Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 18.853
Filtrar
1.
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
2.
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
3.
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
4.
Yonsei Med J ; 61(7): 644-646, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32608210

RESUMO

A weight-holding tremor is a rare type of hand tremor that occurs only when someone holds some weight. Here we report three cases of isolated weight-holding tremors, of which one patient was diagnosed with Parkinson's disease (PD) and the others as a variant of essential tremor (ET). A 68-year-old woman presented with a left-hand tremor that appeared only when she held objects with some weight. Her tremor was reminiscent of the re-emergent tremor of PD, and dopamine transporter imaging revealed reduced uptake at the right posterior putamen. A 21-year-old man and a 71-year-old woman also presented with similar weight-holding tremors. However, these tremors were not re-emergent, and no signs of parkinsonism were observed during follow-up. Although the underlying etiologies of these tremors differed, all three tremors worsened as the held weight increased. These tremors could be isolated isometric tremors, but further research is needed to clarify the nature of this rare tremor.


Assuntos
Tremor Essencial/diagnóstico , Doença de Parkinson/complicações , Tomografia por Emissão de Pósitrons/métodos , Tremor/diagnóstico por imagem , Tremor/etiologia , Adulto , Idoso , Peso Corporal , Dopamina/metabolismo , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Tremor Essencial/fisiopatologia , Feminino , Humanos , Masculino , Tremor/classificação , Tremor/fisiopatologia
5.
PLoS One ; 15(7): e0236841, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32730364

RESUMO

PURPOSE: [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) parameters have shown prognostic value in nasopharyngeal carcinomas (NPC), mostly in monocenter studies. The aim of this study was to assess the prognostic impact of standard and novel PET parameters in a multicenter cohort of patients. METHODS: The established PET parameters metabolic tumor volume (MTV), total lesion glycolysis (TLG) and maximal standardized uptake value (SUVmax) as well as the novel parameter tumor asphericity (ASP) were evaluated in a retrospective multicenter cohort of 114 NPC patients with FDG-PET staging, treated with (chemo)radiation at 8 international institutions. Uni- and multivariable Cox regression and Kaplan-Meier analysis with respect to overall survival (OS), event-free survival (EFS), distant metastases-free survival (FFDM), and locoregional control (LRC) was performed for clinical and PET parameters. RESULTS: When analyzing metric PET parameters, ASP showed a significant association with EFS (p = 0.035) and a trend for OS (p = 0.058). MTV was significantly associated with EFS (p = 0.026), OS (p = 0.008) and LRC (p = 0.012) and TLG with LRC (p = 0.019). TLG and MTV showed a very high correlation (Spearman's rho = 0.95), therefore TLG was subesequently not further analysed. Optimal cutoff values for defining high and low risk groups were determined by maximization of the p-value in univariate Cox regression considering all possible cutoff values. Generation of stable cutoff values was feasible for MTV (p<0.001), ASP (p = 0.023) and combination of both (MTV+ASP = occurrence of one or both risk factors, p<0.001) for OS and for MTV regarding the endpoints OS (p<0.001) and LRC (p<0.001). In multivariable Cox (age >55 years + one binarized PET parameter), MTV >11.1ml (hazard ratio (HR): 3.57, p<0.001) and ASP > 14.4% (HR: 3.2, p = 0.031) remained prognostic for OS. MTV additionally remained prognostic for LRC (HR: 4.86 p<0.001) and EFS (HR: 2.51 p = 0.004). Bootstrapping analyses showed that a combination of high MTV and ASP improved prognostic value for OS compared to each single variable significantly (p = 0.005 and p = 0.04, respectively). When using the cohort from China (n = 57 patients) for establishment of prognostic parameters and all other patients for validation (n = 57 patients), MTV could be successfully validated as prognostic parameter regarding OS, EFS and LRC (all p-values <0.05 for both cohorts). CONCLUSIONS: In this analysis, PET parameters were associated with outcome of NPC patients. MTV showed a robust association with OS, EFS and LRC. Our data suggest that combination of MTV and ASP may potentially further improve the risk stratification of NPC patients.


