complete metabolic response by PET/CT imaging. CONCLUSION: PET/CT shows a great value in the evaluation of prognosis and response in CAR-T-treated R/R DLBCL patients.


Assuntos
Linfoma Difuso de Grandes Células B , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Terapia Baseada em Transplante de Células e Tecidos , Fluordesoxiglucose F18 , Humanos , Tomografia por Emissão de Pósitrons , Prognóstico , Receptores de Antígenos Quiméricos , Estudos Retrospectivos
19.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(4): 1267-1271, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32798410

RESUMO

OBJECTIVE: To investigate the imaging characteristics of 18F-FDG positron emission computed tomography (18F-FDG PET/CT) in multiple myeloma (MM) patients and to analyze its application value in MM and bone metastases. METHODS: A retrospective analysis was made on MM patients (n=72) and bone metastases patients (n=50) admitted to Hainan Western Central Hospital from January 2017 to March 2019. All patients underwent 18F-FDG PET/CT examination. The distribution of lesions, bone destruction, maximum standardized uptake (SUVmax) and metabolic homogeneity were analyzed in both groups. RESULTS: More than 80% of MM and bone metastases involved thoracic bone, spine and pelvis, followed by limbs. MM was more common in the lesions of thoracic bone and skull than those in bone metastases, the difference was statistically significant (P<0.05). The majority of MM patients presented osteolytic bone destruction (97.2%), mostly showing "insect-like phagocytic pattern", so the bone showed dilated changes, and osteogenic changes were rarely seen (2.8%). Osteolytic bone destruction accounted for 74.0% in patients with bone metastatic tumor, presenting "focal" appearance more often, and osteogenic changes accounted for 26.0%. Osteolytic bone destruction in patients with MM was significantly higher than that in patients with bone metastases(χ2=14.757,P<0.05). The SUVmax of MM (4.25±2.16)was significantly lower than that of bone metastases (7.84±3.25) (t=6.830, P<0.05). Diffuse mild uptake of 18F-FDG was more common in patients with MM, and heterogeneous high uptake of 18F-FDG was more common in patients with bone metastasis, the difference was statistically significant (P<0.05). CONCLUSION: 18F-FDG PET/CT examination is helpful to acquire the imaging features of bone structure and metabolic changes, and shows an important clinical value in the differential diagnosis of MM and bone metastases.


Assuntos
Fluordesoxiglucose F18 , Mieloma Múltiplo , Humanos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
20.
Internist (Berl) ; 61(9): 964-968, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32734334

RESUMO

BACKGROUND: We report the case of a 46-year-old female patient who presented in the emergency department with intermittent disturbances of perception when fasting. DIAGNOSTICS: In the diagnostic fasting test, a hyperinsulinemic hypoglycemia already occurred after 7h. A sonographic examination was inconspicuous, therefore, a Ga 68-HA-DOTATATE positron emission tomography computed tomography (PET-CT) was carried out. The results were indicative of a neuroendocrine neoplasm, which gave rise to the suspicion of an insulinoma. CLINICAL COURSE: For surgical treatment the patient was transferred to an external hospital. Following surgery, the patient was free of symptoms. CONCLUSION: If multiple symptoms of hypoglycemia are present, an insulinoma as the cause must be considered in the differential diagnostics.


Assuntos
Jejum/efeitos adversos , Hipoglicemia/diagnóstico , Hipoglicemia/etiologia , Insulinoma/complicações , Insulinoma/diagnóstico por imagem , Tumores Neuroendócrinos/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/cirurgia , Compostos Organometálicos , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Tomografia por Emissão de Pósitrons , Cintilografia
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