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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

Fluorine-18 fluorodeoxyglucose and positron emission tomography (FDG-PET) is a new imaging modality used in the follow-up of patients with differentiated thyroid cancer if the results of (131)I scintigraphy are negative in spite of an elevated thyroglobulin level. The aim of this retrospective analysis was to estimate the value of FDG-PET regarding the operability of patients with positive findings. From January 1994 to October 1997, we investigated 60 patients with differentiated thyroid carcinoma by FDG-PET. Thirteen patients were operated on after positive findings. Most of these lesions were suspected of having lymph-node involvement or local recurrences in the thyroid bed. One patient showed a solitary distant metastasis in the scapula. Thirteen of 16 operations in these 13 patients confirmed the suspected involvement of thyroid cancer. The false-positive findings were caused by inflamed lymph nodes in two cases and benign thymus tissue in one case. We conclude that PET is a useful diagnostic tool to guide early surgical therapy in patients with (131)I negative differentiated thyroid carcinoma.
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PMID:Histological verification of positive fluorine-18 fluorodeoxyglucose findings in patients with differentiated thyroid cancer. 964 97

Three patients with primary breast sarcoma showed intense F-18 FDG breast uptake on the whole-body scan. In two patients the uptake was irregular and associated with cold foci that corresponded to hypodense lesions noted on the chest CT; these represented areas of pathologically demonstrated tumor necrosis. There was also intense FDG uptake in pulmonary, axillary, and supraclavicular lymph node metastases. All lesions were confirmed by CT scan of the chest. Thus F-18 FDG positron emission tomographic scanning accurately staged the tumors in these two patients, and it documented local recurrence in the third patient. Histopathologic examination showed evidence of a high-grade sarcoma, a primary rhabdomyosarcoma, and a malignant cystosarcoma phyllodes of the breast. Similar to breast carcinoma, F-18 FDG whole-body positron emission tomographic imaging could be useful in diagnosing and staging primary breast sarcomas.
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PMID:F-18 FDG whole-body positron emission tomography scan in primary breast sarcoma. 973 83

Decision tree analysis was used to assess cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma, < or = Stage IIIB), based on the data of the current decision tree. Decision tree models were constructed with two competing strategies (CT alone and CT plus chest FDG-PET) in 1,000 patient population with 71.4% prevalence. Baselines of FDG-PET sensitivity and specificity on detection of lung cancer and lymph node metastasis, and mortality and life expectancy were available from references. Chest CT plus chest FDG-PET strategy increased a total cost by 10.5% when a chest FDG-PET study costs 0.1 million yen, since it increased the number of mediastinoscopy and curative thoracotomy despite reducing the number of bronchofiberscopy to half. However, the strategy resulted in a remarkable increase by 115 patients with curable thoracotomy and decrease by 51 patients with non-curable thoracotomy. In addition, an average life expectancy increased by 0.607 year/patient, which means increase in medical cost is approximately 218,080 yen/year/patient when a chest FDG-PET study costs 0.1 million yen. In conclusion, chest CT plus chest FDG-PET strategy might not be cost-effective in Japan, but we are convinced that the strategy is useful in cost-benefit analysis.
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PMID:[Decision tree sensitivity analysis for cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma)]. 975 18

Fluorine-18-fluorodeoxyglucose (F-18 FDG) PET was used to evaluate early-stage larynx cancer before and after radiotherapy. Less radical salvage surgery might be possible after timely diagnosis of recurrent or persistent tumor after radiotherapy. Eight patients with early-stage laryngeal cancer (two carcinoma in situ; six stage T1: tumor limited to vocal cords with normal mobility) underwent irradiation for potential cure. Five patients had pre- and postradiotherapy F-18 FDG PET, and three had postradiotherapy F-18 FDG PET only. All patients underwent a CT scan of the neck at the time of the F-18 FDG PET scan. One patient had a positive result of postradiotherapy F-18 FDG PET but a negative result of a CT of the neck, and biopsy revealed recurrent squamous carcinoma. Seven patients who had negative results of postradiotherapy F-18 FDG PET were free of disease at the 15-month median follow-up evaluation. (Three of them had no cancer on biopsy of the larynx, and four others were followed with periodic endoscopic examinations that revealed complete disappearance of the tumor.) F-18 FDG PET scan may be useful for earlier diagnosis of recurrent or persistent laryngeal cancer after radiotherapy and is preferable to repeated biopsies, which would traumatize radiation-damaged tissues. A prompt early diagnosis of failure of radiotherapy will lead to less radical salvage surgery.
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PMID:F-18 FDG PET scan after radiotherapy for early-stage larynx cancer. 981 62

The value of whole body PET-FDG in the evaluation of metastases has been demonstrated in a wide variety of tumors. In this report, we present the case of a patient with antecedent of papillary thyroid carcinoma, who was operated twelve years ago, and submitted to an ablative dose of residual thyroid tissue through 131I, being the levels of thyroglobulin normals. After twelve years of evolution, the patient refers bag pain and respiratory trouble, appearing in the CT image suspicious of metastases in right pulmonary base. The levels of thyroglobulin were shown increased, being the 131I scan negative. A whole body PET-FDG study was performed in order to exclude metastases of his malignant process, showed multiple high FDG uptake focus in brain, cerebellum, neck, chest, lymphatic nodes and bone, suggestive of dedifferentiated disease These findings were confirmed subsequently in the clinic evolution. Therefore, whole-body PET-FDG is a complementary diagnostic technique for study patients with CDT (Thyroid Differentiated Carcinoma) with 131I scan negative and rising thyroglobulin levels.
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PMID:[PET-FDG in thyroid cancer with high thyroglobulin levels and negative 131-I scan. A case report]. 1007 19

