scholarly journals 18FDG-PET/CT Specificity for the Detection of Lymphoma Recurrence in the Tonsils

OTO Open ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 2473974X2110590
Author(s):  
Jonathan D. West ◽  
Mary E. Kim ◽  
Dorian M. Lapalma ◽  
Maria Vergara-Lluri ◽  
Peter Conti ◽  
...  
Keyword(s):  
Patient Population ◽  
Medical Center ◽  
False Positive Rate ◽  
Case Series ◽  
Surgical Pathology ◽  
Specific Patient ◽  
18Fdg Pet ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
History Of

Objective In patients with a history of lymphoma who demonstrate palatine tonsil uptake on posttreatment PET/CT (positron emission tomography/computed tomography), tonsillectomy is often performed to evaluate for lymphoma recurrence. However, predictive clinical and imaging factors for true tonsil recurrence in this setting are not well established; this will be explored herein. Study Design Retrospective case series. Setting Patients treated at a tertiary medical center from January 2008 to May 2020. Methods Chart review was performed on all patients with a history of treated lymphoma in clinical remission who presented for evaluation of abnormal PET/CT imaging findings and subsequently underwent tonsillectomy. Results Among 15 patients who met inclusion criteria, 14 had benign findings on surgical pathology, yielding a false-positive rate of 93%. The patient with malignancy was identified on biopsy after inconclusive surgical pathology and is the only documented case of recurrence in this specific patient population throughout the literature. The patient presented with B symptoms, irregularly shaped tonsils, increased lymph node activity on PET/CT, and uptrending bilateral tonsil activity but with one of the lowest maximum standardized uptake values of the cohort. The singular distinguishing feature for the patient with recurrent disease was a prior tonsil biopsy suspicious for recurrence, which prompted the otolaryngology referral. Conclusion PET/CT lacks specificity in identifying lymphoma recurrence in the oropharynx. Clinical and radiographic features that were previously considered concerning for recurrence are most likely not indicative of malignancy in this patient population. Our findings call into question whether tonsillectomy should be routinely performed in this patient population.

scholarly journals Comparison of Standardized Uptake Values in Normal Structures Between PET/CT and PET/MRI in an Oncology Patient Population

2013 ◽  
Vol 15 (6) ◽  
pp. 776-785 ◽  
Author(s):  
Sharif Kershah ◽  
Sasan Partovi ◽  
Bryan J Traughber ◽  
Raymond F. Muzic ◽  
Mark D Schluchter ◽  
...  
Keyword(s):  
Patient Population ◽  
Oncology Patient ◽  
Standardized Uptake Values ◽  
Pet Ct

scholarly journals MP11: COMORBID DEPRESSION OR ANXIETY IS ASSOCIATED WITH AORTIC VASCULAR INFLAMMATION AND CORONARY HEART DISEASE BEYOND TRADITIONAL CARDIOVASCULAR RISK FACTORS IN PSORIASIS

2016 ◽  
Vol 64 (3) ◽  
pp. 809.1-809
Author(s):  
T Aberra ◽  
A Joshi ◽  
J Lerman ◽  
J Rodante ◽  
J Silverman ◽  
...  
Keyword(s):  
Vascular Inflammation ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
High Risk Population ◽  
Inflammatory Disorder ◽  
Comorbid Depression ◽  
18Fdg Pet ◽  
Increased Risk ◽  
Pet Ct ◽  
History Of

