Lymph Node Staging with Choline PET/CT in Patients with Prostate Cancer: A Review

Due to its prevalence, prostate cancer represents a serious health problem. The treatment, when required, may be local in case of limited disease, locoregional if lymph nodes are involved, and systemic when distant metastases are present. In order to choose the best treatment regimen, an accurate disease staging is mandatory. However, the accuracy of conventional imaging modalities in detecting lymph node and bone metastases is low. In the last decade, molecular imaging, particularly, choline PET-CT has been evaluated in this setting. Choline PET represents the more accurate exam to stage high-risk prostate cancer, and it is useful in staging patients with biochemical relapse, in particular when PSA kinetics is high and/or PSA levels are more than 2 pg/ml. The present paper reports results of available papers on these issues, with particular attention to lymph node staging

A simple and accurate dosimetry protocol to estimate activity for hyperthyroidism treatment

BACKGROUND: Aim of the study was to evaluate accuracy of different dosimetry protocols in estimating the required 131I activity to treat hyperthyroid patients. MATERIALS AND METHODS: Forty consecutive patients were analysed: twenty-eight Graves’ disease; twelve autonomous thyroid nodule (ATN). Maximum-uptake, effective half-time and residence-time were estimated from Radioiodine Uptake Test. Residence-time was estimated using a bi-compartmental model. For 131I activity calculation, algorithms laid down in European Association of Nuclear Medicine (EANM) guidelines, ICRP 53 approach and a mono-exponential formula (ME), were compared with OLINDA/EXM results. RESULTS: Based on EANM guidelines, activities to be administered were 3% higher in Graves’ disease (p = 0.001) and 3% higher in ATN (p = 0.046). Calculated activities using ICRP 53 approach were significantly lower compared to OLINDA/EXM: 33% in Graves’ disease; 17% in ATN. Activities recommended by ME, were significantly higher: in Graves’ disease 20%; 42% in ATN. CONCLUSIONS: Only EANM algorithm predict quite well, compared to OLINDA/EXM, the required activity to treat hyperthyroid patients

Fluorodeoxyglucose-positron emission tomography/computed tomography in the staging and evaluation of treatment response in a patient with Castleman's disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Castleman's disease is a rare lymphatic polyclonal disorder that is characterised by unicentric or multicentric lymph node hyperplasia and non-specific symptoms and signs including fever, asthenia, weight loss, enlarged liver and abnormally high blood levels of antibodies.</p> <p>Case presentation</p> <p>We present the case of a 74-year-old man with Castleman's disease. The disease was detected with a contrast-enhanced computed tomography (CT) scan and a fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT study; diagnosis was made with histopathology. After treatment with surgical excision followed by chemotherapy, the disease response was evaluated using both diagnostic techniques. However, only the PET study was able to identify the spread of the disease to the abdominal lymph nodes, which were both enlarged and normal size, and, after treatment, to evaluate the disease response.</p> <p>Conclusion</p> <p>Based on the results of previous case reports and on those of the present study, it seems that Castleman's disease has a high glucose metabolic activity. Therefore, the use of PET can be considered appropriate in order to stage or restage the disease and to evaluate the response of the disease to treatment.</p

a simple and accurate dosimetry protocol to estimate activity for hyperthyroidism treatment

BACKGROUND: Aim of the study was to evaluate accuracy of different dosimetry protocols in estimating the required 131I activity to treat hyperthyroid patients. MATERIALS AND METHODS: Forty consecutive patients were analysed: twenty-eight Graves' disease; twelve autonomous thyroid nodule (ATN). Maximum-uptake, effective half-time and residence-time were estimated from Radioiodine Uptake Test. Residence-time was estimated using a bi-compartmental model. For 131I activity calculation, algorithms laid down in European Association of Nuclear Medicine (EANM) guidelines, ICRP 53 approach and a mono-exponential formula (ME), were compared with OLINDA/EXM results. RESULTS: Based on EANM guidelines, activities to be administered were 3% higher in Graves' disease (p = 0.001) and 3% higher in ATN (p = 0.046). Calculated activities using ICRP 53 approach were significantly lower compared to OLINDA/EXM: 33% in Graves' disease; 17% in ATN. Activities recommended by ME, were significantly higher: in Graves' disease 20%; 42% in ATN. CONCLUSIONS: Only EANM algorithm predict quite well, compared to OLINDA/EXM, the required activity to treat hyperthyroid patients

Role of fluorine-18 fluorodeoxyglucose PET/CT in head and neck oncology: the point of view of the radiation oncologist

Squamous cell carcinoma is the most common malignant tumour of the head and neck. The initial TNM staging, the evaluation of the tumour response during treatment, and the long-term surveillance are crucial moments in the approach to head and neck squamous cell carcinoma (HNSCC). Thus, at each of these moments, the choice of the best diagnostic tool providing the more precise and larger information is crucial. Positron emission tomography with fluorine-18 fludeoxyglucose integrated with CT (F-18-FDG-PET/CT) rapidly gained clinical acceptance, and it has become an important imaging tool in routine clinical oncology. However, controversial data are currently available, for example, on the role of F-18-FDG-PET/CT imaging during radiotherapy planning, the prognostic value or its real clinical impact on treatment decisions. In this article, the role of F-18-FDG-PET/CT imaging in HNSCC during pre-treatment staging, radiotherapy planning, treatment response assessment, prognosis and follow-up is reviewed focusing on current evidence and controversial issues. A proposal on how to integrate F-18-FDG-PET/CT in daily clinical practice is also described

Lymphoscintigraphy for Sentinel Node Mapping in Head and Neck Cancer

International audienc