We evaluated 10 patients with suspected recurrent papillary thyroid cancer using [18F]fluorodeoxyglucose positron emission tomography (FDG PET). Prior therapy included total (n = 8) or subtotal (n = 2) thyroidectomy, radiation therapy (n = 2) and radioiodine ablation (n = 2). All patients had an 131I scan and one or more of the following imaging studies: 99Tcm-sestamibi scan. 111In-octreotide scan, sonography (US), computed tomography (CT) and magnetic resonance imaging (MRI). Both the PET and 131I scans were negative in four patients. The PET and 131I scan results were discordant in six patients. Of the six discordant cases, five had true-positive PET scans and false-negative 131I studies. Three of these patients underwent neck lymph node dissection that showed positive histology for metastatic papillary carcinoma. Another patient had fine-needle aspiration (FNA) of a parapharyngeal mass that was also positive for papillary carcinoma. One patient was treated with radiation to the thyroid surgical bed based on an elevated serum thyroglobulin and a positive PET finding. Tumour response with a decrease in the size of the lesion was documented by a follow-up MRI scan. The remaining patient had a presumed false-positive PET scan, since a difficult hypocellular FNA of a small palpable lymph node was negative for tumour. We conclude that FDG PET is useful in the evaluation of patients with suspected recurrent papillary thyroid cancer when the 131I scan is negative.
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PMID:Evaluation of suspected recurrent papillary thyroid carcinoma with [18F]fluorodeoxyglucose positron emission tomography. 1023 58

We describe the case of a 42-year old female patient with a carcinoma of the adrenal cortex. The primary tumor was resected without residual tumor tissue; only two weeks later there was a new large tumor formation in the adrenal gland's bed. PET-investigation showed the large local recurrency, multiple lung-, and liver-metastasis, so that no further operative therapy was performed. FDG-PET seems to be suitable for diagnosis and staging of adrenal cortex carcinoma in one single examination.
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PMID:[Imaging of an adrenal cortex carcinoma and its metastasis with FDG-PET]. 1039 78

Primary tumors of the larynx and hypopharynx are preferably treated with high-dose radiation therapy. In these patients, it may be difficult to distinguish recurrent disease from post-treatment reactions. The aim of the present study was to assess the value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in the detection of local relapses of laryngeal or hypopharyngeal carcinoma after radiotherapy using a dual-head PET camera. Forty-eight patients (43 male, 5 female; mean age +/-SD, 61+/-9.5 years) with suspected recurrent laryngeal or hypopharyngeal cancer were prospectively studied. The mean interval between initial treatment and suspicion of recurrent disease was 14.6 months (range: 3-100 months). FDG dual-head PET was followed by endoscopy with or without biopsy under general anaesthesia within a period of 2 months in all patients. The mean period of follow-up after FDG dual-head PET was 13.7 months. In 19 out of 31 patients with focally increased uptake, tumour recurrence (mean diameter: 2.4 cm; range 0.4-6.5 cm) was found at initial endoscopy. In five patients recurrence was found during follow-up with a mean interval of 6.6 months. Seven patients had a false-positive study due to benign lesions or swallowing artefacts. In none of the patients with a normal PET study was tumour recurrence found during follow-up. The sensitivity and specificity of FDG dual-head PET were 100% and 71%, respectively. It is concluded that FDG dual-head PET is highly sensitive for the detection of local recurrence of laryngeal and hypopharyngeal carcinoma after radiotherapy. Some lesions were detected with a mean interval of 6.6 months before histological confirmation. In patients suspected of having recurrent laryngeal or hypopharyngeal cancer in whom FDG-PET is negative, endoscopy may be omitted for at least 6 months and possibly for up to 1 year.
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PMID:The detection of local recurrent head and neck cancer with fluorine-18 fluorodeoxyglucose dual-head positron emission tomography. 1039 25

18F-fluorodeoxyglucose positron emission tomography was able to identify previously unknown primary tumors in 2 of 4 patients after an unsuccessful conventional diagnostic workup such as chest radiography, ultrasound, computed tomography, MRI and various endoscopies. The 2 patients in which the primary tumors were detected proved to have a carcinoma of the lung, one of the patients received radiotherapy and chemotherapy after the detection of the primary tumor by FDG PET. The primary tumor of the lung demonstrated no focal FDG uptake after the successive treatment. On the other hand, in one patient with prostatic carcinoma and another in which the primary tumor has yet to be detected, FDG PET was unable to identify the primary tumor. This suggests a limitation of PET studies in detecting cancers. Because of increased glycolysis in cancer cells, FDG PET can be used to detect cancers with its high sensitivity, surveying the entire body non-invasively in one session. PET has the advantage of detecting primary tumors of an unknown origin when compared to conventional diagnostic studies.
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PMID:[Evaluation of 18F-FDG positron emission tomography (PET) in the detection of unknown primary tumors]. 1042 68


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