Abstract Background F-18 fluorodeoxyglucose (18 F-FDG) positron emission tomography (PET) is a useful tool for the detection of local inflamed atherosclerotic lesions. Objective This study used ...hybrid PET/computed tomography (CT) to examine the effects of 2 doses of atorvastatin on18 F-FDG uptake in atherosclerotic plaques in Japanese adults with stable angina pectoris who were scheduled to undergo percutaneous coronary intervention (PCI). Methods This was a prospective, randomized, investigator-blinded, open-label study in patients with dyslipidemia (total cholesterol ≥220 mg/dL and/or LDL-C ≥140 mg/dL) who were scheduled to undergo PCI for stable angina pectoris and had not received any lipid-lowering drugs within 1 year before enrollment. Patients were randomly allocated to receive atorvastatin 5 or 20 mg/d for 6 months. At baseline (the day after PCI),18 F-FDG uptake in the ascending aorta and femoral artery was determined using PET/CT imaging, and the mean target-to-background ratio (TBR) was calculated in individual plaques. The same regions were assessed by PET/CT after 6 months of treatment. Changes from baseline to follow-up in the lipid profile, serum malondialdehyde-modified LDL-C (MDA–LDL-C), and serum high-sensitivity C-reactive protein (hs-CRP) were also examined. Drug adherence, adverse events, and changes in medications were monitored at monthly outpatient visits. Results Of 32 patients initially screened, 2 were excluded due to newly diagnosed cancer; thus, 30 patients were randomly assigned to treatment, 15 in each group. Patients were predominantly male (18 60%), with a mean (SD) age of 54 (11) years, mean body weight of 65 (12) kg, and mean total cholesterol, HDL-C, and triglyceride concentrations of 240 (29), 48 (14), and 180 (102) mg/dL, respectively. After 6 months, the 20-mg group had significant reductions from baseline in mean (SD) TBR in the ascending aorta (from 1.15 0.14 to 1.05 0.12; percent change, −7.9% 9.4%; P = 0.007) and the femoral artery (from 1.12 0.11 to 1.02 0.11; percent change, −9.9% 13.8%; P = 0.012). The corresponding changes from baseline were not statistically significant in the 5-mg group. The differences in percent change in TBR in the 2 locations were not significant between groups. When data from the 2 groups were combined, the overall reduction in TBR from baseline to 6 months was significant in both the ascending aorta ( P = 0.003) and the femoral artery ( P = 0.021). The decreases in TBR in both arteries were significantly correlated with reductions in LDL-C (ascending aorta: r2 = 0.230 P = 0.012; femoral artery: r2 = 0.338 P = 0.003), MDA–LDL-C (ascending aorta: r2 = 0.183 P = 0.028; femoral artery: r2 = 0.247 P = 0.010), and hs-CRP (ascending aorta: r2 = 0.132 P = 0.048; femoral artery: r2 = 0.271 P = 0.007). One patient in the 5-mg group and 2 patients in the 20-mg group had ∼2-fold increases in serum aminotransferases on a single occasion; however, no specific musculoskeletal or hepatic adverse events were observed, and aminotransferase values decreased to within normal ranges without changes in the atorvastatin dose. Conclusion Six months of treatment with atorvastatin 20 mg, but not 5 mg, was associated with a significant reduction in TBR in the ascending aorta and femoral artery in these Japanese adults with dyslipidemia undergoing PCI for stable angina pectoris. University Hospital Medical Information Network Clinical Trials Registry identifier: C000000371.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
•Primary histiocytic sarcoma of the central nervous system is extremely rare.•Immunoprofile of CD68 + and CD163 + confirmed the diagnosis of histiocytic sarcoma.•The first pathological anatomy foster ...knowledge of histiocytic sarcoma.
