Showing papers by "Phoebe Putney Memorial Hospital published in 2011"

Head and neck paragangliomas

Abstract: Background The purpose of this study was to describe the natural history and optimal treatment for head and neck paragangliomas (PGs). Methods Our methods were the review of the pertinent literature. Results PGs are rare tumors seen most commonly in the head and neck. Approximately 90% are sporadic; the remainder are familial and related to mutations of the succinate dehydrogenase (SDH) gene complex. Most PGs are benign and slow growing; 6% to 19% are malignant, as evidenced by the development of metastases. PGs may be treated by complete resection or moderate-dose radiotherapy with a ≥90% likelihood of cure. The optimal radiotherapy dose is approximately 45 Gy/25 fractions/5 weeks. The treatment modality selected depends on the risk of complications. Due to their rarity, the optimal treatment for malignant PGs is unclear. Conclusion PGs may be treated by either complete resection or radiotherapy with a high likelihood of success. Treatment depends on the location and extent of the PG and the morbidity associated with treatment. © 2010 Wiley Periodicals, Inc. Head Neck, 2010

Early dynamic PET/CT and 18F-FDG blood flow imaging in bladder cancer detection: A novel approach

Abstract: 1909 Objectives The present standard protocols for performing hybrid positron emission tomography (PET) and computed tomography (CT) with 18F-fluoro-2-deoxyglucose (18F-FDG) call for data acquisition to start 50-60 min. post-injection (PI) of the radiopharmaceutical. However, this prolonged period of tracer incubation allows its accumulation in the urinary bladder making it difficult, if not impossible, to identify abnormal growths on the surface of this organ. Our objective was to identify bladder wall lesions using a novel PET/CT and 18F-FDG imaging protocol. This novel approach was inspired by the angiogenesis property observed in cancer cells and the delayed excretion of high activity concentration 18F-FDG in urinary bladder by the kidneys. Methods Early (starting at injection time) dynamic PET/CT and 18F-FDG scans were performed on 7 consecutive male patients with pathology confirmed bladder cancer. A series of 5 dynamic scans of 2 min. each, starting at injection time, were obtained on each patient’s bladder using a single bed-position. Areas of increased 18F-FDG blood flow, observed on bladder wall scans, were considered suspicious for cancer and compared to the final pathologic report. Results Five out of 7 patients’ scans displayed increased blood flow activity to bladder wall areas that were pathologically proven to be malignancies. The other 2 patients’ scans that failed to show increased blood flow activity to the bladder walls were classified, based on pathology reports, as true negative and false negative. The average maximum standard uptake values (SUVmax ± SD) observed in bladder wall areas with increased and normal blood flow were 2.7 ± 0.7 and 1.1 ± 1.3 g/mL, respectively. Conclusions Although the sample size of this study was relatively small and a larger population group is needed to confirm these findings, its results strongly suggest that this novel PET/CT and 18F-FDG bladder imaging approach could be the protocol of the future in bladder cancer evaluation