The aim of the study was to investigate the role of
fluorine-fluorodeoxyglucose (
F-FDG) positron emission tomography/computed tomography (PET/CT) for evaluating the efficacy of radiofrequency ...ablation (RFA) in primary and metastatic liver tumors compared with contrast-enhanced ultrasound examination (CEUS) and to find its place in overall staging and the follow-up diagnostic algorithm.
PET/CT examinations were performed 2 months after RFA for 20 patients with a total of 34 liver lesions. CEUS was performed within 10 days after PET/CT, and the results were compared. Seven patients were staged with PET/CT and the others with a contrast-enhanced CT.
A total of 48
F-FDG PET/CT examinations were performed. We observed complete response in 8 patients (40%), 2 patients (10%) had stable disease, one (5%) had partial response, and 9 patients (45%) had progression (including 2 cases with extrahepatic involvement). Compared with CEUS, there was a mismatch in 3 cases. Five patients underwent additional RFA for 7 lesions.
According to our preliminary data, PET/CT may be a valuable method, with comparable or eventually even better sensitivity than CEUS, for early evaluation of the efficacy of RFA for the treatment of metastatic and primary liver lesions and planning of future treatment. PET/CT might be recommended as a staging method before undergoing RFA of liver lesions for determining the local extent of the disease in the liver in combination with CEUS with an advantage in visualization of extrahepatic involvement. However, more patients need to be investigated in order to demonstrate and confirm the obtained results with certainty.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Objectives: The aim of the study was to investigate the role of 18fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for evaluating the efficacy of ...radiofrequency ablation (RFA) in primary and metastatic liver tumors compared with contrast-enhanced ultrasound examination (CEUS) and to find its place in overall staging and the follow-up diagnostic algorithm. Methods: PET/CT examinations were performed 2 months after RFA for 20 patients with a total of 34 liver lesions. CEUS was performed within 10 days after PET/CT, and the results were compared. Seven patients were staged with PET/CT and the others with a contrast-enhanced CT. Results: A total of 48 18F-FDG PET/CT examinations were performed. We observed complete response in 8 patients (40%), 2 patients (10%) had stable disease, one (5%) had partial response, and 9 patients (45%) had progression (including 2 cases with extrahepatic involvement). Compared with CEUS, there was a mismatch in 3 cases. Five patients underwent additional RFA for 7 lesions. Conclusion: According to our preliminary data, PET/CT may be a valuable method, with comparable or eventually even better sensitivity than CEUS, for early evaluation of the efficacy of RFA for the treatment of metastatic and primary liver lesions and planning of future treatment. PET/CT might be recommended as a staging method before undergoing RFA of liver lesions for determining the local extent of the disease in the liver in combination with CEUS with an advantage in visualization of extrahepatic involvement. However, more patients need to be investigated in order to demonstrate and confirm the obtained results with certainty.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Objectives: The aim of the study was to investigate the role of .sup.18fluorine-fluorodeoxyglucose (.sup.18F-FDG) positron emission tomography/computed tomography (PET/CT) for evaluating the efficacy ...of radiofrequency ablation (RFA) in primary and metastatic liver tumors compared with contrast-enhanced ultrasound examination (CEUS) and to find its place in overall staging and the follow-up diagnostic algorithm. Methods: PET/CT examinations were performed 2 months after RFA for 20 patients with a total of 34 liver lesions. CEUS was performed within 10 days after PET/CT, and the results were compared. Seven patients were staged with PET/CT and the others with a contrast-enhanced CT. Results: A total of 48 .sup.18F-FDG PET/CT examinations were performed. We observed complete response in 8 patients (40%), 2 patients (10%) had stable disease, one (5%) had partial response, and 9 patients (45%) had progression (including 2 cases with extrahepatic involvement). Compared with CEUS, there was a mismatch in 3 cases. Five patients underwent additional RFA for 7 lesions. Conclusion: According to our preliminary data, PET/CT may be a valuable method, with comparable or eventually even better sensitivity than CEUS, for early evaluation of the efficacy of RFA for the treatment of metastatic and primary liver lesions and planning of future treatment. PET/CT might be recommended as a staging method before undergoing RFA of liver lesions for determining the local extent of the disease in the liver in combination with CEUS with an advantage in visualization of extrahepatic involvement. However, more patients need to be investigated in order to demonstrate and confirm the obtained results with certainty. Keywords: Radiofrequency ablation, PET/CT, CEUS, metastatic liver lesions, primary liver tumors Amaç: Bu çalismanin amaci, primer ve metastatik karaciger tümörlerinde radyofrekans ablasyonunun (RFA) etkinligini degerlendirmede .sup.18flor-florodeoksiglukoz (.sup.18F-FDG) pozitron emisyon tomografisi/bilgisayarli tomografinin (PET/BT) rolünü kontrastli ultrason tetkikine (CEUS) kiyasla arastirmak ve genel evreleme ve takip tani algoritmasindaki yerini bulmaktir. Yöntem: Toplam 34 karaciger lezyonu olan 20 hastaya RFA'dan 2 ay sonra