Histiocytic sarcoma (HS) is an extremely rare non-Langerhans histiocyte disorder of unknown origin. Recently, biomarkers for the confirmation of HS diagnosis have been reported. This report describes a case of primary HS of the central nervous system with description of the pathological anatomy. The patient was older than those in other such cases reported in the literature and presented with unspecific symptoms. This case highlights the difficulty in diagnosis and importance of suspicion of HS.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Objective: Intravenous (IV) recombinant tissue plasminogen activator (rt-PA) and mechanical thrombectomy (MT) are effective treatments for acute ischemic stroke (AIS). However, the treatment for AIS ...in pregnancy is not established because no clinical trials have included pregnant patients. We present a case of middle cerebral artery (MCA) M2 segment occlusion in pregnancy treated with IV thrombolysis and endovascular therapy.Case Presentation: A 36-year-old woman being 6 weeks pregnant presented with right-sided hemiparesis and aphasia. MRI showed a high-intensity area on diffusion-weighted imaging of the left parietal lobe, and MRA showed left MCA M2 segment occlusion. She underwent IV rt-PA and MT and achieved thrombolysis in cerebral infarction 2b revascularization without complications. The protein S concentration was lower than that in the physiological changes during pregnancy. She was diagnosed with embolic stroke related to coagulopathy in pregnancy, and she underwent anticoagulation. At the 3-month follow-up, the modified Rankin Scale was 0. She miscarried at 4 months, and the fetal death was presumed to be obstetric cause.Conclusion: IV rt-PA and MT may be effective and safe treatments for pregnant patients. Estimated fetal radiation exposure during MT is low and is presumed not to affect fetal development. We should mitigate the radiation dose and reduce the dose of iodinated contrast agents, particularly in pregnant patients.
Objective: We report a case of acute middle cerebral artery (MCA) occlusion caused by tumor embolism.Case Presentation: A 64-year-old man with lung cancer presented with sudden onset left-sided ...hemiparesis and sensory disturbance. Diffusion-weighted imaging (DWI) revealed hyper-intense foci in the right MCA territory and magnetic resonance angiography (MRA) demonstrated right MCA M2 segment occlusion. Mechanical thrombectomy (MT) was performed with Thrombolysis in Cerebral Infarction 2B recanalization. On histopathology, thrombus composed of fibrin and squamous cell carcinoma was observed. We diagnosed him with tumor embolism from lung cancer that invaded the pulmonary vein and the left atrium.Conclusion: Tumor cells may be confirmed by pathological examination regardless of the morphology of the embolus. Pathological examination of the cerebral embolus is useful for the accurate diagnosis of ischemic stroke subtypes.
Aim: To investigate whether 18F-fluorodeoxyglucose uptake is associated with overall survival in patients with major salivary gland cancer using univariate and multivariate analyses after adjusting ...for pathological stage (eighth edition of the International Union Against Cancer). Patients and Methods: A total of 32 patients with major salivary gland cancer treated with curative surgery were enrolled. Parameters for 18F-fluorodeoxyglucose uptake were assessed by positron-emission tomography combined with computed tomography. Results: Using univariate and multivariate analyses after adjusting for pathological stage, a maximum standardized uptake value ≥26, peak standardized uptake value ≥20.3, metabolic tumor volume ≥9.7, and total lesion glycolysis ≥263 were significantly correlated with shorter overall survival. Conclusion: Parameters of 18F-fluorodeoxyglucose uptake in major salivary gland cancer are predictive of overall survival after adjusting for the pathological stage.
We investigated whether 18F-fluorodeoxyglucose uptake parameters using positron emission tomography combined with computed tomography predicts several survival outcomes, including lung ...metastasis-free survival, in patients with laryngeal or pharyngeal cancer who underwent salvage surgery. The maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis were calculated as 18F-fluorodeoxyglucose uptake parameters in 51 patients with laryngeal or pharyngeal cancer before salvage surgery. In univariate analysis, the maximum standardized uptake value ≥ 22.8, metabolic tumor volume ≥ 2.4, and total lesion glycolysis ≥ 5.4 were significantly correlated with shorter overall survival. In multivariate analysis with adjustment for clinical stage, patients with total lesion glycolysis ≥ 5.4 exhibited significantly shorter overall survival. Furthermore, total lesion glycolysis ≥ 5.4 was significantly correlated with shorter disease-specific survival, distant metastasis-free survival, and lung metastasis-free survival in univariate analysis. In conclusion, total lesion glycolysis predicts the survival outcomes including lung metastasis in patients with laryngeal or pharyngeal cancer who underwent salvage surgery.
To predict survival outcomes of different patients with the same stage of disease is difficult. The possible correlation between
F-fluorodeoxyglucose (
F-FDG) uptake parameters and survival outcomes ...was investigated in oral squamous cell carcinoma patients by multivariate analysis adjusted for the pathological stage according to the 8th edition of the tumor-node-metastasis (TNM) classification of the Union for International Cancer Contro.
F-FDG-uptake parameters of 28 patients were assessed by positron emission tomography with computed tomography (PET/CT).
