scholarly journals Neurolymphomatosis of the Brachial Plexus and its Branches: Case Series and Literature Review

2018 ◽  
Vol 45 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Pierre R. Bourque ◽  
Jodi Warman Chardon ◽  
Mark Bryanton ◽  
Melissa Toupin ◽  
Bruce F. Burns ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Imaging Modality ◽  
Case Series ◽  
Brachial Plexopathy ◽  
Mr Neurography ◽  
Anatomical Distribution ◽  
Positron Emission ◽  
Pet Ct ◽  
Diagnostic Modalities ◽  
Dedicated Mri

AbstractBackground: Neurolymphomatosis is a process of neoplastic endoneurial invasion, most strongly associated with non-Hodgkin’s lymphoma. It must be distinguished from paraneoplastic, metabolic, nutritional and treatment-related causes of neuropathy that are common in this patient population. Methods: This brief case series illustrates the protean manifestations of neurolymphomatosis of the brachial plexus, ranging from focal distal mononeuropathy to multifocal brachial plexopathy, either as the index manifestation of lymphoma or as a complication of relapsing disease. Results: Prominent asymmetry, pain and nodular involvement on neuroimaging may help distinguish neurolymphomatosis from paraneoplastic immune demyelinating radiculoneuropathy. MR neurography criteria for the diagnosis of neurolymphomatosis include hyperintensity on T2 and STIR sequences, focal and diffuse nerve enlargement with fascicular disorganization and gadolinium enhancement. No specific anatomical distribution within the brachial plexus has, however, been found to be characteristic. Fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging is the imaging modality with the highest sensitivity for detection of nodal or extranodal spread in lymphoma. Conclusions: Brachial plexus neuropathy in neurolymphomatosis is highly protean in its distribution, semiology and relation to lymphoma staging. Dedicated MRI and PET-CT imaging are leading diagnostic modalities.

Comparison Between 18F-Dopa and 18F-Fet PET/CT in Patients with Suspicious Recurrent High Grade Glioma: A Literature Review and Our Experience

2019 ◽  
Vol 12 (3) ◽  
pp. 220-228 ◽  
Author(s):  
Laura Evangelista ◽  
Lea Cuppari ◽  
Luisa Bellu ◽  
Daniele Bertin ◽  
Mario Caccese ◽  
...  
Keyword(s):  
Case Series ◽  
High Grade Glioma ◽  
High Grade ◽  
True Negative ◽  
Fet Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Definition Of ◽  
Sensitivity Specificity

Purpose: The aims of the present study were to: 1- critically assess the utility of L-3,4- dihydroxy-6-18Ffluoro-phenyl-alanine (18F-DOPA) and O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) Positron Emission Tomography (PET)/Computed Tomography (CT) in patients with high grade glioma (HGG) and 2- describe the results of 18F-DOPA and 18F-FET PET/CT in a case series of patients with recurrent HGG. Methods: We searched for studies using the following databases: PubMed, Web of Science and Scopus. The search terms were: glioma OR brain neoplasm and DOPA OR DOPA PET OR DOPA PET/CT and FET OR FET PET OR FET PET/CT. From a mono-institutional database, we retrospectively analyzed the 18F-DOPA and 18F-FET PET/CT of 29 patients (age: 56 ± 12 years) with suspicious for recurrent HGG. All patients underwent 18F-DOPA or 18F-FET PET/CT for a multidisciplinary decision. The final definition of recurrence was made by magnetic resonance imaging (MRI) and/or multidisciplinary decision, mainly based on the clinical data. Results: Fifty-one articles were found, of which 49 were discarded, therefore 2 studies were finally selected. In both the studies, 18F-DOPA and 18F-FET as exchangeable in clinical practice particularly for HGG patients. From our institutional experience, in 29 patients, we found that sensitivity, specificity and accuracy of 18F-DOPA PET/CT in HGG were 100% (95% confidence interval- 95%CI - 81-100%), 63% (95%CI: 39-82%) and 62% (95%CI: 39-81%), respectively. 18F-FET PET/CT was true positive in 4 and true negative in 4 patients. Sensitivity, specificity and accuracy for 18F-FET PET/CT in HGG were 100%. Conclusion: 18F-DOPA and 18F-FET PET/CT have a similar diagnostic accuracy in patients with recurrent HGG. However, 18F-DOPA PET/CT could be affected by inflammation conditions (false positive) that can alter the final results. Large comparative trials are warranted in order to better understand the utility of 18F-DOPA or 18F-FET PET/CT in patients with HGG.

