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Breast Care ◽  
2022 ◽  
Author(s):  
Marcus Jannes ◽  
Alexander König ◽  
Martin Kolben ◽  
Claudius Fridrich ◽  
Verena Kirn

Introduction: The risk for metastasis at primary diagnosis of breast cancer is about 4%. The German guidelines give clear indications for when, whom and how to stage breast cancer patients. Ideally, this should be done via CAT scan of the thorax and abdomen and an additional bone scan. But daily practice shows that the way health care providers handle staging recommendations can vary. To objectify adherence to guidelines we started a nation-wide survey. Methods: Between July and September 2020 we sent out a survey via email to all certified and non certified breast centers and in addition to all Departments of Obstetrics and Gynecology in Germany. We asked for timing of staging, conditions that cause staging and the applied method. In case we did not get back any reply we sent out a reminder. Results: A total of 220 certified breast centers/28 non-certified breast center/48 Departments of Gynecology and Obstetrics who care for breast cancer patients took part in our survey. A general pre-therapeutic staging was performed in 16,4%/39,3%/66,7% of all institutions and a general post-operative staging was performed in 4,1%/0%/6,3% of each institutional type, respectively. In terms of the applied method, 75% of all certified breast centers used a CAT scan and bone scan, while 23,3% primarily use chest x-ray, ultrasound of the abdomen (27,7%) or MRI. As a potential reason for using x-ray and ultrasound the presence of a „low-risk“ breast cancer was mentioned. Summary: Although certified breast centers show the highest adherence to current guidelines, some still perform a general staging or do not use the recommended staging method. The low probability for primary metastatic breast cancer and the use of a reasonable exposure to radiation warrant a critical discussion.


2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Fiza M. Khan ◽  
Bo Chen ◽  
Amol M. Takalkar
Keyword(s):  

Author(s):  
Tongtong Li ◽  
Qiang Lin ◽  
Yanru Guo ◽  
Shaofang Zhao ◽  
Xianwu Zeng ◽  
...  

Abstract Bone scan is widely used for surveying bone metastases caused by various solid tumors. Scintigraphic images are characterized by inferior spatial resolution, bringing a significant challenge to manual analysis of images by nuclear medicine physicians. We present in this work a new framework for automatically classifying scintigraphic images collected from patients clinically diagnosed with lung cancer. The framework consists of data preparation and image classification. In the data preparation stage, data augmentation is used to enlarge the dataset, followed by image fusion and thoracic region extraction. In the image classification stage, we use a self-defined convolutional neural network consisting of feature extraction, feature aggregation, and feature classification sub-networks. The developed multi-class classification network can not only predict whether a bone scan image contains bone metastasis but also tell which subcategory of lung cancer that a bone metastasis metastasized from is present in the image. Experimental evaluations on a set of clinical bone scan images have shown that the proposed multi-class classification network is workable for automated classification of metastatic images, with achieving average scores of 0.7392, 0.7592, 0.7242, and 0.7292 for accuracy, precision, recall, and F-1 score, respectively.


2021 ◽  
Vol 9 (2) ◽  
pp. 103-107
Author(s):  
I Benali ◽  
M Allaoui ◽  
A Mejdoubi

Leiomyosarcoma is a rare neoplasm with a poor survival rate. Between June 2018 to January 2019 we treated a rare case of Prostate Leiomyosarcoma initially metastatic to the lung and the liver with multiple pelviclymph nodes. Five cycles of chemotherapy and palliative radiotherapy have been delivered with a mean follow up of 1 year .Chestabdominal-pelvic CT scan with MRI and bone scan are necessarily to assess clinical staging. The objective of this study is to review our experience in the management of Prostate Leiomyosarcoma at the Casablanca Cancer Center of Mohammed VI University of Health Sciences with a literature review of this rare neoplasm.


2021 ◽  
Vol 12 (1) ◽  
pp. 20-26
Author(s):  
Halil Ćorović ◽  
Nusret Salkica ◽  
Safet Hadžimusić ◽  
Enis Tinjak ◽  
Adel Brčaninović

Introduction: Prostate cancer has been the leading type of cancer to affect male population, and as such, it is a subject to efforts to furthermore diagnostic tools already in existence as well as development of new ones which will Aid early diagnostic, treatments as well as a follow up procedures and clinical trials. Bone scan index is a useful and objective biomarker used as a valuable tool for determination as to precise bone involvement in advanced cases, as well as a tool to predict the outcome in prostate cancer patients in clinical trials.Methods: This paper is a non-experimental (qualitative) research, that is, a scientific review of the literature.Results: The results we analyzed in this paper were collected from published academic journals.Conclusion: As a new imaging biomarker, bone scan index has potential to predict therapeutic effects and survival of patients with prostate cancer. Using measurable diagnostic image parameters, the bone scan index is important for determining metastatic bone changes in prostate cancer patients.


