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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asia Oceania Journal of Nuclear Medicine and Biology
- نوع مقاله: Journal Article
- کلمات کلیدی: PET/CT,Rosai Dorfman,Bone,subcutaneous tissue
- چکیده:
- چکیده انگلیسی: Rosai Dorfman disease is a rare form of nonlangerhans cell histiocytosis, presenting with extensive lymphadenopathies. Treatment in most cases of nodal disease, involves close observation; however, extranodal involvement requires a more definitive treatment strategy. Herein, we report a case of extensive Rosai Dorfman disease in a 43-year-old woman presenting for evaluation of treatment response by 18F-FDG PET/CT after frequent relapses and disease progression. In addition to extensive lymphadenothapies in cervical, supraclavicular, superior mediastinum, axillary, abdominopelvic and inguinofemoral regions, the patient had metabolically active bone and subcutaneous lesions which were not previously recognized. Following this 18F-FDG PET/CT study, the patient management was changed to sirolimus and prednisolone. To choose the best treatment option for Rosai Dorfman patients, knowledge of the full extent of disease is important. Compared with conventional imaging, 18F-FDG PET/CT has the advantage of being a whole-body imaging modality and can recognize disease involvement prior to any anatomical changes.
- انتشار مقاله: 17-06-1399
- نویسندگان: Armaghan Fard-Esfahani,Bahare Saidi,Sara Seyedinia,Alireza Emami Ardekani,Mohammad Eftekhari
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Oceania Journal of Nuclear Medicine and Biology
- نوع مقاله: Journal Article
- کلمات کلیدی: Breast cancer,Myocardial perfusion,Radiotherapy,SPECT
- چکیده:
- چکیده انگلیسی: Objective(s): Radiation therapy for breast cancer can induce myocardial capillary injury and increase cardiovascular morbidity and mortality. A prospective cohort was conducted to study the prevalence of myocardial perfusion abnormalities following radiation therapy of left-sided breast cancer patients as compared to those with right–sided cancer.
Methods: To minimize potential confounding factors, only those patients with low 10-year risk of coronary artery disease (based on Framingham risk scoring) were included. All patients were initially treated by modified radical mastectomy and then were managed by postoperative 3D Conformal Radiation Therapy (CRT) to the surgical bed with an additional 1-cm margin, delivered by 46-50 Gy (in 2 Gy daily fractions) over a 5-week course. The same dose-adjusted chemotherapy regimen (including anthracyclines, cyclophosphamide and taxol) was given to all patients. Six months after radiation therapy, all patients underwent cardiac SPECT for the evaluation of myocardial perfusion.
Results: A total of 71 patients with a mean age of 45.3±7.2 years [35 patients with leftsided breast cancer (exposed) and 36 patients with right-sided cancer (controls)] were enrolled. Dose-volume histogram (DVH) [showing the percentage of the heart exposed to >50% of radiation] was significantly higher in patients with left-sided breast cancer. Visual interpretation detected perfusion abnormalities in 42.9% of cases and 16.7% of controls (P=0.02, Odds ratio=1.46). In semiquantitative segmental analysis, only apical (28.6% versus
8.3%, P=0.03) and anterolateral (17.1% versus 2.8%, P=0.049) walls showed significantly reduced myocardial perfusion in the exposed group. Summed Stress Score (SSS) of>3 was observed in twelve cases (34.3%), while in five of the controls (13.9%),(Odds ratio=1.3). There was no significant difference between the groups regarding left ventricular ejection fraction.
Conclusion: The risk of radiation induced myocardial perfusion abnormality in patients treated with CRT on the left hemi thorax is not low. It is reasonable to minimize the volume of the heart being in the field of radiation employing didactic radiation planning techniques. Also it is advisable to screen these patients with MPI-SPECT, even if they are clinically asymptomatic, as early diagnosis and treatment of silent ischemia may change the outcome.- انتشار مقاله: 06-04-1393
- نویسندگان: Mohammad Eftekhari,Robabeh Anbiaei Anbiaei,Hanie Zamani,Babak Fallahi,Davood Beiki,Ahmad Ameri,Alireza Emami-Ardekani,Armaghan Fard-Esfahani,Ali Gholamrezanezhad,Seid Kazem Razavi Ratki,Alireza Momen Roknabadi
- مشاهده