Role of [18F]-FDG-PET/MDCT in evaluating early response in patients with Hodgkin's lymphoma.

PURPOSE: The authors evaluated the prognostic role of 18-fluoro-fluorodeoxyglucose positron emission tomography/multidetector computed tomography ([(18)F]-FDG PET/MDCT) in treating patients with Hodgkin's lymphoma (HL). MATERIALS AND METHODS: We retrospectively evaluated 132 patients with HL studied with PET/MDCT before the start of chemotherapy (CTX) for staging purposes and again after two CTX cycles with [doxorubicin (Adriblastin), bleomycin, vinblastine, dacarbazine (ABVD_] (interim PET/MDCT), at least 30 days after the end of the last CTX cycle and/or 3 months after the end of radiotherapy, if delivered (final PET-MDCT). RESULTS: Interim PET-MDCT was negative in 104/132 patients (79%), and their final PET-MDCT showed complete remission in 102/104 (98%) of cases, with disease recurrence/persistence in two (2%). In the remaining 28 (21%) patients, interim PET-MDCT revealed an early response in 68% of cases and chemoresistance with disease progression in 32% of cases; in these 28 patients, final PET-MDCT showed a lack of response to treatment in 43% of cases (43%) and complete remission in 57% of cases. Statistical analysis of these data showed that interim PET-MDCT had a negative predictive value of 98% and a positive predictive value of 42%, with values of sensitivity, specificity and diagnostic accuracy of 85.7%, 86.4% and 86.4%, respectively. CONCLUSIONS: Interim PET-MDCT has a reliable prognostic role in diagnosis and treatment of patients with HL, as it helps predict which patients are more likely to achieve a complete response at the end of treatment. PET/MDCT may also lead to a change in treatment, with reduced treatment-related toxic effects and significantly reduced total costs

Methicillin resistant- and Methicillin susceptible Staphylococcus aureus: comparison of genomic similarity of strains isolated from human and veterinary specimens using amplified fragment length polymorphism (AFLP).

In consequence of a previous study on Methicillin-resistant (MRSA) and Methicillin-susceptible (MSSA) Staphylococcus aureus isolated from veterinary samples, a correlated study was carried out to evaluate the genetic relatedness among MRSA and MSSA isolated from human and veterinary specimens using the amplified fragment length polymorphism (AFLP) fingerprinting technique. Twenty-four out of 32 veterinary strains and 21 out of 29 human strains were MRSA. The methicillin resistance was evaluated with E-test and the presence of mec A gene was confirmed with PCR. The results of the genomic analysis revealed that all the isolated strains were distinct. An analysis of molecular variance (AMOVA) was also carried out to verify the distribution of variance a) among and within strains of different origin (human and veterinary) and b) among and within MRSA and MSSA strains. The results showed that in both cases the major component of variance was within strains (76.66 and 92.55%, respectively, for the first and second case). A more accurate molecular technique, like AFLP rather PFGE, and the use of a sophisticate statistical analysis, like AMOVA, are strictly recommended to avoid that different strains are wrongly considered correlated

Is cerebral glucose metabolism affected by chemotherapy in patients with Hodgkin's lymphoma?

OBJECTIVE: The aim of the study was to investigate the effect of chemotherapy treatment with ABVD on brain glucose metabolism in patients with Hodgkin's disease (HD). METHODS: A total of 49 patients (23 men, 26 women; mean age 32±9 years) diagnosed with HD were included in the study. All of them underwent a baseline (PET0) and an interim (PET2) 2-deoxy-2-[(18)F]fluoro-D-glucose ((18)F-FDG) PET/computed tomography (CT) brain scan. All patients were treated after PET0 with two cycles of ABVD consisting of doxorubicin (adriamycin), bleomycin, vinblastine, and dacarbazine for 2 months. Thirty-five patients were evaluated further 15±6 days after four additional cycles (PET6). Differences in brain (18)F-FDG uptake were analyzed by statistical parametric mapping (SPM2). RESULTS: Compared with PET0, PET2 showed a significantly higher metabolic activity in the right angular gyrus (Brodmann area 39) and a significant metabolic reduction in Brodmann areas 10, 11, and 32 bilaterally. All these changes disappeared at PET6. CONCLUSION: Our results support the conclusion of a very limited impact of ABVD chemotherapy on brain metabolism in patients with HD