AIMS: The studyAIMed at comparing two methods for evaluating thymidinekinase TK in serum - an older RIA method and novel DiviTum - in patients with MM and MGUS, and also comparing them with biochemical markers and degree of activity evaluated by imaging methods 99mTc-MIBI scintigraphy and 18F-FDG PET/CT. METHODS: Serum thymidinekinase TK levels were evaluated by DiviTum and an RIA method (TK REA kit by Immunotech);The study analyzed correlation of TK activity in serum with biochemical markers reflecting activity of MM: β2-m, LDH, the ratio of kappa to lambda (κ/λ) free light chains and percentage of bone marrow plasma cells (BMPC). 99mTc-MIBI scintigraphy and 18F-FDG PET/CT were performed at the time of diagnosis. The degree of activity was expressed semiquantitatively. Scans were classified as 0 (normal activity), 1 (diffuse positivity) or 2 (focal positivity). RESULTS: We found a strong positive correlation between TK in serum evaluated by DiviTum and by TK REA.. The DiviTum analytic method extended the detection range and was able to detect higher levels of TK than the RIA method. DiviTum technique found positive correlation with β2-m (r = 0.497) and LDH (r = 0.502) and moderate positive correlation with BMPC (r = 0.368). Significantly higher TK values measured by TK REA and DiviTum in the group of patients with MM (stages I, II or III) than in those with MGUS. Increased TK levels were observed in MIBI- or PET/CT-positive patients. Analysis of repeated measurements of TK in serum during treatment of MM patients found a correlation between change in TK measured by DiviTum and LDH during treatment. CONCLUSIONS: Analysis revealed a significant correlation between TK in serum and LDH, β2-m and BMPC. Increased levels of TK in serum were observed in MIBI- or PET/CT-positive patients. Combination of positivity of imaging methods which can localize active tumor lesions and increased levels of TK in serum can have an impact on decision-making and optimization of the therapeutic approach.
- MeSH
- biologické markery krev MeSH
- dospělí MeSH
- fluorodeoxyglukosa F18 farmakologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mnohočetný myelom diagnostické zobrazování enzymologie MeSH
- monoklonální gamapatie nejasného významu diagnostické zobrazování enzymologie MeSH
- počítačová rentgenová tomografie * MeSH
- pozitronová emisní tomografie * MeSH
- prognóza MeSH
- radiofarmaka farmakologie MeSH
- radioimunoanalýza MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- thymidinkináza krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
BACKGROUND: The aim was to compare the speckle tracking echocardiography (STE) derived systolic longitudinal strain (SL(Smax)) with rest single photon emission computed tomography (SPECT) perfusion imaging (Q(REST)), and to define the optimal cut-offs for SL(Smax) to discriminate transmural scar on contrast-enhanced magnetic resonance imaging (ceCMR). METHODS AND RESULTS: In 100 patients with chronic ischemic left ventricular (LV) dysfunction, myocardial viability was assessed using STE and rest SPECT to predict LV segmental relative extent of delayed enhancement (DE) >75% on ceCMR. Correlation was found between regional SL(Smax) (r=-0.59, P<0.0001) and DE on ceCMR. The SL(Smax) optimal cut-off -5.3% identified segments with DE>75% on ceCMR (sensitivity 83.1%, specificity 84.6%). Optimal cut-offs SL(Smax) for segments corresponding to individual perfusion territories (-3.6%, -5.3% and -4.7% for LAD, LCx resp. RCA perfusion territories) were identified. There was a significant difference (AUC 0.866 vs. 0.822 for SL(Smax) resp. Q(REST), p=0.036) in the accuracy of predicting non-viable segment due to the greater accuracy of SL(Smax) than Q(REST) in the RCA perfusion territory (AUC 0.893 vs. 0.75 for SLSmax resp. Q(REST), P=0.001). CONCLUSIONS: STE enabled identification of LV non-viable segments. Cut-off values derived for perfusion territories of individual coronary arteries improve the accuracy of predicting a transmural scar presence. In comparison with rest myocardial SPECT perfusion imaging, STE is more accurate in predicting non-viable myocardium.
