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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this study was to investigate whether in patients with head and neck cancer, staging is possible with fluorine-18 fluorodeoxyglucose (18F-FDG) using a dual-head positron emission tomography (PET) camera. Twenty patients (ten men, ten women; mean age: 60 years) were studied using 185 MBq (5 mCi) 18F-FDG. Two of these patients who were suspected of having recurrence in the neck were restaged 19 and 12 months, respectively, after the resection of the primary tumour. The images were visually analyzed and the results were correlated with computed tomography (CT) (n = 18), ultrasonography (n = 17) and pathological findings. With respect to the primary tumour, FDG dual-head PET and CT revealed a sensitivity of 100% and 59%, respectively (P < 0.001). In seven patients lymph node metastases were found in the neck specimen. Two of them had bilateral metastases. FDG dual-head PET correctly identified all nine pathological neck sides whereas CT and ultrasonography depicted eight of nine and seven of eight pathological sides, respectively. In three patients, false-positive FDG uptake was seen, which was due to a preceding biopsy in two cases. The sensitivity of FDG dual-head PET, CT and ultrasonography in the identification of pathological neck sides was 100%, 89% and 87%, respectively, and the specificity was 90%, 93% and 50%, respectively. With knowledge of the preceding biopsies, the specificity of FDG dual-head PET would have been 97%. The smallest lymph node metastasis detected by FDG dual-head PET that was missed by CT had a diameter of 0.6 cm. Measurement of 18F-FDG with a dual-head PET camera is very sensitive in the detection of primary head and neck cancers and accurate in the preoperative assessment of lymph node metastases. The results justify a prospective study on the identification of metastases in patients with head and neck cancer. In addition, it is justified to start a study on the detection of unknown primary tumours in patients with cervical metastases.
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PMID:Preoperative assessment of cervical lymph nodes in head and neck cancer with fluorine-18 fluorodeoxyglucose using a dual-head coincidence camera: a pilot study. 1038 94

To evaluate the effectiveness of PET with FDG in the preoperative identification of loco-regional lymph node metastases in patients with head and neck tumors a total of 24 consecutive patients coming to the E.N.T. Center were studied. In all cases staging was made using CT and/or MRI and by PET with FDG. All patients then underwent surgery performed by one single team and the histopathological findings were evaluated every time by the same pathologists. The sensitivity (87.5% vs. 53.1%), specificity (99% vs. 87.8%) and diagnostic precision (98.2% vs. 85.3) achieved by PET with FDG proved significantly better than the radiological imaging methods. In particular, given that in the present study PET showed a negative predictive value of 99%, when planning a functional lymphadenectomy this technique can be suggested as a preoperative guide in mapping out lymph node metastases.
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PMID:[Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) in the diagnosis and preoperative staging of head and neck tumors: a prospective study]. 1038 52

The aim of this study was to propose and validate a new method of making fused images from CT and FDG PET images for the upper abdominal area with no body surface marker. PET and CT were carried out in patients with pancreatic cancer (N = 5) and mass-forming pancreatitis (N = 2). First, we determined the midsagittal plane from PET and CT data. From the difference in location of the midsagittal planes, rotations of Y (from back to front) and Z axes (from foot to head) and X translation (from right to left) were calculated. An upper pole of the kidney was determined from PET and CT data. It showed Y and Z translations. The images of the three-dimensional data sets were fused on a workstation. Reproducibility was assessed with randomly misaligned PET and CT data sets. Pancreatic cancer and its lymph node metastases were identified easily on fused images. In reproducibility assessment, the average error of rotation was 0.77 degree. The average errors of translation were 3.43, 4.70, and 9.23 mm on the X, Y, and Z axes, respectively. In conclusion, this PET/CT image registration technique is feasible and practical. It allows precise anatomical assessment of normal and abnormal FDG accumulation.
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PMID:Interactive fusion of three-dimensional images of upper abdominal CT and FDG PET with no body surface markers. 1039 85