Assuntos
Quimiorradioterapia/mortalidade , Glicólise , Carcinoma Nasofaríngeo/mortalidade , Neoplasias Nasofaríngeas/mortalidade , Tomografia por Emissão de Pósitrons/métodos , Feminino , Fluordesoxiglucose F18/metabolismo , Seguimentos , Humanos , Agências Internacionais , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/diagnóstico por imagem , Carcinoma Nasofaríngeo/patologia , Carcinoma Nasofaríngeo/terapia , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/terapia , Prognóstico , Compostos Radiofarmacêuticos/metabolismo , Estudos Retrospectivos , Taxa de Sobrevida , Carga Tumoral
6.
Clin Imaging ; 67: 136-142, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32622334

RESUMO

We report a marked abnormality in myocardial attenuation on non-gated contrast-enhanced CT in a patient with multiorgan sarcoidosis and correlate our findings with CMR, PET and SPECT. The noteworthy observation of myocardial hypoattenuation, in correspondence with the multimodality cardiovascular imaging findings, suggests that standard contrast-enhanced CT may provide information regarding tissue characterization. This report also demonstrates the independent clinical utility of CMR and PET in the evaluation and management of cardiac sarcoidosis.


Assuntos
Cardiomiopatias/diagnóstico por imagem , Sarcoidose/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Miocárdio , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos
7.
Neurology ; 95(7): e815-e826, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32690787

RESUMO

OBJECTIVES: To investigate the relationships of serum albumin with in vivo Alzheimer disease (AD) pathologies, including cerebral ß-amyloid (Aß) protein deposition, neurodegeneration of AD-signature regions, and cerebral white matter hyperintensities (WMH), in the human brain. METHODS: A total of 396 older adults without dementia underwent comprehensive clinical assessments, measurement of serum albumin level, and multimodal brain imaging, including [11C] Pittsburgh compound B-PET, 18F-fluorodeoxyglucose-PET, and MRI. Serum albumin was categorized as follows: <4.4 g/dL (low albumin), 4.4 to 4.5 g/dL (middle albumin), and >4.5 g/dL (high albumin; used as a reference category). Aß positivity, AD-signature region cerebral glucose metabolism (AD-CM), AD-signature region cortical thickness (AD-CT), and WMH volume were used as outcome measures. RESULTS: Serum albumin level (as a continuous variable) was inversely associated with Aß deposition and Aß positivity. The low albumin group showed a significantly higher Aß positivity rate compared to the high albumin group (odds ratio 3.40, 95% confidence interval 1.67-6.92, p = 0.001), while the middle albumin group showed no difference (odds ratio 1.74, 95% confidence interval 0.80-3.77, p = 0.162). Neither serum albumin level (as a continuous variable) nor albumin categories were related to AD-CM, AD-CT, or WMH volume. CONCLUSIONS: Low serum albumin may increase the risk of AD dementia by elevating amyloid accumulation. In terms of AD prevention, more attention needs to be paid to avoid a low serum albumin level, even within the clinical normal range, by clinicians.


Assuntos
Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/sangue , Encéfalo/metabolismo , Albumina Sérica/metabolismo , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/patologia , Amiloide/metabolismo , Amiloidose/patologia , Encéfalo/patologia , Feminino , Fluordesoxiglucose F18/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons/métodos
8.
Lancet ; 395(10242): 1988-1997, 2020 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-32593336

