Objectives: Radiation pneumonitis (RP) can be an adverse complication of radiotherapy (RT) and can limit the application of
the already planned radiation dose. It is often associated with RT of lung ...carcinoma and is occasionally caused by radiation
therapy of breast carcinoma and lymphomas located in the mediastinum. Positron emission tomography/computed
tomography (PET/CT) emerges lately as a prospective modality for early diagnostics of RP. The aim of this study was to
summarize the initial data from diagnostic application of PET/CT in patients suspicious of RP and to derive criteria, which can
help differentiate RP from early recurrence of the disease and/or residual tumor.
Methods: The current study included 23 patients who had metabolic (PET) and anatomical (CT) changes consistent with RP.
We additionally defined metabolic activity (SUVmax) in the lung parenchyma of 20 patients without RT.
Results: All patients had increased metabolic activity in the lung parenchyma involved in the irradiated area with a mean
SUVmax 3.45 (ranging between 1 and 7.1). The control group had a physiological background metabolic activity-SUVmax 0.61
+/- 0.11.
Conclusion: Metabolic changes in patients suspicious of RP involved diffusely increased metabolic activity coinciding with the
anatomical changes in the irradiated area. Three out of 23 patients had a proven recurrence of the primary neoplastic process
in the irradiated area. The metabolic changes in those patients involved an increase in metabolic activity at follow-up or lack of
tendency towards normalization after chemotherapy, which implied the existence of viable tumor cells. Our initial experience
in the diagnostic application of 18F-FDG PET/CT in patients suspicious of RP allows us to summarize the following: PET/CT is
a reliable imaging modality in the diagnostics of RP. Through its sequential use, we can differentiate inflammatory changes
related to RP from early recurrence of the primary neoplastic process.
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.
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
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.
We aimed to assess the additional value of SPECT/CT over planar lymphoscintigraphy (PI) in sentinel node (SN) detection in malignancies with different lymphatic drainage such as breast cancer, ...melanoma, and pelvic tumors.
From 2010 to 2013, 1,508 patients were recruited in a multicenter study: 1,182 breast cancer, 262 melanoma, and 64 pelvic malignancies (prostate, cervix, penis, vulva). PI was followed by SPECT/CT 1-3 h after injection of (99m)Tc-colloid particles. Surgery was performed the same or next day.
Significantly more SNs were detected by SPECT/CT for breast cancer (2,165 vs. 1,892), melanoma (602 vs. 532), and pelvic cancer (195 vs. 138), all P < 0.001. The drainage basin mismatch between PI and SPECT/CT was 16.5% for breast cancer, 11.1% for melanoma, and 51.6% for pelvic cancers. Surgical adjustment was 17% for breast cancer, 37% for melanoma, and 65.6% for pelvic cancer.
SPECT/CT detected more SNs and changed the drainage territory, leading to surgical adjustments in a considerable number of patients in all malignancies studied but especially in the pelvic cancer group because of this group's deep lymphatic drainage. We recommend SPECT/CT in all breast cancer patients with no SN visualized on PI, all patients with melanoma of the head and neck or trunk, all patients with pelvic malignancies, and those breast cancer and melanoma patients with unexpected drainage on PI.
Extracellular vesicles (EVs) are released from almost all cells and tissues. They are able to transport substances (e.g. proteins, RNA or DNA) at higher concentrations than in their environment and ...may adhere in a receptor-controlled manner to specific cells or tissues in order to release their content into the respective target structure. Blood contains high concentrations of EVs mainly derived from platelets, and, at a smaller amount, from erythrocytes. The female and male reproductive tracts produce EVs which may be associated with fertility or infertility and are released into body fluids and mucosas of the urogenital organs. In this review, the currently relevant detection methods are presented and critically compared. During pregnancy, placenta-derived EVs are dynamically detectable in peripheral blood with changing profiles depending upon progress of pregnancy and different pregnancy-associated pathologies, such as preeclampsia. EVs offer novel non-invasive diagnostic tools which may reflect the situation of the placenta and the foetus. EVs in urine have the potential of reflecting urogenital diseases including cancers of the neighbouring organs. Several methods for detection, quantification and phenotyping of EVs have been established, which include electron microscopy, flow cytometry, ELISA-like methods, Western blotting and analyses based on Brownian motion. This review article summarises the current knowledge about EVs in blood and cord blood, in the different compartments of the male and female reproductive tracts, in trophoblast cells from normal and pre-eclamptic pregnancies, in placenta ex vivo perfusate, in the amniotic fluid, and in breast milk, as well as their potential effects on natural killer cells as possible targets.