Radionuclides have been used for the diagnosis and therapy of cancers. In Japan, about 1.8 million studies are performed annually, especially on bone, the heart, the brain and cancer. In contrast to anatomical studies with X-ray, US or CT, nuclear medicine provides physiological or metabolic images. The characteristics of nuclear medicine come from the use of tracer studies employing various radiopharmaceuticals. The most commonly used radionuclides for cancer studies are 67Ga and 201T1. Recently, however, many other radiopharmaceuticals with tumor specificity have been developed, such as 99mTc labeled monoclonal antibodies and 111In labeled octreotide. 18F-FDG, which images glucose metabolism, is very useful in the management of lung, colorectal and other cancers. Furthermore, radionuclides are also employed in the therapy of cancer, such 131I-labeled anti-CD20 antibody for the B-cell lymphoma and 89Sr for the palliation of bone pain caused by prostate and breast cancer metastases.
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PMID:[Current status of nuclear medicine in Japan]. 1041 Jan 41

Fluorine-18-2-deoxy-2-fluoro-D-glucose (F-18 FDG) PET may be more suitable for follow-up after cancer treatment than other morphologic approaches, because it reflects tumor viability. A patient with abdominal lymph node metastases from colon cancer was followed by CT and F-18 FDG PET during chemotherapy. F-18 FDG PET tumor images changed in accordance with the clinical progress, whereas CT findings were relatively unchanged. This case clearly shows the utility of F-18 FDG PET for follow-up during cancer chemotherapy.
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PMID:FDG PET evaluation of residual masses and regrowth of abdominal lymph node metastases from colon cancer compared with CT during chemotherapy. 1046 23

Imaging procedures are important in the initial staging and subsequent management of testicular germ cell tumors on account of the differing stage-dependent options for therapy. While the diagnosis of advanced tumors gives no cause for controversial discussion the situation in the clinical stage 1 of germ cell tumors is more ambiguous. The lymph node status is only assessed correctly in about 70% of the patients using the currently available methods since metastases in normally large lymph nodes are not detected on slice images. Although most clinical experience has been gained with computed tomography (CT), magnetic resonance imaging (MRI) offers an equally efficient diagnostic procedure. The significance of positron emission tomography with 18-fluorodeoxyglucose (FDG-PET) appears to be limited on account of the absence of accumulation in lymph node metastases of the differentiating teratoma. Sonography and lymphography have not proved to be useful for retroperitoneal lymph node diagnosis. The present review presents and discusses the current value of the available imaging procedures for staging and follow-up of malignant testicular germ cell tumors in relation to modern therapy regimens.
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PMID:[The lymph node staging of malignant testicular germ-cell tumors]. 1050 80

Information on parasite viability in alveolar echinococcosis (AE) cannot be obtained by conventional imaging techniques. We evaluated the glucose metabolism of AE lesions by use of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) in 12 inoperable patients. Eight patients showed either perilesional or focal enhancement ("hot spots"), whereas 4 patients had nonenhancing (metabolically inactive) lesions. With PET, necrotic parasitic lesions and areas of enhanced metabolic activity could be clearly discriminated. Most notably, 3 of 8 patients with metabolically active lesions who were reexamined after chemotherapy treatment clearly showed improvement: the initial surrounding hot spots had disappeared in 2 of them, and had significantly decreased in 1. PET may prove valuable in assessing the efficacy of chemotherapy by showing the disappearance of metabolic activity and may also be useful for timely detection of relapses and metastases. Although costly and not readily available, FDG-PET is a promising tool toward improved management of AE and may thus help lower costs of long-term chemotherapy.
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PMID:Pericystic metabolic activity in alveolar echinococcosis: assessment and follow-up by positron emission tomography. 1052 57