RESUMO

BACKGROUND: Alzheimer's disease and its complications are the leading cause of death in adults with Down syndrome. Studies have assessed Alzheimer's disease in individuals with Down syndrome, but the natural history of biomarker changes in Down syndrome has not been established. We characterised the order and timing of changes in biomarkers of Alzheimer's disease in a population of adults with Down syndrome. METHODS: We did a dual-centre cross-sectional study of adults with Down syndrome recruited through a population-based health plan in Barcelona (Spain) and through services for people with intellectual disabilities in Cambridge (UK). Cognitive impairment in participants with Down syndrome was classified with the Cambridge Cognitive Examination for Older Adults with Down Syndrome (CAMCOG-DS). Only participants with mild or moderate disability were included who had at least one of the following Alzheimer's disease measures: apolipoprotein E allele carrier status; plasma concentrations of amyloid ß peptides 1-42 and 1-40 and their ratio (Aß1-42/1-40), total tau protein, and neurofilament light chain (NFL); tau phosphorylated at threonine 181 (p-tau), and NFL in cerebrospinal fluid (CSF); and one or more of PET with 18F-fluorodeoxyglucose, PET with amyloid tracers, and MRI. Cognitively healthy euploid controls aged up to 75 years who had no biomarker abnormalities were recruited from the Sant Pau Initiative on Neurodegeneration. We used a first-order locally estimated scatterplot smoothing curve to determine the order and age at onset of the biomarker changes, and the lowest ages at the divergence with 95% CIs are also reported where appropriate. FINDINGS: Between Feb 1, 2013, and June 28, 2019 (Barcelona), and between June 1, 2009, and Dec 31, 2014 (Cambridge), we included 388 participants with Down syndrome (257 [66%] asymptomatic, 48 [12%] with prodromal Alzheimer's disease, and 83 [21%] with Alzheimer's disease dementia) and 242 euploid controls. CSF Aß1-42/1-40 and plasma NFL values changed in individuals with Down syndrome as early as the third decade of life, and amyloid PET uptake changed in the fourth decade. 18F-fluorodeoxyglucose PET and CSF p-tau changes occurred later in the fourth decade of life, followed by hippocampal atrophy and changes in cognition in the fifth decade of life. Prodromal Alzheimer's disease was diagnosed at a median age of 50·2 years (IQR 47·5-54·1), and Alzheimer's disease dementia at 53·7 years (49·5-57·2). Symptomatic Alzheimer's disease prevalence increased with age in individuals with Down syndrome, reaching 90-100% in the seventh decade of life. INTERPRETATION: Alzheimer's disease in individuals with Down syndrome has a long preclinical phase in which biomarkers follow a predictable order of changes over more than two decades. The similarities with sporadic and autosomal dominant Alzheimer's disease and the prevalence of Down syndrome make this population a suitable target for Alzheimer's disease preventive treatments. FUNDING: Instituto de Salud Carlos III, Fundació Bancaria La Caixa, Fundació La Marató de TV3, Medical Research Council, and National Institutes of Health.


Assuntos
Doença de Alzheimer/metabolismo , Biomarcadores/sangue , Síndrome de Down/complicações , Adulto , Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/epidemiologia , Peptídeos beta-Amiloides/metabolismo , Amiloidose/diagnóstico por imagem , Amiloidose/patologia , Apolipoproteínas E/metabolismo , Estudos de Casos e Controles , Disfunção Cognitiva/psicologia , Estudos Transversais , Síndrome de Down/epidemiologia , Síndrome de Down/mortalidade , Síndrome de Down/psicologia , Fluordesoxiglucose F18/administração & dosagem , Humanos , Imagem por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Proteínas de Neurofilamentos/líquido cefalorraquidiano , Tomografia por Emissão de Pósitrons/métodos , Prevalência , Espanha/epidemiologia , Reino Unido/epidemiologia , Proteínas tau/metabolismo
10.
PLoS One ; 15(6): e0233209, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497135

RESUMO

The impact of a method for MR-based respiratory motion correction of PET data on lesion visibility and quantification in patients with oncologic findings in the lung was evaluated. Twenty patients with one or more lesions in the lung were included. Hybrid imaging was performed on an integrated PET/MR system using 18F-FDG as radiotracer. The standard thoracic imaging protocol was extended by a free-breathing self-gated acquisition of MR data for motion modelling. PET data was acquired simultaneously in list-mode for 5-10 mins. One experienced radiologist and one experienced nuclear medicine specialist evaluated and compared the post-processed data in consensus regarding lesion visibility (scores 1-4, 4 being best), image noise levels (scores 1-3, 3 being lowest noise), SUVmean and SUVmax. Motion-corrected (MoCo) images were additionally compared with gated images. Non-motion-corrected free-breathing data served as standard of reference in this study. Motion correction generally improved lesion visibility (3.19 ± 0.63) and noise ratings (2.95 ± 0.22) compared to uncorrected (2.81 ± 0.66 and 2.95 ± 0.22, respectively) or gated PET data (2.47 ± 0.93 and 1.30 ± 0.47, respectively). Furthermore, SUVs (mean and max) were compared for all methods to estimate their respective impact on the quantification. Deviations of SUVmax were smallest between the uncorrected and the MoCo lesion data (average increase of 9.1% of MoCo SUVs), while SUVmean agreed best for gated and MoCo reconstructions (MoCo SUVs increased by 1.2%). The studied method for MR-based respiratory motion correction of PET data combines increased lesion sharpness and improved lesion activity quantification with high signal-to-noise ratio in a clinical setting. In particular, the detection of small lesions in moving organs such as the lung and liver may thus be facilitated. These advantages justify the extension of the PET/MR imaging protocol by 5-10 minutes for motion correction.


