Cíl: 18 F-fluorestradiol je nové radiofarmakum, které lze použít při zobrazování karcinomu prsu, indikace v klinických postupech ještě nemají své pevné místo, proto je cílem studie posoudit klinický význam zobrazení karcinomu prsu estrogen-pozitivních receptorů (ER+) pomocí 18 F-fluorestradiolu (18 F-FES) PET/CT nebo PET/MR z hlediska využití při rozhodnutí o léčbě. Studie se zabývá také volbou využití PET/CT nebo PET/MR ve stagingu a restagingu karcinomu prsu. Metodika: U 40 pacientek s estrogen pozitivním karcinomem prsu bylo provedeno hybridní zobrazení s intravenózní aplikací 18 F-FES, ve 25 případech bylo použito PET/CT, v 15 případech PET/MR. Radiofarmakum bylo injekčně aplikováno v aktivitě 2,5 MBq/kg. U deseti pacientek byla jako restagingová metoda použito PET/ MR, v pěti případech stagingu před operací bylo provedeno PET/MR s cíleným plným diagnostickým MR zobrazením prsu v pronační poloze s následným zobrazením trupu v poloze na zádech. Všechna vyšetření PET/MR byla provedena po aplikaci gadoliniové kontrastní látky, zobrazení zahrnovalo zobrazení mozku v T1 STARVIBE. PET/CT bylo provedeno kontinuální PET akvizicí následně po akvizici CT s intravenózním podáním jodované kontrastní látky, v pěti případech bylo provedeno ve stagingu, ve 20 případech v restagingu. Výsledky: Nejdůležitějším výsledkem byla detekce ER+ metastáz při negativním výsledku 18 F-FDG-PET (12krát) – včetně mozkových a jaterních metastáz, perzistující ER+ metastáz (7krát), staging onemocnění (10krát), ztráta ER (4krát) a negativní nález pro metastázy (2), při pěti vyšetřeních nebyly nalezeny žádné přidané informace. Závěr: 18 F-FES-PET poskytuje klinicky vý- znamné informace pro volbu léčebné strategie, 18 F-FES-PET/MR je výhodné vyšetření při zaměření na zobrazení mozku a jater s možnos- tí prokázat anebo vyloučit metastázy v těchto orgánech.
Aim. 18 F-fluoroestradiol is a novel radiopharmaceutical useful in the imaging of breast carcinoma, the indications in clinical scenarios are under development. The purpose of the study is to assess the clinical impact of the imaging of the breast carcinoma with estrogenpositive receptors (ER+) using 18 F-fluoroestra- diol ( 18 F-FES) PET/CT or PET/MRI according to the treatment decision making. The study is concerned in the different preference of PET/CT and PET/MRI in the staging and restaging. Methods. 40 patients with estrogen positive breast carcinoma underwent the hybrid imaging after intravenous application of 18 F-FES, in 25 cases it was used PET/CT, in 15 cases PET/ MRI. The radiopharmaceutical was injected with the activity of 2,5 MBq/kg. In 10 patient, PET/MRI was used as restaging method, PET/ MRI was performed in the 5 cases of the staging before surgery with targeted full diagnostic MRI imaging of the breast in prone position, followed by the trunk imaging in supine position. All PET/MRI were performed after application of the gadolinium contrast material, the imaging included brain imaging in T1 STARVIBE. PET/CT was performed using the continuous PET acquisition after CT with the intravenous administration of the iodinated contrast material, in 5 cases was performed in staging, in 20 cases in restaging Results. The most important informa- tion was detection of ER+ metastases when 18 F-FDG-PET was negative (12×) – including brain and liver metastases, the persistent ER+ of the metastases (7×), staging of the disease (10×), the loss of the ER (4x) and the negative finding for metastases (2), no added information was found in 5 examinations. Conclusion. 18 F-FES-PET provided the impor- tant clinical information to treatment strategy, 18 F-FES-PET/MRI improves the imaging of metastases in brain and liver.
Zobrazení vlastní tkáně nádoru prostaty je při použití postupů zobrazení obvyklých u jiných nádorů obtížné, nedostatečné je používat metody zobrazení pomocí kontrastního CT vyšetření, z hybridních metod také PET/CT s aplikací 18F-fluorodeoxyglukózy. Magnetickou rezonanci je možné využít v detekci karcinomu prostaty u mužů s elevací prostatického specifického antigenu (PSA) a/nebo zvýšeným indexem zdravé prostaty (PHI). V současnosti je možné využití spojení radiologických metod a nukleární medicíny - výpočetní tomografie a pozitronové emisní tomografie (PET/CT) nebo magnetické rezonance a pozitronové emisní tomografie (PET/MR). Pro pozitronovou emisní tomografii je možné využití 18F-fluorocholinu (18F-FCH), 18F-fluciclovinu, a 18F-natriumfluoridu (18F-NaF) nebo 68Ga-PSMA-11 (ligand prostatického specifického membránového antigenu), a to ve vyhledávání, stagingu a restagingu karcinomu prostaty. PET/MR nebo PET/CT s podáním 68Ga-PSMA-11 představuje současnou optimální metodu při stagingu, restagingu a kontrole účinku terapie karcinomu prostaty.
