Novel Coronavirus Pneumonia and Cardiomyopathy: A Case Report

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Imaging in occupational lung diseases

This chapter consists of a review of the literature regarding radiographic and tomographic characteristics of the principal occupational respiratory diseases (silicosis and asbestosis). Special attention is given to the practical relevance of high-resolution computed tomography, which is the most sensitive and specific method of identifying and quantifying the extent of pleural and parenchymal lesions related to such diseases.A presente revisão apresenta as características radiográficas e tomográficas das principais doenças ocupacionais respiratórias (silicose e asbestose). Em especial, enfatiza-se a relevância prática da tomografia computadorizada de alta resolução, método mais sensível e específico para a detecção e quantificação da extensão das lesões pleuroparenquimatosas a elas relacionadas.Universidade Federal de São Paulo (UNIFESP)Memorial Sloan-Kettering Cancer CenterUniversidade de São Paulo Faculdade de Medicina Hospital das ClínicasUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de DiagnósticoUNIFESP, EPM, Depto. de DiagnósticoSciEL

O PET/CT interim com fluoreto- 18 F é capaz de predizer desfechos após a terapia com rádio-223?

To dichloride ( 223 RaCl 2 ) therapy is able to identify patients that will not respond to treatment. We retrospectively reviewed 34 histologically confirmed cases of hormone-refractory prostate cancer with bone metastasis in patients submitted to 223 RaCl 2 therapy. All of the patients underwent baseline and interim 18 F-fluoride PET/CT studies. The interim study was performed immediately prior to the fourth cycle of 223 RaCl 2 . The skeletal tumor burden—expressed as the total lesion fluoride uptake above a maximum standardized uptake value of 10 (TLF 10 )—was calculated for the baseline and the interim studies. The percent change in TLF 10 between the baseline and interim studies (%TFL 10 ) was calculated as follows: %TFL 10 = interim TLF 10 − baseline TLF 10 / baseline TLF 10 . End points were overall survival, progression-free survival, and skeletal-related events. The mean age of the patients was 72.4 ± 10.2 years (range, 43.3–88.8 years). The %TLF 10 was not able to predict overall survival (p = 0.6320; hazard ratio [HR] = 0.753; 95% confidence interval [CI]: 0.236–2.401), progression-free survival (p = 0.5908; HR = 1.248; 95% CI: 0.557–2.797) nor time to a bone event (p = 0.5114; HR = 1.588; 95% CI: 0.399–6.312). The skeletal tumor burden on an interim 18 F-fluoride PET/CT, performed after three cycles of 223 RaCl 2 , is not able to predict overall survival, progression-free survival, or time to bone event, and should not be performed to monitor response at this time5213340FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPnão temAvaliar se o PET/CT interim com fluoreto-18F após a terceira dose da terapia com dicloreto de rádio-223 (223Ra) é capaz de identificar pacientes que não responderão ao tratamento. Revisamos, retrospectivamente, 34 pacientes com diagnóstico histológico de câncer de próstata refratários a hormonioterapia e com metástases ósseas que foram submetidos a 223Ra. Todos os pacientes foram submetidos a PET/CT com fluoreto-18F antes de iniciar o tratamento (basal) e imediatamente antes da quarta dose de 223Ra (interim). A carga tumoral esquelética (TLF10) foi calculada em ambos os exames da PET/CT com fluoreto-18F de cada paciente e foi determinada a alteração percentual na TLF10 entre eles (%TFL10 = TLF10 interim - TLF10 basal / TLF10 basal). Foram avaliados a sobrevida global, a sobrevida livre de progressão e o tempo para um evento ósseo. A idade média dos pacientes foi 72,4 ± 10,2 anos (variação: 43,3-88,8 anos). A %TLF10 não foi capaz de predizer a sobrevida global (p = 0,6320; HR = 0,753; intervalo de confiança [IC] 95%: 0,236-2,101), a sobrevida livre de progressão (p = 0,5908; HR = 1,248; IC 95%: 0,557-2,797) nem o tempo para um evento ósseo (p = 0,5114; HR = 1,588; IC 95%: 0,399-6,312). A carga tumoral esquelética da PET/CT com fluoreto-18F realizada após três doses de 223Ra não é capaz de predizer sobrevida global, sobrevida livre de progressão ou tempo até um evento ósseo, e não deve ser realizada para monitorar a resposta ao tratamento desses pacientes, nesse momento