Assuntos
Artefatos , Processamento de Imagem Assistida por Computador/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Movimento (Física) , Imagem Multimodal/métodos , Tomografia por Emissão de Pósitrons/métodos , Mecânica Respiratória , Idoso , Idoso de 80 Anos ou mais , Feminino , Radioisótopos de Flúor , Fluordesoxiglucose F18 , Humanos , Aumento da Imagem/métodos , Pulmão/fisiologia , Masculino , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos
11.
Br J Radiol ; 93(1112): 20200167, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32579403

RESUMO

OBJECTIVE: To compare the diagnostic performance of fecal biomarkers and 18F-fludeoxyglucose (18F-FDG) positron emmision tomography-MR (PET-MR) in the assessment of disease activity in patients with ulcerative colitis. METHODS: This study was conducted under the framework of a single-center clinical trial (clinicaltrials.gov [NCT03781284]). N = 50 participants were enrolled. Fecal samples were collected before bowel preparation. All patients underwent whole-body 18F-FDG PET-MR followed by ileocolonoscopy within 24 h. Diagnostic performance of five fecal biomarkers (calprotectin, lactoferrin, polymorphonuclear leukocyte elastase, S100A12 and eosinophil-derived neurotoxin), MR morphological parameters (MRmorph), diffusion-weighted imaging and PET in detecting active disease determined by Rachmilewitz endoscopic activity index (EAI) were evaluated and compared with each other. Correlations between fecal biomarkers, PET and endoscopy were calculated. RESULTS: According to EAI, n = 38 patients presented with endoscopically active disease (16 mild, 19 moderate and 3 severe). All five biomarkers, PET and MRmorph could differentiate endoscopically active disease from endoscopic remission without significant difference regarding their operating characteristics (accuracies between 0.673 for calprotectin and 0.898 for lactoferrin). In predicting endoscopically moderate to severe disease, PET showed the highest diagnostic performance (accuracy = 0.857) compared to calprotectin and lactoferrin (accuracy = 0.633 and 0.735). PET had also the strongest correlation with endoscopy (ρ = 0.685, p < 0.001), while within fecal biomarkers the levels of lactoferrin and eosinophil-derived neurotoxin correlated significantly with EAI (ρ = 0.423 and 0.528, both p < 0.05). CONCLUSION: Both fecal biomarkers and PET-MR were excellent non-invasive diagnostic tools in the assessment of disease activity in ulcerative colitis. ADVANCES IN KNOWLEDGE: Both fecal biomarkers and PET-MR parameters are able to predict endoscopically active disease with comparable diagnostic performance. PET had the highest correlation with endoscopy and outperformed fecal biomarkers in differentiating moderate to severe from mild disease.


Assuntos
Colite Ulcerativa/diagnóstico , Fezes/química , Imagem por Ressonância Magnética/métodos , Tomografia por Emissão de Pósitrons/métodos , Adulto , Idoso , Biomarcadores/análise , Colite Ulcerativa/diagnóstico por imagem , Colonoscopia , Neurotoxina Derivada de Eosinófilo/análise , Feminino , Fluordesoxiglucose F18 , Humanos , Lactoferrina/análise , Elastase de Leucócito/análise , Complexo Antígeno L1 Leucocitário/análise , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Proteína S100A12/análise , Adulto Jovem
12.
Cancer Imaging ; 20(1): 39, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32546207