Ultrasonography (US), radiography of the kidneys, ureters and bladder (RKUB), intravenous urography (IVU) and especially non-enchanced CT are well established diagnostic modalities in screening ...patients with urolithiasis, while not always fully diagnostic especially when obstructive uropathy or calculous pyelonephritis are present . Diuretic renal scintigraphy (DRS) can determine obstruction, may differentiate between complete or partial, acute or chronic obstruction, but can not specify the cause and often the location of obstruction. The imaging protocol, including DRS with technetium-99m-mercaptylacetyltriglycine ((99m)Tc-MAG3) and single photon emission tomography/computed tomography (SPET/CT) of the kidneys, ureters, and urinary bladder allows for both functional and morphological information, visualization of renal stones and possible renal complications. The main advantages and limitations of this combined examination are discussed and the test is compared to the separate use of DRS and low dose of CT, in urolithiasis.
Radiation pneumonitis (RP) can be an adverse complication of radiotherapy (RT) and can limit the application of the already planned radiation dose. It is often associated with RT of lung carcinoma ...and is occasionally caused by radiation therapy of breast carcinoma and lymphomas located in the mediastinum. Positron emission tomography/computed tomography (PET/CT) emerges lately as a prospective modality for early diagnostics of RP. The aim of this study was to summarize the initial data from diagnostic application of PET/CT in patients suspicious of RP and to derive criteria, which can help differentiate RP from early recurrence of the disease and/or residual tumor.
The current study included 23 patients who had metabolic (PET) and anatomical (CT) changes consistent with RP. We additionally defined metabolic activity (SUV
) in the lung parenchyma of 20 patients without RT.
All patients had increased metabolic activity in the lung parenchyma involved in the irradiated area with a mean SUV
3.45 (ranging between 1 and 7.1). The control group had a physiological background metabolic activity-SUV
0.61 +/- 0.11.
Metabolic changes in patients suspicious of RP involved diffusely increased metabolic activity coinciding with the anatomical changes in the irradiated area. Three out of 23 patients had a proven recurrence of the primary neoplastic process in the irradiated area. The metabolic changes in those patients involved an increase in metabolic activity at follow-up or lack of tendency towards normalization after chemotherapy, which implied the existence of viable tumor cells. Our initial experience in the diagnostic application of
F-FDG PET/CT in patients suspicious of RP allows us to summarize the following: PET/CT is a reliable imaging modality in the diagnostics of RP. Through its sequential use, we can differentiate inflammatory changes related to RP from early recurrence of the primary neoplastic process.
Objectives: Radiation pneumonitis (RP) can be an adverse complication of radiotherapy (RT) and can limit the application of the already planned radiation dose. It is often associated with RT of lung ...carcinoma and is occasionally caused by radiation therapy of breast carcinoma and lymphomas located in the mediastinum. Positron emission tomography/computed tomography (PET/CT) emerges lately as a prospective modality for early diagnostics of RP. The aim of this study was to summarize the initial data from diagnostic application of PET/CT in patients suspicious of RP and to derive criteria, which can help differentiate RP from early recurrence of the disease and/or residual tumor. Methods: The current study included 23 patients who had metabolic (PET) and anatomical (CT) changes consistent with RP. We additionally defined metabolic activity (SUV.sub.max) in the lung parenchyma of 20 patients without RT. Results: All patients had increased metabolic activity in the lung parenchyma involved in the irradiated area with a mean SUV.sub.max 3.45 (ranging between 1 and 7.1). The control group had a physiological background metabolic activity-SUV.sub.max 0.61 +/- 0.11. Conclusion: Metabolic changes in patients suspicious of RP involved diffusely increased metabolic activity coinciding with the anatomical changes in the irradiated area. Three out of 23 patients had a proven recurrence of the primary neoplastic process in the irradiated area. The metabolic changes in those patients involved an increase in metabolic