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Influence of FDG/PET CT image registration and fusion on the anal canal carcinoma target volume delineation FDG/PET CT图像配准融合对肛管癌靶体积划定的影响
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/AOO1304143D
Igor Ðan, B. Petrovic, M. Erak, S. Lučić, I. Nikolic, M. Petrović, Vladimir Ðan
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引用次数: 0
Accurate assessment of renal function prior and after peptide receptor radionuclide therapy 肽受体放射性核素治疗前后肾功能的准确评估
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/aoo1304146i
B. Ilinčić, Z. Stošić, V. Čabarkapa, R. Žeravica, R. Mijović
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引用次数: 0
Bone: From planar imaging to SPECT & PET/CT 骨:从平面成像到SPECT和PET/CT
Q4 Medicine Pub Date : 2012-12-01 DOI: 10.2298/AOO1204117M
J. Mihailovic, L. Freeman
Since its introduction into clinical medicine 50 years ago, the radionuclide bone scan has played a key role in diagnosing a variety of osseous disorders; particularly metastatic disease. Using small diagnostic doses of Strontium-85 in the 1960’s, it was rapidly established that the study was much more sensitive than skeletal radiographs. The introduction of Technetium-99m phosphate agents in the early 1970’s, offered greatly improved resolution. Whole body imaging became the standard procedure. Interestingly, the positron-emitter, Fluorine 18-sodium fluoride was used by some investigators with the rectilinear scanner. Very recently, this radiotracer has been re-introduced and is witnessing considerable growth using modern PET/CT instrumentation. The cortical bone tracers, 99mTc-MDP and 18F-Fluoride assess osteoblastic response to the invading lesion. In the study of metastatic disease, it is superb for sclerotic blastic lesions. Although it detects most lytic lesions, many can be missed. This is due to a lack of osteoblastic response. The tumor may be slow growing, such as myeloma or conversely very rapidly growing and destructive, such as lung or kidney metastases. In these lesions, 18F-FDG is superior because it is concentrating in the tumor cells and does not depend on osteoblastic response to the tumor. In their early cause, many lytic lesions may be confined to the medullary portion of bone and not yet involve the cortex. Comparative studies of PET and CT have clearly shown the superior sensitivity of FDG in detecting metastatic bone lesions.
自50年前引入临床医学以来,放射性核素骨扫描在诊断各种骨骼疾病方面发挥了关键作用;尤其是转移性疾病。在20世纪60年代,使用小剂量的锶-85进行诊断,很快就确立了这项研究比骨骼x光片灵敏得多。20世纪70年代早期引入的锝-99m磷酸盐剂大大提高了分辨率。全身成像成为标准程序。有趣的是,正电子发射器氟18-氟化钠被一些研究人员用直线扫描仪使用。最近,这种放射性示踪剂已经重新引入,并且使用现代PET/CT仪器正在见证相当大的增长。皮质骨示踪剂99mTc-MDP和18f -氟化物评估成骨细胞对侵袭病变的反应。在转移性疾病的研究中,它对硬化性母细胞病变是极好的。虽然它可以检测到大多数溶解性病变,但也有许多可能被遗漏。这是由于缺乏成骨细胞反应。肿瘤可能生长缓慢,如骨髓瘤,或相反,生长非常迅速和破坏性,如肺或肾转移瘤。在这些病变中,18F-FDG是优越的,因为它集中在肿瘤细胞中,不依赖于对肿瘤的成骨细胞反应。在早期,许多溶解性病变可能局限于骨髓质部分,尚未累及皮质。PET和CT的对比研究清楚地表明FDG在检测转移性骨病变方面具有优越的敏感性。
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引用次数: 1
Positron emission tomography in neoplasms of the digestive system 消化系统肿瘤的正电子发射断层扫描
Q4 Medicine Pub Date : 2012-12-01 DOI: 10.2298/AOO1204086M
J. Mihailovic, L. Freeman