- MeSH
- dysfunkce levé srdeční komory diagnóza MeSH
- echokardiografie * MeSH
- ischemická choroba srdeční diagnóza patofyziologie ultrasonografie MeSH
- jednofotonová emisní výpočetní tomografie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- odpočinek MeSH
- prediktivní hodnota testů MeSH
- přežití tkáně MeSH
- radiofarmaka diagnostické užití MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- zátěžový test MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
POEMS syndrome is a clinical condition with a very heterogeneous clinical manifestation. Its presentation as well as monitoring is complex and dependent on the clinician´s experience. One of the leading presenting symptoms is based on evaluation of skeletal damage with typical osteosclerotic or mixed lesions. Aims and methods. Our aim was to compare the usefulness of different imaging methods in the diagnostics of POEMS syndrome, such as conventional radiography, densitometry, technetium scintigraphy, PET/CT scan, MRI and angiography on a series of three patients with POEMS syndrome with different clinical manifestations and course of disease. Results. Our series demonstrates different types of skeletal involvement in POEMS syndrome. Although conventional X-ray is the imaging method mostly used for the evaluation, its sensitivity and specificity is low. Under specific conditions, other imaging methods should be considered, giving a more complex outlook of the disease’s skeletal involvement. Nevertheless, FDG-PET/CT confirmed its superiority in defining both skeletal lesions as well as the activity of the neoplastic process. Conclusions. We conclude that the different manifestation of the disease implies the necessity of a complex evaluation of imaging methods in mutual concordance. FDG-PET/CT emerges as the most contributive method for the evaluation of both the extent and activity of the disease.
- MeSH
- dospělí MeSH
- kosti a kostní tkáň patologie radiografie MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- multimodální zobrazování MeSH
- osteoskleróza diagnóza komplikace radiografie MeSH
- počítačová rentgenová tomografie MeSH
- POEMS syndrom diagnóza komplikace MeSH
- senioři nad 80 let MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
BACKGROUND: Monoclonal antibodies have dramatically changed the treatment possibilities for follicular lymphoma. (90)Y-ibritumomab tiuxetan (Zevalin) is the first radioimmunotherapy agent approved for the treatment of relapsed and resistant follicular lymphoma patients. Long-term benefit was observed especially for patients achieving CR after radioimmunotherapy. METHODS AND RESULTS: A 65-year-old female patient with the second relapse of CD20 positive follicular lymphoma and multiple concomitant diseases was treated with four weekly doses of rituximab (375 mg/m(2)). (18)F-fluoro-deoxyglucose positron emission tomography combined with computed tomography (PET-CT) demonstrated only partial response to therapy with persistent PET scan positivity in enlarged abdominal lymph nodes. Therefore, it was decided to treat her with a 1200-MBq (32-mCi) dose of (90)Y-ibritumomab tiuxetan radioimmunotherapy. No acute complications were noted afterwards. Hematological nadirs were reached 4 weeks later, with a platelet count of 24 x 10(9)/l that normalized within the next 2 weeks. The patient had neither infection nor bleeding complications. Eight weeks after radioimmunotherapy, the PET-CT scans documented only 3 lymph nodes around the abdominal aorta, maximum size 2 x 1 cm. The PET scan analysis proved no accumulation of (18)F-fluoro-deoxy-glucose in any lymph nodes or other organs and tissues. CONCLUSIONS: Sequential treatment with rituximab and (90)Y-ibritumomab tiuxetan may be an interesting alternative in cases of relapsed follicular or other indolent lymphomas in pretreated or older patients with other concomitant diseases.
- MeSH
- folikulární lymfom farmakoterapie radioterapie MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- monoklonální protilátky terapeutické užití MeSH
- myší monoklonální protilátky MeSH
- protinádorové látky terapeutické užití MeSH
- radioimunoterapie MeSH
- radioizotopy ytria terapeutické užití MeSH
- recidiva MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- MeSH
- jednofotonová emisní výpočetní tomografie statistika a číselné údaje využití MeSH
- lidé MeSH
- nemocnice trendy MeSH
- průzkumy zdravotní péče MeSH
- radionuklidy diagnostické užití MeSH
- srdce MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- kardiologická služba nemocniční statistika a číselné údaje trendy MeSH
- lékařská praxe - způsoby provádění statistika a číselné údaje MeSH
- lidé MeSH
- nukleární lékařství - oddělení nemocnice trendy MeSH
- tomografie emisní počítačová využití MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- arteria hepatica MeSH
- jaterní cirhóza MeSH
- jaterní oběh MeSH
- játra MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- MeSH
- bronchoalveolární lavážní tekutina MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- plíce MeSH
- plicní nemoci diagnóza MeSH
- radioizotopy galia diagnostické užití MeSH
- radioizotopy kobaltu diagnostické užití MeSH
- sarkoidóza diagnóza MeSH
- scintilace - počítání metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
