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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with a benign chromophobe adenoma, who had incomplete surgical removal followed by radiotherapy, continued to have epileptic seizures up to two or three times a day. She was studied with positron emission tomography using 18F-2-deoxyglucose (FDG). This technique showed a high level of glucose utilization in the area of the operated tumor but also clear reduction of glucose utilization in the left medial temporal region adjacent to the sella and the scar tissue from the neoplasm. This area of reduced glucose utilization corresponded well to the same finding observed in other patients with complex partial epilepsy. A left temporal anterior lobectomy was carried out followed by improved control of the epilepsy. Positron emission tomography using FDG, together with electrophysiological examinations, may assist in the management of epilepsy related to pituitary tumors.
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PMID:Pituitary adenoma with seizures: PET demonstration of reduced glucose utilization in the medial temporal lobe. 348 98

The most commonly used radionuclides for cancer patients in Japan have been still 67Ga and 201T1 chloride. In addition to the diagnosis of lung cancer and thyroid tumor, 201T1 is recently applied to patients with brain tumor, bone and soft tissue tumor and parathynoid adenoma. Comparing to Nuclear Cardiology and Brain Nuclear Medicine, where many new radiopharmaceuticals have been developed, there are few new drugs in Nuclear Oncology. In other words, new radiopharmaceuticals are expected to be developed for the diagnosis and/or therapy of cancer. In addition to 131I for thyroid cancer, new radiopharmaceuticals such as 111In-octreotide and 99mTc(V)-DMSA have been clinically employed. In spite of strong expectation, radiolabeled monoclonal antibodies have not been clinically used in Japan. However, the technique of humanized antibodies has been established and in U.S.A., 131I-labeled antibodies are reported to be effective for the treatment of malignant lymphoma. 89Sr is useful for the relief of bone pain caused by the bone metastasis. New findings that SPECT of 18F-FDG, a positron emitter, has been revealed to have a great potential in the management of cancer patients, will give a great impact on Nuclear Oncology.
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PMID:[Current status of nuclear oncology in Japan]. 852 36

We evaluated the usefulness of FDG-PET for the detection of thyroid tumours and the differentiation between benign and malignant tumours. The subjects consisted of 5 normal volunteers and 22 patients, including 3 with follicular adenoma, 16 with papillary carcinoma and 3 with follicular carcinoma. The results were then evaluated both visually and semi-quantitatively using the standardized uptake value (SUV). All 22 tumours were seen as areas of high FDG uptake. FDG uptake in the normal thyroid gland, follicular adenoma, papillary carcinoma and follicular carcinoma was 1.0 +/- 0.2, 2.1 +/- 0.4, 4.7 +/- 3.2 and 4.6 +/- 2.9, respectively. Significant differences were observed between papillary carcinoma and both follicular adenoma (P < 0.05) and the normal thyroid gland (P < 0.001), and between follicular adenoma and the normal thyroid gland (P < 0.001). For the diagnosis of carcinoma, 58% sensitivity, 100% specificity and 73% accuracy were obtained when the highest FDG uptake value in adenoma was taken as the threshold. Our results thus indicate that high FDG uptake in a thyroid tumour suggests malignancy even though low levels of FDG uptake cannot completely rule out malignancy.
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PMID:An evaluation of FDG-PET in the detection and differentiation of thyroid tumours. 939 98