2 SUMMARY PET/CT has proven to be extremely useful in studying neoplasms of the colon and esophagus. It has been less promising for lesions of the stomach, pancreas and hepatobiliary tract. Colorectal cancer is the third most common non-cutaneous cancer representing 13% of all malignancies. The use of colonoscopy has significantly contributed to the earlier detection and higher cure rate. PET/CT is not a screening procedure. It is very good for staging, recurrence detection and monitor- ing therapeutic interventions. It is excellent for detecting distant metastases, e.g. liver lesions, but is less accurate for detecting nodal involvement. The CT portion of the study enhances certainty of lesion localization and characterization. Esophageal cancer is less common in the U.S. in that it represents 7% of G-I cancers, but only 1% of all cancers. The major problem is that often it is advanced to Stages III or IV before it comes to clinical recognition. A 5-year survival has been improved from 3% to 10% by the use of induction chemoradiotherapy. PET has proven useful in staging and deter- mining resectability, monitoring response to therapy, radiotherapy treatment planning and distinguishing between post- op scar and residual or recurrent disease on CT. Gastric cancer results have been more variable. The intestinal (tubular variety) shows better uptake than the non-intestinal (signet ring cell) variety because of the greater mucous content of the latter which is associated with more false negatives. FDG uptake in pancreatic cancer is also variable. Attempts at distinguishing carcinoma from pancreatitis have been limited. When lesions do show uptake, PET/CT has been helpful in monitoring therapeutic interventions. Hepatocellular cancer demonstrates significant FDG uptake in only 50-70% of cases. Cholangio carcinomas; particularly the peripheral variety, do show significant FDG uptake.
PET/CT已被证明在研究结肠和食道肿瘤方面非常有用。对于胃、胰腺和肝胆道的病变,它的前景就不那么乐观了。结直肠癌是第三大最常见的非皮肤癌症,占所有恶性肿瘤的13%。结肠镜检查的使用大大有助于早期发现和更高的治愈率。PET/CT不是筛查程序。它是非常好的分期,复发检测和监测治疗干预。它在检测远处转移瘤(如肝脏病变)方面非常出色,但在检测淋巴结累及方面不太准确。该研究的CT部分增强了病变定位和表征的确定性。食管癌在美国不太常见,它占G-I癌症的7%,但只占所有癌症的1%。主要的问题是,在进入临床诊断之前,它通常已经发展到第三或第四阶段。通过诱导放化疗,5年生存率从3%提高到10%。PET已被证明在分期和确定可切除性、监测治疗反应、放射治疗计划以及区分术后疤痕和CT上的残留或复发疾病方面是有用的。胃癌的结果变化更大。肠道(管状细胞)比非肠道(印戒细胞)表现出更好的吸收,因为后者的粘液含量更高,这与更多的假阴性有关。胰腺癌中FDG的摄取也是不同的。鉴别胰腺癌和胰腺炎的尝试有限。当病变确实显示摄取时,PET/CT有助于监测治疗干预措施。肝细胞癌仅在50-70%的病例中表现出显著的FDG摄取。Cholangio癌;特别是周边品种,确实表现出显著的FDG摄取。
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引用次数: 0
Peptide receptor radionuclide therapy of neuroendocrine tumors: Case series 肽受体放射性核素治疗神经内分泌肿瘤:病例系列
Q4 Medicine Pub Date : 2012-08-03 DOI: 10.2298/AOO1204143M
M. Matović
th 2009 to February the 6 th 2012) with PRRT in Nuclear Medicine Center, Clinical Center Kragujevac. There were carci- noids in 8 cases (6pts had intestinal and 2pts had lung carcinoid), medullary thyroid carcinoma in 5 cases, pancreatic carcinoma in 3 cases, paraganlioma in 2 cases, pheochromocytoma in 2 cases and in 7 cases primary tumors were not detected. We used 56 doses of different kinds of radiopharmaceuticals: 32 doses of 90Y-DOTATOC, 12 doses of 177Lu-DOTATATE, and 12 doses combining the 90Y-DODTATOC and 177Lu-DOTATATE. The PRRT was given in cycles: 12 pts received one cycle, 9 pts two cycles, 4 pts three cycles, 1 patient 4cycles and 2 pts five cycles of PRRT. The radioactivity was 3.2-7.40 GBq per cycle, and intervals between cycles ranged from 6 to 8 weeks. Results: The response to PRRT was assessed by morphological imaging (MSCT and MRI) as well as by tumor marker follow up (CgA, 5-HIAA, catecholamines, CT and CEA). Seven pts (25.9%) had partial response (PR), 17 pts (63.0%) had stable disease (SD), and 3 pts (11.1%) had progressive disease (PD). None of our patients had complete response (CR). All patients received PRRT under renal protection with amino acid infusions. In spite of this precaution, two patients with previously diagnosed diabetes mellitus suffered from serious deterioration of renal function after PRRT. Conclusion: The efficacy and safety of PRRT observed in our case series was in accordance with previously published
