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Bertagna F.,University of Brescia | Treglia G.,Catholic University of the Sacred Heart | Piccardo A.,Nuclear Medicine | Giubbini R.,University of Brescia
Journal of Clinical Endocrinology and Metabolism | Year: 2012

Context: Thyroid incidentaloma diagnosed by 2-[18F]-fluoro-2-deoxy-D- glucose positron emission tomography/computed tomography (F-18-FDG-PET/CT) is defined as a thyroid uptake incidentally and newly detected in a patient studied for nonthyroid purpose. In this review, we have comprehensively analyzed the diagnostic and clinical significance of F-18-FDG-PET/CT thyroid incidentalomas revealed during studies performed for an unrelated and nonthyroid purpose. Evidence Acquisition: Acomprehensive literature research of the PubMed/MEDLINE databases was conducted to find relevant published articles about the F-18-FDG-PET or F-18-FDG-PET/CT thyroid incidentalomas. Evidence Synthesis: All studies considered in this review have investigated a very large number of patients, achieving overall about 147,505 units. The pooled incidence of thyroid incidentalomas detected by F-18-FDG-PET or PET/CT was 2.46% (95% confidence interval, 1.68-3.39%). The malignancy ratio was 34.6% (95% confidence interval, 29.3-40.2%). Conclusion: F-18-FDG-PET/CT thyroid incidentaloma is a relevant clinical finding; diffuse uptakes and most focal uptakes are commonly caused by benign diseases, whereas about one third of focal uptakes are malignant; the most frequent malignant histological type responsible for F-18-FDG-PET/CT thyroid incidentaloma is papillary thyroid carcinoma. Copyright © 2012 by The Endocrine Society.

Buscombe J.,Nuclear Medicine
Current Pharmaceutical Design | Year: 2014

The G-protein coupled receptor system is involved in a range of cell types and actions and as such has a universal potential in identifying cell functions. The most widely explored system is that of the somatostatin receptors which has been exploited for both imaging and therapy. However, even with this fairly simple system, variation is seen in the behaviour of cells between patients and within different cell population within the patient. Newer work will exploit different ligands in a wider range of both tumour types and non-oncological processes such as inflammation. © 2014 Bentham Science Publishers.

Hatt M.,French Institute of Health and Medical Research | Tixier F.,French Institute of Health and Medical Research | Cheze Le Rest C.,Nuclear Medicine | Pradier O.,Radiotherapy | Visvikis D.,French Institute of Health and Medical Research
European Journal of Nuclear Medicine and Molecular Imaging | Year: 2013

Purpose: Intratumour uptake heterogeneity in PET quantified in terms of textural features for response to therapy has been investigated in several studies, including assessment of their robustness for reconstruction and physiological reproducibility. However, there has been no thorough assessment of the potential impact of preprocessing steps on the resulting quantification and its predictive value. The goal of this work was to assess the robustness of PET heterogeneity in textural features for delineation of functional volumes and partial volume correction (PVC). Methods: This retrospective analysis included 50 patients with oesophageal cancer. PVC of each PET image was performed. Tumour volumes were determined using fixed and adaptive thresholding, and the fuzzy locally adaptive Bayesian algorithm, and heterogeneity was quantified using local and regional textural features. Differences in the absolute values of the image-derived parameters considered were assessed using Bland-Altman analysis. The impact on their predictive value for the identification of patient nonresponders was assessed by comparing areas under the receiver operating characteristic curves. Results: Heterogeneity parameters were more dependent on delineation than on PVC. The parameters most sensitive to delineation and PVC were regional ones (intensity variability and size zone variability), whereas local parameters such as entropy and homogeneity were the most robust. Despite the large differences in absolute values obtained from different delineation methods or after PVC, these differences did not necessarily translate into a significant impact on their predictive value. Conclusion: Parameters such as entropy, homogeneity, dissimilarity (for local heterogeneity characterization) and zone percentage (for regional characterization) should be preferred. This selection is based on a demonstrated high differentiation power in terms of predicting response, as well as a significant robustness with respect to the delineation method used and the partial volume effects. © 2013 Springer-Verlag Berlin Heidelberg.

Feyer P.,Nuclear Medicine | Jordan K.,Martin Luther University of Halle Wittenberg
Annals of Oncology | Year: 2011

Chemotherapy-induced nausea and vomiting (CINV) continues to be one of the most feared side effects of chemotherapy. Inadequately controlled CINV can have a significant negative impact on quality of life and can in some cases compromise adherence to treatment. However, the repercussions of CINV for patients are often underestimated. Advances in our understanding of the physiology of CINV and the identification of risk factors have greatly contributed towards improvements in the control of CINV. A number of antiemetic agents are currently available for the prophylaxis and treatment of CINV, including 5-hydroxytryptamine 3 receptor antagonists corticosteroids, neurokinin 1 receptor antagonists, dopamine receptor antagonists, benzodiazepines, neuroleptics and cannabinoids. With the correct use of these agents, CINV can be prevented to a great extent; however, adherence to guidelines is disappointingly low. Furthermore, a significant number of patients still experience nausea and vomiting despite optimal treatment. More effective therapies are, therefore, greatly needed, with the ultimate goal of attaining complete control of CINV. This review focuses on the current understanding of CINV, problems associated with its management and the status of promising antiemetic therapies. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

Schmid S.,Medical Oncology | Siano M.,Medical Oncology | Joerger M.,Medical Oncology | Rodriguez R.,Pathology | And 2 more authors.
Lung Cancer | Year: 2015

We present the case of a patient with rapidly accelerated fibrosarcoma gene F (BRAF) mutated adenocarcinoma of the lung, responding to BRAF inhibitor dabrafenib after progressing on vemurafenib followed by docetaxel. The present case illustrates the potential benefit of successful rechallenge with a BRAF inhibitor, a well known phenomenon observed in other oncogenic driven molecular subtypes of non-small cell lung cancer (NSCLC) such as epidermal growth factor receptor mutation. Rechallenge with a BRAF inhibitor in BRAF mutated NSCLC should be considered, particularly in the absence of alternative therpateutic options. © 2014 Elsevier Ireland Ltd.

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