Evaluation of the Effectiveness of Bevacizumab Treatment in Patients with Metastatic Colorectal Cancer with PET-CT

Purpose: To evaluate the response to therapy with PET-CT in metastatic colorectal cancer patients treated with Bevacizumab and chemotherapy.Methods: Twenty-two patients with metastatic colorectal cancer that were treated with bevacizumab and 6 cycles of chemotherapy were evaluated by whole-body PET-CT scan before and after the treatment in accordance with the European Organization for Research and Treatment of Cancer criteria.Results: While 31.8% of patients responded to treatment (complete response + partial response), 68.2% did not respond to treatment (stable disease + progressive disease). The mean hepatic, extra hepatic, abdomen, lung and bone metastases SUVmax values were higher after treatment in comparison to the pre-treatment values. There was an increase in SUVmax values in those who did not respond to the treatment, while a decrease was observed in those who responded to the treatment. Survival was significantly increased in all patients that responded to the treatment. The difference in terms of gender, histological subtype, histological grade, primary tumor location, presence of metastases in regional lymph nodes and liver at the time of diagnosis or the response to the treatment was not statistically significant.Conclusions: In this study we detected metabolic response before anatomical response with PET-CT in one third of metastatic colorectal cancer patients treated with Bevacizumab and chemotherapy. This finding suggests that PET-CT may be used as a measure to follow therapy response and predict the prognosis in metastatic colorectal cancer patients

Choledochoduodenal fistula: An unusual cause of recurrent cholangitis in children

Choledochoduodenal fistula (CDF) is an unusual clinical entity and a diagnostic challenge in children. We herein present CDF as an unusual cause of recurrent cholangitis in a 6-year-old child. To the best of our knowledge, this is the youngest patient reported until date. In this paper, we also highlight possible etiologic factors, presenting symptoms, diagnostic methods, and treatment modalities of CDF

A Practical MRI Technique for Detecting Abdominal Aorta Aneurysm and Peripheral Arterial Disease

WOS: 000376566800003Aim: Peripheral Arterial Disease(PAD) and abdominal aorta aneurysm(AAA) are frequent problems in geriatric population. In DSA, CTA or MRA techniques contrast agents has to be used for diagnosis that can be nephrotoxic for elderly patients. Magnetic resonans imaging (MRI) is the most powerful, non-ionising radiological diagnostic tool that has the highest soft tissue contrast resolution. The aim of our study was to investigate the effectivity of MRI by the means of detecting the AAA and PAD in comparison with DSA. Material and Method: After getting ethical commitee approvel and informed consent, we have performed Balanced turbo field echo(B-TFE) MRI technique without contrast agent in 1.5 Tesla MRI device before DSA examination. The luminal diameters of renal arteries, infrarenal abdominal aorta, iliac and femoral arteries was measured by using Philips DICOM Viewer R2.2 application. The intraclass corelation coefficient and reliability used to check if the techniques could be used for each other and the t-test was used to measure the differences between them. Results: There has been a high relationship between B-TFE and DSA in detecting the pathologies of larger arteries like aorta. In the case of small arterial pathologies, there is relatively lower relationship between BTFE and DSA. Discussion: For the diagnosis of AAA and PAD, DSA is the gold standart technique but it is invasive and patients have radiation exposure. In the follow up of geriatric patients with larger arterial pathologies B-TFE can be used instead of contrast enhanced MRA and invasive DSA

PULMONARY EMBOLISM: CARDIOVASCULAR AND PARENCHYMAL CHANGES

WOS: 000435654000009Aim: To investigate the effects and the severity of pulmonary embolism on the cardiovascular system and lung parenchyma. Material and Method: Pulmonary artery (PA) obstruction index ratios were calculated, and cardiovascular and pleuroparenchymal changes were retrospectively assessed in 180 patients with a prediagnosis of PE using computerized tomography pulmonary angiography (CTPA). Results: Main PA, right PA, and mean superior vena cava (VCS) diameters, right (RV) and left ventricle (LV) short diameters, and RV/LV ratios in patients with PE were increased (p<0.001, p=0.004, p=0.007, p=0.01, p=0.001, respectively) and correlated with the obstruction index ratio (OIR). Also, the convexity of the interventricular septum, VCI, and vena azygos reflux frequency were increased with PE (p<0.001, p=0.001, p=0.001) and with massive PE (p<0.001, p=0.003, p<0.001). It was determined that the frequency of the presence of wedge-shaped opacities and vein mark findings was increased in patients with PE (p<0.001, p<0.001); however, it was found less frequently in patients with massive PE when compared to the submassive patients (p=0.002, p=0.014). The presence of atelectasis was not different between patients with and without PE; consolidation, ground glass appearance, oligemia frequency, and the average scores were increased in the patients with PE (p=0.02, p<0.001, p=0.001), and there was a positive correlation between the oligemia score and OIR (r=0.202, p=0.027). Pleural effusion was infrequent with PE. Discussion: CTPA is a rapid and reliable method for the determination of the severity of PE, affected vascular structures and lung regions, and for the assessment of right heart function

Comparing 1470-and 980-nm diode lasers for endovenous ablation treatments

WOS: 000356531400022PubMed: 25990260The purpose of this study was to compare the effectiveness of 1470- and 980-nm lasers with regard to power output, complications, recanalization rates, and treatment response. We prospectively evaluated the effectiveness of endovenous laser ablation (EVLA) in a total of 152 great and small saphenous veins from 96 patients. Lasers were randomly used based on the availability of the units. Patients were clinically evaluated for Clinical Etiologic Anatomic Pathophysiologic (CEAP) stage and examined with Doppler ultrasound. Treatment response was determined anatomically by occlusion of the vein and clinically by the change in the venous clinical severity score (VCSS). Seventy-eight of the saphenous veins underwent EVLA with a 980-nm laser and 74 underwent EVLA with a 1470-nm laser. Treatment response was (68) 87.2 % in the 980-nm group and (74) 100 % in the 1470-nm group (p = 0.004). The median VCSS decreased from 4 to 2 in the 980-nm group (p < 0.001) and from 8 to 2 (p < 0.001) in the 1470-nm group. At 1-year follow-up, seven veins treated with 980 nm and two veins treated with 1470 nm were recanalized (p = 0.16); the average linear endovenous energy density (LEED) was 83.9 (r, 55-100) J/cm and 58.5 (r, 45-115) J/cm, respectively (p < 0.001). Postoperative minor complications occurred in 23 (29.4 %) limbs in the 980-nm group and in 19 (25.6 %) limbs of the 1470-nm group (p = 0.73). EVLA with the 1470-nm laser have less energy deposition for occlusion and better treatment response