Purpose of StudyPsoriasis is a chronic inflammatory disorder associated with vascular inflammation (VI), measured by 18-fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG PET/CT), and increased risk of MI. Patients with psoriasis are more likely to have comorbid depression and anxiety. Whether these comorbidities accelerate the development of CVD in psoriasis is unclear. We hypothesized that aortic VI and coronary plaque burden would be increased in patients with psoriasis who have depression and/or anxiety compared to those with psoriasis who do not.Methods UsedPatients were prospectively enrolled. Those who reported a history of depression and/or anxiety (n=40) on survey and age- and gender-matched patients who reported no history of psychiatric illness (n=40) were selected. Target-to-Background ratio from 18FDG PET/CT was used to assess aortic VI, and coronary CT angiography scans were analyzed for coronary plaque composition.Summary of ResultsBoth aortic VI and coronary plaque burden were higher in psoriasis patients with comorbid depression or anxiety compared to those without (table 1). After adjustment for Framingham Risk Score, body mass index, and statin use; VI (β=0.24, p=0.02), total plaque burden (β=0.13, p=0.04), and non-calcified burden (β=0.13, p=0.04) were associated with comorbid depression and/or anxiety.ConclusionsPatients with psoriasis who have comorbid depression or anxiety have increased aortic VI and coronary plaque burden, suggesting that identification of psychiatric diagnoses in psoriasis may be warranted for future CV risk reduction in this high risk population.Abstract MP11 Figure 1

scholarly journals Jejunojejunal Intussusception due to Metastatic Melanoma Seven Years after the Primer

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Alexander Giakoustidis ◽  
Thomas Goulopoulos ◽  
Anastasios Boutis ◽  
George Kavvadias ◽  
Aristidis Kainantidis ◽  
...  
Keyword(s):  
Small Intestine ◽  
Metastatic Melanoma ◽  
Medical Condition ◽  
Hashimoto Thyroiditis ◽  
Initial Manifestation ◽  
Intestinal Intussusception ◽  
18Fdg Pet ◽  
Loss Of Weight ◽  
Pet Ct ◽  
History Of

Intestinal intussusception in adults is a rare medical condition accounting for less than 5% of all intussusceptions. Herein we present a 45-year-old patient with a history of abdominal pain and loss of weight. CT scan revealed jejunojejunal intussusceptions. The patient was subjected to exploratory operation and small intestine resection due to a mass causing intestinal intussusception. Pathology confirmed suspected diagnosis of metastatic melanoma to small intestine secondary to melanoma, 7 years after the initial manifestation. Postoperative evaluation with 18FDG-PET/CT revealed increased uptake in the thyroid gland. Subsequent total thyroidectomy revealed severe Hashimoto thyroiditis and no signs of metastasis. The patient received adjuvant immunotherapy and is healthy with no signs of recurrence 3 years after the initial diagnosis and treatment.

scholarly journals The Utility of 18FDG-PET/CT in Diagnosing Fever of Unknown Origin: The Experience of a Large Tertiary Medical Center

2021 ◽  
Vol 18 (10) ◽  
pp. 5360
Author(s):  
Hussein Mahajna ◽  
Keren Vaknin ◽  
Jennifer Ben Shimol ◽  
Abdulla Watad ◽  
Arsalan Abu-Much ◽  
...  
Keyword(s):  
Weight Loss ◽  
Predictive Value ◽  
Fever Of Unknown Origin ◽  
Diagnostic Yield ◽  
Medical Center ◽  
False Negative ◽  
Unknown Origin ◽  
18Fdg Pet ◽  
Pet Ct ◽  
Work Up

Fever of unknown origin (FUO) poses a diagnostic challenge, and 18-fluorodexoyglucose positron emission tomography with computed tomography (18FDG-PET/CT) may identify the source. We aimed to evaluate the diagnostic yield of 18FDG-PET/CT in the work-up of FUO. The records of patients admitted to Sheba Medical Center between January 2013 and January 2018 who underwent 18FDG-PET/CT for the evaluation of FUO were reviewed. Following examination of available medical test results, 18FDG-PET/CT findings were assessed to determine whether lesions identified proved diagnostic. Of 225 patients who underwent 18FDG-PET/CT for FUO work-up, 128 (57%) met inclusion criteria. Eighty (62.5%) were males; mean age was 59 ± 20.3 (range: 18–93). A final diagnosis was made in 95 (74%) patients. Of the 128 18FDG-PET/CT tests conducted for the workup of FUO, 61 (48%) were true positive, 26 (20%) false positive, 26 (20%) true negative, and 15 (12%) false negative. In a multivariate analysis, weight loss and anemia were independently associated with having a contributary results of 18FDG-PET/CT. The test yielded a sensitivity of 70%, specificity of 37%, positive predictive value of 70%, and negative predictive value of 37%. 18FDG-PET/CT is a valuable tool in the diagnostic workup of FUO. It proved effective in diagnosing almost half the patients, especially in those with anemia and weight loss.

