scholarly journals Brain metastases: the role of clinical imaging

2021 ◽  
Author(s):  
Sophie H. A. E. Derks ◽  
Astrid A. M. van der Veldt ◽  
Marion Smits
Keyword(s):  
Brain Metastases ◽  
Tumour Progression ◽  
Imaging Techniques ◽  
3 Dimensional ◽  
Endogenous Contrast ◽  
Positron Emission ◽  
Golden Standard ◽  
New Biomarkers ◽  
The Right

Imaging of brain metastases (BMs) has advanced greatly over the past decade. In this review, we discuss the main challenges that BMs pose in clinical practice, and describe the role of imaging. Firstly, we describe the increased incidence of BMs of different primary tumours and the rationale for screening. A challenge lies in selecting the right patients for screening: not all cancer patients develop BMs in their disease course. Secondly, we discuss the imaging techniques to detect BMs. A 3-dimensional (3D) T1-weighted MRI sequence is the golden standard for BM detection, but additional anatomical (susceptibility weighted imaging, diffusion weighted imaging), functional (perfusion MRI) and metabolic (MR spectroscopy, positron emission tomography) information can help to differentiate from other intracranial aetiologies. Thirdly, we describe the role of imaging before, during, and after treatment of BMs. For surgical resection, imaging is used to select surgical patients, but also to assist intraoperatively (neuronavigation, fluorescence-guided surgery, ultrasound). For treatment planning of stereotactic radiosurgery, MRI is combined with CT. For surveillance after both local and systemic therapies, conventional MRI is used. However, advanced imaging is increasingly performed to distinguish true tumour progression from pseudoprogression. Lastly, future perspectives are discussed, including radiomics, new biomarkers, new endogenous contrast agents and theranostics.

scholarly journals News about the Role of Fluid and Imaging Biomarkers in Neurodegenerative Diseases

Biomedicines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 252
Author(s):  
Jacopo Meldolesi
Keyword(s):  
Neurodegenerative Diseases ◽  
Imaging Techniques ◽  
Imaging Biomarkers ◽  
Positron Emission ◽  
Specific Proteins ◽  
Great Relevance ◽  
The Brain ◽  
Positive Point

Biomarkers are molecules that are variable in their origin, nature, and mechanism of action; they are of great relevance in biology and also in medicine because of their specific connection with a single or several diseases. Biomarkers are of two types, which in some cases are operative with each other. Fluid biomarkers, started around 2000, are generated in fluid from specific proteins/peptides and miRNAs accumulated within two extracellular fluids, either the central spinal fluid or blood plasma. The switch of these proteins/peptides and miRNAs, from free to segregated within extracellular vesicles, has induced certain advantages including higher levels within fluids and lower operative expenses. Imaging biomarkers, started around 2004, are identified in vivo upon their binding by radiolabeled molecules subsequently revealed in the brain by positron emission tomography and/or other imaging techniques. A positive point for the latter approach is the quantitation of results, but expenses are much higher. At present, both types of biomarker are being extensively employed to study Alzheimer’s and other neurodegenerative diseases, investigated from the presymptomatic to mature stages. In conclusion, biomarkers have revolutionized scientific and medical research and practice. Diagnosis, which is often inadequate when based on medical criteria only, has been recently improved by the multiplicity and specificity of biomarkers. Analogous results have been obtained for prognosis. In contrast, improvement of therapy has been limited or fully absent, especially for Alzheimer’s in which progress has been inadequate. An urgent need at hand is therefore the progress of a new drug trial design together with patient management in clinical practice.

Radiology of the head and neck

2021 ◽  
pp. 973-976
Author(s):  
Ivan Zammit-Maempel
Keyword(s):  
Head And Neck ◽  
Imaging Techniques ◽  
Cone Beam Ct ◽  
Neck Mass ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Video Fluoroscopy

Various imaging techniques are used in the staging and follow-up of head and neck cancer and evaluating patients presenting with a neck mass. The workhorses in imaging the neck are ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) with positron emission tomography CT (PET-CT) increasingly being requested. Plain radiographs, contrast studies, video fluoroscopy, angiography, and cone beam CT have limited but important roles. This chapter discusses the role of some of these modalities.