RESUMO

PURPOSE: Evaluate the feasibility of fluorine-18 (18F) fluorodeoxyglucose (FDG) positron emission tomography (PET) and magnetic resonance (MR) imaging in patients with gastric cancer by optimizing the scan protocol and to compare the image quality to 18F FDG PET and computed tomography (CT). METHODS: The PET/CT and PET/MR imaging were sequentially performed in 30 patients with gastric cancer diagnosed by gastroscope using a single-injection-with-dual-imaging protocol. After intravenous injection of 18F-FDG (mean, 249 MBq), PET/CT imaging including low-dose CT was performed (mean uptake time, 47 ± 6 min), and PET/MR imaging including a T1-weighted Dixon sequence for attenuation correction and two different T2-weighted sequences was subsequently acquired (88 ± 15 min after 18F-FDG injection). Four series of images (CT from PET/CT, T1W, T2W Half-Fourier acquisition single-shot turbo spin-echo [T2W-HASTE] and T2W-BLADE from PET/MR) were visually evaluated using a 3-4 points scale for: (1) image artifacts, (2) lesion conspicuity and (3) image fusion quality. The characteristics of the primary lesions were assessed and compared between the PET/CT and PET/MR acquisitions. RESULTS: The image quality and lesion conspicuity of the T2W-HASTE images were significantly improved compared to that of the T2W-BLADE images. A significantly higher number of artifacts were seen in the T2W-HASTE images compared with the T1W and CT images (p < 0. 05). No differences in the accuracy of image fusion between PET/MR and PET/CT (p > 0. 05); however, significant difference was seen in the lesion conspicuity measurements (p < 0.05) with T2W-HASTE being superior. For information about the primary lesion characteristics, the T2W-HASTE images provided the most successful identifications compared with those of the T1W and PET/CT (13vs7vs5) images. CONCLUSIONS: PET/MR with the T2W-HASTE was better at revealing the details of local stomach lesions compared with PET/CT imaging. Combining the PET/MR with the T2W-HASTE technique is a promising imaging method for diagnosing and staging gastric cancer.


Assuntos
Imagem por Ressonância Magnética/métodos , Imagem Multimodal/métodos , Tomografia por Emissão de Pósitrons/métodos , Neoplasias Gástricas/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Feminino , Fluordesoxiglucose F18 , Humanos , Imagem por Ressonância Magnética/normas , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/normas , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons/normas , Compostos Radiofarmacêuticos , Neoplasias Gástricas/patologia , Tomografia Computadorizada por Raios X/normas
13.
Anticancer Res ; 40(6): 3491-3497, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32487649

RESUMO

AIM: To investigate the usefulness of classification of ring-type dedicated breast positron-emission tomography (dbPET) findings in detection of breast cancer. PATIENTS AND METHODS: A total of 709 patients with breast cancer underwent dbPET before treatment. Each finding was morphologically categorized as a focus (uptake size ≤5 mm), mass (>5 mm), or non-mass (multiple uptakes not belonging to a three-dimensional mass or without distinct mass features). Non-mass uptakes were additionally classified as linear, focal, segmental, regional, or diffuse distributions. Lesion-to-background ratios were calculated. RESULTS: Among 910 abnormal findings, 700 (76.9%) were malignant and 210 (23.1%) were benign. Morphologically, 198 (21.8%) lesions were foci, 431 (47.4%) were masses, and 281 (30.9%) were non-masses. In multivariate analysis, mass, focal and segmental distributions of non-mass lesions and high lesion-to-background ratio were significantly related to breast cancer (all p<0.001). CONCLUSION: Classification of abnormal findings on dbPET using morphology and lesion-to-background ratio were useful to detect breast cancer.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Tomografia por Emissão de Pósitrons , Feminino , Fluordesoxiglucose F18 , Humanos , Imagem por Ressonância Magnética , Mamografia , Gradação de Tumores , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons/métodos , Curva ROC , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Ultrassonografia
14.
Medicine (Baltimore) ; 99(22): e20446, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481449

