scholarly journals Preoperative Screening CT and PET/CT Scanning for Acral Melanoma: Is it Necessary?

2021 ◽  
Vol 10 (4) ◽  
pp. 811
Author(s):  
Taketoshi Ide ◽  
Takamichi Ito ◽  
Maiko Wada-Ohno ◽  
Masutaka Furue
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Signs ◽  
Ct Scanning ◽  
Distant Metastases ◽  
Nodal Metastasis ◽  
Preoperative Imaging ◽  
Histopathological Analysis ◽  
Preoperative Screening ◽  
Acral Melanoma ◽  
Pet Ct

The efficacy of preoperative imaging for acral melanoma (AM) has not been fully evaluated. We examined the accuracy of imaging modalities in the detection of nodal and distant metastases in patients with AM. A retrospective review of 109 patients with AM was performed. All patients had no clinical signs suggestive of distant metastases, and underwent preoperative screening computed tomography (CT) and positron emission tomography (PET)/CT scans. Of 100 patients without lymphadenopathy, 17 patients were suspected of having nodal metastasis in CT and PET/CT, but only two of them were confirmed on histopathological analysis. On the other hand, 12 out of 83 negatively imaged patients showed histopathological signs of nodal metastasis; thus, the sensitivity and specificity of nodal detection were 14.3% and 82.6%, respectively. Regard to the detection of distant metastases, four patients were suspected of having metastasis, but this was later ruled out. The remaining 96 negatively imaged patients were confirmed to have no metastasis at the time of CT and PET/CT by the follow-up. In contrast, distant metastases were found by CT and PET/CT in four of nine patients (44.4%) with lymphadenopathy. Routine preoperative CT and PET/CT for AM patients without lymphadenopathy may not be warranted because of low sensitivity and specificity, but it can be considered for those with lymphadenopathy.

Preoperative Staging of Large Primary Breast Cancer With [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Compared With Conventional Imaging Procedures

2008 ◽  
Vol 26 (29) ◽  
pp. 4746-4751 ◽  
Author(s):  
David Fuster ◽  
Joan Duch ◽  
Pilar Paredes ◽  
Martín Velasco ◽  
Montserrat Muñoz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Sensitivity And Specificity ◽  
Primary Breast Cancer ◽  
Distant Metastases ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Pet Ct ◽  
Large Primary

Purpose To evaluate the utility of positron emission tomography (PET) and [18F]fluorodeoxyglucose in the initial staging of large primary breast tumors. Patients and Methods This prospective study was approved by the ethics committee, and all patients gave their informed consent before enrollment. Sixty consecutive patients with large (> 3 cm) primary breast cancer diagnosed by clinical examination and breast magnetic resonance imaging (MRI) were entered onto the study. The mean age was 57 ± 13 years. Chest computed tomography (CT), liver ultrasonography, bone scan, and PET/CT were performed in all patients. All findings were histologically confirmed, and/or at least 1 year of follow-up was required. Correlation between parameters was calculated using Pearson's correlation coefficient. P < .05 was considered statistically significant. Results Primary tumor was identified by both PET/CT and MRI in all patients. Multifocal and/or multicentric tumors were found in 19 patients by MRI. Axillary lymph node metastases were found in 20 of 52 patients. Extra-axillary metastatic lymph nodes were also found in three patients. One patient showed an infiltrated lymph node in the contralateral axilla. The sensitivity and specificity for PET/CT to detect axillary lymph nodes metastases were 70% and 100%, respectively. PET/CT diagnosed all extra-axillary lymph nodes. The overall sensitivity and specificity of PET/CT in detecting distant metastases were 100% and 98%, respectively; whereas the sensitivity and specificity of conventional imaging were 60% and 83%, respectively. PET led to a change in the initial staging in 42% of patients. Conclusion PET/CT underestimates locoregional lymph node staging in large primary breast cancer patients. PET/CT is a valuable tool to discard unsuspected extra-axillary lymph nodes and distant metastases.