New insights into the role of imaging in polymyalgia rheumatica

Rheumatology ◽  
2020 ◽  
Author(s):  
Dario Camellino ◽  
Christina Duftner ◽  
Christian Dejaco
Keyword(s):  
Fdg Pet ◽  
Clinical Symptoms ◽  
Imaging Techniques ◽  
Diagnostic Value ◽  
Current Data ◽  
Acute Phase Reactants ◽  
Anatomical Basis ◽  
Positron Emission ◽  
Diagnostic Values

Abstract PMR is an inflammatory rheumatic disease of elderly people characterized by pain and stiffness in the neck, shoulder and pelvic girdles. No specific diagnostic confirmatory tests exist and clinical symptoms, as well as increased acute phase reactants, are unspecific. The diagnostic value of imaging including ultrasound, MRI and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) with/without CT for PMR is increasingly studied. These techniques, particularly FDG-PET/CT, may help to detect underlying GCA in PMR patients with an incomplete response to glucocorticoids and/or recurrent relapses. Recent imaging studies provide novel insights into the anatomical basis of inflammation in PMR, particularly at hip and spine, which may help to distinguish this disease from other mimicking conditions. In this review, we discuss novel insights into the pathoanatomy of PMR, compare the diagnostic values of different imaging techniques and summarize current data on the role of imaging for monitoring and outcome prediction.

scholarly journals Primary Hyperparathyroidism Manifesting with Severe Hypercalcemia in a Nonagenarian Man: Pitfall of Common Imaging Techniques, Localization by 18F-Choline Positron Emission Tomography/Computed Tomography and Successful Management with Calcimimetics

2019 ◽  
Vol 62 (4) ◽  
pp. 156-160 ◽  
Author(s):  
Luca Foppiani ◽  
Gianluca Bottoni ◽  
Arnoldo Piccardo
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Condition ◽  
Imaging Techniques ◽  
Gastrointestinal Symptoms ◽  
First Year ◽  
Old Patients ◽  
Severe Hypercalcemia ◽  
Positron Emission ◽  
Vitamin D Levels ◽  
The Right

A nonagenarian hypertensive man with chronic kidney disease (CKD) was admitted to the emergency department for gastrointestinal symptoms and worsening symptoms of depression. Severe hypercalcemia (15.3 mg/dL) was found and he was hospitalized. Fluids, loop diuretics and glucocorticoids were administered intravenously, which partially reduced calcium levels over a few days and improved his clinical condition. PTH levels proved increased (306 pg/mL) and 25-OHD levels were reduced; primary hyperparathyroidism (PHPT) was diagnosed. Neck ultrasonography (USG) did not show parathyroid enlargement, nor did 99mTechnetium-sestamibi (SESTAMIBI) scintigraphy reveal hyperfunctioning parathyroid glands. By contrast, 18F-choline PET/CT evidenced a nodule located close to the oesophagus, behind the right thyroid lobe, which proved compatible with a hyperfunctioning parathyroid gland. Since the patient declined surgery, and zoledronate was unfit owing to areas of rarefaction of the jaw, the calcimimetic cinacalcet was started; the dosage was progressively titrated up to 120 mg/day with normalisation of calcium levels over time. PTH levels, however, proved erratic and showed an upward trend over the first year of therapy; however its levels partially decreased following increase of vitamin D levels by replacement therapy. Cinacalcet is a useful and safe drug, which can normalise calcium levels and improve the clinical condition, even in very old patients with severe PHPT who decline or are unfit for surgery.

scholarly journals Photon-deficient Mass on FDG-PET Scan in Renal Cell Carcinoma: A Case Report

