Review of recent research on hepatitis C therapy for 54th annual meeting of the American association for the study of liver diseases

[Crohn's disease].

Objective: The aim was to formulate clinical practice guidelines for pheochromocytoma and paraganglioma (PPGL). Participants: The Task Force included a chair selected by the Endocrine Society Clinical Guidelines Subcommittee (CGS), seven experts in the field, and a methodologist. The authors received no corporate funding or remuneration. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. The Task Force reviewed primary evidence and commissioned two additional systematic reviews. Consensus Process: One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, European Society of Endocrinology, and Americal Association for Clinical Chemistry reviewed drafts of the guidelines. Conclusions: The Task Force recommends that initial biochemical testing for PPGLs shou...

/pdf/pheochromocytoma-and-paraganglioma-an-endocrine-society-4ij7m1t7fo.pdf

Pheochromocytoma and paraganglioma: An endocrine society clinical practice guideline

https://cdr.lib.unc.edu/downloads/00000227t

ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging)

ContextFocal pulmonary lesions are commonly encountered in clinical practice,
and positron emission tomography (PET) with the glucose analog 18-fluorodeoxyglucose
(FDG) may be an accurate test for identifying malignant lesions.ObjectiveTo estimate the diagnostic accuracy of FDG-PET for malignant focal pulmonary
lesions.Data SourcesStudies published between January 1966 and September 2000 in the MEDLINE
and CANCERLIT databases; reference lists of identified studies; abstracts
from recent conference proceedings; and direct contact with investigators.Study SelectionStudies that examined FDG-PET or FDG with a modified gamma camera in
coincidence mode for diagnosis of focal pulmonary lesions; enrolled at least
10 participants with pulmonary nodules or masses, including at least 5 participants
with malignant lesions; and presented sufficient data to permit calculation
of sensitivity and specificity were included in the anaylsis.Data ExtractionTwo reviewers independently assessed study quality and abstracted data
regarding prevalence of malignancy and sensitivity and specificity of the
imaging test. Disagreements were resolved by discussion.Data SynthesisWe used a meta-analytic method to construct summary receiver operating
characteristic curves. Forty studies met inclusion criteria. Study methodological
quality was fair. Sample sizes were small and blinding was often incomplete.
For 1474 focal pulmonary lesions of any size, the maximum joint sensitivity
and specificity (the upper left point on the receiver operating characteristic
curve at which sensitivity and specificity are equal) of FDG-PET was 91.2%
(95% confidence interval, 89.1%-92.9%). In current practice, FDG-PET operates
at a point on the summary receiver operating characteristic curve that corresponds
approximately to a sensitivity and specificity of 96.8% and 77.8%, respectively.
There was no difference in diagnostic accuracy for pulmonary nodules compared
with lesions of any size (P = .43), for semiquantitative
methods of image interpretation compared with qualitative methods (P = .52), or for FDG-PET compared with FDG imaging with a modified
gamma camera in coincidence mode (P = .19).ConclusionsPositron emission tomography with 18-fluorodeoxyglucose is an accurate
noninvasive imaging test for diagnosis of pulmonary nodules and larger mass
lesions, although few data exist for nodules smaller than 1 cm in diameter.
In current practice, FDG-PET has high sensitivity and intermediate specificity
for malignancy.

Accuracy of Positron Emission Tomography for Diagnosis of Pulmonary Nodules and Mass Lesions: A Meta-analysis

Neurolymphomatosis is a rare manifestation of non-Hodgkin lymphoma characterized by infiltration of peripheral nerves, nerve roots, plexus and cranial nerves by malignant lymphocytes. This report presents positron emission tomography/computed tomography (PET/CT)imaging with 2-deoxy-2-(18)F-fluoro-D-glucose ((18)F-FDG) in 3 cases of non-Hodgkin lymphoma with nerve infiltration, including one newly diagnosed lymphoma, one recurrent lymphoma in previous nerve lesions and one newly recurrent lymphoma. PET/CT could reveal the affected neural structures including cranial nerves, spinal nerve roots, brachial plexus, cervicothoracic ganglion, intercostal nerves, branches of the vagus nerve, lumbosacral plexus and sciatic nerves. There was relative concordance between PET/CT and MRI in detection of affected cranial nerves. PET/CT seemed to be better than MRI in detection of affected peripheral nerves. (18)F-FDG PET/CT was a whole-body imaging technique with the ability to reveal the affected cranial nerves, peripheral nerves, nerve roots and plexus in non-Hodgkin lymphoma. A thorough understanding of disease and use of advanced imaging modalities will increasingly detect neurolymphomatosis.

http://aojnmb.mums.ac.ir/article_2307_f9f34e1d89d4eb16d8842e7275124c6a.pdf

18F-FDG PET/CT in Neurolymphomatosis: Report of 3 Cases

Exercise-redistribution 201Tl with reinjection at rest and exercise-rest 99mTc-methoxy isobutyl isonitrile (MIBI) cardiac imaging was performed in a patient with multivessel chronic coronary artery disease (CAD) and evaluated before and after coronary revascularization. Thallium reinjection showed reversible defects of the inferior and septal walls and irreversible defect of the infero-apical region. Technetium-99m-MIBI scintigraphy demonstrated irreversible defects of the inferior, septal and infero-apical regions. After coronary artery bypass grafts, both thallium reinjection and 99mTc-MIBI images showed only irreversible defects of the infero-apical region. Functional recovery of the inferior and septal walls was observed on two-dimensional echocardiography. Thallium reinjection identifies severely ischemic but viable myocardium more accurately than 99mTc-MIBI in chronic CAD. Thallium myocardial imaging with reinjection at rest is recommended for evaluating patients with chronic ischemic left ventricular dysfunction to determine if these patients are candidates for revascularization procedures.

