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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asia Oceania Journal of Nuclear Medicine and Biology
- نوع مقاله: Journal Article
- کلمات کلیدی: Breast cancer,SPECT/CT,Sentinel node,Planar Scintigraphy
- چکیده:
- چکیده انگلیسی: Objective(s): This study sought to determine the diagnostic yield of SPECT/CT in localizing axillary sentinel lymph nodes (SLNs) in early breast cancer patients where planar scintigraphy (PS) was equivocal or negative.
Methods: Prospective analysis of early stage breast cancer patients with nonpalpable axillary nodes undergoing SLN localization prior to nodal sampling for axillary staging. PS findings were categorized as: Category A: non-visualization of SLN; Category B: unusual uptake location; Category C: equivocal uptake /
difficult interpretation. The K-coefficient of Cohen was used to evaluate the correlation between PS and SPECT/CT results. PS and SPECT/CT images were interpreted separately, and SLN identification on each of the modalities was correlated to BMI (Body mass index) and peroperative radio guided results.
Results: Between April 2015 and January 2017, 1028 early breast cancer cases underwent sentinel lymphoscintigraphy. Of total, 134 (13%) patients underwent SPECT/CT in addition to PS. All were females with mean age of 48.15 years (range: 26-82 years). Right sided in 68, left in 64 and 2 with bilateral carcinoma. By TNM classification: 49 (37%) T1, 78 (58%) T2 and 7 (5%) had DCIS/Paget’s disease. Overall SLNs were detected on both PS and SPECT/CT in 60% cases. Of category A (n=54); 35/54 (64%) SLN localized on SPECT/CT; 32 were level-I; 2 Level-II; 1 Level-III nodes. In 19, SLN was not localized. Of category B (n=18), 5 had prior lumpectomy, SPECT/CT localized tracer uptake to 17 level-I sentinel nodes, 3 level-II and level III / IMC in 9. Of category C (n=62), 29 had prior lumpectomy. SPECT/CT confirmed SLN in all the cases. Radio-guided surgery confirmed SPECT/CT results. The correlation between the two techniques was low (K=0.34). Where PS was negative; SPECT/CT localized nodes in statistically significant number of cases (P=0.01). PS identified SLN uptakes in 80/134 (60%) cases with a mean BMI of 21.6±4.8 kg/m2 while SPECT/CT detected ‘‘hot’’ nodes in 115/134 (86%) cases with a mean BMI of 29.6±5.6 kg/m2. For overweight/obese patients (n=59) (BMI>25 kg/m2), PS failed to identify SLNs in 49 and SPECT/CT failed to do so in 18 (P<0.001).
Conclusion: SPECT/CT has diagnostic yield and helps in precise SLN localization where planar imaging is negative or shows unusual site of uptake.- انتشار مقاله: 29-10-1396
- نویسندگان: Maimoona Siddique,Muhammad Khalid Nawaz,Humayun Bashir
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Oceania Journal of Nuclear Medicine and Biology
- نوع مقاله: Journal Article
- کلمات کلیدی: 18F FDG PET-CT scan,small cell lung cancer,Disease free survival
- چکیده:
- چکیده انگلیسی: Objective(s): Small cell lung cancer (SCLC) is an aggressive neuroendocrine carcinoma, which accounts for 10-15% of pulmonary cancers and exhibits early metastatic spread. This study aimed to determine the added value of 18F-FDG PET/CT imaging in tumor, node, and metastasis (TNM) staging of SCLC, compared to the conventional computed tomography (CT) scan and its potential role as a prognosticator.
Methods: This retrospective review was conducted on 23 patients, who were histopathologically diagnosed to have SCLC and referred for undergoing 18F-FDG PET/CT scanning during October 2009-December 2015. The rate of agreement between the CT and 18F-FDG PET/CT findings for TNM staging was calculated using the Cohen’s kappa (κ). The median follow-up time was eight months, ranging 27-3 months). The overall and disease-free survival rates were calculated based on the extent of disease.
Results: 19 cases were male and four female with the mean age of 58±9 years. The 18F-FDG PET/CT identified limited and extensive diseases in 2 (8.7%) and 21 (91.3%) patients, respectively. In addition, the results of the Cohen’s kappa demonstrated a strong (κ=0.82), fair (κ=0.24), and poor (κ=0.12) agreement between the PET/CT and CT findings for determining tumor, node, and metastasis stages, respectively. The 18F-FDG PET/CT scans upstaged disease in 47% of the cases with visceral and osseous metastasis. The disease-free survival rates for the limited and extensive diseases were 100% and 23% within the 12-month follow-up. In addition, 8 (35%) patients expired during the follow-up period.
Conclusion: Improved nodal and metastatic disease identification highlights the role of 18F-FDG PET/CT scanning in initial staging of SCLC with prognostic implications.
- انتشار مقاله: 24-09-1395
- نویسندگان: Saima Riaz,Humayun Bashir,Imran K Niazi
- مشاهده