2008 ◽  
Vol 2 ◽  
pp. CCRep.S724
Author(s):  
George Shih ◽  
Wei-Jen Shih ◽  
Bonnie Mitchell ◽  
Primo P Milan
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Fdg Pet ◽  
Renal Cell ◽  
Positron Emission Tomography Imaging ◽  
Imaging Study ◽  
Positron Emission ◽  
Fdg Pet Scan ◽  
The Right

F-18 Fluorodeoxyglucose Positron Emission Tomography imaging (F-18 FDG PET) detects malignancies depending on the uptake profile of glycolysis of tumors; however, the role of FDG PET is limited in the evaluation of primary renal malignancy because of low FDG uptake by renal cell carcinoma and also because normal urinary excretion of FDG seen in the images. A patient with renal cell carcinoma whose FDG PET imaging study incidentally shows a photon-deficient mass in the upper pole of the right kidney is present here. The diagnosis is also validated by the histopathological findings of tumor necrosis, hemorrhage, and scars.

The role of FDG-PET scans in patients with lymphoma

Blood ◽  
2007 ◽  
Vol 110 (10) ◽  
pp. 3507-3516 ◽  
Author(s):  
Pamela Seam ◽  
Malik E. Juweid ◽  
Bruce D. Cheson
Keyword(s):  
Fdg Pet ◽  
Imaging Modality ◽  
False Negative ◽  
Surrogate Marker ◽  
3 Dimensional ◽  
Positron Emission ◽  
Development Data ◽  
Pretreatment Staging ◽  
Pet Scans

Abstract18-Fluoro-deoxyglucose positron emission tomography (FDG-PET) is a noninvasive, 3-dimensional imaging modality that has become widely used in the management of patients with malignant lymphomas. This technology has been demonstrated to be more sensitive and specific than either 67gallium scintigraphy or computerized tomography, providing a more accurate distinction between scar or fibrosis and active tumor. PET scans have been evaluated in pretreatment staging, restaging, monitoring during therapy, posttherapy surveillance, assessment of transformation, and, more recently, as a surrogate marker in new drug development. Data to support these various roles require prospective validation. Moreover, caution must be exercised in the interpretation of PET scans because of technical limitations, variability of FDG avidity among the different lymphoma histologic subtypes, and in the large number of etiologies of false-negative and false-positive results. Recent attempts to standardize PET in clinical trials and incorporation of this technology into uniformly adopted response criteria will hopefully lead to improved outcome for patients with lymphoma.

scholarly journals Implementation and role of modern musculoskeletal imaging in rheumatological practice in member countries of EULAR

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e000950
Author(s):  
Peter Mandl ◽  
Anna Ciechomska ◽  
L Terslev ◽  
Xenofon Baraliakos ◽  
PG Conaghan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Emission Tomography ◽  
Musculoskeletal Imaging ◽  
Resonance Imaging ◽  
Positron Emission

ObjectivesTo document the current training, implementation and role of modern musculoskeletal imaging techniques: ultrasound, magnetic resonance imaging, computed tomography and positron emission tomography, among rheumatologists in the member countries of the EULAR.MethodsEnglish-language questionnaires for each imaging modality developed by a EULAR task force were sent out to national and international scientific societies as well as imaging experts in the given modalities involved in research and/or training. The surveys were distributed via an online survey tool (SurveyMonkey). Simple descriptive and summary statistics were calculated from the responses.ResultsMore than 90% of ultrasound (US) experts reported the availability of a US unit in their department. Suspicion of rheumatoid arthritis and spondyloarthritides were the main clinical indications for performing US for diagnostic purposes. Suspicion of sacroiliitis and degenerative spine disease were the most common indications to perform magnetic resonance imaging (MRI) or computed tomography (CT) for diagnostic purposes, while positron emission tomography was mainly performed to diagnose large vessel vasculitis and to investigate fever of unknown origin. The reported percentage of rheumatologists performing US was highly variable, ranging from more than 80% in 6% of countries to less than 10% in 15% of countries. The majority of experts (77%) reported that their national rheumatology societies organise musculoskeletal US courses, while courses in MRI or CT organised by the national rheumatology societies were less commonly reported (29% and 8%, respectively).ConclusionsRheumatologists in Europe utilise modern imaging techniques; however, access to the techniques and training offered is varied.

