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Olomouc, Czech Republic

Scudla V.,III. interni klinika FN a LF UP | Herman M.,Radiologicka klinika FN a LF UP | Myslivecek M.,Klinika nuklearni mediciny FN a LF UP
Onkologie | Year: 2011

The paper presents recent opinion on individual imaging methods in the diagnostics of multiple myeloma (MM), and its differentiation from monoclonal gammopathy of undetermined significance (MGUS). We assess the possibilities and difficulties in the differentiation of individual manifestations of myeloma bone disease using conventional radiography, computed tomography (CT), magnetic resonance imaging (including whole body MR), 99mTc-MIBI scintigraphy, and FDG-PET/CT which combines positron emission tomography and multidetector computed tomography. We describe the contribution of new imaging methods for MM stratification (Durie-Salmon Plus staging system), monitoring of the course of MM including therapeutics response, recognition of relapse/progression, and extramedular progression of the disease. We also evaluate interpretation difficulties of individual imaging methods, and the principles of their individual choice in specific clinical situations. Source

Koranda P.,Klinika nuklearni mediciny FN a LF UP | Myslivecek M.,Klinika nuklearni mediciny FN a LF UP | Svebisova H.,Onkologicka Klinika FN a LF UP | Frysak Z.,III. interni klinika FN a LF UP | And 2 more authors.
Ceska Radiologie | Year: 2011

Aim. The majority of neuroendocrine tumors (NETs) exhibits an indolent growth pattern (well-differentiated tumors), but a substantial number may metastasize. The minority of NETs is aggressive and can have a highly malignant course. The aim of the study was to evaluate the reliability of contrast-enhanced 18F-FDG PET/CT in the staging of malignant NETs. Method. A total of 41 patients with verified or suspected NETs underwent contrast-enhanced 18F-FDG PET/CT. NETs were histologically verified in 29 patients (15 carcinoids, 8 neuroendocrine carcinomas, 2 medullary carcinomas, 2 Merkel cell carcinomas, 1 pheochromocytoma, 1 inzulinoma). 111In-pentetreotide or 123I-MIBG scintigraphies were performed in patients with absent or spurious accumulation of 18F-FDG. Results. 18F-FDG PET/CT did not reveal 18F-FDG uptake in 6 patients with histologically confirmed NETs (5/15 carcinoids, 1/8 neuroendocrine carcinomas) only. The NETs were detected using 111In-pentetreotide or 123I-MIBG scintigraphy in all 18F-FDG false negative patients. On the contrary, 18F-FDG PET/CT was more accurate than 111In-pentetreotide or 123I-MIBG scintigraphy in patients with high-grade neuroendocrine carcinomas and medullar thyroid carcinomas. Conclusion. Contrast enhanced 18F-FDG PET/CT identified malignant tissue in the majority of patients with malignant NETs, 18F-FDG PET/CT was an efficient diagnos-tic tool in patients with intermediate- and high-grade NETs. 18F-FDG PET/CT and 111In-pentetreotide scintigraphy are complementary examinations - functional imaging with both radiopharmaceuticals has a potential for a more comprehensive assessment of these tumors. Source

Rehak Z.,Oddeleni Nuklearni Mediciny | Fojtik Z.,Interni hematologicka a onkologicka klinika FN a LF MU | Frysakova L.,III. interni klinika FN a LF UP | Simikova J.,Interni Oddeleni | And 12 more authors.
Ceska Revmatologie | Year: 2014

Giant cell arteritis (GCA) is a systemic vasculitis of large arteries, which affects older people, more frequently women. Febrile illness with elevation of nonspecific laboratory markers of inflammation (ESR, CRP) may be the first symptom of this disease. In such a condition an FDG PET (PET/CT) examination can be performed due to a wider differential diagnosis. Findings of high FDG uptake in the aorta and large arteries, especially those originating from the aortic arch, are relatively uniform and typical of GCA, even at a stage when structural changes of the arteries have not developed yet. Involvement of temporal artery can be visualized using hybrid PET/CT scanners, yet rather in isolated cases. FDG uptake in the walls of large arteries can be also used to assess the disease activity (both remission and possible relapse), furthermore, this finding correlates with laboratory evidence of disease activity (ESR, CRP). Although PET (PET/CT) examination is frequently used for primary diagnosis and monitoring of disease activity, these examinations are not considered standard. Herein, we present 4 patients using visual documentation. In these patients, PET (PET/CT) examination was used for primary diagnosis, and is compared with the CT angiography or MR angiography. In 2 patients, histological verification is presented. In 3 out of 4 patients, further course of the disease was monitored by PET examination as well. Source

Minarik J.,III. interni klinika FN a LF UP | Scudla V.,III. interni klinika FN a LF UP | Bacovsky J.,III. interni klinika FN a LF UP | Pika T.,III. interni klinika FN a LF UP
Onkologie | Year: 2011

POEMS syndrome is a rare clinical entity with a very variable behaviour and clinical manifestation. It belongs to a group of diseases known as plasma cell dyscrasias and is characterised by a coincidence of monoclonal gammopathy with peripheral neuropathy and focal osteosclerotic bone lesions. Using three case reports, our paper presents different manifestations of this clinical entity as well as an assessment of possible diagnostic and therapeutic approaches to individuals with POEMS syndrome. The aim is to present this less known condition from the group of monoclonal gammopathies as well as the practical approach to diagnosing individuals with concurrent paraprotein and peripheral neuropathy. Source

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