The prognostic role of end of treatment FDG-PET-CT in patients with diffuse large B cell lymphoma can be improved by considering it with absolute monocyte count at diagnosis

AbstractIt is well established that some patients with diffuse large B-cell lymphoma (DLBCL) and the negative end of treatment PET-CT (EOT-PET-CT) will relapse, while a proportion with positive upt..

Autonomous functioning thyroid nodules and 131I in diagnosis and therapy after 50 years of experience: What is still open to debate?

PURPOSE OF THE REPORT: Autonomous functioning thyroid nodules (AFTN), defined as "hot nodules" at thyroid scan, are often cured by radioiodine treatment. The aim of our study was to investigate the long-term outcome in patients treated with an I calculated dose, to identify a possible "size-tailored" dose, and to simplify follow-up procedures. PATIENTS AND METHODS: Retrospective analysis was carried out on 1402 cases, covering a period of 50 years, of AFTN treated with an I calculated dose. Our study focused on nodular size and mean administered dose. Concordance between thyroid scan and serum TSH levels at 3-6 months from treatment was considered. RESULTS: A single I dose was effective for the vast majority of patients (93%). The outcome was influenced by nodular size. On the basis of the Italian dose limit for outpatient treatment, our population was divided into subgroups according to administered doses (more or less than 16 mCi) and nodular dimensions: no differences in outcome were observed for each class of nodule size. A dose ≤10 mCi was effective on the smaller nodules (50.1% of our population). The agreement between TSH and scan after treatment was 90.3% at 3 months and 94.5% at 6 months. CONCLUSIONS: I therapy with a calculated dose is an effective treatment of AFTN. If a fixed dose is chosen, 16 mCi is often resolutive and for nodules 5 cm are eligible for surgery. TSH is the only parameter required to evaluate the outcome. © 2013 by Lippincott Williams & Wilkins

Neurometabolic Features of Takotsubo Syndrome: A Brain 18F-FDG PET Case Control-Prospective Study

Takotsubo syndrome (TTS) is an acute heart failure syndrome featured by transient left ventricular systolic dysfunction. TTS pathophysiology is still unclear.1 A retrospective analysis using brain 18F-fluorodeoxyglucose (18F-FDG) positron emission tomographic (PET)–computed tomography (CT) showed higher amygdala activity in subjects who subsequently developed TTS, suggesting a premorbid state.2 The aim of this study was to evaluate potential features of brain metabolism in TTS patients compared with a control group

Papillary thyroid cancer: Time course of recurrences during postsurgery surveillance

Context: The current use of life-long follow-up in patients with papillary thyroid cancer (PTC) is based largelyonthe study of individuals diagnosed and treated in the latter half of the 20th century when recurrence rates were approximately 20% and relapses detected up to 20-30 years after surgery. Since then, however, diagnosis, treatment, and postoperative monitoring of PTC patients have evolved significantly. Objectives: The objective of the study was to identify times to PTC recurrence and rates by which these relapses occurred in a more recent patient cohort. Patients and Design: We retrospectively analyzed follow-up data for 1020 PTC patients consecutively diagnosed in 1990-2008 in 8 Italian hospital centers for thyroid disease. Patients underwent thyroidectomy, with or without radioiodine ablation of residual thyroid tissue and were followed up with periodic serum thyroglobulin assays and neck sonography. Results: At the initial posttreatment (â\u89¤12 months) examination, 948 patients had no structural/functional evidence of disease. During follow-up (5.1-20.4 years; median 10.4 years), recurrence (cervical lymph nodes, thyroid bed) was diagnosed in 13 (1.4%) of these patients. All relapses occurred 8 or fewer years after treatment (10 within the first 5 years, 6 within the first 3 years). Recurrence was unrelated to the use/omission of postoperative radioiodine ablation. Conclusion: In PTC patients whose initial treatment produces disease remission (no structural evidence of disease), recurrent disease is rare, and it usually occurs during the early postoperative period. The picture of recurrence timing during the follow-up provides a foundation for the design of more cost-effective surveillance protocols for PTC patients. Copyright © 2013 by The Endocrine Society