Chronic bronchitis mimicking metastases from thyroid medullary carcinoma demonstrated by indium-111 pentetreotide scintigraphy

We present a case of medullary thyroid carcinoma (MTC) with pulmonary symptoms, elevated calcitonin and CEA levels. Both [111In]pentetreotide (Octreoscan) scintigraphy and 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) scan revealed mild increased uptake of radionuclides in the upper lobe of the right lung compatible with metastases. Histopathological analysis showed it to be chronic bronchitis. The patient was followed without any treatment. Three months later, no pathological uptake on [111In]pentetreotide (Octreoscan) was observed. False positive [111In]pentetreotide uptake in the lungs was likely related to acute exacervation of the chronic bronchitis

Abdominal lymph node metastasis in patients with non-small-cell lung cancer as shown by PET/CT

Purpose: The aim of this study is to investigate the frequency and the spread of abdominal lymph node metastasis in patients with non-small-cell lung cancer (NSCLC) by F-FDG PET/CT. Patients and Methods: Retrospective evaluation of the F-FDG PET/CT examinations of 1191 patients diagnosed with NSCLC was performed. The metastatic abdominal lymph nodes of the patients were classified as inside the routine imaging field (covering the field of chest CT including adrenal glands) and outside the field. Results: Seventy-four patients (6 F, 68 M; mean: 61 ± 11 years old) among 1191 patients (6%) were identified to have abdominal lymph node metastases. These abdominal lymph node metastasis changed management in 10 out of 74 patients (14%), and there were lymph node metastases outside the routine conventional imaging field in 43 (58%) patients. Conclusions: F-FDG PET/CT provided identification of the distant metastatic lymph nodes out of conventional imaging field in more than half of NSCLC patients with abdominal metastasis which changed patient management in 14% of the patients due to abdominal lymph node metastasis outside the routine imaging field. This study shows the necessity of imaging NSCLC patients with an imaging protocol with larger imaging field like PET/CT. © 2013 by Lippincott Williams & Wilkins

Urine endothelin-1 levels as a predictor of renal scarring in children with urinary tract infections

Aims: Endothelin-1 (ET-1) contributes to renal fibrogenesis in several manners such as increasing collagen synthesis in mesangium, decreasing extracellular matrix (ECM) degradation by mesangial cells and stimulating mesangial contraction. The aim of our study was to investigate whether urine level of ET-1 (uET-1) could represent a useful biomarker of renal scarring and if so, to determine the optimal cut-off level for uET-1 to predict a renal scar. Methods: 44 children with renal scarring and 32 children without renal scarring were enrolled in the study. Urine ET-1 was measured by enzyme-linked immunosorbent assay. Results: Mean uET-1 level was significantly higher in the scar group than in controls (2.75 +/- 1.35 fmol/ ml vs. 0.68 +/- 0.41 fmol/ml, p = 0.001). The optimal cut-off level was 1.064 fmol/ml for uET-1 to predict renal scarring. Using this cut-off point, sensitivity and specificity were 97.73% and 93.91%, respectively. AUC was found 0.975 (95% CI 0.917 - 0.996) for uET-1. Mean urine Endothelin-1/Creatinine ratio (uET-1/Cr) was also significantly higher in the scar group than in the control group (4.04 +/- 2.29 fmol/mg Cr vs. 1.09 +/- 0.67 fmol/mg Cr, p = 0.0001). Using 1.67 fmol/mgCr as optimal cut-off level, sensitivity and specificity were 95.45% and 84.09%, respectively. AUC was 0.945 (95% CI 0.875 - 0.982) for uET-1/Cr. Conclusion: Our study suggests that both uET-1 and tiET-1/Cr can be used for prediction of renal scarring in children with normal renal function. Measuring urine level of ET-I can help us to avoid unnecessary DMSA studies if the patient's uET-1 level is found to be under the determined cut-off point

Radioguided Surgery of Thyroid Carcinoma Recurrences

Current application of radioguided techniques for treatment of papillary thyroid cancer recurrence