The guidelines for publishing economic evaluations require a statement of the economic importance of the analysis and the viewpoint from which it has been carried out, as well as specification of at least two alternative programmes or interventions, the form of economic evaluation, the outcome measure, the method of costing, the time horizon and adjustment for timing of costs and benefits (e.g. by a discount factor), and the allowance for uncertainties (e.g. by implementation of a sensitivity analysis). The decision analysis can be based on clinical trial data, on retrospective or administrative databases, or on modelling. The choice of outcome measures is the key issue in an economic evaluation. In cost-effectiveness analysis, benefits are usually measured in natural units. This is the form of economic evaluation most frequently used in nuclear medicine. Endpoints of effectiveness applied in studies in this field have been procedures avoided, procedures initiated, cardiac events, survival probability, morbidity, quality of life and protracted or failed surgical procedures. In other instances, surrogate endpoints have been used such as metastases detected, staging, viability or tumour response. This, however, limits comparability of cost-effectiveness considerably, as proof of a change in the health outcome cannot be obtained. Measures of utility such as QALYs (quality-adjusted life years) have so far only been applied for decision tree analysis. Useful examples of economic evaluation studies in nuclear medicine are presented here for fluorodeoxyglucose positron emission tomography (FDG-PET) in the preoperative staging of non-small cell lung cancer, for FDG-PET in differentiating indeterminate solitary pulmonary nodules, for somatostatin receptor scintigraphy in detecting metastases of carcinoid tumours, for routine preoperative scintigraphy with sestamibi in patients with parathyroid adenoma, for periodic measurement of thyroid-stimulating hormone in detecting mild thyroid failure, for diagnostic algorithms including a lung scan in patients with suspected pulmonary embolism, for myocardial perfusion imaging as an incremental prognostic factor in patients with coronary artery disease, and for the use of radioiodine as first-line therapy of Graves' hyperthyroidism and of toxic nodular goitres. Further evaluations of effectiveness or utility should be carried out within a multidisciplinary framework to ensure that nuclear medical procedures are included in the general management guidelines.
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PMID:Economic evaluation studies in nuclear medicine: the need for standardization. 1036 54

A 41-year-old male with primary hypothyroidism and a huge TSH-secreting pituitary tumor presented with a bleeding nasal mass that was initially misdiagnosed as a paraganglioma. Other unique features of the case include lack of complaints related to hypothyroidism, an extremely elevated TSH level of 3474 mU/l, and a low prolactin level. The presence of primary hypothyroidism made differentiating TSH-secreting pituitary adenoma from secondary thyrotroph hyperplasia difficult. A low molar ratio of alpha-subunit to TSH on presentation, together with normalization of TSH level and a 50% reduction in the size of the tumor after 6 weeks of thyroxine replacement therapy, suggested the presence of thyrotroph hyperplasia. However, the lack of further decrease in the size of the tumor that was associated with increased metabolic activity on 18-FDG PET scan, intense uptake on octreotide scan, and an elevated alpha-subunit to TSH molar ratio despite the normalization of free T4 and TSH levels for 16 months suggested the coexistence of thyrotroph adenoma. Together, the findings support the view that thyrotroph adenoma/irreversible hyperplasia can result from long standing primary hypothyroidism.
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PMID:Primary hypothyroidism-associated TSH-secreting pituitary adenoma/hyperplasia presenting as a bleeding nasal mass and extremely elevated TSH level. 1043 50

Hypofunctioning nodules on scintiscan using Tc-99m Pertechnetate or I-123 have a higher probability of malignancy compared to eu- or hyperfunctioning nodules. However, in the preoperative assessment of thyroid nodules, ultrasonography and ultrasonography guided fine needle aspiration biopsy play the most important role, especially for papillary thyroid cancer. The problem of differentiating follicular adenoma from highly differentiated follicular carcinoma however remains. Also the additional use of a multi tracer imaging strategy (Tl-201/Tc-99m subtraction scan, Tc-99m Sestamibi, Tc-99m Tetrofosmin dual phase scintigraphy) has not solved this problem. Although it is unlikely, the question whether FDG PET is able to give a better differentiation between benign and malignant tumours in the preoperative assessment of thyroid nodules is not answered up to now. In contrast to preoperative diagnostics, FDG PET is of great value in the postoperative follow up of differentiated thyroid cancer. In case of elevated serum thyroglobulin but negative I-131 WBS FDG PET is the method of choice to detect I-131 negative recurrences and metastases. FDG uptake in metastases from differentiated thyroid cancer is correlated to low differentiation and maybe bad prognosis. There is also evidence that FDG PET may have a role in the follow up of anaplastic and especially in medullary thyroid cancer in the future.
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PMID:The role of F-18FDG PET in thyroid cancer. 1081 62

