Parathyroid cancer is an uncommon malignant cancer and is associated with a poor prognosis.The staging of parathyroid cancer represents an important issue both at initial diagnosis and after surgery and medical treatm...Parathyroid cancer is an uncommon malignant cancer and is associated with a poor prognosis.The staging of parathyroid cancer represents an important issue both at initial diagnosis and after surgery and medical treatment.The role of positron emission tomography/computed tomography(PET/CT)with 18F-Fluorodeoxyglucose(18F-FDG)as an imaging tool in parathyroid cancer is not clearly reported in the literature,although its impact in other cancers is well-defined.The aim of the following illustrative clinical cases is to highlight the impact of PET/CT in the management of different phases of parathyroid cancer.We describe five patients with parathyroid malignant lesions,who underwent FDG PET/CT at initial staging,restaging and post-surgery evaluation.In each patient we report the value of PET/CT comparing its findings with other common imaging modalities(e.g.,CT,planar scintigraphy with 99mTcsestamibi,magnetic resonance imaging)thus determining the complementary benefit of FDG PET/CT in parathyroid carcinoma.We hope to provide an insight into the potential role of PET/CT in assessing the extent of disease and response to treatment which are the general principles used to correctly evaluate disease status.展开更多
AIM: To review the benefits of single photon emission computed tomography(SPECT)/computed tomography(CT) hybrid imaging for diagnosis of various endocrine disorders.METHODS: We performed MEDLINE and Pub Med searches u...AIM: To review the benefits of single photon emission computed tomography(SPECT)/computed tomography(CT) hybrid imaging for diagnosis of various endocrine disorders.METHODS: We performed MEDLINE and Pub Med searches using the terms: "SPECT/CT"; "functional anatomic mapping"; "transmission emission tomography"; "parathyroid adenoma"; "thyroid cancer"; "neuroendocrine tumor"; "adrenal"; "pheochromocytoma"; "paraganglioma"; in order to identify relevant articles published in English during the years 2003 to 2015. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts(case reports, reviews, meta-analyses and abstracts) concerning the application of SPECT/CT to endocrine imaging were analyzed to provide a descriptive synthesis of the utility of this technology.RESULTS: The emergence of hybrid SPECT/CT camera technology now allows simultaneous acquisition of combined multi-modality imaging, with seamless fusion of three-dimensional volume datasets. The usefulness of combining functional information to depict the biodistribution of radiotracers that map cellular processes of the endocrine system and tumors of endocrine origin, with anatomy derived from CT, has improved the diagnostic capability of scintigraphy for a range of disorders of endocrine gland function. The literature describes benefits of SPECT/CT for ^(99m)Tc-sestamibi parathyroid scintigraphy and ^(99m)Tc-pertechnetate thyroid scintigraphy, ^(123)I- or ^(131)I-radioiodine for staging of differentiated thyroid carcinoma, ^(111)In- and ^(99m)Tclabeled somatostatin receptor analogues for detection of neuroendocrine tumors, ^(131)I-norcholesterol(NP-59) scans for assessment of adrenal cortical hyperfunction, and ^(123)I- or ^(131)I-metaiodobenzylguanidine imaging for evaluation of pheochromocytoma and paraganglioma.CONCLUSION: SPECT/CT exploits the synergism between the functional information from radiopharmaceutical imaging and anatomy from CT, translating to improved diagnostic accuracy and meaningful impact on patient care.展开更多
The aim of this study was to collect the evidence on the performance of 2-deoxy-2-[^(18)F]fluoro-D-glucose(^(18)F-FDG)Positron Emission Tomography/Computed Tomography(PET/CT)in terms of detection rate(DR)and diagnosti...The aim of this study was to collect the evidence on the performance of 2-deoxy-2-[^(18)F]fluoro-D-glucose(^(18)F-FDG)Positron Emission Tomography/Computed Tomography(PET/CT)in terms of detection rate(DR)and diagnostic accuracy in identifying hematogenous metastases in patients with differentiated thyroid cancer and compare its performance with that of other imaging techniques.A comprehensive PubMed/MEDLINE database research was carried out to retrieve studies documenting the performance of^(18)F-FDG PET/CT in depicting hematogenous metastases in patients with differentiated thyroid cancer.Statistical analysis was performed on a per-patient and per-lesion basis.The literature search yielded 15 articles to be included in the systematic review.^(18)F-FDG PET/CT showed a pooled DR of 85.08%on a per-patient analysis and 89.70%on a per-lesion analysis.For bone lesions,a high DR(81.78%)was found for^(18)F-FDG PET/CT.For the sub-group analysis of lung lesions,pooled DR was 92.77%for^(18)F-FDG PET/CT,95.02%for CT,and 64.93%for magnetic resonance imaging(MRI).On a per-patient analysis,^(18)F-FDG PET/CT demonstrated a pooled sensitivity(SS)of 87.3%[95%confidence interval(CI):77.3%-94%]and a pooled specificity(SP)of 95.6%(95%CI:87.6-99.1).On a per-lesion analysis(328 metastases),PET/CT showed a pooled SS and SP of 86.3%(95%CI:73.5%-93.5%)and 93.4%(95%CI:71.7%-98.8%)in the detection of hematogenous metastases.The presented systematic review and meta-analysis favor the use of^(18)F-FDG PET/CT in the detection of hematogenous metastases in patients with differentiated thyroid cancer.The limited literature warrants further studies to confirm our findings.展开更多
文摘Parathyroid cancer is an uncommon malignant cancer and is associated with a poor prognosis.The staging of parathyroid cancer represents an important issue both at initial diagnosis and after surgery and medical treatment.The role of positron emission tomography/computed tomography(PET/CT)with 18F-Fluorodeoxyglucose(18F-FDG)as an imaging tool in parathyroid cancer is not clearly reported in the literature,although its impact in other cancers is well-defined.The aim of the following illustrative clinical cases is to highlight the impact of PET/CT in the management of different phases of parathyroid cancer.We describe five patients with parathyroid malignant lesions,who underwent FDG PET/CT at initial staging,restaging and post-surgery evaluation.In each patient we report the value of PET/CT comparing its findings with other common imaging modalities(e.g.,CT,planar scintigraphy with 99mTcsestamibi,magnetic resonance imaging)thus determining the complementary benefit of FDG PET/CT in parathyroid carcinoma.We hope to provide an insight into the potential role of PET/CT in assessing the extent of disease and response to treatment which are the general principles used to correctly evaluate disease status.