scholarly journals The role of positron emission tomography in the assessment of cardiac sarcoidosis

2019 ◽  
Vol 92 (1100) ◽  
pp. 20190247 ◽  
Author(s):  
Dario Genovesi ◽  
Matteo Bauckneht ◽  
Corinna Altini ◽  
Cristina Elena Popescu ◽  
Paola Ferro ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Cardiac Sarcoidosis ◽  
Morphological Changes ◽  
Imaging Techniques ◽  
Left Ventricular ◽  
Emission Tomography ◽  
Non Invasive ◽  
Positron Emission ◽  
Fluorodeoxyglucose Pet

The myocardium and the cardiovascular system are often involved in patients with sarcoidosis. As therapy should be started as early as possible to avoid complications such as left ventricular dysfunction, a prompt and reliable diagnosis by means of non-invasive tests would be highly warranted. Among other techniques,18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has emerged as a high sensitive tool to detect sites of inflammation before morphological changes are visible to conventional imaging techniques. We therefore aim at summarizing the most relevant findings in the literature on the use of18F-fluorodeoxyglucose PET in the diagnostic workup of cardiac sarcoidosis and to underline future perspectives.

Lateralization of Speech and Auditory Temporal Processing

1998 ◽  
Vol 10 (4) ◽  
pp. 536-540 ◽  
Author(s):  
Pascal Belin ◽  
Monica Zilbovicius ◽  
Sophie Crozier ◽  
Lionel Thivard ◽  
and Anne Fontaine ◽  
...  
Keyword(s):  
Auditory Cortex ◽  
Temporal Processing ◽  
Auditory Processing ◽  
Cerebral Activation ◽  
Language Lateralization ◽  
Auditory Temporal Processing ◽  
Positron Emission ◽  
Human Volunteers ◽  
The Right

To investigate the role of temporal processing in language lateralization, we monitored asymmetry of cerebral activation in human volunteers using positron emission tomography (PET). Subjects were scanned during passive auditory stimulation with nonverbal sounds containing rapid (40 msec) or extended (200 msec) frequency transitions. Bilateral symmetric activation was observed in the auditory cortex for slow frequency transitions. In contrast, left-biased asymmetry was observed in response to rapid frequency transitions due to reduced response of the right auditory cortex. These results provide direct evidence that auditory processing of rapid acoustic transitions is lateralized in the human brain. Such functional asymmetry in temporal processing is likely to contribute to language lateralization from the lowest levels of cortical processing.

scholarly journals Development of PET Radioligands Targeting COX-2 for Colorectal Cancer Staging, a Review of in vitro and Preclinical Imaging Studies

2021 ◽  
Vol 8 ◽  
Author(s):  
Caroline Dagallier ◽  
François Avry ◽  
Yann Touchefeu ◽  
Frédéric Buron ◽  
Sylvain Routier ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Imaging Techniques ◽  
Cancer Staging ◽  
Markers Of Inflammation ◽  
Positron Emission ◽  
Public Health Challenge ◽  
Cox 2

Colorectal cancer (CRC) is the second most common cause of cancer death, making early diagnosis a major public health challenge. The role of inflammation in tumorigenesis has been extensively explored, and among the identified markers of inflammation, cyclooxygenase-2 (COX-2) expression seems to be linked to lesions with a poor prognosis. Until now, COX-2 expression could only be accessed by invasive methods, mainly by biopsy. Imaging techniques such as functional Positron Emission Tomography (PET) could give access to in vivo COX-2 expression. This could make the staging of the disease more accurate and would be of particular interest in the exploration of the first metastatic stages. In this paper, we review recent progress in the development of COX-2 specific PET tracers by comparing the radioligands' characteristics and highlighting the obstacles that remain to be overcome in order to achieve the clinical development of such a radiotracer, and its evaluation in the management of CRC.

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