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ABSTRACT: Positron emission tomography-computed tomography (PET-CT) has been shown to detect unexpected synchronous malignancies in up to 4.8% of patients and has been shown to be more sensitive than conventional staging alone. Detection of an unsuspected synchronous malignancy on PET-CT will often affect both patient treatment and prognosis. This article reviews expected patterns of disease spread so that a synchronous malignancy can be more easily recognized.
Proceedings (Baylor University. Medical Center) 07/2011; 24(3):210-5.
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ABSTRACT: the purpose of this study was to determine if visualization of discrete sacral foramina on bone scintigraphy can be used as an adjunct criterion supportive of a superscan diagnosis.
the Radiology Information System at our institution was queried for all bone scintigraphy reports, during July 1999 to July 2009, containing the words/phrases: normal bone scan, normal bone scintigraphy, superscan, or diffuse osseous metastatic disease. The final study group consisted of 22 normal studies and 8 superscans. All studies were reviewed by 2 nuclear medicine physicians who rated the examinations on a numeric scale of bone-to-soft tissue activity, whether they would classify the study as a superscan (based on previously published criteria), whether sacral foramina were visualized, and, if so, how many?
of the 22 normal studies, no distinct sacral foramen was visualized in 17 cases. Of the 8 superscan patients, 1 patient demonstrated 8 foramina, 4 patients demonstrated 4 foramina, 1 patient demonstrated 3 foramina, and 2 patients demonstrated none. There was a statistically significant difference between the normal and superscan groups (P < 0.0017). Based on statistical analysis, it was determined that visualizing at least 3 distinct sacral foramina could be used as an ancillary finding to support the diagnosis of superscan.
the ability to clearly visualize at least 3 sacral foramina is a statistically significant finding that may be useful as an ancillary criterion to differentiate normal bone scintigraphy from a superscan.
Clinical nuclear medicine 01/2011; 36(1):21-4. · 3.92 Impact Factor
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ABSTRACT: Malignant non-Hodgkin lymphomas (NHLs) are commonly staged according to the Ann Arbor staging system developed for Hodgkin's lymphoma. Recently, new staging modalities including metabolic imaging by positron emission tomography (PET) using F-18 fluorodeoxy-glucose (FDG) have been developed. In the present study, we investigated 77 untreated patients with different histologies of NHL both with conventional imaging techniques and FDG-PET. The patients were classified according to the World Health Organization classification and came from 2 major PET imaging centers in Louisiana and Texas. Seventy-six of 77 cases of NHLs were positive by PET imaging. PET imaging resulted, both in high/intermediate grade and indolent NHLs, in a higher stage in more than 20% of cases. In the subtype of high grade NHL diffuse large B cell lymphoma, upstaging by PET appears to be clinically relevant as a marker for a more aggressive tumor. In low grade NHL, stage changes were less pronounced. PET imaging did not reliably detect all cases of bone marrow involvement (especially in indolent lymphomas). However, even in low-grade NHL, clear indications exist for performing PET imaging. The value, the clinical relevance, and new developments in PET imaging for the different types of NHLs are discussed in detail.
The Journal of the Louisiana State Medical Society: official organ of the Louisiana State Medical Society 158(4):193-201.