文摘AIM: To review the benefits of single photon emission computed tomography(SPECT)/computed tomography(CT) hybrid imaging for diagnosis of various endocrine disorders.METHODS: We performed MEDLINE and Pub Med searches using the terms: "SPECT/CT"; "functional anatomic mapping"; "transmission emission tomography"; "parathyroid adenoma"; "thyroid cancer"; "neuroendocrine tumor"; "adrenal"; "pheochromocytoma"; "paraganglioma"; in order to identify relevant articles published in English during the years 2003 to 2015. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts(case reports, reviews, meta-analyses and abstracts) concerning the application of SPECT/CT to endocrine imaging were analyzed to provide a descriptive synthesis of the utility of this technology.RESULTS: The emergence of hybrid SPECT/CT camera technology now allows simultaneous acquisition of combined multi-modality imaging, with seamless fusion of three-dimensional volume datasets. The usefulness of combining functional information to depict the biodistribution of radiotracers that map cellular processes of the endocrine system and tumors of endocrine origin, with anatomy derived from CT, has improved the diagnostic capability of scintigraphy for a range of disorders of endocrine gland function. The literature describes benefits of SPECT/CT for ^(99m)Tc-sestamibi parathyroid scintigraphy and ^(99m)Tc-pertechnetate thyroid scintigraphy, ^(123)I- or ^(131)I-radioiodine for staging of differentiated thyroid carcinoma, ^(111)In- and ^(99m)Tclabeled somatostatin receptor analogues for detection of neuroendocrine tumors, ^(131)I-norcholesterol(NP-59) scans for assessment of adrenal cortical hyperfunction, and ^(123)I- or ^(131)I-metaiodobenzylguanidine imaging for evaluation of pheochromocytoma and paraganglioma.CONCLUSION: SPECT/CT exploits the synergism between the functional information from radiopharmaceutical imaging and anatomy from CT, translating to improved diagnostic accuracy and meaningful impact on patient care.
文摘The aim of this study was to collect the evidence on the performance of 2-deoxy-2-[^(18)F]fluoro-D-glucose(^(18)F-FDG)Positron Emission Tomography/Computed Tomography(PET/CT)in terms of detection rate(DR)and diagnostic accuracy in identifying hematogenous metastases in patients with differentiated thyroid cancer and compare its performance with that of other imaging techniques.A comprehensive PubMed/MEDLINE database research was carried out to retrieve studies documenting the performance of^(18)F-FDG PET/CT in depicting hematogenous metastases in patients with differentiated thyroid cancer.Statistical analysis was performed on a per-patient and per-lesion basis.The literature search yielded 15 articles to be included in the systematic review.^(18)F-FDG PET/CT showed a pooled DR of 85.08%on a per-patient analysis and 89.70%on a per-lesion analysis.For bone lesions,a high DR(81.78%)was found for^(18)F-FDG PET/CT.For the sub-group analysis of lung lesions,pooled DR was 92.77%for^(18)F-FDG PET/CT,95.02%for CT,and 64.93%for magnetic resonance imaging(MRI).On a per-patient analysis,^(18)F-FDG PET/CT demonstrated a pooled sensitivity(SS)of 87.3%[95%confidence interval(CI):77.3%-94%]and a pooled specificity(SP)of 95.6%(95%CI:87.6-99.1).On a per-lesion analysis(328 metastases),PET/CT showed a pooled SS and SP of 86.3%(95%CI:73.5%-93.5%)and 93.4%(95%CI:71.7%-98.8%)in the detection of hematogenous metastases.The presented systematic review and meta-analysis favor the use of^(18)F-FDG PET/CT in the detection of hematogenous metastases in patients with differentiated thyroid cancer.The limited literature warrants further studies to confirm our findings.