activity at follow-up or lack of tendency towards normalization after chemotherapy, which implied the existence of viable tumor cells. Our initial experience in the diagnostic application of .sup.18F-FDG PET/CT in patients suspicious of RP allows us to summarize the following: PET/CT is a reliable imaging modality in the diagnostics of RP. Through its sequential use, we can differentiate inflammatory changes related to RP from early recurrence of the primary neoplastic process. Keywords: .sup.18F-FDG PET/CT, radiation pneumonitis, radiotherapy, hybrid imaging Amac: Radyasyon pnomonisi (RP) radyoterapinin (RT) yan etkisi olarak gorulebilir ve planlanmis olan radyasyon dozunun uygulanmasini engelleyebilir. Siklikla akciger karsinomu icin uygulanan RT'ye baglidir ancak meme kanseri ve mediastinal lenfoma icin uygulanan RT ile de olusabilir. Son zamanlarda pozitron emisyon tomografi/bilgisayarli tomografi (PET/BT), RP'nin erken tanisi icin kullanilmaktadir. Bu calismanin amaci RP suphesi olan hastalarda tanisal PET/BT uygulamasinin ilk verilerini ozetlemek ve RP'yi erken nuks ve/veya rezidu tumorden ayirt etmede kullanilabilecek kriterler olusturmaktir. Yontem: Bu calismaya RP ile uyumlu metabolik (PET) ve anatomik (BT) degisiklikleri olan 23 hasta dahil edilmistir. Buna ek olarak RT almamis 20 hastanin akciger parankiminde metabolik aktiviteyi (SUV.sub.max) degerlendirdik. Bulgular: Tum hastalarda radyasyon uygulanmis alanlarda akciger parankiminde metabolik aktivite artmisti (ortalama SUV 3,45, aralik 1-7,1). Kontrol grubunda fizyolojik metabolik aktivite mevcuttu (SUV 0,61 +/- 0,11). Sonuc: RP suphesi olan hastalardaki metabolik degisiklikler anatomik olarak radyasyon uygulanmis alanlara denk gelen diffuz artmis metabolik aktiviteyi icermekteydi. Yirmi uc hastanin ucunde bu bolgede primer neoplastik surecin kanitlanmis nuksu vardi. Bu hastalardaki metabolik degisiklikler arasinda, canli tumor hucrelerinin varligini ima eder sekilde, takip surecinde metabolik aktivitede artis ya da kemoterapi sonrasi normale donme egiliminin olmamasi bulundu. RP suphesi olan hastalarda .sup.18F-FDG PET/BT'nin tanisal uygulamasinda ilk deneyimlerimiz dogrultusunda PET/BT'nin RP tanisinda guvenilir bir goruntuleme yontemi oldugu sonucuna vardik. Surekli kullanimi ile RP'ye bagli enflamatuvar degisiklikleri primer neoplastik surecin erken nuksunden ayirt edebiliriz. Anahtar kelimeler: .sup.18F-FDGPET/BT, radyasyon pnomonisi, radyoterapi, hibrid goruntuleme
Objectives: Radiation pneumonitis (RP) can be an adverse complication of radiotherapy (RT) and can limit the application of the already planned radiation dose. It is often associated with RT of lung ...carcinoma and is occasionally caused by radiation therapy of breast carcinoma and lymphomas located in the mediastinum. Positron emission tomography/computed tomography (PET/CT) emerges lately as a prospective modality for early diagnostics of RP. The aim of this study was to summarize the initial data from diagnostic application of PET/CT in patients suspicious of RP and to derive criteria, which can help differentiate RP from early recurrence of the disease and/or residual tumor. Methods: The current study included 23 patients who had metabolic (PET) and anatomical (CT) changes consistent with RP. We additionally defined metabolic activity (SUVmax) in the lung parenchyma of 20 patients without RT. Results: All patients had increased metabolic activity in the lung parenchyma involved in the irradiated area with a mean SUVmax 3.45 (ranging between 1 and 7.1). The control group had a physiological background metabolic activity-SUVmax 0.61 +/- cm. Conclusion: Metabolic changes in patients suspicious of RP involved diffusely increased metabolic activity coinciding with the anatomical changes in the irradiated area. Three out of 23 patients had a proven recurrence of the primary neoplastic process in the irradiated area. The metabolic changes in those patients involved an increase in metabolic activity at follow-up or lack of tendency towards normalization after chemotherapy, which implied the existence of viable tumor cells. Our initial experience in the diagnostic application of18F-FDG PET/CT in patients suspicious of RP allows us to summarize the following: PET/CT is a reliable imaging modality in the diagnostics of RP. Through its sequential use, we can differentiate inflammatory changes related to RP from early recurrence of the primary neoplastic process.
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