于2009年至2012年2月6日在克拉古耶瓦茨临床中心核医学中心进行PRRT。类癌8例(肠类癌6例,肺类癌2例),甲状腺髓样癌5例,胰腺癌3例,副神经节瘤2例,嗜铬细胞瘤2例,原发肿瘤未检出7例。我们使用了56种不同剂量的放射性药物:90Y-DOTATOC 32剂,177Lu-DOTATATE 12剂,90Y-DOTATOC与177Lu-DOTATATE联用12剂。PRRT分周期给予:12例接受1个周期,9例接受2个周期,4例接受3个周期,1例接受4个周期,2例接受5个周期的PRRT。每周期放射性为3.2 ~ 7.40 GBq,周期间隔为6 ~ 8周。结果:通过形态学成像(MSCT和MRI)以及肿瘤标志物随访(CgA、5-HIAA、儿茶酚胺、CT和CEA)评估PRRT的疗效。7名患者(25.9%)部分缓解(PR), 17名患者(63.0%)病情稳定(SD), 3名患者(11.1%)病情进展(PD)。所有患者均无完全缓解(CR)。所有患者均在氨基酸输注肾保护下接受PRRT治疗。尽管采取了这种预防措施,但两名先前诊断为糖尿病的患者在PRRT后肾功能严重恶化。结论:在我们的病例系列中观察到的PRRT的有效性和安全性与先前发表的一致
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引用次数: 3
SPECT/CT for tumour imaging SPECT/CT用于肿瘤成像
Q4 Medicine Pub Date : 2012-01-01 DOI: 10.1007/978-3-642-15726-4_3
C. Aparici, A. Avram, Á. Castrejón, R. Dvorak, P. Erba, J. Fettich, José Manuel Cordero García, V. M. P. García, R. Hawkins, M. Hodolič, P. T. Rubio, Youngho Seo, A. M. G. Vicente, J. Woll, K. Wong
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引用次数: 0
Radioimmunotherapy of Lymphoma 淋巴瘤的放射免疫治疗
Q4 Medicine Pub Date : 2012-01-01 DOI: 10.1007/978-1-4614-4021-5_1
S. Goldsmith
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引用次数: 2
PET/CT in thyroid carcinoma 甲状腺癌的PET/CT表现
Q4 Medicine Pub Date : 2012-01-01 DOI: 10.2298/AOO1204112M
J. Mihailovic
The diagnostic imaging procedures that have a role in detection of malignant thyroid tissue are radioiodine (131I) diagnostic whole-body scintigraphy (WBS), neck ultrasound, and CT and MRI for evaluation of the mediastinal area. Despite excellent morphologic characterization of metastatic nodal recurrences, MRI cannot reliably make a differentiation between benign and malignant lymph nodes. Although it detects enlarged metastatic lymph nodes, there are also many small nodal metastases that are usually missed. In one-third of patients with well differentiated thyroid carcinoma, there are carcinomas with dedifferentiated tumor cells: metastatic tissue may not concentrate radioiodine well; thus 131I-WBS is negative despite elevated thyroglobulin (Tg) levels. Although MRI helps in detection of these non-iodine avid metastases, FDG PET/CT can perform more effectively. Due to its high glycolytic rate, changes in glucose transport systems and hexokinase activity, [18F] fluorodeoxyglucose (FDG) accumulates in malignant tissue and is useful for identification of distant metastases in these patients. Iodine positive metastases are often negative with FDG-PET imaging while iodine negative metastases exhibit increased FDG-uptake. If a metastatic lesion is identified by FDG positron emission tomography/ computed tomography (PET/CT), the usual approach is to first send the patient to surgery for removal of neoplastic tissue, if possible. This is followed by re-treatment with 131I therapy after tumor redifferentiation with retinoic acid. In a limited number of patients, iodine negative thyroid cancer may express somatostatin receptors and radiopeptide therapy may be utilized. FDG PET/CT is a hybrid imaging diagnostic tool which helps in detection of non-iodine avid metastases. It has a role in exact localization of recurrences which will assist in the decision to remove the malignant tissue surgically.