RESUMO

BACKGROUNDS: We performed a meta-analysis to compare F-FDG-PET and F-FDG-PET/CT for the diagnostic performance in thyroid nodules with indeterminate cytology by Bethesda classification. METHODS: PubMed and Embase databases were searched for eligible studies from the earliest available date of indexing through September 2019. Only studies with clearly stated histopathology confirmation were included. Publication bias was assessed by Deeks funnel plot. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, and diagnostic odds ratio was determined by random-effect analysis, respectively. All diagnostic estimate indexes were determined separately for PET alone and PET/CT and were compared pair-wisely using Z-test. RESULTS: We included 214 patients from five PET alone studies and 420 patients from 8 PET/CT studies in this meta-analysis. The range of the prevalence of malignancy was 11% to 27% for PET alone studies (Median, 20%) and 4% to 50% for PET/CT studies (Median, 24%). The sensitivity (0.95 vs 0.73, P < .01), negative likelihood ratio (0.20 vs 0.53, P = .04) and negative predictive value (0.99 vs 0.91, P < .01) of PET alone are significantly better than those of PET/CT. For PET/CT, Fagan nomogram indicated that when the pre-test probability was set at 24%, the negative post-test probability could decrease to 12%. CONCLUSION: This meta-analysis reveals that in evaluating thyroid nodules with indeterminate cytology by Bethesda classification, the rule-out performance of F-FDG-PET is significantly better than F-FDG-PET/CT, although the latter represents a more objective and accurate technique. We hypothesize that the lack of precise localization of suspicious FDG uptake in the neck region may have contributed to this overvaluation for PET alone studies, and advocate that future studies be performed with PET/CT rather than PET alone to avoid misinterpretation and overvaluation in this scenario.


Assuntos
Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Nódulo da Glândula Tireoide/diagnóstico por imagem , Humanos , Tomografia Computadorizada por Raios X/métodos
15.
Acta Cir Bras ; 35(5): e202000505, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32578672

RESUMO

PURPOSE: The objective of this study was to investigate the accuracy of 18F-FDG-PET in the diagnosis of multibacterial abdominal sepsis by cecum ligation and puncture (CLP) in rats. METHODS: Adult Wistar rats ( Rattus norvegicus ), weighing 227±35g, were allocated into a sepsis group by CLP (n=10) and sham group (n=10). 18F-FDG-PET using microPET was performed on all rats after 24 hours. RESULTS: All animals survived for postoperative 24h. The abdomen/liver ratio of the standardized uptake value (SUV) percentage was significantly higher in the sepsis group than in the sham (p=0.004). The ROC curve showed an accuracy of 18F-FDG-PET to detect abdominal sepsis of 88.9% (p=0.001), sensitivity of 90% and specificity of 88.9%. When a cut-off point of 79% of the ratio between the SUV on the abdominal region and liver was established, the sensitivity was 90%, specificity of 88.9%; positive and negative predictive values of 90.0% and 88.9%, respectively. CONCLUSIONS: The diagnostic accuracy of 18F-FDG-PET in rats with abdominal sepsis was significantly high. It was also demonstrated the predictive ability of the abdomen/liver SUV ratio to diagnose abdominal sepsis. These findings may have implications for the clinical setting, locating septic foci with PETscan.


Assuntos
Fluordesoxiglucose F18 , Infecções Intra-Abdominais/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Sepse/diagnóstico por imagem , Animais , Infecções Intra-Abdominais/patologia , Valor Preditivo dos Testes , Ratos , Ratos Wistar , Valores de Referência , Reprodutibilidade dos Testes , Sepse/patologia , Fatores de Tempo
16.
Neurology ; 95(3): e256-e267, 2020 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-32591471

RESUMO

OBJECTIVE: We studied interrelationships between CSF biomarkers and associations with APOE ε4 genotype, demographic variables, vascular variables, and clinical diagnosis in Olmsted County, Minnesota. METHODS: We included 774 Mayo Clinic Study of Aging participants (693 cognitively unimpaired [CU]; 71 with mild cognitive impairment [MCI]). CSF ß-amyloid 42 (Aß42), total tau (t-tau), and hyperphosphorylated tau (p-tau) were analyzed using Aß42 CSF, t-tau CSF, and p-tau (181P) CSF electrochemiluminescence immunoassays. Bivariate mixture models were used to evaluate latent classes. We used linear regression models to evaluate independent associations of APOE ε4, demographic factors, cardiovascular risk, and diagnosis with CSF biomarker levels. Results were weighted back to the Olmsted County population. RESULTS: Interrelationships between CSF Aß42 and p-tau/t-tau were consistent with 2 latent classes in the general population. In subgroup 1 (n = 547 [71%]), we found a strong positive correlation between Aß42 and p-tau (ρ = 0.81), while the correlation was much smaller in group 2 (ρ = 0.26, n = 227 [29%]). Group 2 was associated with older age, APOE ε4 genotype, a diagnosis of MCI, and elevated amyloid PET. Overall, APOE ε4 genotype and MCI were associated with Aß42, while age was associated with p-tau/t-tau. There were no associations with sex, education, or vascular risk. CONCLUSION: We hypothesize the population without dementia can be subdivided into participants with and without biological Alzheimer disease (AD) based on the combination of CSF Aß42 and p-tau/t-tau (represented also by the p-tau/t-tau/Aß42 ratio). In those without biological AD, common factors such as CSF dynamics may cause a positive correlation between CSF Aß42 and p-tau/t-tau, while AD leads to dissociation of these proteins.