A peak of standardized uptake value of primary tumor (p-SUVpeak) of ≥14.1 was significantly correlated with shorter overall survival by univariate and multivariate analyses adjusted for the pathological TNM stage. A p-SUVpeak of ≥14.1 was significantly associated with shorter local recurrence-free survival and disease-free survival.
A higher p-SUVpeak on pretreatment
F-FDG-PET/CT is a prognostic parameter of identifying lower survival outcomes.
In this study, we aimed to develop a hybrid method for automated detection of high-uptake regions in the breast and axilla using dedicated breast positron-emission tomography (db PET) and whole-body ...PET/computed tomography (CT) images. In our proposed method, high-uptake regions in the breast and axilla were detected using db PET images and whole-body PET/CT images. In db PET images, high-uptake regions in the breast were detected using adaptive thresholding technique based on the noise characteristics. In whole-body PET/CT images, the region of the breast that includes the axilla was first extracted using CT images. Next, high-uptake regions in the extracted breast region were detected on the PET images. By integration of the results of the two types of PET images, a final candidate region was obtained. In the experiments, the accuracy of extracting the region of the breast and detection ability was evaluated using clinical data. As a result, all breast regions were extracted correctly. The sensitivity of detection was 0.765, and the number of false positive cases were 1.8, which was 30% better than those on whole-body PET/CT alone. These results suggested that the proposed method, combining the two types of PET images is effective for improving detection performance.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Objectives
We investigated a possible correlation between the maximum standardized uptake value (SUV
max
), which is assessed by pretreatment
18
F-fluorodeoxyglucose positron emission tomography with ...computed tomography, and the overall survival (OS) in patients with hypopharyngeal squamous cell carcinoma from two institutions on long-term follow-up, and examined whether SUV
max
is correlated with several survival outcomes, including lung metastasis-free survival.
Methods
A total of 81 patients were enrolled. The survival rate was calculated by the Kaplan–Meier method. Both univariate and multivariate survival analyses were assessed by a Cox proportional hazards model.
Results
SUV
max
≥15.2 in institution A (
p
= 0.0306) or SUV
max
≥8 in institution B (
p
= 0.0132) was significantly predictor of a lower OS. We disaggregated the data by high SUV
max
(SUV
max
≥15.2 from institution A and SUV
max
≥8 from institution B) and low SUV
max
(SUV
max
<15.2 from institution A and SUV
max
<8 from institution B). Patients with a high SUV
max
exhibited a significantly lower OS in both univariate (
p
= 0.001) and multivariate (
p
= 0.0046) analyses for adjusted for the clinical stage and treatment group. The patients with a high SUV
max
exhibited significantly shorter disease-specific (
p
= 0.0068), distant metastasis-free (
p
= 0.0428), and lung metastasis-free (
p
= 0.0328) survivals.
Conclusions
High SUV
max
was significantly correlated with a lower OS, disease-specific survival, distant metastasis-free survival, and lung metastasis-free survival in a multi-institutional retrospective study.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
High uptake of F18-fluorodeoxyglucose parameters for glucose metabolism is related to shorter survival in sinonasal tract cancer with various histological classifications. We investigated whether ...F18-fluorodeoxyglucose uptake parameters are associated with survival outcomes for patients with only squamous cell carcinoma (SCC) in the sinonasal tract that are treated either with surgery or nonsurgery.
We retrospectively observed F18-fluorodeoxyglucose uptake parameters on positron emission tomography with computed tomography for the primary tumour of SCC in 39 patients. Log-rank test or a Cox regression model with 95% confidence interval (95%CI) and hazard ratio (HR) were used for monovariable or multivariable analysis, respectively. We determined cut-off values of the F18-fluorodeoxyglucose uptake parameters using the lowest
value for monovariable sinonasal tract cancer-specific survival analysis.
Monovariable analysis showed that patients with metabolic tumour volume (MTV) ≥ 21.8 had a shorter cancer-specific, disease-free and local recurrence-free survival than those with MTV < 21.8. After adjusting for age, gender, clinical stage and treatment group in the multivariable analysis, MTV (≥21.8/<21.8) was related to shorter cancer-specific (HR: 3.69, 95%CI: 1.17-12.0), disease-free (HR: 3.38, 95%CI: 1.19-9.71) and local recurrence-free (HR: 5.42, 95%CI: 1.59-20.3) survivals.
MTV as advances in diagnostics of sinonasal tract SCC is a predictor.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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