In the follow up of differentiated thyroid carcinoma (DTC) several scintigraphic methods are used in addition to the serum thyroglobulin and ultrasonography of the neck. Iodine-131 whole body scintigraphy (WBS), which is performed since many years, is able to detect iodine positive recurrence, lymph node metastases and distant metastases in a very specific way. However, the problem of I-131 WBS is the fact that only 67% of metastases from DTC accumulate iodine. Therefore non specific radionuclides like TI-201 or tracers such as Tc-99m Sestamibi or Tc-99m Tetrofosmin and new metabolic tracers like F-18 FDG were introduced in the diagnostic work up to detect iodine negative metastases as well. This study describes the comparison of different tracers in 35 patients with elevated thyroglobulin and suspicion of metastatic disease or already known metastases from DTC.
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PMID:Comparison of different tracers in the follow up of differentiated thyroid carcinoma. 1052 27

The management of patients with unknown primary tumours (UPT) often includes a large number of radiographical studies and invasive procedures, but the occult primary tumour is detected in less than 25%. In this prospective study we explored whether non-invasive whole body PET scans using FDG (18-F-fluorodeoxyglucose) are of clinical value in detection of UPT. Whole-body FDG-PET scans were performed in 20 patients following standard staging procedures according to histology. PET results were verified either histologically or by the clinical course of the disease. 11 patients had neck metastases (5 squamous cell, 5 adenocarcinomas and 1 poorly differentiated carcinoma). The remaining patients had metastases located in bone (3), bone marrow (1), brain (1), pericardium (1), skin (1), pleura (1) and chest wall (1). All metastatic lesions were visible with PET. In 13 patients PET suggested the site for the primary tumour and this was verified in 9 (45%), either histologically or by the clinical course of disease. 8 of these had primary lung cancer and 1 had carcinoma at the basis of the tongue. In most patients PET had no treatment related implications. 3 patients with non-small cell lung cancer (NSCLC) received chemotherapy prompted by the PET result. The rest received either radical radiotherapy to the head and neck region (7), palliative radiotherapy to the metastatic lesion (8), chemotherapy based on signet ring cell carcinoma in bone marrow (1) or no therapy (1). These results indicates that PET is useful in UPT preceding expensive and invasive diagnostic procedures and can result in a faster diagnosis in approximately one third of the patients who then avoid unnecessary extensive procedures. Furthermore, a larger proportion of patients will receive treatment aimed at the correct diagnosis. A prospective cost-effectiveness analysis of PET in this setting is warranted.
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PMID:18F-FDG whole body positron emission tomography (PET) in patients with unknown primary tumours (UPT). 1053 51

Iodine-131 is the most specific radionuclide to follow up patients with differentiated thyroid cancer (DTC). However there are some aspects that should be considered if 131I whole body scintigraphy (131I WBS) is performed. 1) Several prior conditions, including a bTSH above 30 mU/l and an urinary iodine excretion below 100-150 micrograms/g Crea, should be fulfilled. 2) Only about two thirds of metastases from DTC accumulate iodine. Therefore, in addition to 131I WBS, there is a need for other nonspecific tracers such as 99mTc Tetrofosmin WBS, 99mTc Sestamibi WBS or F-18 FDG PET to detect also iodine negative recurrences or metastases. There new tracers, especially F-18 FDG PET have demonstrated a very high detection rate of iodine negative metastases with mostly low differentiation. 3) The sensitivity of 131I WBS depends on the administered dose. Whereas the sensitivity of a diagnostic 131I WBS (up to 185 MBq) is below 60%, the value for a post-therapeutic 131I WBS (after 3700-7400 MBq) increases up to 75%. This means that in case of elevated serum thyroglobulin, iodine positive metastases cannot be excluded until WBS after 131I therapy is performed. 4) In patients with elevated serum thyroglobulin and/or known metastases, who are scheduled for 131I treatment, the question arises whether a diagnostic 131I WBS should be performed and if so, which dose should be administered to avoid thyroid stunning. There is evidence in the literature that the dose for a pre-therapeutic diagnostic 131I WBS should not exceed 74 MBq. 5) Despite the high specificity of 131I WBS, several pitfalls of iodine accumulation in non-malignant diseases and malignancies of other origin than thyroid cancer should be taken into account.
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PMID:131I whole body scintigraphy in thyroid cancer patients. 1056 34


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