Improved detection of viable myocardium with thallium-201 reinjection in chronic coronary artery disease: comparison with technetium-99m-MIBI imaging.

The aim of this study was to compare the results of ultrasound (US), whole-body scintigraphy with iodine-131 (I-131 WBS) and positron emission tomography with fluorine-18 deoxyglucose (FDG-PET) in the follow-up of patients after thyroidectomy for differentiated thyroid carcinoma (DTC). Thirteen patients (3 men, 10 women) were evaluated by neck US, I-131 WBS and FDG-PET. In each patient six anatomical regions (right and left thyroid bed, right and left cervical region, right and left supraclavicular region) were investigated, for a total of 78 regions. Distant metastases were investigated by I-131 WBS and FDG-PET and considered separately in the analysis. Imaging findings were compared with the reference standards, such as fine-needle aspiration cytology (2), biopsy (4) or clinical-radiological studies (7). US, FDG-PET and I-131 WBS showed concordant negative results in most (70, 90%) of the anatomical sites considered. In one patient with left cervical lymph node metastasis, the imaging techniques showed concordant positive results (1%). In the remaining 7 regions (9%), the imaging results were discordant; in particular, tumour lesions, nodal metastases (4) and thyroid bed recurrences (3) were detected by US only (3), by US and I-131 WBS (1) and by FDG-PET only (3). With regard to distant metastases, FDG-PET and I-131 WBS yielded concordant negative results in the majority (77%) of patients (9); in one patient only were the two imaging techniques concordant in their positive result. In the last three patients, the results were discordant; in particular, distant metastases were detected by I-131 WBS only in two patients and by FDG-PET only in one patient. Our work indicates a fundamental role for US in evaluation of the neck after surgery for DTC. WBS is useful to determine differentiation of tumour lesions, to identify thyroid remnants and to look for distant metastases. FDG-PET has an important role in cases of dedifferentiated thyroid carcinoma in which WBS and thyroglobulin measurements are unable to detect tumour lesions.

/pdf/postsurgical-diagnostic-evaluation-of-patients-with-2mxefv3o97.pdf

Postsurgical diagnostic evaluation of patients with differentiated thyroid carcinoma: comparison of ultrasound, iodine-131 scintigraphy and PET with fluorine-18 fluorodeoxyglucose

Objective:To investigate the association of mural parameters of MR-enterography (MRE) with one-year therapeutic management of Crohn’s disease (CD) patients.Methods:CD patients, undergone MRE with d...

MR-enterography in Crohn's disease: what MRE mural parameters are associated to one-year therapeutic management outcome?

123I-radiolabeled metaiodobenzylguanidine (123I-MIBG) cardiac imaging has been used to evaluate the distribution of sympathetic nervous system (SNS) in the heart. Different heart diseases have shown impaired cardiac SNS distribution as reflected by MIBG activity. The aim of this study was to assess the cardiac distribution of SNS in normal subjects, using MIBG imaging. Ten normal subjects (1 male and 9 females, mean age 46 +/- 9 years) with no cardiac abnormalities underwent myocardial 123I-MIBG scintigraphy, Tc-99m methoxyisobutylisonitrile (MIBI) cardiac perfusion imaging and equilibrium radionuclide angiography (RNA). Regional myocardial MIBG and MIBI activities were quantitatively evaluated using a region of interest analysis. For this purpose, the left ventricle was divided into 6 myocardial regions as anterior, apical, inferior, septum, lateral and posterolateral. In particular, myocardial MIBG and MIBI activities were measured as myocardium to mediastinum ratio. Regional left ventricular function was assessed by RNA. Myocardial MIBG uptake was homogeneous in anterior (2.2 +/- 0.5), inferior (2.5 +/- 0.7), septal (2.4 +/- 0.4), lateral (2.3 +/- 0.4), and posterolateral (2.3 +/- 0.4) regions. Conversely, MIBG uptake was significantly lower in the apical region (1.9 +/- 0.3) compared to all other left ventricular segments (p < 0.05). Regional myocardial perfusion, as measured by MIBI uptake, was homogeneous in all regions. No regional left ventricular wall motion abnormalities were observed by RNA. In conclusion, our data suggest that a decreased MIBG uptake may be observed in the left ventricular apical region of normal subjects reflecting reduced sympathetic innervation of the apex. This finding is not related to myocardial perfusion or wall motion abnormalities. The knowledge of cardiac sympathetic innervation in normal subjects may be helpful to assess SNS abnormalities in heart disease.

Simone Maurea

Papers

18F-FDG PET/CT in Neurolymphomatosis: Report of 3 Cases

Improved detection of viable myocardium with thallium-201 reinjection in chronic coronary artery disease: comparison with technetium-99m-MIBI imaging.

Postsurgical diagnostic evaluation of patients with differentiated thyroid carcinoma: comparison of ultrasound, iodine-131 scintigraphy and PET with fluorine-18 fluorodeoxyglucose

MR-enterography in Crohn's disease: what MRE mural parameters are associated to one-year therapeutic management outcome?

[The heterogeneity of myocardial sympathetic innervation in normal subjects: an assessment by iodine-123 metaiodobenzylguanidine scintigraphy].