Staging PET–CT Scanning Provides Superior Detection of Lymph Nodes and Distant Metastases than Traditional Imaging in Locally Advanced Breast Cancer

2016 ◽  
Vol 40 (8) ◽  
pp. 2036-2042 ◽  
Author(s):  
Pankaj Kumar Garg ◽  
Suryanarayana V. S. Deo ◽  
Rakesh Kumar ◽  
Nootan Kumar Shukla ◽  
Sanjay Thulkar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Ct Scanning ◽  
Distant Metastases ◽  
Advanced Breast ◽  
Pet Ct

scholarly journals The value of intraoperative ultrasound and preoperative imaging, individually and in combination, in liver resection for metastatic colorectal cancer

2011 ◽  
Vol 93 (3) ◽  
pp. 246-249 ◽  
Author(s):  
Jeffrey T Lordan ◽  
Katherine M Stenson ◽  
Nariman D Karanjia
Keyword(s):  
Liver Resection ◽  
Sensitivity And Specificity ◽  
Intraoperative Ultrasound ◽  
Preoperative Imaging ◽  
Categorical Variables ◽  
Histopathological Analysis ◽  
Continuous Variables ◽  
Chi Square ◽  
Term Survival

INTRODUCTION Liver resection is proved to offer potential long-term survival for colorectal liver metastases (CRLM). Accurate radiological assessment is vital to enable an appropriate surgical approach. The role of intraoperative ultrasound (IOUS) has been controversial. This study was designed to analyse the accuracy of IOUS compared with that of preoperative imaging (POI) in these patients. MATERIALS AND METHODS A prospective analysis of 51 consecutive patients who underwent liver resection for CRLM was undertaken. The accuracy of POI and IOUS were correlated and compared with histopathological analysis. Statistical analyses included t-tests, to compare continuous variables, and chi-square and Fisher’s exact tests to compare categorical variables. p<0.05 was considered significant RESULTS POI correlated with histology in 35 patients (68.6%). The sensitivity and specificity were 82.4% and 86.3% respectively. IOUS correlated with histology in 31 (60.8%) patients. The sensitivity and specificity were 84.3% and 76.5% respectively. There was no difference in accuracy between modalities. The accuracy of POI combined with IOUS correlated with histology in 40 patients (78.4%). The sensitivity and specificity were 88.2% and 84.3% respectively. The accuracy of combined modalities was significantly greater than IOUS or POI alone. CONCLUSIONS POI combined with IOUS may significantly increase the diagnostic accuracy of patients undergoing liver resection for CRLM.

scholarly journals Role of fused PET/CT compared to the standard contrast-enhanced CT in the follow-up assessment of the treated gastric malignancy

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Ahmed A. Baz ◽  
Talaat A. Hassan
Keyword(s):  
Computed Tomography ◽  
Distant Metastases ◽  
Treatment Method ◽  
Nodal Metastasis ◽  
Diagnostic Modality ◽  
Malignant Carcinoid ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Pet Ct

Abstract Background To investigate the use of fused positron emission tomography/computed tomography (PET/CT) compared to contrast-enhanced computed tomography (CECT) in the follow-up of treated gastric malignancies, all data were collected and analyzed retrospectively, enrolling 68 patients (18 females and 50 males) (their age range = 34–73 years). The patients had been referred to a private imaging center for their assessment by PET/CT. Results Adenocarcinoma was present in 73.5%, lymphoma was present in 23.5%, and malignant carcinoid was found in 3% of cases. All patients had received at least one treatment method including endoscopic/surgical resection, chemotherapy, and radiotherapy. By PET/CT, gastric recurrence/residual was depicted in 30 patients (47.0%) compared 46 patients (67.5%) as detected by CECT, and this was statistically significant (P value = 0.006), nodal metastasis was present in 18 patients (26.5%) compared to 26 patients (38%) as detected by CECT (P value = 0.143), and distant metastasis was present in 18 patients (26.5%) compared to 24 patients (35%) as depicted by CECT (P value = 0.265). Conclusion PET/CT offered a useful diagnostic modality as compared to CECT for follow-up evaluation of cases with treated gastric malignancies through a precise detection of the gastric lesions but it had rather comparable results in the detection of nodal and distant metastases.

scholarly journals A RARE CASE OF UNDIFFERENTIATED EMBRYONAL SARCOMA OF LIVER IN 8 YEAR FEMALE CHILD

2020 ◽  
pp. 1-2
Author(s):  
Asit V Patel ◽  
Shreosi P Sarkar ◽  
Ashwin P Godbole ◽  
Dhruv N Shah ◽  
Poorn V Pandya
Keyword(s):  
Rare Case ◽  
Distant Metastases ◽  
Female Child ◽  
Histopathological Analysis ◽  
Liver Mass ◽  
Physical Status ◽  
Immunohistochemical Examination ◽  
Pet Ct ◽  
Rare Case Report ◽  
Embryonal Sarcoma