Assuntos
Envelhecimento/líquido cefalorraquidiano , Disfunção Cognitiva/líquido cefalorraquidiano , Disfunção Cognitiva/diagnóstico por imagem , Medicina Baseada em Evidências/métodos , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/patologia , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Biomarcadores/líquido cefalorraquidiano , Disfunção Cognitiva/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Minnesota/epidemiologia , Fragmentos de Peptídeos/líquido cefalorraquidiano , Tomografia por Emissão de Pósitrons/métodos , Punção Espinal/métodos , Proteínas tau/líquido cefalorraquidiano
17.
Neurology ; 95(1): e23-e34, 2020 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-32518145

RESUMO

OBJECTIVE: To evaluate FDG-PET as an antemortem diagnostic tool for Alzheimer-related TAR DNA-binding protein of 43 kDa (TDP-43) proteinopathy. METHODS: We conducted a cross-sectional neuroimaging-histologic analysis of patients with antemortem FDG-PET and postmortem brain tissue from the Mayo Clinic Alzheimer's Disease Research Center and Study of Aging with Alzheimer spectrum pathology. TDP-43-positive status was assigned when TDP-43-immunoreactive inclusions were identified in the amygdala. Statistical parametric mapping (SPM) analyses compared TDP-43-positive (TDP-43[+]) with TDP-43-negative cases (TDP-43[-]), correcting for field strength, sex, Braak neurofibrillary tangle, and neuritic plaque stages. Cross-validated logistic regression analyses were used to determine whether regional FDG-PET values predict TDP-43 status. We also assessed the ratio of inferior temporal to medial temporal (IMT) metabolism as this was proposed as a biomarker of hippocampal sclerosis. RESULTS: Of 73 cases, 27 (37%) were TDP-43(+), of which 6 (8%) had hippocampal sclerosis. SPM analysis showed TDP-43(+) cases having greater hypometabolism of medial temporal, frontal superior medial, and frontal supraorbital (FSO) regions (p unc < 0.001). Logistic regression analysis showed only FSO and IMT to be associated with TDP-43(+) status, identifying up to 81% of TDP-43(+) cases (p < 0.001). An IMT/FSO ratio was superior to the IMT in discriminating TDP-43(+) cases: 78% vs 48%, respectively. CONCLUSIONS: Alzheimer-related TDP-43 proteinopathy is associated with hypometabolism in the medial temporal and frontal regions. Combining FDG-PET measures from these regions may be useful for antemortem prediction of Alzheimer-related TDP-43 proteinopathy. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that hypometabolism in the medial temporal and frontal regions on FDG-PET is associated with Alzheimer-related TDP-43 proteinopathy.


Assuntos
Doença de Alzheimer/complicações , Neuroimagem/métodos , Tomografia por Emissão de Pósitrons/métodos , Proteinopatias TDP-43/diagnóstico por imagem , Proteinopatias TDP-43/etiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Fluordesoxiglucose F18 , Humanos , Masculino , Compostos Radiofarmacêuticos , Estudos Retrospectivos
18.
Clin Imaging ; 67: 113-116, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32559681