PET/BT tetkikleri yapildi. PET/BT'den sonraki 10 gün içinde CEUS yapildi ve sonuçlar karsilastirildi. Yedi hasta PET/BT ile digerleri ise kontrastli BT ile evrelendirildi. Bulgular: Toplam 48 adet .sup.18F-FDG PET/BT incelemesi yapildi. Sekiz hastada (%40) tam yanit, 2 hastada (%10) stabil hastalik, 1 hastada (%5) kismi yanit ve 9 hastada (%45) progresyon (ekstrahepatik tutulumlu 2 olgu dahil) gözlemlendi. CEUS ile karsilastirildiginda, 3 olguda uyumsuzluk bulundu. Bes hastaya, toplam 7 lezyon için ek RFA uygulandi. Sonuç: Ön verilerimize göre PET/BT, metastatik ve primer karaciger lezyonlarinin tedavisinde RFA'nin etkinliginin erken degerlendirilmesi ve gelecekteki tedavinin planlanmasi için CEUS ile karsilastirilabilir veya sonuç olarak daha iyi hassasiyete sahip degerli bir yöntem olabilir. PET/BT, ekstrahepatik tutulumun görsellestirilmesinde avantajli olmasi ile birlikte, CEUS ile birlikte karacigerdeki hastaligin lokal boyutunu belirlemede karaciger lezyonlari için RFA öncesinde bir evreleme yöntemi olarak önerilebilir. Bununla birlikte, elde edilen sonuçlari kesin olarak göstermek ve dogrulamak için daha fazla hastanin arastirilmasi gerekir. Anahtar kelimeler: Radyofrekans ablasyon, PET/BT, CEUS, metastatik karaciger lezyonlari, primer karaciger tümörleri
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
We present the case of a patient with newly diagnosed high-risk prostate cancer. The patient underwent nephrectomy for renal cell carcinoma (RCC) in 2009. The prostate-specific membrane antigen ...(PSMA) scan revealed a primary tumor with seminal vessel involvement, PSMA-positive regional lymph nodes, several nodular lung lesions with mild PSMA uptake, PSMA-positive mediastinal lymph nodes, and a PSMA-positive mass in the pancreatic head. Ultrasound-guided biopsy was performed for the pancreatic lesions revealing metastasis from a RCC. Simultaneous treatment for prostate cancer and metastatic RCC was initiated. To separate metastatic sites for both primaries, we attempted to use fluorodeoxyglucose positron emission tomography/computed tomography, which was moderately positive for the pancreatic mass but not for the other locations. RCC is a 68Ga PSMA-positive tumor; the synchronous combination of RCC with prostate cancer can be confusing and requires more complex clinical interpretation.We present the case of a patient with newly diagnosed high-risk prostate cancer. The patient underwent nephrectomy for renal cell carcinoma (RCC) in 2009. The prostate-specific membrane antigen (PSMA) scan revealed a primary tumor with seminal vessel involvement, PSMA-positive regional lymph nodes, several nodular lung lesions with mild PSMA uptake, PSMA-positive mediastinal lymph nodes, and a PSMA-positive mass in the pancreatic head. Ultrasound-guided biopsy was performed for the pancreatic lesions revealing metastasis from a RCC. Simultaneous treatment for prostate cancer and metastatic RCC was initiated. To separate metastatic sites for both primaries, we attempted to use fluorodeoxyglucose positron emission tomography/computed tomography, which was moderately positive for the pancreatic mass but not for the other locations. RCC is a 68Ga PSMA-positive tumor; the synchronous combination of RCC with prostate cancer can be confusing and requires more complex clinical interpretation.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
We present the case of a patient with newly diagnosed high-risk prostate cancer. The patient underwent nephrectomy for renal cell carcinoma (RCC) in 2009. The prostate-specific membrane antigen ...(PSMA) scan revealed a primary tumor with seminal vessel involvement, PSMA-positive regional lymph nodes, several nodular lung lesions with mild PSMA uptake, PSMA-positive mediastinal lymph nodes, and a PSMA-positive mass in the pancreatic head. Ultrasound-guided biopsy was performed for the pancreatic lesions revealing metastasis from a RCC. Simultaneous treatment for prostate cancer and metastatic RCC was initiated. To separate metastatic sites for both primaries, we attempted to use fluorodeoxyglucose positron emission tomography/computed tomography, which was moderately positive for the pancreatic mass but not for the other locations. RCC is a .sup. (68)Ga PSMA-positive tumor; the synchronous combination of RCC with prostate cancer can be confusing and requires more complex clinical interpretation. Keywords: PSMA, FDG, PET/CT, prostate cancer, RCC, pancreatic metastasis Bu olgu sunumunda yeni tani almis yuksek riskli prostat kanseri olan bir hastayi sunuyoruz. Hastaya 2009 yilinda renal hucreli karsinom (RHK) nedeniyle nefrektomi uygulandi. Prostat spesifik membran antijeni (PSMA) taramasinda seminal vezikul tutulumu olan primer bir tumor, PSMA pozitif bolgesel lenf nodlari, hafif PSMA tutulumu olan birkac noduler akciger lezyonu, PSMA-pozitif mediastinal lenf nodlari ve pankreas basinda PSMA pozitif kitle saptandi. Pankreas lezyonlari icin ultrason esliginde biyopsi yapildi ve bu lezyonlarin RHK metastazi oldugunu ortaya cikardi. Prostat kanseri ve metastatik RHK'nin eszamanli tedavisine baslandi. Her iki primer icin metastatik bolgeleri ayirmak amaciyla, florodeoksiglukoz pozitron emisyon tomografisi/bilgisayarli tomografiyi kullanmayi denedik; bu, pankreas kitlesi icin orta derecede pozitifti, ancak diger lokasyonlar icin pozitif degildi. RHK, .sup.(68)Ga PSMA pozitif bir tumordur; RHK'nin prostat kanseri ile eszamanli kombinasyonu kafa karistirici olabilir ve daha karmasik klinik yorumlama gerektirir. Anahtar kelimeler: PSMA, FDG, PET/BT, prostat kanseri, RHK, pankreas metastazi
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
PDF