scholarly journals Insight into the current practice of ototoxicity monitoring during cisplatin therapy

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
N. M. Santucci ◽  
B. Garber ◽  
R. Ivory ◽  
M. A. Kuhn ◽  
M. Stephen ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Monitoring Program ◽  
Case Series ◽  
Prior History ◽  
Study Cohort ◽  
Aural Rehabilitation ◽  
Academic Medical ◽  
History Of ◽  
Monitoring Protocols

Abstract Background The aim of this study is to evaluate the current state of ototoxicity monitoring for patients receiving cisplatin chemotherapy in an academic medical center with particular attention to how closely monitoring adheres to national ototoxicity guidelines. Methods Case series including retrospective medical records review of patients (age > 18) treated with cisplatin at University of California Davis Medical Center between January 2014 and August 2017. Patient and ototoxicity related variables were analyzed. Patients that underwent a transfer of care during treatment and with less than 3 months of follow-up were excluded. Results Three hundred seventy-nine patients met study criteria, of which 104 (27.4%) had a prior history of hearing loss. Prior to treatment, 196 (51.7%) patients were counseled regarding the ototoxic nature of cisplatin and 92 (24.3%) patients had a pretreatment audiogram. During treatment, 91 (24%) patients had documented otologic complaints. Only 17 patients (4.5%) patients had an audiogram ordered during their cisplatin treatment period. 130 (34.3%) patients had otologic complaints following cisplatin treatment. Audiograms were ordered for 20 (7.8%), 13 (5.1%), and 16 (6.2%) patients at 1-month, 3-month, and 6-month follow-ups, respectively. No patients in the study cohort received baseline, treatment, and post-treatment audiograms as recommended by national ototoxicity monitoring protocols. Patients with Head and Neck Cancer (HNC) represented the largest subgroup that received cisplatin (n = 122, 32.2%) and demonstrated higher rates of ototoxicity counseling (n = 103, 84.4%) and pretreatment audiograms (n = 70, 57.4%) compared to the non HNC group (n = 36, 36.2%, P < 0.0001 and n = 22, 8.5%, P < 0.0001). Conclusions There is poor adherence to national ototoxicity monitoring guidelines at a large academic medical center. This is a missed opportunity for intervention and aural rehabilitation. Improved education and collaboration between otolaryngology, audiology, and medical oncology is needed to develop and promote an effective ototoxicity-monitoring program. Graphical abstract

scholarly journals Hemichorea in a patient with ipsilateral cortical infarction: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jie Wei ◽  
Yue Zhang
Keyword(s):  
Ischemic Stroke ◽  
Frontal Lobe ◽  
Brain Lesion ◽  
Antipsychotic Treatment ◽  
Left Frontal Lobe ◽  
Cortical Infarction ◽  
18Fdg Pet ◽  
Pet Ct ◽  
History Of ◽  
The Right

Abstract Background Hemichorea is usually caused by contralateral deep structures of brain. It rarely results from acute cortical ischemic stroke and that caused by ipsilateral brain lesions is even rarer. Case presentation A 64-year-old female presented with acute obtuseness and left-sided hemichorea. She had a history of right frontal lobe surgery and radiotherapy due to brain metastasis from lung cancer 8 years ago. MRI revealed acute left frontal lobe infarction in addition to an old right frontal lobe lesion. 18FDG PET-CT showed hypometabolism in the left frontal lobe and hypermetabolism in the right basal ganglia region and central sulcus. The choreatic movement remitted after antipsychotic treatment. Conclusion The mechanism of hemichorea after ipsilateral cortical infarction is poorly understood. We assume both previous contralateral brain lesion and recent ipsilateral ischemic stroke contributed to the strange manifestation in this case.