Introduction: Undifferentiated embryonal sarcoma of liver (USEL) is a rare disease that 90% occurs in children between age group 6-10 years with no gender discrepancy. Diagnosis of USEL relies on postoperative pathology and immunohistochemistry. Objective : This is a rare case report of an 8 year female patient who underwent excision of liver mass with left side lobectomy for a liver mass which turned out to be Undifferentiated Embryonal Sarcoma of Liver(USEL) on Histopathological analysis and Immunohistochemical examination. Results : Patient was diagnosed to be having Gastrointestinal Stromal Tumor of stomach on radiological investigations but intraoperatively turned out to be a liver mass for which patient underwent excision of liver mass with left side lobectomy for a liver mass which turned out to be Undifferentiated Embryonal Sarcoma of Liver(USEL) on Histopathological analysis and Immunohistochemical examination. Patient underwent chemotherapy including ifosfamide, mesna and doxorubicin. Currently, the patient’s physical status is normal with no distant metastases shown in PET-CT. Conclusion : Undifferentiated Embryonal Sarcoma of Liver is a rare entity but with adequate surgical procedure and followup chemotherapy or radiotherapy has excellent prognosis

scholarly journals The Role of [18F]Fluciclovine PET/CT in the Characterization of High-Risk Primary Prostate Cancer: Comparison with [11C]Choline PET/CT and Histopathological Analysis

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1575
Author(s):  
Lucia Zanoni ◽  
Riccardo Mei ◽  
Lorenzo Bianchi ◽  
Francesca Giunchi ◽  
Lorenzo Maltoni ◽  
...  
Keyword(s):  
Bone Marrow ◽  
High Risk ◽  
Malignant Lesion ◽  
Lesion Detection ◽  
Histopathological Analysis ◽  
Choline Pet ◽  
Primary Prostate Cancer ◽  
Pet Ct

The primary aim of the study was to evaluate the role of [18F]Fluciclovine PET/CT in the characterization of intra-prostatic lesions in high-risk primary PCa patients eligible for radical prostatectomy, in comparison with conventional [11C]Choline PET/CT and validated by prostatectomy pathologic examination. Secondary aims were to determine the performance of PET semi-quantitative parameters (SUVmax; target-to-background ratios [TBRs], using abdominal aorta, bone marrow and liver as backgrounds) for malignant lesion detection (and best cut-off values) and to search predictive factors of malignancy. A six sextants prostate template was created and used by PET readers and pathologists for data comparison and validation. PET visual and semi-quantitative analyses were performed: for instance, patient-based, blinded to histopathology; subsequently lesion-based, un-blinded, according to the pathology reference template. Among 19 patients included (mean age 63 years, 89% high and 11% very-high-risk, mean PSA 9.15 ng/mL), 45 malignant and 31 benign lesions were found and 19 healthy areas were selected (n = 95). For both tracers, the location of the “blinded” prostate SUVmax matched with the lobe of the lesion with the highest pGS in 17/19 cases (89%). There was direct correlation between [18F]Fluciclovine uptake values and pISUP. Overall, lesion-based (n = 95), the performance of PET semiquantitative parameters, with either [18F]Fluciclovine or [11C]Choline, in detecting either malignant/ISUP2-5/ISUP4-5 PCa lesions, was moderate and similar (AUCs ≥ 0.70) but still inadequate (AUCs ≤ 0.81) as a standalone staging procedure. A [18F]Fluciclovine TBR-L3 ≥ 1.5 would depict a clinical significant lesion with a sensitivity and specificity of 85% and 68% respectively; whereas a SUVmax cut-off value of 4 would be able to identify a ISUP 4-5 lesion in all cases (sensitivity 100%), although with low specificity (52%). TBRs (especially with threshold significantly higher than aorta and slightly higher than bone marrow), may be complementary to implement malignancy targeting.

scholarly journals Image Registration of 18F-FDG PET/CT Using the MotionFree Algorithm and CT Protocols through Phantom Study and Clinical Evaluation