Imaging of the prostate tumour ́s own tissue is using standard tumour imaging approaches remains difficult, the imaging using contrast enhanced computed tomography and also the hybrid imaging using PET/CT with the application of the 18F-fluorodeoxyglucose is insufficient. Magnetic resonance imaging is useful in detection of prostate cancer in patients with elevated prostatic specific antigen (PSA) and/or with increased prostate health index (PHI). Currently, it is possible to use combination of radiological and nuclear medicine methods - hybrid positron emission tomography combined with computed tomography (PET/CT) or with magnetic resonance imaging (PET/MRI) with the application of 18F-fluorocholine (FCH), 18F-fluciclovine, 18F-natriumfluoride (18F-NaF) or 68Ga-PSMA-11 (ligand of prostatic specific membrane antigen) in detection, staging or restaging of prostate carcinoma. PET/CT or PET/MRI with the application of 68Ga-PSMA-11 represents current optimal method for staging, restaging and evaluation of prostate cancer therapy response.
- MeSH
- Diagnostic Imaging classification methods MeSH
- Fluorodeoxyglucose F18 therapeutic use MeSH
- Humans MeSH
- Magnetic Resonance Imaging methods MeSH
- Multimodal Imaging * classification methods MeSH
- Prostatic Neoplasms * diagnostic imaging diagnosis MeSH
- Positron Emission Tomography Computed Tomography methods MeSH
- Prostate-Specific Antigen analysis MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
18 F-FDG-PET zobrazení u nemocných s neurodegenerativními onemocněními je nejvhod- nější metodou k rozpoznání jednotlivých typů neurodegenerací. Jednotlivé typy onemocnění nebo jejich skupiny vykazují specifické vzorce distribuce hypometabolismu – lze tak odlišit zejména frontotemporální degeneraci od demence s Lewyho tělísky a od Alzheimerovy nemoci, a dále onemocnění charakterizovaná poruchami vyjadřování ze skupiny primární progresivní afázie nebo onemocnění s poru- chami pohybu typu kortikobazální degenerace. Doplňující zobrazení s pomocí amyloid specifických látek pak slouží k potvrzení přítomnosti amyloidu beta v kortikální šedé hmotě u nemocných Alzheimerovou chorobou.
18 F-FDG-PET imaging in patients with neurode- genertive diseases is the oiptimal method to distinguish several types of the neurodegenerations including coexisting pathologies. Individual types of diseases or groups of diseases exhibit specific patterns of hypometabolism distribution – in particular, frontotemporal degeneration can be distinguished from dementia with Léwy bodies and Alzheimer’s disease, as well as diseases characterized by speech disorders from the group of primary progressive aphasia or diseases with movement disorders such as corticobasal degeneration. Additional amyloid-beta imaging serves to confirm the amyloid beta presence within gray cortical matter in Alzheimer disease.
- MeSH
- Humans MeSH
- Liver Diseases * diagnostic imaging MeSH
- Pancreatic Diseases * diagnostic imaging MeSH
- Bile Duct Diseases * diagnostic imaging MeSH
- Radiography methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
BACKGROUND/AIM: To test the correlation of 68Ga-PSMA-11 uptake and the expression of PSMA (prostatic specific membrane antigen) with the Gleason score, apparent diffusion coefficient (ADC) and pharmacokinetic parameters obtained from dynamic contrast agent-enhanced MRI/PET. PATIENTS AND METHODS: Forty newly diagnosed, therapy naïve patients with prostatic carcinoma (PC) (mean age of 56.7, range=34-79), who were referred for 68Ga-PSMA-11-PET/MRI for primary staging and had undergone radical prostatectomy (RAPE) were included in this prospective study. Their blood samples were tested for serum levels of prostate-specific antigen (PSA) and proPSA. The patients' prostates were evaluated using whole-mount sections, which helped determine the extent and grade of the tumor; tests were performed to determine immunohistochemical PSMA expression. RESULTS: A correlation between PSMA expression and the accumulation of 68Ga-PSMA-11 was found using the Spearman correlation coefficient (p=0.0011). A stronger correlation was found between Gleason patterns 3 or 4 and PSMA expression (p=0.06). Furthermore, the correlation of Gleason score with the overall 68Ga-PSMA-11 accumulation within the tumor or non-tumor tissue was found to be significant (p=0.0157). A significant relation was found only with the Kep elimination rate constant, which was stronger in Gleason pattern 4 than in Gleason pattern 3. A weaker correlation was found between the accumulation of 68Ga-PSMA-11 and Ktrans in Gleason pattern 4: the most significant relation being between ADCmin and Gleason pattern 3 and 4 (p=0.0074). The total size of the tumor correlated with levels of proPSA (p<0.0001), and its extra prostatic extension correlated with levels of proPSA (p<0.0001). CONCLUSION: 68Ga-PSMA-11 correlates well with the expression of PSMA. Gleason pattern 3 and 4 had a higher correlation with 68Ga-PSMA-11 levels than did Gleason pattern 5. Either no correlation, or a weak correlation, was established with pharmacokinetics.