scholarly journals 68Ga-DOTATOC PET/CT Follow Up after Single or Hypofractionated Gamma Knife ICON Radiosurgery for Meningioma Patients

2021 ◽  
Vol 11 (3) ◽  
pp. 375
Author(s):  
Fabio Barone ◽  
Francesco Inserra ◽  
Gianluca Scalia ◽  
Massimo Ippolito ◽  
Sebastiano Cosentino ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Case Series ◽  
Biological Response ◽  
Standardized Uptake Value ◽  
Emission Tomography ◽  
Tumor Diameter ◽  
Relative Percentage ◽  
Positron Emission ◽  
Pet Ct

68Ga-DOTATOC represents a useful tool in tumor contouring for radiosurgery planning. We present a case series of patients affected by meningiomas on who we performed 68Ga-DOTATOC positron emission tomography (PET)/CT pre-operatively, a subgroup of which also underwent a post-operative 68Ga-DOTATOC PET/CT to evaluate the standardized uptake value (SUV) modification after Gamma Knife ICON treatment in single or hypofractionated fractions. Twenty patients were enrolled/included in this study: ten females and ten males. The median age was 52 years (range 33–80). The median tumor diameter was 3.68 cm (range 0.12–22.26 cm), and the median pre-radiotherapy maximum SUV value was 11 (range 2.3–92). The average of the relative percentage changes between SUVs at baseline and follow up was −6%, ranging from −41% to 56%. The SUV was reduced in seven out of 12 patients (58%), stable in two out of 12 (17%), and increased in three out of 12 (25%), suggesting a biological response of the tumor to the Gamma Knife treatment in most of the cases. 68Ga-DOTATOC-PET represents a valuable tool in assessing the meningioma diagnosis for primary radiosurgery; it is also promising for follow-up assessment.

scholarly journals Extraparotid Warthin Tumors Imitating Metastasis of Oral Cancers

2021 ◽  
Author(s):  
Michał Gontarz ◽  
Krzysztof Gąsiorowski ◽  
Jakub Bargiel ◽  
Tomasz Marecik ◽  
Paweł Szczurowski ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Case Series ◽  
Warthin Tumor ◽  
Tumor Node Metastasis ◽  
Surgical Specimen ◽  
Neck Metastasis ◽  
Oral Cancers ◽  
Node Metastasis ◽  
Positron Emission ◽  
Pet Ct

Abstract Introduction Extraparotid Warthin tumor (WT) is a very rare entity, especially when synchronous with oral cancer (OC). Objective The present study presents a case series of extraparotid WTs detected in the surgical specimen of patients treated for OC. Methods From 2007 to 2016, 336 patients were operated for OC in our institution. Neck dissection was performed in 306 patients. Results In the 306 patients operated for OC whose necks were dissected, unexpected WTs were observed in 4 surgical neck specimens. In 3 cases, extraparotid WTs were responsible for tumor, node, metastasis (TNM) overstaging before surgery. Conclusion Extraparotid WTs may be discovered during neck dissection in ∼ 1% of OC patients, and they may mimic neck metastasis, especially in positron-emission tomography/computed tomography (PET/CT) imaging.

scholarly journals Case series: MRD negativity assessment using 11C-Acetate PET with 3-weekly daratumumab-based quadruplet induction in newly diagnosed multiple myeloma

2021 ◽  
Vol 12 ◽  
pp. 204062072110303
Author(s):  
Cheong Ngai ◽  
Shaji Kumar ◽  
Garrett Chi-lai Ho ◽  
Sirong Chen ◽  
Chor-sang Chim
Keyword(s):  
Multiple Myeloma ◽  
Residual Disease ◽  
Case Series ◽  
Progression Free Survival ◽  
Complete Response ◽  
Newly Diagnosed ◽  
Free Survival ◽  
Positron Emission ◽  
Pet Ct ◽  
Subsequent Relapse

Complete response (CR) is an important favorable factor for survival in multiple myeloma (MM). However, CR patients continue to relapse, especially in the presence of minimal residual disease (MRD). Bone marrow (BM) MRD is predictive of progression-free survival (PFS) in MM. However, myeloma outside the BM aspiration site may result in subsequent relapse despite MRD-negativity. Therefore, positron emission tomography-computed tomography (PET-CT) based on F-fluorodeoxyglucose (FDG) is a complementary tool to monitor residual disease in MM. However, FDG may miss myeloma lesions that are not FDG-avid. On the other hand, 11C-Acetate (ACT) has been found to be a more sensitive and specific tracer than FDG in MM. Recently, the addition of daratumumab to bortezomib, thalidomide, dexamethasone (VTd) or bortezomib, lenalidomide, dexamethasone (VRd) backbone has been proven to improve outcomes. Herein, we report three newly-diagnosed MM patients achieving deep responses with imaging CR using ACT PET in addition to conventional immunofixation CR and MRD-negative CR after a 3-weekly daratumumab-based quadruplet induction regimen.