Factors Associated with Refractory Nasal Congestion Following Adenoidectomy

2020 ◽  
pp. 000348942094034
Author(s):  
Aneesh Patel ◽  
Christopher D. Brook ◽  
Jessica R. Levi
Keyword(s):  
Clinical Decision Making ◽  
Medical Center ◽  
Nasal Congestion ◽  
Case Series ◽  
Clinical Decision ◽  
Repeat Surgery ◽  
Factors Associated ◽  
Refractory Symptoms ◽  
History Of ◽  
Chi Square Analysis

Objective: The objective of this study was to better characterize factors associated with refractory rhinitis in pediatric patients who underwent adenoidectomy compared to those who had symptom resolution. Methods: The authors conducted a case series of patients younger than 18 years old who underwent adenoidectomy at Boston Medical Center from October 2012 to December 2018. Patients who underwent tonsillectomy and adenoidectomy or who underwent adenoidectomy for indications other than rhinitis were excluded. Patients who had refractory rhinitis symptoms postoperatively were compared to those who had resolution of their symptoms using Chi-square analysis and t-tests. Results: One hundred three patients who had refractory symptoms following adenoidectomy were compared to 139 patients who had resolution of symptoms. Patients who had refractory symptoms had significantly higher proportion of use (89.3%, P = .0011) and higher mean number of preoperative (1.50, P = .0226) and postoperative (1.10, P < .0001) medications, including nasal saline, intranasal steroids, antihistamines, and/or antibiotics. They were more likely to receive postoperative allergy evaluations (50%, P = .0068) and repeat surgery (30.1%, P < .0001), and had a higher proportion of reported history of allergies (24.3%, P = .0089). Conclusion: Use and number of preoperative medications, reported history of allergies, and postoperative allergy evaluation were significantly higher in patients with refractory chronic rhinitis following adenoidectomy. This study identified differences in patients who developed refractory symptoms that may help clinical decision making for surgical management.

Herpetic Whitlow of the Hand in Infants

2020 ◽  
Author(s):  
Mohammad M. Al-Qattan ◽  
Nada G. AlQadri ◽  
Ghada AlHayaza
Keyword(s):  
Bacterial Infection ◽  
Case Reports ◽  
Case Series ◽  
Individual Case ◽  
Senior Author ◽  
Secondary Bacterial Infection ◽  
Clinical Appearance ◽  
History Of ◽  
Mode Of Transmission ◽  
Time Of Presentation

Abstract Introduction Herpetic whitlows in infants are rare. Previous authors only reported individual case reports. We present a case series of six infants. Materials and Methods This is a retrospective study of six cases of herpetic whitlows in infants seen by the senior author (MMA) over the past 23 years (1995–2017 inclusive). The following data were collected: age, sex, digit involved in the hand, mode of transmission, time of presentation to the author, clinical appearance, presence of secondary bacterial infection, presence of other lesions outside the hand, method of diagnosis, treatment, and outcome. Results All six infants initially presented with classic multiple vesicles of the digital pulp. In all cases, there was a history of active herpes labialis in the mother. Incision and drainage or deroofing of the vesicles (for diagnostic purposes) resulted in secondary bacterial infection. Conclusion The current report is the first series in the literature on herpetic whitlows in infants. We stress on the mode of transmission (from the mother) and establishing the diagnosis clinically. In these cases, no need for obtaining viral cultures or polymerase chain reaction; and no medications are required. Once the vesicles are disrupted, secondary bacterial infection is frequent and a combination of oral acyclovir and intravenous antibiotics will be required.

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