Change in Nephrometry Scoring in Small Renal Masses (<4cm) on Active Surveillance: Preliminary Observations from Tayside Active Surveillance Cohort (TASC) Study

Rationale and Objectives: - Prediction of growth, in particular knowing the possibility of aggressive cancer in small renal masses on active surveillance, remains poorly understood. The study was designed to determine whether serial nephrometry score measurements could predict possibility of aggressive malignancy (grade of cancer) in patients with small renal masses opting for active surveillance initially. Materials and Methods: - One hundred sixteen patients between January 2000 and December 2016 undergoing partial nephrectomy were recruited. Out of these, 97 were analyzed using different nephrometry scoring systems. Measurement of nephrometry scores (Radius of tumors, Exo/Endophytic; Nearness of tumors to the collecting system or sinus; Anterior/posterior; Location in relation to polar lines, Preoperative Aspects and Dimensions Used for Anatomical, Centrality Index) was performed by two researchers. Among the patients opting for partial nephrectomy, 40 were on active surveillance for at least 12 months (mean 32; 12-60 months) before partial nephrectomy. Computed tomography scan images of these patients were retrieved and analyzed including comparison to histopathology. Results: - Nephrometry scores measured on serial computed tomography scan images showed a significant correlation between change in score and grade of cancer on multivariate analysis (P value .001). Addition of multivariate analysis to nomogram based on change in size alone did not improve predictive value of area under the curve significantly. Conclusions: - Change in nephrometry scoring measurements correlates with grade of cancer in small renal masses but falls short of significantly predicting presence of malignancy or grade of cancer on nomogram in patients opting for active surveillance for small renal masses. At present, this approach may be inadequate for decision-making

Multi-detector row computed tomography angiography of peripheral arterial disease

With the introduction of multi-detector row computed tomography (MDCT), scan speed and image quality has improved considerably. Since the longitudinal coverage is no longer a limitation, multi-detector row computed tomography angiography (MDCTA) is increasingly used to depict the peripheral arterial runoff. Hence, it is important to know the advantages and limitations of this new non-invasive alternative for the reference test, digital subtraction angiography. Optimization of the acquisition parameters and the contrast delivery is important to achieve a reliable enhancement of the entire arterial runoff in patients with peripheral arterial disease (PAD) using fast CT scanners. The purpose of this review is to discuss the different scanning and injection protocols using 4-, 16-, and 64-detector row CT scanners, to propose effective methods to evaluate and to present large data sets, to discuss its clinical value and major limitations, and to review the literature on the validity, reliability, and cost-effectiveness of multi-detector row CT in the evaluation of PAD

Clinical presentation and diagnostic methods of Takayasu arteritis – case study

Takayasuov arteritis vrlo je rijedak oblik vaskulitisa karakteriziran nejasnim simptomima u ranim fazama bolesti, koji nerijetko ostanu neliječeni kroz dulje vrijeme. U mnogim se slučajevima dijagnoza Takayasuovoga arteritisa postavlja u drugoj fazi bolesti kada su razvijene komplikacije kao posljedica stenozirajućih promjena na krvnim žilama. Kolor dopler je metoda koju treba izabrati za evaluaciju i praćenje promjena na stijenkama krvnih žila u svim fazama te bolesti.Takayasu arteritis is a rare form of vasculitis characterized in early phases of the disease by unclear symptoms which may not be recognized for a long period of time. In the majority of Takayasu arteritis cases the diagnosis is first established in the second phase of the disease when the majority of possible complications occur as a consequence of arterial stenosis. Color doppler flow imaging is the diagnostic method of choice for evaluation and follow up of the artery wall thickening progression in all phases of the disease

Management of COPD:Is there a role for quantitative imaging?

While the recent development of quantitative imaging methods have led to their increased use in the diagnosis and management of many chronic diseases, medical imaging still plays a limited role in the management of chronic obstructive pulmonary disease (COPD). In this review we highlight three pulmonary imaging modalities: computed tomography (CT), magnetic resonance imaging (MRI) and optical coherence tomography (OCT) imaging and the COPD biomarkers that may be helpful for managing COPD patients. We discussed the current role imaging plays in COPD management as well as the potential role quantitative imaging will play by identifying imaging phenotypes to enable more effective COPD management and improved outcomes