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 669
Author(s):  
Deok-Hwan Kim ◽  
Eun-Hye Yoo ◽  
Ui-Seong Hong ◽  
Jun-Hyeok Kim ◽  
Young-Heon Ko ◽  
...  
Keyword(s):  
Ct Scan ◽  
Ct Scanning ◽  
Motion Artifacts ◽  
Scanning Time ◽  
Pet Ct ◽  
Static Images ◽  
Type C ◽  
Natural Breathing ◽  
Fdg Pet Ct ◽  
Patient Studies

We evaluated the benefits of the MotionFree algorithm through phantom and patient studies. The various sizes of phantom and vacuum vials were linked to RPM moving with or without MotionFree application. A total of 600 patients were divided into six groups by breathing protocols and CT scanning time. Breathing protocols were applied as follows: (a) patients who underwent scanning without any breathing instructions; (b) patients who were instructed to hold their breath after expiration during CT scan; and (c) patients who were instructed to breathe naturally. The length of PET/CT misregistration was measured and we defined the misregistration when it exceeded 10 mm. In the phantom tests, the images produced by the MotionFree algorithm were observed to have excellent agreement with static images. There were significant differences in PET/CT misregistration according to CT scanning time and each breathing protocol. When applying the type (c) protocol, decreasing the CT scanning time significantly reduced the frequency and length of misregistrations (p < 0.05). The MotionFree application is able to correct respiratory motion artifacts and to accurately quantify lesions. The shorter time of CT scan can reduce the frequency, and the natural breathing protocol also decreases the lengths of misregistrations.

scholarly journals Can mean ADC value and ADC ratio of benign prostate tissue to prostate cancer assist in the prediction of clinically significant prostate cancer within the PI-RADSv2 scoring system?

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Samar Ramzy Ragheb ◽  
Reem Hassan Bassiouny
Keyword(s):  
Prostate Cancer ◽  
Sensitivity And Specificity ◽  
Gleason Score ◽  
Treatment Strategies ◽  
Serum Levels ◽  
Prostatic Tissue ◽  
Histopathological Analysis ◽  
Adc Value ◽  
The Mean ◽  
Clinically Significant

Abstract Background The aim of this study is to investigate whether quantitative DW metrics can provide additive value to the reliable categorization of lesions within existing PI-RADSv2 guidelines. Fifty-eight patients with clinically suspicious prostate cancer who underwent PR examination, PSA serum levels, sextant TRUS-guided biopsies, and bi-parametric MR imaging were included in the study. Results Sixty-six lesions were detected by histopathological analysis of surgical specimens. The mean ADC values were significantly lower in tumor than non-tumor tissue. The mean ADC value inversely correlated with Gleason score of tumors with a significant p value < 0.001.Conversely, a positive relationship was found between the ADC ratio (ADC of benign prostatic tissue to prostate cancer) and the pathologic Gleason score with a significant elevation of the ADC ratio along with an increase of the pathologic Gleason score (p < 0.001). ROC curves constructed for the tumor ADC and ADC ratio helped to distinguish pathologically aggressive (Gleason score ≥ 7) from non-aggressive (Gleason score ≤ 6) tumors and to correlate it with PIRADSv2 scoring to predict the presence of clinically significant PCA (PIRADSv2 DW ≥ 4). The ability of the tumor ADC and ADC ratio to predict highly aggressive tumors (GS> 7) was high (AUC for ADC and ADC ratio, 0.946 and 0.897; p = 0.014 and 0.039, respectively). The ADC cut-off value for GS ≥ 7 was < 0.7725 and for GS ≤ 6 was > 0.8620 with sensitivity and specificity 97 and 94%. The cutoff ADC ratio for predicting (GS > 7) was 1.42 and for GS ≤ 6 was > 1.320 with sensitivity and specificity 97 and 92%. By applying this ADC ratio cut-off value the sensitivity and specificity of reader 1 for correct categorization of PIRADSv2 DW > 4 increased from 90 and 68% to 95 and 90% and that of reader 2 increased from 94 and 88% to 97 and 92%, respectively. Conclusion Estimation of DW metrics (ADC and ADC ratio between benign prostatic tissue and prostate cancer) allow the non-invasive assessment of biological aggressiveness of prostate cancer and allow reliable application of the PIRADSv2 scoring to determine clinically significant cancer (DW score > 4) which may contribute in planning initial treatment strategies.

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