Author(s):  
A. L. Dolbov ◽  
A. A. Stanjevskiy ◽  
D. N. Maistrenko ◽  
M. I. Shkolnik ◽  
А. Yu. Pakhomov ◽  
...  

Relevance: Prostate cancer is one of the most frequently diagnosed malignant neoplasms of the genitourinary system in men in the world. Recently, there has been an active introduction into clinical practice of positron emission tomography technology combined with computed tomography (PET/CT) with 68Ga‑PSMA‑617 based on prostate‑specific membrane antigen (PSMA), the capabilities of which significantly increase the effectiveness of the diagnosis of prostate cancer at various clinical stages compared with routine methods used in the staging of prostate cancer.Purpose: To compare the diagnostic effectiveness of PET/CT with 68Ga‑PSMA‑617 with traditional methods of radiation imaging (computed tomography, magnetic resonance imaging and bone scan) in the staging of prostate cancer and to clarify the impact of this technology on the choice of surgical treatment.Material and methods: PET/CT with 68Ga‑PSMA was performed in our center in order to stage the verified prostate cancer in 109 patients aged 48 to 80 years (median 64.5). The selection criteria were: a PSA level of more than 5 ng/ml, the presence of a newly identified, histologically verified prostate cancer, lack of treatment, suspicion of metastatic lesion of the lymph nodes of the pelvis and skeleton. Patients were divided into groups by prostate‑specific antigen level, Gleason score, and d’Amico.Results: In the analysis of PET/CT results and MRI/CT comparison and Bone scan, 56 (51.4 %) of 109 patients showed a change in the TNM stage. A change in the data on the local spread of the tumor with an increase in the stage according to criterion T due to the detection of pathological accumulation of RFP in seminal vesicles was detected in 21 (37.5 %) of 56 patients. Additionally, according to PET/CT data, 13 (23.2 %) of 56 patients were found to have lesions of regional lymph nodes (N). Metastatic lesions of distant lymph nodes (M1a) and bones (M1b), not visualized during routine radiation examination, were observed in 32 (57.1 %) and 36 (64.3 %) of 56 patients, respectively.Conclusions: The use of PET/CT 68Ga‑PSMA‑617 in patients with newly diagnosed prostate cancer at the staging stage allows us to obtain valuable additional information about the local, regional and long‑term prevalence of the pathological process, and in some cases — to change the stage of the disease by TNM (usually by increasing it), which has a significant impact on the tactics of therapeutic measures and the choice of the optimal method of therapy for prostate cancer.


2021 ◽  
Author(s):  
Soo Bin Park ◽  
Chae Hong Lim ◽  
Won Ho Chang ◽  
Jung Hwa Hwang ◽  
Ji Young Lee ◽  
...  

Abstract Purpose We investigated the diagnostic performance of single photon emission computed tomography (SPECT)/computed tomography (CT) as a combination of functional and anatomic imaging, in patients with unspecified chest wall pain. Methods Fifty-two patients with unspecified chest wall pain and no history of recent major traumatic events or cardiac disease were included. The number and location of radioactive chest wall lesions were evaluated on both planar images and SPECT/CT. The clinical diagnosis was made based on all of the clinical and imaging data and follow-up information. Results Chest wall diseases were diagnosed in 42 patients (80.8 %). SPECT/CT showed abnormal findings in 35 (67.3 %) patients with positive predictive value (PPV) of 97.1 %. SPECT/CT revealed 56 % more lesions than planar bone scan (P = 0.002) and most of the abnormal radioactive lesions (94.6 %) showed combined morphological changes on the matched CT component. When comparing between age subgroups (< 60 y vs. ≥ 60 y), the prevalence of chest wall disease and diagnosis rate of fracture was significantly higher in the older age group. On SPECT/CT, the older age group showed higher frequency of having abnormal finding (95.8 % vs. 42.9 %, P < 0.001) and significantly more lesions were detected (a total of 189 vs. 32, P = 0.003). Conclusion SPECT/CT showed good diagnostic performance and proved to have higher sensitivity, detecting 56 % more lesions than planar bone scan. A negative result could be helpful for excluding pathologic chest wall disease. SPECT/CT might be recommended for integration in to the diagnostic workup in patients with unspecified chest wall pain, especially in patients ≥ 60 y of age, considering the high disease prevalence and the high frequency of positive results.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4993-4993
Author(s):  
Mahdi Bedrouni ◽  
Lahoud Touma ◽  
Stephan Botez ◽  
Denis Soulieres ◽  
Stephanie Forte