scholarly journals A Complex Component of the Nervous System: Brachial Plexus

2018 ◽  
Vol 1 (1) ◽  
pp. 01-06
Author(s):  
Nephthys Sanzhar ◽  
Erasyl M Davis ◽  
M.K. Siminoski
Keyword(s):  
Brachial Plexus ◽  
Imaging Modality ◽  
Traumatic Injury ◽  
Screening Method ◽  
Imaging Method ◽  
Full Potential ◽  
Brachial Plexopathy ◽  
Advantages And Disadvantages ◽  
Obstetric Brachial Plexus ◽  
Almost All

Brachial plexopathy is a type of peripheral neuropathy. Injuries to the brachial plexus can be classified according to their severity, ranging from neuropraxia, the mildest form, to axonotmesis and neurotmesis, the most severe forms. The causes of brachial plexopathy include traumatic and non-traumatic injuries. Because the brachial plexus can sustain various types of injuries, different imaging modalities are required. Recent advances in diagnostic imaging have enabled better investigation of brachial plexopathy. This article reviews the major and most widely used imaging methods used for investigating brachial plexopathy along with newer modalities. The indications, advantages, and disadvantages of each modality are examined. The major factor in realizing the full potential of any imaging method is the knowledge of the requesting physician about the capabilities and limitations of each method. Magnetic resonance imaging (MRI) is the standard imaging modality for evaluating non-traumatic injury to the brachial plexus; however, there are several limitations to its use and, therefore, other modalities should be pursued. MR myelography should be used for traumatic meningoceles and root avulsions. MR neurography is a relatively new technique with massive potential. It is a tissue-specific modality with the ability to elicit morphological as well as pathological features of nerves. CT myelography is the gold standard for evaluating traumatic injury of the brachial plexus. Other potential uses are with tumors of the brachial plexus as well as obstetric brachial plexus palsies. Finally, sonography is addressed. With its ability to detect almost all plexopathies and the fact that it does not employ radiation and can be done in virtually every patient, it should be the baseline or, at least, the screening method for plexopathies.

scholarly journals Cumulative radiation doses from recurrent PET/CT examinations

2021 ◽  
pp. 20210388
Author(s):  
Makoto Hosono ◽  
Mamoru Takenaka ◽  
Hajime Monzen ◽  
Mikoto Tamura ◽  
Masatoshi Kudo ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Imaging Modality ◽  
Tracking System ◽  
Radiation Doses ◽  
Effective Radiation Dose ◽  
Positron Emission ◽  
Pet Ct ◽  
Tissue Contrast ◽  
Key Issues ◽  
Effective Radiation

Positron emission tomography (PET)/computed tomography (CT) is an essential imaging modality for the management of various diseases. Increasing numbers of PET/CT examinations are carried out across the world and deliver benefits to patients; however, there are concerns about the cumulative radiation doses from these examinations in patients. Compared to the radiation exposure delivered by CT, there have been few reports on the frequency of patients with a cumulative effective radiation dose of ≥100 mSv from repeated PET/CT examinations. The emerging dose tracking system facilitates surveys on patient cumulative doses by PET/CT because it can easily wrap up exposure doses of PET radiopharmaceuticals and CT. Regardless of the use of a dose tracking system, implementation of justification for PET/CT examinations and utilisation of dose reduction measures are key issues in coping with the cumulative dose in patients. Despite all the advantages of PET/MRI such as eliminating radiation exposure from CT and providing good tissue contrast in MRI, it is expensive and cannot be introduced at every facility; thus, it is still necessary to utilise PET/CT with radiation reduction measures in most clinical situations.

