SPECT/CT-Infektdiagnostik am Skelett

Zusammenfassung: Klinisches/methodisches Problem: Knöcherne Infekte stellen nicht selten eine diagnostische und klinische Herausforderung dar. Radiologische Standardverfahren: Nuklearmedizinische Standardverfahren für die Diagnostik akuter und chronischer Knocheninfekte sind die Mehrphasenskelettszintigraphie und die Infektszintigraphie mit markierten Leukozyten. Methodische Innovationen: Die Einführung von Hybridtechnologien wie der SPECT/CT hat die nuklearmedizinische Infektbildgebung tiefgreifend verändert. Leistungsfähigkeit: Die SPECT/CT erlaubt bei der Frage nach Knocheninfekten insgesamt eine wesentlich genauere Beurteilung als planare Aufnahmen und SPECT. Bewertung: Die integrierte Akquisition von metabolischer, funktioneller und topographisch-morphologischer Information mit SPECT/CT steigerte insbesondere die Spezifität der Mehrphasenskelettszintigraphie und der Infektszintigraphie mit markierten Leukozyte

Therapeutic impact of 2-[fluorine-18]fluoro-2-deoxy-D-glucose positron emission tomography in the pre- and postoperative staging of patients with clinically intermediate or high-risk breast cancer

Background: Positron emission tomography with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG-PET) is an accurate imaging modality for the staging of breast cancer. The aim of this study was to determine the potential therapeutic impact of pre- and postoperative FDG-PET in patients with clinically intermediate or high-risk breast cancer. Patients and methods: One hundred and fourteen patients with newly diagnosed breast cancer were examined before (73) or after (41) surgery. Patient data were translated into three scoring sheets corresponding to information available before positron emission tomography (PET), after PET and after further diagnostic tests. Three medical oncologists independently reviewed the retrospectively acquired patient data and prospectively made decisions on the theoretically planed treatment for each time point, according to the recommendations of St Gallen Consensus Guidelines 2005. Results: FDG-PET changed the planed treatment in 32% of 114 patients. In 20% of cases, therapeutic intention (curative versus palliative) was modified. Radiation treatment planning was changed in 27%, surgical planning in 9%, chemotherapy in 11% and intended therapy with bisphosphonates in 13% of all patients. Conclusion: Based on current treatment guidelines, FDG-PET, as a staging procedure in patients with newly diagnosed clinically intermediate or high-risk breast cancer examined pre- and postoperatively, may have a substantial therapeutic impact on treatment plannin

Cardiac Implantable Electronic Device-Related Infection Due to Granulicatella adiacens.

Cardiac implantable electronic device-related infection is clinically challenging. Curative treatment commonly includes system removal. A case caused by Granulicatella adiacens occurred in a 32-year-old woman. Clinical course, literature review, and biofilm investigations enabled successful antibiotic management without system removal