在恶性甲状腺组织检测中起作用的诊断成像程序是放射性碘(131I)诊断全身显像(WBS),颈部超声,以及用于评估纵隔区域的CT和MRI。尽管转移性淋巴结复发的形态学特征很好,但MRI不能可靠地区分良性和恶性淋巴结。虽然它可以检测到扩大的转移性淋巴结,但也有许多小的淋巴结转移通常会被遗漏。在三分之一的高分化甲状腺癌患者中,存在肿瘤细胞去分化的癌:转移组织可能不能很好地浓缩放射性碘;因此,尽管甲状腺球蛋白(Tg)水平升高,131I-WBS仍呈阴性。虽然MRI有助于检测这些非碘性转移,但FDG PET/CT可以更有效地执行。由于其高糖酵解率、葡萄糖转运系统和己糖激酶活性的改变,[18F]氟脱氧葡萄糖(FDG)在恶性组织中积累,可用于鉴别这些患者的远处转移。碘阳性转移灶FDG-PET成像通常为阴性,而碘阴性转移灶fdg摄取增加。如果通过FDG正电子发射断层扫描/计算机断层扫描(PET/CT)发现转移灶,通常的方法是首先将患者送去手术切除肿瘤组织,如果可能的话。肿瘤再分化后再用维甲酸进行131I治疗。在有限数量的患者中,碘阴性甲状腺癌可能表达生长抑素受体,可能使用放射肽治疗。FDG PET/CT是一种混合成像诊断工具,有助于检测非碘性转移。它具有精确定位复发的作用,这将有助于手术切除恶性组织的决定。
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引用次数: 0
Increased mean corpuscular volume as a predictor of response during bevacizumab treatment 增加平均红细胞体积作为贝伐单抗治疗期间反应的预测因子
Q4 Medicine Pub Date : 2012-01-01 DOI: 10.2298/AOO1202015Z
Lidia Aneta Zygulska, K. Krzemieniecki
Background: Remission during sunitinib (a multikinase inhibitor and antiangiogenic drug) treatment correlates with appearance of macrocytosis. There are some suggestions that bevacizumab, an antiangiogenic drug, may result in macrocytosis as well. There are no published data available on the influence of bevacizumab on macrocytosis. This paper attempted to answer the question: does bevacizumab induce macrocytosis being a predictor of the response? Methods: Between August 2008 and August 2011, 53 patients (29 male and 24 female) were treated with bevacizumab in the combination with chemotherapy at the Oncological Department, University Hospital in Krakow, Poland. Efficacy of bevacizumab was assessed on the basis of the computer tomography scans performed every 3 months within the period of 12 months. Concurrently, mean corpuscular volume (MCV) was evaluated and correlated to the response of the treatment. Results: The percentage increase of MCV compared to baseline at 3, 6, 9 and 12 months was 3.7%, 9.2%, 8.7% and 11.8% respectively. The mean value of baseline MCV was 85.3 fl. The mean value of MCV at 3, 6, 9 and 12 months was 90.5 fl, 93 fl, 91.8 fl and 93.1 fl respectively. Macrocytosis did not occur in our study but an increase of MCV was observed within bevacizumab therapy. It was closely related to the response of the treatment. It seems that an increase of MCV can be a predictive agent of bevacizumab response. Conclusion: Bevacizumab does not induce macrocytosis. Increased MCV after treatment with bevacizumab is related to the treatment response. MCV can be a predictor of the response during bevacizumab treatment. A small number of the observed patients requires further investigations.