Utility of Molecular Imaging with 2-Deoxy-2-[Fluorine-18] Fluoro-D-Glucose Positron Emission Tomography (18F-FDG PET) for Small Cell Lung Cancer (SCLC): A Radiation Oncology Perspective

2019 ◽  
Vol 12 (1) ◽  
pp. 4-10 ◽  
Author(s):  
Omer Sager ◽  
Ferrat Dincoglan ◽  
Selcuk Demiral ◽  
Bora Uysal ◽  
Hakan Gamsiz ◽  
...  
Keyword(s):  
Molecular Imaging ◽  
Radiation Oncology ◽  
Imaging Modality ◽  
Small Cell ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Non Invasive ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg

Background and Objective: Although accounting for a relatively small proportion of all lung cancers, small cell lung cancer (SCLC) remains to be a global health concern with grim prognosis. Radiotherapy (RT) plays a central role in SCLC management either as a curative or palliative therapeutic strategy. There has been considerable progress in RT of SCLC, thanks to improved imaging techniques leading to accurate target localization for precise delivery of RT. Positron emission tomography (PET) is increasingly used in oncology practice as a non-invasive molecular imaging modality. Methods: Herein, we review the utility of molecular imaging with 2-deoxy-2-[fluorine-18] fluoro-Dglucose PET (18F-FDG PET) for SCLC from a radiation oncology perspective. Results: There has been extensive research on the utility of PET for SCLC in terms of improved staging, restaging, treatment designation, patient selection for curative/palliative intent, target localization, response assessment, detection of residual/recurrent disease, and prediction of treatment outcomes. Conclusion: PET provides useful functional information as a non-invasive molecular imaging modality and may be exploited to improve the management of patients with SCLC. Incorporation of PET/CT in staging of patients with SCLC may aid in optimal treatment allocation for an improved therapeutic ratio. From a radiation oncology perspective, combination of functional and anatomical data provided by integrated PET/CT improves discrimination between atelectasis and tumor, and assists in the designation of RT portals with its high accuracy to detect intrathoracic tumor and nodal disease. Utility of molecular imaging for SCLC should be further investigated in prospective randomized trials to acquire a higher level of evidence for future potential applications of PET.

Impact of initial imaging with gallium-68 dotatate PET/CT on diagnosis and management of patients with neuroendocrine tumors (NETs): A sequential case series.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 379-379
Author(s):  
Hagen F. Kennecke ◽  
Preethi Raghu ◽  
Bruce Lin ◽  
Gayle L. Funk ◽  
Adnan Alseidi ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Imaging Modality ◽  
Case Series ◽  
Lesion Detection ◽  
Unknown Primary ◽  
Somatostatin Analogue ◽  
Diagnosis And Management ◽  
Pet Ct ◽  
Initial Imaging ◽  
The Impact

379 Background: Somatostatin analogue functional imaging with Ga-68 Dotatate PET/CT has demonstrated superiority in lesion detection in patients with NETs. The effect of this novel imaging modality on US clinical practice and its usefulness in different types of NETs is not well described. We describe the impact of initial NETSPOT imaging on diagnosis and management in NET patients at a large urban medical center. Methods: Consecutive patients diagnosed with NETs and referred to our institution who received an initial Ga-68 Dotatate PET/CT between 07/2017-09/2018 were included. Imaging was reviewed and compared to prior available CT, MRI, and/or In-111 Pentetreotide scans. Results: Among 101 patients, 51/50 were female/male, tumor origins were gastroenteropancreatic (GEP) (75%), Unknown Primary (UP) (13%), lung (8%), thymic (2%), and other (2%). All tumors were histologically well/moderately differentiated and 37/51/3/10 were G1/G2/G3/Unknown, respectively. Initial imaging with Ga-68 Dotatate PET/CT revealed additional metastatic disease in 37 of 77(48%) patients with prior evidence of metastatic disease. Most common sites were distant lymph nodes (18), bone (15) and liver (9), peritoneal/pleural (4). A previously UP tumor was identified in 3 patients. No patients with metastatic lung carcinoids (6 atypical, 2 typical) or thymic NETs (2 atypical/G2) NETs had evidence of Ga-68 Dota PET/CT uptake above reference liver SUV levels. Results of imaging altered patient management as follows: 14 initiated systemic therapy due to documentation of progression, in 6 surgical therapy was altered, in 4 biopsy/other management was changed. In 11 patients with no tumor Ga-68 Dotatate uptake, decisions about use of PRRT and somatostatin analogues was altered. Conclusions: In this series, Ga-68 Dotatate PET/CT altered diagnosis and management in 35/101 NET patients. Among GEP and UP NETs, Dotatate imaging diagnosed primarily new nodal, bone, liver and pleural/peritoneal metastases missed by other imaging modalities. Results support the routine use of Ga-68 Dotatate PET/CT in the care of patients with advanced and early stage NETS.

scholarly journals A Case of Suspected Breast Cancer Metastasis to Brachial Plexus Detected by Magnetic Resonance Neurography

2016 ◽  
Vol 9 (2) ◽  
pp. 395-399 ◽  
Author(s):  
Atsushi Mizuma ◽  
Chikage Kijima ◽  
Eiichiro Nagata ◽  
Shunya Takizawa
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance ◽  
Brachial Plexus ◽  
Cancer Metastasis ◽  
Breast Cancer Metastasis ◽  
Brachial Plexopathy ◽  
Axillary Lymph ◽  
Gallium Scintigraphy ◽  
Mr Neurography ◽  
Motor Weakness

Metastasis of breast cancer is often detected through a long-term course and difficult to diagnose. We report a case of brachial plexopathy suspected to be the initial lesion of breast cancer metastasis, which was only detected by magnetic resonance (MR) neurography. A 61-year-old woman was admitted to our hospital within 2 years after operation for breast cancer because of progressive dysesthesia and motor weakness initially in the upper limb on the affected side and subsequently on the contralateral side. Enhanced computed tomography, axillary lymph node echo, gallium scintigraphy, and short tau inversion recovery MR images showed no abnormalities. MR neurography revealed a swollen region in the left brachial plexus. We suspected neuralgic amyotrophy and initiated treatment with intravenous immunoglobulin therapy and steroid therapy. However, there was no improvement, and the progression of motor weakness in the bilateral lower limbs appeared over 4 years. Concomitant elevation of carbohydrate antigen 15-3 level (58.9 U/ml) led us to suspect breast cancer metastasis, which was associated with the worsening of neurological findings, although gallium scintigraphy and bone scintigraphy showed no inflammatory and metastatic lesions. Swelling of the cauda equina in enhanced lumbar MR imaging and abnormal accumulation at the brachial plexus and cervical spinal cord in positron-emission tomography were newly detected contrary to the normal findings on the gallium scintigraphy, which suggested cerebrospinal fluid seeding. We suspected breast cancer metastasis about the initial brachial plexopathy based on the clinical course. MR neurography may be a helpful tool to detect metastatic lesion, especially in nerve roots.

The utility of 68Ga-DOTATATE PET/CT in localizing primary/metastatic pheochromocytoma and paraganglioma in children and adolescents – a single-center experience

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sanjeet Kumar Jaiswal ◽  
Vijaya Sarathi ◽  
Gaurav Malhotra ◽  
Priya Hira ◽  
Ravikumar Shah ◽  
...  
Keyword(s):  
Functional Imaging ◽  
Fdg Pet ◽  
Disease Surveillance ◽  
Imaging Modality ◽  
Von Hippel Lindau ◽  
Single Center Experience ◽  
Contrast Enhanced Ct ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractObjectivesPediatric pheochromocytoma and paraganglioma (PPGL) are rare tumors with limited data on the diagnostic performance of 68Ga-DOTA(0)-Tyr(3)-octreotate positron emission tomography–computed tomography (68Ga-DOTATATE PET/CT). We have described our experience of 68Ga-DOTATATE PET/CT in overall and von Hippel Lindau (VHL)-associated pediatric PPGL and compared its sensitivity with that of 131I-meta-iodobenzyl-guanidine (131I-MIBG), 18F-fluorodeoxyglucose PET/CT (18F-FDG PET/CT), and contrast-enhanced CT (CECT).MethodsRetrospective evaluation of consecutive PPGL patients (age: ≤20 years), who had undergone at least one functional imaging [131I-MIBG, 18F-FDG PET/CT, and/or 68Ga-DOTATATE PET/CT], was done. Composite of anatomical and all the performed functional imaging scans, image comparator (IC), was considered as the gold standard for sensitivity analysis.ResultsIn a cohort of 32 patients (16 males, age at diagnosis: 16.4 ± 2.68 years), lesion-wise sensitivity of 68Ga-DOTATATE PET/CT (95%) was higher than that of both 18F-FDG-PET/CT (80%, p=0.027) and 131I-MIBG (65%, p=0.0004) for overall lesions, than that of 18F-FDG-PET/CT (100 vs. 67%, p=0.017) for primary PPG, and than that of 131I-MIBG (93 vs. 42%, p=0.0001) for metastases. In the VHL (n=14), subgroup, 68Ga-DOTATATE PET/CT had higher lesion-wise sensitivity (100%) compared to 18F-FDG PET/CT (74%, p=0.045) and 131I-MIBG (64%, p=0.0145).ConclusionsIn our pediatric PPGL cohort, overall lesion-wise sensitivity of 68Ga-DOTATATE PET/CT was higher than that of 18F–FDG PET/CT and 131I-MIBG scintigraphy. Hence, we recommend 68Ga-DOTATATE PET/CT as the preferred modality in pediatric PPGL. 68Ga-DOTATATE PET/CT may evolve as a preferred imaging modality for disease surveillance in VHL.

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