Abstract Introduction: Numb Chin Syndrome (NCS) is a rare sensory neuropathy characterized by inferior alveolar or mental nerve damage. It manifests as hypoesthesia, paraesthesia, or pain in the chin and lower lip. Few case reports have been published on NCS secondary to sickle cell disease (SCD). As a result, information about causes, disease course and treatment are lacking. Our objective was to synthesize all currently available relevant literature on this rare condition. Methods: A systematic review was performed following the PRISMA guidelines. The following databases were searched: Medline, EMBASE and CINAHL Complete. The search strategy was designed by a librarian and utilized text words and relevant indexing terms to identify studies about NCS in patients with SCD. Conference abstracts of relevant scientific meetings were manually searched. No language limits were applied. Reviews, notes, editorials or comments were excluded. Patient demographics (including age, sex, country, SCD genotype), clinical presentation, investigations, treatment and outcomes were extracted by two independent reviewers. Results: The systematic search revealed 73 publications (Figure). Only 11 publications from the databases and 3 from a manual search met the inclusion/exclusion criteria. Together, these case reports and series described 33 unique SCD patients. They originated from different regions (India, Turkey, Jamaica, USA, France, England). They were published between 1972 and 2021. Reports described between 1 and 13 patients each. Mean age was 28.3 years (standard deviation 11.7) and ranged from 11 to 60 years (Table). Sixteen were female. Genotype distribution was as follows: SS in 13 (39%), SC in 5 (15%), Sbeta-thalassemia in 3 (9%), not reported in 12 (36%). All but one case (97%) were associated with a vaso-occlusive crisis (VOC) and/or acute chest syndrome (ACS). One patient also developed multiorgan failure. One case occurred post dental surgery which led to a VOC. One case was associated with mandibular osteomyelitis and four others with infections. One patient presented with avascular osteonecrosis of the mandible. Comorbid medical conditions were reported as follows: rheumatoid arthritis treated with prednisone (1), pregnancy (1), type II diabetes (1) metastatic breast cancer treated by chemotherapy (1), membranoproliferative glomerulonephritis (1), asthma (1), retinal detachment (1) and splenectomy (1). X-Rays were the most utilized imaging modality (10 [30%]), followed by CT-scan (7 [21%]), magnetic resonance imaging (MRI) (6 [18%]) and bone scan (2 [6%]). Two X-Rays revealed subtle radiolucencies suggestive of bone infarction, 1 X-Ray changes consistent with avascular necrosis and 1 X-Ray lytic lesions typical of osteomyelitis. One patient had a normal X-ray, but a CT-scan showed loss of cortical condensation around the mental canal which corresponded on a bone scan to a region of slightly increased tracer uptake suggestive of infarction. The MRI for one patient with bilateral NCS showed increased T2 signal in both mandibular rami with associated small subperiosteal fluid collections. One patient had a lumbar puncture that was normal. Management of the neuropathy was mostly directed towards the underlying cause: treatment of VOC and SCD acute complications, antibiotics for infection, and tooth extraction for infectious control. Two patients received transfusions during their acute medical condition. The duration of symptoms ranged from a few hours to 14 years. Eleven patients (33%) were reported to have a complete resolution of NCS. Conclusion: We provide a systematic review of the clinical manifestations, investigations and management of NCS in patients with SCD. NCS occurred most often in the context of VOC/ACS. Radiological evidence of mandibular infarction was reported for some. Together, this suggests that vaso-occlusion and bone infarction could be pathophysiological mechanisms of NCS. Careful evaluation is warranted to rule out differential causes including local infection, avascular necrosis, primary neoplasm or metastatic disease. Publication bias, a small sample size, and author-dependant lexical variability used to describe NCS are some limitations to our review. Through this largest report of NCS in SCD, we draw attention to a rare and potentially underrecognized neurological complication that deserves further investigation to optimize management. Figure 1 Figure 1. Disclosures Soulieres: Novartis: Research Funding; BMS: Membership on an entity's Board of Directors or advisory committees. Forte: Novartis: Honoraria; Canadian Hematology Society: Research Funding; Pfizer: Research Funding.


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