Nuklearmedizin und Strahlentherapie

Objectives: A systematic review process was adopted to derive more robust estimates of the diagnostic accuracy of 18F-fluorodeoxyglucose(18F-FDG) positron emission tomography /computed tomography (PET/CT) for prostate cancer we pooled published studies.
Methods: A comprehensive literature search about published studies till November 2017 was performed. Methodological quality of each study was assessed. A meta-analysis was used to analyze the sensitivity, specificity, diagnostic odds ratio (DOR), area under the curve (AUC), summary receiver operating characteristic (sROC) curve and Ǫ* indexes with statistical software.
Results: Ten articles including 364 patients and 505 lesions, which published between 2009 and 2017, met the inclusion criteria for the meta-analysis. The pooled sensitivity and specificity of 18F-FDG PET-CT in prostatic cancer were 0.65 (95% CI, 0.47-0.79) and 0.85 (95% CI, 0.71-0.93), respectively. The overall PLR, NLR and DOR were 4.3 (95% CI, 2.0-9.2), 0.41 (95% CI, 0.25-0.68) and 10 (95% CI, 3-32), respectively. The area under the summary ROC curve was 0.84. There is not exist publication bias in the included studies according to the Deek’s test.
Conclusions: The results of our meta-analysis suggested that 18F-FDG PET-CT were imaging methods with high accuracy in differential diagnosis of prostate cancer patients.

Background: The diagnostic testing for breast cancer has been limited by the absence of a method, which can quantitatively differentiate tissue differences; specifically differentiation between calcium deposits, normal breast tissue, inflammatory changes in breast tissue and breast cancer. Such a quantitative method would remove the issue of sensitivity and specificity errors and allow for diagnostic decision-making including treatment monitoring.
Method: A series of investigations were conducted over an 18-year period of time looking at more than 1000 women and men suspected of having breast tissue abnormalities. The studies compared pathologic tissue results with outcomes using other diagnostic studies and FMTVDM-BEST©â„— Imaging. The studies began with asking the fundamental questions necessary to produce such a quantitative diagnostic test, followed by correcting for errors encountered by other methods. Following the initial work comparing FMTVDM-BEST©â„— Imaging with other tests and tissue pathology results, the investigations turned to monitoring changes in women over time, demonstrating the ability to monitor treatment results from surgery, chemotherapy, radiation therapy, immune therapy, diet and lifestyle changes. Further work was conducted to assure that the time within a woman’s cycle did not affect FMTVDM-BEST©â„— Imaging. The next series of studies looked at the effect that soy protein, smoking and hormone treatment (HRT) had on breast tissue health and the relationship between breast cancer and these influences. The summation of all of these studies included looking at breast density and breast implants as well as male patients.
Results: FMTVDM-BEST©â„— Imaging quantitatively differentiates between breast calcium deposits, normal breast tissue, inflammatory changes and breast cancer. It can monitor transitions in tissue showing both the progression and regression of disease allowing clinicians to monitor treatment outcomes independent of the treatment approach used. FMTVDM-BEST©â„— Imaging is not affected by breast density, breast implants, mastectomy or size of breast; including male patients. : FMTVDM-BEST©â„— Imaging provides the first and only quantitative method, which can differentiate tissues based upon changes in measurements obtained from this patented method. As such, it can detect changes in tissue leading to breast cancer allowing for greater treatment opportunities, as well as monitoring outcomes of treatment for breast cancer and other abnormalities (e.g. fibrocystic disease). FMTVDM-BEST©â„— Imaging works independent of whether the patient has dense breast tissue, breast implants, is on HRT, smokes or has undergone previous treatment in both men and women.

Objective: We aimed to determine the usefulness of the apparent diffusion coefficient (ADC) values for the differential diagnosis of hepatocellular carcinomas and most common metastatic liver tumors and we aimed to compare the characteristic properties. We also aimed to detect novel lesions on ADC maps before the lesion is clinically and radiologically detected by conventional methods.

Materials and Methods: We evaluated characteristic properties, contrast enhancement patterns of liver metastasis of malignancies like adenocancer, renal cell carcinoma (RCC), gastrointestinal stromal tumor (GIST) and hepatocellular carcinoma (HCC) on magnetic resonance imaging (MRI) and diffusion weighted (DW) imaging. ADCs were measured both from the cystic and solid parts of the tumoral lesions. Solid and cystic parts were grouped seperately and compared individually.

