Pronostic value of pretherapeutic 18F-FDG PET/CT in cancer of the uterine cervix: a retrospective study of 53 patients].

International audienceOBJECTIVES: Assessment of prognostic value of pretherapeutic (18)F-FDG PET/CT (PET). PATIENTS AND METHODS: Retrospective study of 53 patients with invasive uterine cervix carcinoma. Each patient has been evaluated with pretherapeutic whole-body FDG PET/CT and pelvic MRI. Minimal follow-up lasted for 1 year. On PET/CT, we have visually analyzed metabolism of primary tumor, pelvic and para-aortic lymph nodes in comparison with surrounding structures. We have compared prognostic factors as pretherapeutic haemoglobin rate, FIGO staging, MRI and PET/CT data using Mann-Whitney univariate analysis and Cox multivariate analysis. RESULTS: Para-aortic lymph node abnormal uptake on PET/CT was the only independent predictor of progression-free survival. Pelvic lymph node involvement on PET/CT was the only independent predictor of overall survival. MRI did not provide any additional information. DISCUSSION AND CONCLUSION: Lymph node involvement visually assessed by (18)F-FDG PET/CT was the most significant prognostic factor for overall and progression-free survival

[Desmoid tumor of the breast in a 9 years old little girl].

International audienceAggressive fibromatosis (desmoid tumour) of the breast is a rare tumour that accounts only for 0.2% of primary breast tumours. This is a benign mesenchymal tumour that develops from muscular fasciae and aponeuroses. It is characterized by its local evolution and its tendency to relapse without metastasizing. Wide radical resection should be attempted whenever possible. Positive margins at resection and reoperation are associated with a high risk of local recurrence. The role of radiotherapy and of medical treatments- especially anti-estrogens - remains unclear. We report here the case of desmoid tumour of the breast arising in a 9-year-old little girl

Prospective comparison of FDG PET/CT and diffusion-weighted MRI for para-aortic metastases detection in cancer of the uterine cervix.

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Does chemotherapy influence the quantification of SUV when contrast-enhanced CT is used in PET/CT in lymphoma?

International audiencePURPOSE: In patients with lymphoma, we investigated the impact of contrast-enhanced CT on PET attenuation correction in lesions and normal tissues, particularly when PET/CT was performed after chemotherapy. METHODS: Fifty patients (51+/-18 years) with Hodgkin's disease (n=17) or non-Hodgkin lymphomas (n=33) were studied before and after chemotherapy. PET/CT scans were performed 60 min after injection of FDG. Iopamiron 300 (iopamidol, 1.5 cc/kg) was injected immediately afterwards, followed 50 s later by a second craniocaudal CT (CT+). PET images were successively reconstructed using the unenhanced CT (PET-) and the CT+ (PET+) for attenuation correction, using iterative reconstruction (4 iterations, 8 subsets, 5 mm post-filtering). HU(mean), SUV(max) and SUV(mean) were measured before and after chemotherapy in ten non-tumoural ROIs [aorta, femur, kidney, lung, iliopsoas muscle, occipital cortex, T12 vertebra, liver, spleen and inferior vena cava (IVC)] and in tumoural lymphadenopathies or malignant tissues (n=397 and 51 VOIs respectively before and after chemotherapy) using a 3D-thresholding method (identical threshold for PET- and PET+). ROIs were defined on the PET- and automatically applied on the unenhanced CT (CT-), the CT+ and the PET+. RESULTS: In the non-tumoural tissues, HU(mean) increased significantly in the CT+ compared with the CT- in the vessels and the highly vascularised organs, and slight increases were observed in the occipital cortex (+11%), the iliopsoas muscle (+6%) and the femur (+3%). SUV(max) increased significantly in the PET+ compared with the PET- in the aorta (+14%), the liver (+10%), the spleen (+10%) and the IVC (+12%). SUV(mean) increased significantly in the PET+ compared with the PET- in the aorta (+15%), the kidney (+13%), the liver (+11%), the spleen (10%) and the IVC (+12%). In the lesions, HU(mean) was not significantly different before and after chemotherapy, whatever the normal region considered. SUV(max) increased significantly after treatment in the T12 vertebra (+12%). SUV(mean) increased significantly after treatment in the T12 vertebra (+13%) and in the liver (+12%). HU(mean) increased significantly in the CT+ compared with the CT- in the lesions (+55%) before chemotherapy. SUV(max) and SUV(mean) increased significantly in the PET+ compared with the PET- in the lesions (+4%) only before chemotherapy. No significant difference was seen in measurements (HU(mean), SUV(max) and SUV(mean)) after chemotherapy. CONCLUSION: Our study demonstrates that use of enhanced CT for attenuation correction has a negligible effect on quantification at staging and after chemotherapy. A "single-shot" enhanced PET/CT may thus be performed in the evaluation of patients with lymphoma at staging, during treatment and at follow-up

Influence of PET/CT on radiologists and contrast-enhanced CT on nuclear medicine physicians in patients with lymphoma.

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