背景:舒尼替尼(一种多激酶抑制剂和抗血管生成药物)治疗期间的缓解与巨细胞增生的出现相关。有一些建议,贝伐单抗,一种抗血管生成药物,也可能导致巨细胞增多。目前还没有关于贝伐单抗对巨细胞增多症影响的公开数据。这篇论文试图回答这个问题:贝伐单抗诱导的巨噬细胞增生是否可以作为反应的预测因子?方法:2008年8月至2011年8月,在波兰克拉科夫大学医院肿瘤科接受贝伐单抗联合化疗的53例患者(男性29例,女性24例)。贝伐单抗的疗效是在12个月内每3个月进行一次计算机断层扫描的基础上进行评估的。同时,评估平均红细胞体积(MCV)并将其与治疗反应相关联。结果:与基线相比,3、6、9和12个月时MCV增加的百分比分别为3.7%、9.2%、8.7%和11.8%。基线MCV均值为85.3 fl, 3、6、9、12个月MCV均值分别为90.5 fl、93 fl、91.8 fl、93.1 fl。在我们的研究中没有出现巨噬细胞增多,但在贝伐单抗治疗中观察到MCV的增加。这与治疗效果密切相关。MCV的增加似乎可以作为贝伐单抗反应的预测因子。结论:贝伐单抗不诱导巨细胞增生。贝伐单抗治疗后MCV升高与治疗反应有关。MCV可以预测贝伐单抗治疗期间的反应。少数观察到的患者需要进一步调查。
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引用次数: 0
Testicular (gonadal stromal) fibroma: case report 睾丸(性腺间质)纤维瘤1例
Q4 Medicine Pub Date : 2012-01-01 DOI: 10.2298/AOO1202026T
D. Tegeltija, A. Lovrenski, Milana Panjković, Ž. Eri, I. Klem
Testicular fibroma is a rare benign tumor of gradual growth, usually in the third and fourth decade, in the form of a hypoechogenous nodule with clear boundaries and is usually not accompanied by hormonal abnormalities. Metastasis and recurrence of disease were not noted. A 40-year-old male saught medical attention due to pain in the lower back that spread to the pubic bones and the groin. During physical examination, a painless nodule with clear boundaries was palpated in the right testicle, and the ultrasonographic examination revealed hypoechogenic zone with vague boundaries of about 10 mm in diameter. Standard biochemical analyses of blood and urine tests and tumor markers (CEA, CA 125, CA 19-9, AFP and βHCG) were within the physiological limit. Histopathologic analysis set a diagnosis of testicular fibroma. The absence of sex cords in the tumor tissue made it possible to diagnose the patient using standard staining methods, but in cases where these elements can be histologically verified, immunohistochemical analysis should be introduced into a routine diagnostic algorithm.
睾丸纤维瘤是一种罕见的逐渐生长的良性肿瘤,通常发生在第三和第四个十年,以低回声结节的形式,边界清晰,通常不伴有激素异常。没有发现疾病的转移和复发。A某(40岁)因下背部疼痛扩散到耻骨和腹股沟而就医。体格检查时,右侧睾丸触诊到一无痛性结节,边界清晰,超声检查示低回声区,边界模糊,直径约10mm。血、尿标准生化分析及肿瘤标志物(CEA、ca125、ca19 -9、AFP、βHCG)均在生理限度内。组织病理分析诊断为睾丸纤维瘤。肿瘤组织中性索的缺失使得使用标准染色方法诊断患者成为可能,但在这些元素可以在组织学上得到验证的情况下,免疫组织化学分析应引入常规诊断算法。
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引用次数: 4
期刊
Archive of Oncology
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