Unusual abscesses associated with colon cancer: report of three cases

Three cases of colon cancer accompanied by unusual abscess formation are reported. Case I : A 77-year-old man was diagnosed with a paracolic abscess formation behind the cecum and a swollen appendix by computed tomography (CT) scan. Case II : An 85-year-old woman was diagnosed with an abscess formation of the right iliopsoas muscle, a swollen appendix, and a thickened right colon wall by CT scan. After antibiotic therapy failed, both patients underwent ileocecal resection urgently under suspicion of appendicitis, but cecal cancer around the entrance to the appendix caused secondary appendicitis in both cases. Case III : A 50-year-old woman was diagnosed with sigmoid colon cancer with an abscess formation in the pelvic cavity concomitant with ovarian tumor. A Hartmann procedure was performed, and a pathological examination revealed that a subserosal abscess behind the sigmoid colon cancer perforated the rectum with abscess formation. All cases were definitively diagnosed intraoperatively. The cancer recurred in cases I and III. We emphasize that precise surgical evaluation has an important role in the diagnosis of these complicated diseases. In addition, surgery affords the patient the best chance of recovery, and in these advanced cases radical treatment is recommended as early as possible

Utility of Contrast-Enhanced FDG-PET/CT in the Clinical Management of Pancreatic Cancer Impact on Diagnosis, Staging, Evaluation of Treatment Response, and Detection of Recurrence

Objectives: Fluorodeoxyglucose (FDG)-positron emission tomography/contrast-enhanced computed tomography (PET/CE-CT) involving whole-body scanning first by non-CE-CT and FDG-PET followed by CE-CT has been used for detailed examination of pancreatic lesions. We evaluated PET/CE-CT images with regard to differential diagnosis, staging, treatment response, and postoperative recurrence in pancreatic cancer. Methods: Positron emission tomography/CE-CT was conducted in 108 patients with pancreatic cancer and in 41 patients with other pancreatic tumor diseases. Results: The maximum standardized uptake value (SUVmax) overlapped in benign and malignant cases, suggesting that differential diagnosis of pancreatic tumors based on the SUVmax is difficult. In the evaluation of staging in 31 resectable pancreatic cancer by PET/CE-CT, the diagnostic accuracy rate was more than 80% for most factors concerning local invasion and 94% for distant metastasis but only 42% for lymph node metastasis. Significant positive correlations were found between the SUVmax and tumor size/markers, suggesting that SUVmax may be a useful indicator for the treatment response. Regarding the diagnosis of the postoperative recurrence, PET/CE-CT correctly detected local recurrence in all the 11 cases of recurrence, whereas abdominal CE-CT detected only 7 of 11 cases, suggesting that PET/CE-CT is superior in this context. Conclusions: Positron emission tomography/CE-CT is useful for the clinical management of pancreatic cancer

Comparison of PET image quality between germanium transmission attenuation-corrected images and combined PET/CT images.

Objectives: Combined PET/CT scanners have been developed. CT data obtained with such a PET/CT is used for attenuation correction of the PET data. Because the CT data are of higher spatial resolution and much lower noise than the transmission data from an external radionuclide source, such as Ge-68, combined PET/CT scanners should have an advantage in attenuated PET image quality. In this study, we compared the quality of actual patients PET images between traditionally attenuation-corrected images using transmission data from external radionuclide source and CT transmission attenuation-corrected images of PET/CT.\nMethods: Seventy-five clinical patients with a known or suspected neoplasm were entered into this study. There were fourteen lung cancers, twelve Head and Neck tumors, seven brain tumors, six cervical cancers of uterus, six rectal cancers, six ovarian tumors, five liver tumors, five bone and soft tissue tumors, three orbital tumors, three renal or adrenal tumors, three breast cancers, two bladder cancers, one esophageal tumor, one cardiac tumor and one pancreas cancer. Eighty-five sets of PET and PET/CT studies were done for seventy-five patients. Fifty C-11 methionine studies and thirty-five FDG studies were performed. Following a traditional PET scan with external radionuclide source, combined PET/CT scan was performed for each set of study. Each of the traditional PET images and combined PET/CT images were visually evaluated. \nResults: Emission images CT-corrected generally showed much lower noise than did germanium-corrected images. Small lesions near bladder such as rectal cancers were generally detected well by CT-corrected FDG PET images, though traditional PET showed much noise derived from FDG in the bladder. Although normal liver showed very high accumulaion of C-11 methionine and there were much noise around the liver, lesions near liver such as renal or adrenal lesions were also generally detected well by C-11 methionine PET/CT. A hepatocellular carcinoma showed fairly good accumulation of FDG by PET/CT, but traditional PET image was not able to detect the lesion because of much noise. \nConclusions: Combined PET/CT scanner showed an advantage in attenuated PET image quality as compared to traditional PET using the transmission data from an external radionuclide source.Society of Nuclear Medicine\u27s 50th Annual Meetin

Comparison of PET image quality between germanium transmission attenuation-corrected images and combined PET/CT images.

Objectives: Combined PET/CT scanners have been developed. CT data obtained with such a PET/CT is used for attenuation correction of the PET data. Because the CT data are of higher spatial resolution and much lower noise than the transmission data from an external radionuclide source, such as Ge-68, combined PET/CT scanners should have an advantage in attenuated PET image quality. In this study, we compared the quality of actual patients PET images between traditionally attenuation-corrected images using transmission data from external radionuclide source and CT transmission attenuation-corrected images of PET/CT.\nMethods: Seventy-five clinical patients with a known or suspected neoplasm were entered into this study. There were fourteen lung cancers, twelve Head and Neck tumors, seven brain tumors, six cervical cancers of uterus, six rectal cancers, six ovarian tumors, five liver tumors, five bone and soft tissue tumors, three orbital tumors, three renal or adrenal tumors, three breast cancers, two bladder cancers, one esophageal tumor, one cardiac tumor and one pancreas cancer. Eighty-five sets of PET and PET/CT studies were done for seventy-five patients. Fifty C-11 methionine studies and thirty-five FDG studies were performed. Following a traditional PET scan with external radionuclide source, combined PET/CT scan was performed for each set of study. Each of the traditional PET images and combined PET/CT images were visually evaluated. \nResults: Emission images CT-corrected generally showed much lower noise than did germanium-corrected images. Small lesions near bladder such as rectal cancers were generally detected well by CT-corrected FDG PET images, though traditional PET showed much noise derived from FDG in the bladder. Although normal liver showed very high accumulaion of C-11 methionine and there were much noise around the liver, lesions near liver such as renal or adrenal lesions were also generally detected well by C-11 methionine PET/CT. A hepatocellular carcinoma showed fairly good accumulation of FDG by PET/CT, but traditional PET image was not able to detect the lesion because of much noise. \nConclusions: Combined PET/CT scanner showed an advantage in attenuated PET image quality as compared to traditional PET using the transmission data from an external radionuclide source.Society of Nuclear Medicine\u27s 50th Annual Meetin