We report the case of a MEN 2a patient with a history of medullary thyroid cancer (MTC) treated by total thyroidectomy, who presented an increasing calcitonin level, suggesting tumor recurrence. Conventional radiographic and radionuclide imaging failed to localize the responsible lesions. A planar and tomographic (SPECT) [99mTc]MIBI scan, performed in order to investigate a recent hyperparathyroidism localized a parathyroid adenoma and revealed an abnormal uptake in the left lateral neck region, corresponding to apparently banal lymph nodes on MRI. This abnormal uptake was also observed on a [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) study and was proven to be an uptake in MTC lymph nodes metastases as confirmed by histopathologic analysis. We conclude that, using an adequate acquisition protocol (i.e. SPECT), [99mTc]MIBI scan is potentially able to localize both parathyroid adenoma and recurrent MTC at one and the same time, particularly in case of non-diagnostic conventional imaging techniques. In this setting, the potential usefulness of FDG-PET is also discussed.
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PMID:Usefulness of [99mTC]MIBI and [18F]fluorodeoxyglucose for imaging recurrent medullary thyroid cancer and hyperparathyroidism in MEN 2a syndrome. 1188 24

Accurate characterization of adrenal lesions in lung cancer is essential in the staging of the disease. Computed tomography and magnetic resonance imaging as well as fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging are used to differentiate adrenal metastases from benign adenomas. Although FDG-PET is highly accurate in this regard, benign adrenal cortical adenomas have been shown to accumulate FDG, although to a lesser degree. We present a patient with a history of lung cancer and FDG accumulation in a benign adenoma, probably reflecting areas of chronic inflammation also seen within the gland at pathology.
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PMID:F-18 fluorodeoxyglucose positron emission tomography-positive benign adrenal cortical adenoma: imaging features and pathologic correlation. 1506 28

A 24-year-old woman was admitted to our department for further examination of hypercalcemia, a high level of intact parathyroid hormone (PTH) and a right parathyroid tumor. She complained of bone pain throughout her body and was unable to walk due to systemic cystic osteofibrosis, including a brown tumor of the left lower extremities. Neck ultrasonography (US) and magnetic resonance imaging (MRI) revealed a tumor 2 cm in diameter in the upper side of the right thyroid lobe. 99mTc sestamibi (99mTc-MIBI) imaging and F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) were performed to diagnose primary hyperparathyroidism and examination of other parathyroid glands. However, neither imaging modality detected the parathyroid tumor. To confirm the diagnosis, we performed selective venous sampling around the parathyroid and the patient was diagnosed with primary hyperparathyroidism due to a right parathyroid tumor. Resection of the right parathyroid tumor was performed and the pathological diagnosis was parathyroid adenoma. To date, both 99mTc-MIBI and FDG-PET are useful to localize parathyroid tumors. In this case, however, neither modality detected the tumor. Although recent studies state that expression of P-glycoprotein (P-gp) in parathyroid tumors plays an important role in the false-negative results of both 99mTc-MIBI scans and FDG-PET, immunohistological study detected no P-gp expression in the parathyroid tumor in the current case.
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PMID:A patient with classic severe primary hyperparathyroidism in whom both Tc-99m MIBI scintigraphy and FDG-PET failed to detect the parathyroid tumor. 1549 17

Patients with known tumors can have other tumors in unexpected places, the so-called synchronic or second primary cancers. In these patients, whole-body fluorodeoxyglucose positron emission tomography (FDG-PET) to study known tumors can identify other tumors that would escape notice if only the sites of known tumors were investigated. We present 3 patients in whom whole-body FDG-PET was requested to study known tumors: 2 lung cancers and one melanoma. FDG-PET localized the known lesions and revealed hypermetabolic uptake in the abdomen in all 3 patients. Endoscopic polypectomy and pathologic analysis were performed, revealing 2 colon cancers and a tubular adenoma with a high degree of focal atypia. Whole body FDG-PET is a highly useful technique in the early diagnosis of colorectal cancer, which in turn allows complete cure of patients with this disease.
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PMID:[Early detection with FDG-PET of colonic tumors in patients with another known tumor]. 1569 65


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