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Evangelista L.,Radiotherapy and Nuclear Medicine Unit | Zattoni F.,University of Padua | Guttilla A.,University of Padua | Saladini G.,Radiotherapy and Nuclear Medicine Unit | And 2 more authors.
Clinical Nuclear Medicine | Year: 2013

AIM: The increase of prostate-specific antigen (PSA) after radical retropubic prostatectomy (RP) or external beam radiotherapy (EBRT) is the most sensitive tool for detecting prostate cancer (PCa) recurrence, although this measure cannot distinguish between local, regional, or distant recurrence. The aim of this meta-analysis was to evaluate the diagnostic performance of F-choline and C-choline PET or PET/CT in detection of locoregional or distant metastases in PCa. MATERIALS AND METHODS: Medline, Web of Knowledge, and Google Scholar search was carried out in order to select English-language articles dealing with diagnostic performance of both F-choline and C-choline PET for the detection of PCa recurrence after RP or EBRT. Articles were included only if absolute numbers of true-positive, true-negative, false-positive, and false-negative test results were available or derivable from the text and regarded local, lymph node, and distant metastases. Reviews, clinical reports, and editorial articles were excluded. All complete studies were re-analyzed thus performing a quantitative analysis. RESULTS: From the years 2000 to 2012, we found 53 complete articles that critically evaluated the role of choline PET in restaging patients with PCa recurrence. The meta-analysis was carried out and dealt with 19 selected studies (12 studies for all sites of disease, 3 for lymph node metastases, and 4 for local recurrence), with a total of 1555 patients. The meta-analysis provided a pooled sensitivity of 85.6% (95% CI: 82.9%-88.1%) and pooled specificity of 92.6% (95% CI: 90.1%-94.6%) for all sites of disease (prostatic fossa, lymph nodes, and bone), a pooled sensitivity of 75.4% (95% CI: 66.9%-82.6%) and pooled specificity of 82% (95% CI: 68.6%-91.4%) for prostatic fossa recurrence, and a pooled sensitivity of 100% (95% CI: 90.5%-100%) and pooled specificity of 81.8% (95% CI: 48.2%-97.7%) for lymph node metastases. The heterogeneity ranged between 0.00% and 88.6%. The diagnostic odds ratios were 62.123 (95% CI: 24.783-155.72), 5.869 (95% CI: 1.818-18.946), and 138.57 (95% CI: 11.27-1703.8), respectively, for all sites of disease, local recurrence, and lymph node disease. CONCLUSIONS: Choline PET and PET/CT represent high sensitivity and specificity techniques for the detection of locoregional and distant metastases in PCa patients with recurrence of disease. Moreover, a high diagnostic odds ratio was found for the identification of lymph node disease in patients with biochemical recurrence of PCa. © 2013 by Lippincott Williams and Wilkins. Source

Maffione A.M.,Head Service of Nuclear Medicine and Center | Ferretti A.,Head Service of Nuclear Medicine and Center | Chondrogiannis S.,Head Service of Nuclear Medicine and Center | Rampin L.,Head Service of Nuclear Medicine and Center | And 5 more authors.
Clinical Nuclear Medicine | Year: 2013

Purpose: The aim of this study was to correlate PERCIST criteria and a new criterion developed in our center that we named PREDIST (PET Residual Disease in Solid Tumor) with tumor regression grade (TRG) classification of pathologic response to neoadjuvant chemoradiotherapy (CRT) in patients affected by rectal cancer. Methods: Seventy-three consecutive patients affected by locally advanced rectal cancer (LARC) were retrospectively included. FDG-PET/CT scans were performed at staging time and after the end of CRT (mean time 6.5 weeks). The analysis was performed by PERCIST criteria 1.0 and PREDIST criteria based on a new definition of residual disease. We split the TRG system into responders (TRG1-2) and nonresponders (TRG3-5). Pearson chi-square analysis by cross-tabulations was performed. Results: PREDIST classification was statistically predictive of TRG response (P = 0.004, sensitivity 81.8%and specificity 54.9%). On the contrary, PERCIST criteria was not statistically correlated to TRG (P = 0.128) caused by a very low specificity (9.8%). Conclusions: FDG-PET/CT scan is an accurate tool to predict preoperatively the response to CRT in LARC patients. The novel proposed criterion (PREDIST) seems to be helpful to discriminate responder by nonresponder patients. Copyright © 2013 by Lippincott Williams & Wilkins. Source

Mazza A.,Santa Maria della Misericordia Hospital of Rovigo | Rampin L.,Head Service of Nuclear Medicine and Center | Montemurro D.,General Hospital of Adria Rovigo | Schiavon L.,Santa Maria della Misericordia Hospital of Rovigo | And 6 more authors.
Blood Pressure | Year: 2011

Background. This cross-sectional study investigates the role of renal scintigraphy on cardiovascular (CV) risk stratification in normoalbuminuric, non-diabetic hypertensive subjects (HTs) free from CV disease and renal dysfunction. Methods. In 200 HTs aged 5575 years, glomerular filtration rate (GFR) was measured by technetium-99m-diethylene triamine pentacetic acid clearance during renal scintigraphy. Stage III chronic kidney disease (CKD) was defined as GFR < 60 ml/min/1.73 m 2. For comparing the impact of different methods for CKD diagnosis on CV risk stratification, CKD was also considered as GFR estimated by the Modification of Diet in Renal Disease (MDRD) equation and CockcroftGault's formula. Target organ damage (TOD) was assessed by echocardiography and carotid ultrasonography. Gender-specific odds ratio (OR) with 95% confidence intervals for CKD were derived from a multiple stepwise logistic regression analysis. Global CV risk was stratified according to routine examinations, TOD and CKD. Results. In 38% of cases, an unknown stage III CKD was found. Independent of age, CKD was predicted by history of hypertension (OR = 1.69, p = 0.0001), albuminuria (OR = 1.25, p = 0.0001), smoking (OR = 1.85, p = 0.028) and pulse pressure (OR = 1.21, p = 0.019) in men only. Men had an increased risk of CKD (OR = 2.62, p = 0.002) in comparison with women. Prevalence of TOD was significantly higher only in HTs having CKD diagnosed by renal scintigraphy; TOD and CKD assessment added to classic risk factors modified the CV risk stratification from low-moderate to high and very high. Conclusions. Renal scintigraphy is an important aid in risk stratification and should be performed in HTs aged ≥ 55 years. Pulse pressure was the main blood pressure component that predicted the risk of stage III CKD. © 2011 Scandinavian Foundation for Cardiovascular Research. Source

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