Results: 48 cases, (60% male and 40% female) with ages ranging between 48 and 81 were involved. 28 of them had liver metastasis and 20 of them had HCC. MRIs between the years 2009 and 2012 were analyzed. Among mean ADC values measured from solid contrast-enhancing parts, values of the HCC group were significantly higher than the metastasis group (p=0.004). Also, in metastasis group consisting of many distinct primaries, there were differences in ADC values. A retrospective analysis for follow-up cases showed that the ADC values of the parencyhma where a lesion will appear on later follow-up images were lower than the adjacent parenchyma.

Conclusion: We believe that this method may be useful to detect early metastasis. Studies with larger patient groups could give more significant results which would enable diffusion imaging method to be used in this area.

The work reported in this paper studies the problem of irradiation of a single cancerous region in a (B/Gd) NCT setup by two opposing modulated one-speed neutron beams. The beams, which may have different pulse shapes, have different modulation frequencies and a variable relative time advance. These different frequencies and time advance are shown to be employable as three control variables in the formulation of a nonlinear optimization process that maximizes the therapeutic utility index and the ballistic index for this kind of dynamical (B/Gd)NCT.

Background: Painful metastatic bone dissemination is a common complication of solid malignant tumors that can lead to severe morbidity. There are different treatment strategies currently available for pain relief. Among those, we obtained clinical experience with Sm-153 EDTMP.
Objective: It was to evaluate the overall therapeutic response in 110 patients who underwent a single dose of Sm-153 EDTMP therapy and report if there is a significant correlation of metastatic bone pain response with gender, pathology of primary cancer, patient’s age, extent of the metastatic bone dissemination.
Patients and methods: 110 cancer patients were included in this retrospective analysis, 63 (57.2%) males (age range; 52-89 years) and 47 (42.7%) females (age range: 35-84 y), their diagnosis were prostate and breast cancer, respectively. all patients performed conventional bone scintigraphy to prove the evidence of metastatic bone dissemination. Pain severity was assessed clinically and according to WHO Analgesia Scale.
Results: Out of 110 cancer patients received a therapeutic dose of 153 Sm- EDTMP for palliation of painful metastatic bone lesions, 93.6% (103/110) showed overall therapeutic response and 6.4% (7/110) showed no response at all. 61% (67/110) of patients were completely pain-free, 32.6% (36/110) were partially responded to therapy, that response shows insignificant relations with the patients gender, pathology of primary tumor, patients age as well as the extent of metastatic bone dissemination.
Conclusion: The results of this study showed that a single dose of Sm-153 EDTMP offers an effective treatment option in patients with painful metastatic bone disseminations irrespective to their gender, age, tumor pathology as well as to the bone lesions extent.

Introduction: The survival of children with cancer has improved considerably over the last decades which have led to a growing number of long term survivors. One of the most serious adverse outcomes in this population is subsequent primary neoplasms with the risk as high as six-fold over expected. The relative risk for subsequent pancreatic cancer in childhood cancer survivors is high, especially after subdiafragmatic radiotherapy and/or chemotherapy with alkylating agents. The survival of patient with advanced pancreatic cancer is very low, and early diagnosis is of vital importance.

Case report: We present a female patient, treated for Ewing sarcoma of thoracic wall with multimodal treatment at the age of 5. She received chemotherapy containing a high dose of Cyclophosphamide and postoperative radiotherapy to the left hemithorax with the dose of 15 Gy followed by local boost to the tumour bed. She had regular follow-ups at the Late-effect clinic at the Institute of Oncology in Ljubljana. Well differentiated papillary cancer of thyroid with nodal metastases was diagnosed during a regular neck ultrasound 26 years after the completion of cancer treatment. Two years later, at the age of 33, she presented with abdominal distension, inappetence and diffuse liver metastases with ascites were found by abdominal ultrasound. Tumour marker CA 19-9 was high, but pancreas was morphologically normal on the ultrasound and on abdominal helical CT. Cytological test of ascites and hepatic metastases showed poorly differentiated adenocarcinoma. The disease progressed very fast and she died a month after the appearance of the first symptom. The autopsy revealed poorly differentiated adenocarcinoma of the pancreatic head and body with multiple metastases in abdominal organs and lungs.

Conclusion: It would be reasonable to introduce the same guidelines for screening of subsequent pancreatic cancer in childhood cancer survivors at high risk for subsequent pancreas cancer as proposed for patients with increased risk for familial pancreatic cancer.

Renal scan is used to diagnose certain kidney diseases. It shows not only the anatomy of the kidneys, also the function as well by using specific radionuclide. The functional information allows doctors to give early diagnose of certain diseases and various medical conditions much sooner than other imaging examinations. This study aimed to know how well people know about kidney nuclear imaging. A survey was conducted for 64 participants and it covered a variety of questions. The study showed that the highest percentage of knowledge about nuclear medicine was within the student group, 70-60%. The physician's percentages were closed or even slightly lower than the percentages of others group.