RESUMO

OBJECTIVES: The aim of the present review was to assess the role of combined 18F-Fluorodeoxyglucose (F-18 FDG) and Ga-68 DOTA-peptides positron emission tomography (PET)-computed tomography (CT) in neuroendocrine tumors (NETs). METHODS: We have searched MEDLINE databases, including PubMed and Scopus, for studies about the combined FDG and Ga-68 DOTA-peptides PET-CT or PET/Magnetic Resonance Imaging (MRI) in NETs in the last 15 years (from 2004 to November 2019). No limits were applied to the search strategy. Abstracts, reviews, letters to editors, and editorials were excluded. RESULTS: Seven studies met the inclusion criteria. In total 236 patients received both 68Ga-DOTA-peptides and F-18 FDG PET-CT for the characterization of NETs. In particular, 84 patients had a neuroendocrine lung tumor while the others mainly a gastroenteropancreatic NET. The combined use of F-18 FDG and Ga-68 DOTA-peptides (mainly TOC) PET studies provides complementary information regarding different biological characteristics of the lesions, thus enabling a more accurate selection of patients for targeted radionuclide therapy and a better stratification of the prognosis. CONCLUSIONS: Ga-68 DOTA-peptides and F-18 FDG PET should be considered complementary in patients with NETs. They should be both performed in the initial staging and during follow-up, with a specific selection of patients and in a multidisciplinary vision.


Assuntos
Tumores Neuroendócrinos/diagnóstico por imagem , Adulto , Idoso , Feminino , Fluordesoxiglucose F18 , Radioisótopos de Gálio , Humanos , Neoplasias Intestinais , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/patologia , Octreotida , Compostos Organometálicos , Neoplasias Pancreáticas , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia por Emissão de Pósitrons/métodos , Prognóstico , Neoplasias Gástricas
19.
J Cancer Res Ther ; 16(2): 280-285, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32474514

RESUMO

Context: The safety and efficacy of irreversible electroporation (IRE) for locally advanced pancreatic carcinoma (LAPC) are well established. However, whether adjuvant chemoradiotherapy after IRE increases, the survival rate remains unknown. Therefore, this study evaluated the effect of chemoradiotherapy combined with IRE in patients with LAPC. Subjects and Methods: We retrospectively analyzed 42 patients with LAPC between July 2015 and December 2016 at PLA General Hospital treated with IRE or IRE combined with radiation and/or chemotherapy. These patients were divided into the IRE group and the combined-therapy group. All patients underwent computed tomography (CT), magnetic resonance imaging, and positron-emission tomography-CT and no signs of metastases were found. The prognosis of these patients was observed. Results: The times after operation and after diagnosis in the combined-therapy group (304.20 ± 118.54) and (334.40 ± 114.07) days, respectively, were better those than in the IRE group (214.36 ± 95.68) and (244.68 ± 110.61) days, respectively. Moreover, patients in the combined-therapy group had a significantly better survival rate than the IRE group (80 vs. 45.45%, P < 0.05). Conclusions: IRE combined with radiotherapy or chemotherapy was superior to IRE alone for the treatment of LAPC, as it prolonged the survival time and improved the survival rate, making it worthy of wide dissemination and clinical application.


Assuntos
Quimiorradioterapia Adjuvante/mortalidade , Eletroporação/métodos , Neoplasias Pancreáticas/terapia , Quimiorradioterapia Adjuvante/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Tomografia por Emissão de Pósitrons/métodos , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Tomografia Computadorizada por Raios X/métodos
20.
Surg Clin North Am ; 100(3): 499-506, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32402296

RESUMO

The past decade has brought about dramatic changes in the diagnosis and management of cancer. Advancements in imaging and minimally invasive interventional techniques combine to rapidly diagnose, stage, and in certain cases, treat various forms of cancer. Physicians treating patients with cancer are confronted with many challenges beginning with the initial diagnosis. Imaging plays an integral role in every step of caring for the patient with cancer. Advances in imaging allow the earlier detection and staging of the disease and aid in decision making and treatment planning.


Assuntos
Diagnóstico por Imagem/métodos , Neoplasias/diagnóstico por imagem , Neoplasias/terapia , Radiologia Intervencionista , Meios de Contraste , Fluordesoxiglucose F18 , Humanos , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Biópsia Guiada por Imagem/métodos , Imagem por Ressonância Magnética/métodos , Estadiamento de Neoplasias , Neoplasias/patologia , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA