scholarly journals Chylothorax: The Unusual Suspect

2019 ◽  
Vol 05 (02) ◽  
pp. 075-077
Author(s):  
Anusha C. Madhusoodan ◽  
Gajanan S. Gaude
Keyword(s):  
Computed Tomography ◽  
Lymph Node Biopsy ◽  
Emission Tomography ◽  
Supraclavicular Lymph Node ◽  
Node Biopsy ◽  
Positron Emission ◽  
Lymphatic Duct ◽  
Pet Ct ◽  
Hodgkin's Lymphomas

AbstractA chylothorax results when the lymphatic duct becomes disrupted. It is an uncommon and poorly described complication of both Hodgkin’s and non-Hodgkin’s lymphomas of any histological type and grade. A 62-year-old female presented with dyspnea on exertion and dry cough for 15 days. Chest radiograph showed left-sided effusion. Pleural fluid reports were suggestive of chylothorax. Fluid was drained and CT thorax was performed which revealed multiple supra- and infradiaphragmatic lymphadenopathy. Left supraclavicular lymph node biopsy revealed chronic inflammation. Immunohistochemistry of the same sample was reported as non-Hodgkin’s lymphoma of follicular type grade I/III (2008). Positron emission tomography-computed tomography (PET-CT) showed hypermetabolic areas in supra- and infradiaphragmatic lymph nodes and also in multiple bones (with surrounding regions encasement). Patient has received two cycles of chemotherapy with Bendamustine and Rituximab. She is on regular follow-up with the oncologist and doing fine.

scholarly journals IMAGING IN ENDOCRINOLOGY: 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up

2015 ◽  
Vol 173 (3) ◽  
pp. R115-R130 ◽  
Author(s):  
Massimo Salvatori ◽  
Bernadette Biondi ◽  
Vittoria Rufini
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Whole Body ◽  
Clinical Indications ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

In recent years, 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) has emerged as an important tool for the postoperative management of patients with differentiated thyroid cancer (DTC) and it is widely used in selected clinical situations. The most valuable role that FDG-PET/CT plays in clinical practice is that it can be used to obtain prognostic information in patients with increasing thyroglobulin (Tg) levels and negative 131I whole-body scan post-thyroidectomy and radioiodine (RAI) ablation. FDG-PET/CT may also have a potential role in the initial staging and follow-up of high-risk patients with aggressive histological subtypes, in the identification of patients who are at the highest risk of disease-specific mortality, in the management of patients with RAI-refractory disease, in clinical trials of novel targeted therapies in patients with advanced metastatic disease, and in the evaluation of thyroid nodules with indeterminate fine-needle aspiration for cytology. However, several controversies remain to be resolved, namely: the cutoff value of Tg in the selection of DTC patients for FDG-PET/CT, whether FDG-PET/CT scanning should be performed under thyrotropin stimulation or suppression, and the clinical significance of thyroid FDG-PET/CT incidentalomas. The aim of the present article is to provide an overview of the data about the molecular basis for, clinical indications of, and controversies related to the use of FDG-PET/CT in patients with DTC.

scholarly journals Prognostic Value of Volume-Based Positron Emission Tomography/Computed Tomography in Nasopharyngeal Carcinoma Patients after Comprehensive Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yueli Tian ◽  
Khamis Hassan Bakari ◽  
Shanshan Liao ◽  
Xiaotian Xia ◽  
Xun Sun ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Overall Survival ◽  
Nasopharyngeal Carcinoma ◽  
Prognostic Value ◽  
Emission Tomography ◽  
Whole Body ◽  
Positron Emission ◽  
Pet Ct

Objective. We assessed the prognostic value of standardized uptake value (SUV) and volume-based methods including whole-body metabolic tumor volume (WBMTV) and whole-body total lesion glycolysis (WBTLG) using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) of patients with nasopharyngeal carcinoma (NPC) after therapy. Methods. A total of 221 posttherapy NPC cases were enrolled, all of whom had undergone PET/CT scanning and follow-up in this retrospective study. The diagnostic results of PET/CT were analyzed and compared with histopathological diagnosis or clinical follow-up. Receiver operator characteristic curves, the Kaplan-Meier method, and the log-rank test were used to assess the optimal cutoff values for WBMTV and WBTLG to identify independent predictors of survival. Results. The detection rates of the threshold SUV were 2.5, 20%, and 40%, and SUV background methods were 65.6% (378/576), 80.2% (462/576), 71.5% (412/576), and 90.4% (521/576), respectively (P<0.005). Patients with a WBMTV < 8.10 and/or a WBTLG < 35.58 had significantly better 5-year overall survival than those above the cutoffs (90.7% versus 51.2%, P<0.001; 91.7% versus 50.4%, P<0.001), respectively. Multivariate Cox regression modeling showed both WBTLG (RR, 1.002; P=0.004) and age (RR, 1.046; P=0.006) could be used to predict overall survival. WBTLG (RR, 1.003; P<0.001) may have predictive relevance in estimating disease-free survival. Conclusions. SUV volume-based threshold background methodology had a significantly higher detection rate for metastatic lesions. WBTLG could be used as an independent prognostic indicator for posttherapy NPC.

scholarly journals Malignant Melanoma

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Aída Ortega Candil ◽  
Cristina Rodríguez Rey ◽  
José Luis Carreras Delgado
Keyword(s):  
Essential Role ◽  
Distant Metastases ◽  
Lymph Node Biopsy ◽  
Diagnostic Methods ◽  
Emission Tomography ◽  
Diagnostic Tools ◽  
Choice Procedure ◽  
Node Biopsy ◽  
Positron Emission ◽  
Pet Ct

Nuclear medicine plays an essential role in the correct staging of patients suffering from melanoma. Both sentinel lymph node biopsy (SLNB) and positron emission tomography (PET) represent its main diagnostic tools. SLNB is the choice procedure for lymphatic regional staging of these patients, including the result of this technique in the 2002 American Joint Cancer Committee melanoma staging. SLNB sensitivity is superior than PET/CT for the detection of lymphatic micrometastases in early stages of the disease. PET/CT is mainly used in confirming clinical metastases suspected, detection of recurrences, and recurrence restaging. PET/CT has also shown superiority against conventional diagnostic methods in the detection of distant metastases, being able to detect illness even six months earlier than those methods.

Clinical impact of positron emission tomography or positron emission tomography/computed tomography in the posttherapy surveillance of endometrial carcinoma: evaluation of 88 patients

2008 ◽  
Vol 18 (6) ◽  
pp. 1332-1338 ◽  
Author(s):  
J.-Y. Park ◽  
E. N. Kim ◽  
D.-Y. Kim ◽  
J.-H. Kim ◽  
Y.-M. Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Clinical Impact ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Sensitivity Specificity

The objective of this study was to evaluate the validity and clinical impact of positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) using 18-fluoro-2-deoxy-D-glucose in the posttherapy surveillance of patients with endometrial carcinoma. Eighty-eight patients previously treated for histopathologically diagnosed endometrial adenocarcinoma underwent 99 PET or PET/CT scans at follow-up visits at Asan Medical Center, Seoul, Korea, between 2001 and 2007. The standard of reference for tumor recurrence consisted of histopathologic confirmation or follow-up information at least 6 months after PET or PET/CT. Of the 88 patients, 24 underwent PET (n= 11) and/or PET/CT (n= 14) scans due to suspected disease recurrence. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of PET and/or PET/CT in detecting recurrence in these patients were 100%, 83.3%, 96%, 95%, and 100%, respectively. Especially, PET/CT revealed true-positive findings in three patients with elevated tumor markers but negative CT findings. The remaining 64 patients underwent PET (n= 8) and/or PET/CT (n= 66) as part of routine posttherapy surveillance; these patients were asymptomatic, with no evidence of disease. The sensitivity, specificity, accuracy, PPV, and NPV of PET and/or PET/CT in detecting recurrence in these patients were all 100%. Clinical decisions on treatment were changed in 14 (21.9%) patients by introducing PET or PET/CT into their conventional posttherapy surveillance program. PET and/or PET/CT were highly effective in discriminating true recurrence in patients with suspected recurrence, highly sensitive in detecting recurrence in asymptomatic patients, and had impacts on clinical decisions in a considerable portion of patients.

scholarly journals Positron emission tomography/computed tomography for optimized colon cancer staging and follow-up.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 408-408
Author(s):  
Bodil E. Engelmann ◽  
Annika Loft ◽  
Andreas Kjær ◽  
Hans J. Nielsen ◽  
Anne Kiil Berthelsen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Colon Cancer ◽  
Cancer Staging ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Primary Colon Cancer ◽  
Primary Colon

408 Background: Optimal management of colon cancer requires detailed assessment of extent of disease. Diagnostic accuracy of 18F-fluorodeoxyglucose (FDG) positron emission tomography/ computed tomography (PET/CT) in primary colon cancer staging and for detection of recurrence was investigated. Methods: PET/CT for preoperative staging was performed on 66 prospectively included patients with primary colon cancer. Diagnostic accuracy for PET/CT and CT alone was analysed. Forty-two stage I-III colon cancer patients had PET/CT follow-up examinations every six months for two years. Serological levels of Tissue Inhibitor of Metalloproteinases (TIMP-1), Carcinoembryonic Antigen (CEA), and liberated domain I of urokinase Plasminogen Activator Receptor [uPAR(I)] and FDG-uptake related tumour gene expression were analysed. Results: Accuracy for T-, N- and M-staging by PET/CT were 82 % [95% Confidence Interval (CI) 70; 91], 66 % [CI 51; 78] and 89 % [CI 79; 96]; for CT 77 % [CI 64; 87], 60 % [CI 46; 73] and 69 % [CI 57; 80]. Cumulative relapse incidences for stage I – III colon cancer at 6, 12, 18 and 24 months were 7.1 % [CI 0; 14.9]; 14.3 % [CI 3.7; 24.9]; 19.0 % [CI 7.1; 30.9] and 21.4 % [CI 9.0; 33.8]. PET/CT diagnosed all relapses detected during the first two postoperative years. High preoperative TIMP-1 levels were associated with significant hazards towards both risk of recurrence and shorter overall survival. FDG-uptake in colon cancer showed significant correlation to hexokinase 2, the hypoxia marker carboanhydrase IX and the proliferation marker ki67. Conclusions: This study indicates PET/CT to be a valuable tool for staging and follow-up in colon cancer. TIMP-1 provided prognostic information potentially useful in selection of patients for intensive follow-up.

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