74 research outputs found

    Pediatric reference intervals for thyroid hormone levels from birth to adulthood: a retrospective study

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    <p>Abstract</p> <p>Background</p> <p>Age- and sex-specific reference intervals are an important prerequisite for interpreting thyroid hormone measurements in children. However, only few studies have reported age- and sex-specific pediatric reference values for TSH<sub>basal </sub>(TSH), free T3 (fT3), and free T4 (fT4) so far. Reference intervals are known to be method- and population-dependent. The aim of our study was to establish reference intervals for serum TSH, fT3, and fT4 from birth to 18 years and to assess sex differences.</p> <p>Methods</p> <p>2,194 thyroid hormone tests obtained from a hospital-based pediatric population were included into our retrospective analysis. Individuals with diagnoses or medications likely to affect thyroid function were primarily excluded, as well as the diagnostic groups, if different from the purely healthy subgroup (n = 414). Age groups were ranging from 1 day to 1 month, 1 – 12 months, and 1 – 5, 6 – 10, 11 – 14, and 15 – 18 years, respectively. Levels of fT3, fT4 and TSH were measured on Advia<sup>® </sup>Centaur™ automated immunoassay system.</p> <p>Results</p> <p>The final sample size for reference data creation was 1,209 for TSH, 1,395 for fT3, and 1,229 for fT4. Median and 2.5/10/25/75/90/97.5 percentiles were calculated for each age group. Males had greater mean fT3 concentrations than females (p < 0.001). No sex-differences were found for TSH and fT4 between age-matched serum samples. Median concentrations of fT3, fT4 and TSH were greatest during the first month of life, followed by a continuous decline with age.</p> <p>Conclusion</p> <p>Our results corroborate those of previous studies showing that thyroid hormone levels change markedly during childhood, and that adult reference intervals are not universally applicable to children. Moreover, differences of our reference intervals compared to previous studies were observed, likely caused by different antibody characteristics of various analytical methods, different populations or undefined geographic covariates, e.g. iodine and selenium status.</p

    Biomarkers to personalize treatment with 177Lu-PSMA-617 in men with metastatic castration-resistant prostate cancer - a state of the art review

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    Radioligand therapy with Lutetium-177 (177Lu)-Prostate-specific membrane antigen (PSMA) has shown to prolong survival in metastatic castration resistant prostate cancer (mCRPC). One of the major challenges for clinicians in the future is to select those patients who would benefit most from this therapy to position it in the treatment landscape of mCRPC. This, in turn, will lead to the delivery of personalized therapies. In this narrative review article we summarize recent studies investigating both predictive and prognostic clinical, imaging-based, and molecular biomarkers to predict treatment response to 177Lu-PSMA-617 radioligand therapy with the aim of identifying men who should be considered for this approach. Of note, the evidence on the role of biomarkers currently relies on small retrospective trials and their validation in larger prospective cohorts is necessary before these results can be translated in the clinical practice

    Localization and prediction of malignant potential in recurrent pheochromocytoma/paraganglioma (PCC/PGL) using 18F-FDG PET/CT

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    Background: To our knowledge, data are lacking on the role of 18F-FDG PET/CT in the localization and prediction of neuroendocrine tumors, in particular the pheochromocytoma/paraganglioma (PCC/PGL) group. Purpose: To evaluate the role of 18F-FDG PET/CT in localizing and predicting the malignant potential of PCC/PGL. Material and Methods: Twenty-three consecutive patients with a history of PCC/PGL, presenting with symptoms related to catecholamine excess, underwent 18F-FDG PET/CT. Final confirmation of the diagnosis was made using the composite references. PET/CT findings were analyzed on a per-lesion basis and a per-patient basis. Tumor SUVmax was analyzed to predict the dichotomization of patient endpoints for the local disease and metastatic groups. Results: We investigated 23 patients (10 men, 13 women) with a mean age of 46.43±3.70 years. Serum catecholamine levels were elevated in 82.60% of these patients. There were 136 sites (mean SUVmax: 16.39±3.47) of validated disease recurrence. The overall sensitivities for diagnostic CT, FDG PET, and FDG PET/CT were 86.02%, 87.50%, and 98.59%, respectively. Based on the composite references, 39.10% of patients had local disease. There were significant differences in the SUVmax distribution between the local disease and metastatic groups; a significant correlation was noted when a SUVmax cut-off was set at 9.2 (P<0.05). Conclusion: In recurrent PCC/PGL, diagnostic 18F-FDG PET/CT is a superior tool in the localization of recurrent tumors. Tumor SUVmax is a potentially useful predictor of malignant tumor potential

    Detection of sarcomatoid lung metastasis with 68GA-PSMA PET/CT in a patient with prostate cancer

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    none5siA 70-year-old man with prostate cancer (adenocarcinoma; pT3aN0Mx; GS: 4 + 4) underwent radical prostatectomy and lymph node dissection in February 2008. In December 2009, biochemical recurrence occurred and prostate-specific antigen progressively increased to 4.63 ng/mL despite local salvage radiotherapy and androgen deprivation. 68Ga-PSMA PET/CT showed a positive left iliac lymph node and a pathological left pulmonary lesion, which was highly positive in a subsequent 18F-FDG PET/CT. Lymph node resection confirmed an adenocarcinoma metastasis of the prostate cancer and lung surgery demonstrated a sarcomatoid metastasis of prostate cancer. After surgery, prostate-specific antigen decreased to 0.03 ng/mL.openGeraldo, Llanos*; Ceci, Francesco; Uprimny, Christian; Kendler, Dorota; Virgolini, IreneGeraldo, Llanos*; Ceci, Francesco; Uprimny, Christian; Kendler, Dorota; Virgolini, Iren

    Detection of sarcomatoid lung metastasis with 68GA-PSMA PET/CT in a patient with prostate cancer

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    A 70-year-old man with prostate cancer (adenocarcinoma; pT3aN0Mx; GS: 4 + 4) underwent radical prostatectomy and lymph node dissection in February 2008. In December 2009, biochemical recurrence occurred and prostate-specific antigen progressively increased to 4.63 ng/mL despite local salvage radiotherapy and androgen deprivation. 68Ga-PSMA PET/CT showed a positive left iliac lymph node and a pathological left pulmonary lesion, which was highly positive in a subsequent 18F-FDG PET/CT. Lymph node resection confirmed an adenocarcinoma metastasis of the prostate cancer and lung surgery demonstrated a sarcomatoid metastasis of prostate cancer. After surgery, prostate-specific antigen decreased to 0.03 ng/mL
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