- MeSH
- Edetic Acid MeSH
- Carcinoma * MeSH
- Middle Aged MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Prostatic Neoplasms * diagnostic imaging surgery metabolism MeSH
- Oligopeptides MeSH
- Positron Emission Tomography Computed Tomography MeSH
- Positron-Emission Tomography MeSH
- Prospective Studies MeSH
- Prostate pathology MeSH
- Gallium Radioisotopes MeSH
- Neoplasm Grading MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
V přehledovém článku jsou předloženy základní informace o využití hybridního spojení pozitronové emisní tomografie a magnetické rezonance při zobrazování dětských pacientů, jsou vyloženy základní technické aspekty zobrazení, logistika vyšetření i aspekty specifické pro děti. Souhrnně jsou představeny zásadní infikace v dětském věku, kdy může hrát PET/MRI v diagnostice významnou roli.
Manuscript reviews general information about use of hybrid imaging using positron emission tomography and magnetic resonance imaging in pediatric patients. The basic technical aspects, logistic and specific aspects in children are explained. There are summarized the most serious indications of PET/MRI in children when this kind of imaging might play the important role.
Angiogenesis in healthy tissue and within malignant tumors differs on many levels, which may partly be explained by vascular mimicry formation resulting in altered contrast material or different radiopharmaceuticals distributions. Failed remodulation results in changes in the molecular exchange through the capillary wall and those consequences affect the behavior of contrast agents and radiopharmaceuticals. One of the most indicative signs of malignant tissue is the increased permeability and the faster molecular exchange that occurs between the extracellular and intravascular spaces. Dynamic imaging can help to assess the changed microenvironment. The fast-distribution of molecules reflects newly developed conditions in blood-flow redistribution inside a tumor and within the affected organ during the early stages of tumor formation. Tumor development, as well as aggressiveness, can be assessed based on the change to the vascular bed development, the level of molecular exchange within the tissue, and/or indicative distribution within the organ. The study of the vascular network organization and its impact on the distribution of molecules is important to our understanding of the image pattern in several imaging methods, which in turn influences our interpretation of the findings. A hybrid imaging approach (including PET/MRI) allows the quantification of vascularization and/or its pathophysiological impressions in structural and metabolic images. It might optimize the evaluation of the pretreatment imaging, as well as help assess the effect of therapy targeting neovascularization; antiVEGF drugs and embolization-based therapies, for example.
- MeSH
- Contrast Media MeSH
- Humans MeSH
- Magnetic Resonance Imaging methods MeSH
- Tumor Microenvironment MeSH
- Neoplasms * diagnostic imaging MeSH
- Neovascularization, Pathologic diagnostic imaging pathology MeSH
- Perfusion MeSH
- Radiopharmaceuticals * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Castleman ́s disease is an extremely rare heterogenous lymphoproliferative pathology with a mostly benign behavior. It is a localized or generalized lymph node enlargement of an unknown aetiology. Unicentric form is typically a slow-growing solitary mass occurring mostly in the mediastinum, abdominal cavity, retroperitoneum, pelvis and neck. Aetiology and pathogenesis of CD is probably diverse, varying in different types of this heterogeneous disease. MATERIALS AND METHODS: Authors present a review of this issue based on their extensive experience. The aim is to summarize the crucial factors in the management of diagnostics and a surgical treatment of the unicentric form of Castleman ́s disease. One of the key issues in the unicentric form is precise preoperative diagnostics and thus choosing the right surgical treatment strategy. Authors highlight pitfalls of the diagnosis and surgical treatment. RESULTS: All histological types such as a hyaline vascular type, plasmacytic type and a mixed type are presented as well as options of surgical and conservative treatment. Differential diagnosis and malignant potential is discussed. CONCLUSION: Patients with Castleman ́s disease should be treated in the high- volume centers, with a great experience in major surgical procedures as well as with preoperative imaging diagnostic techniques. Specialized pathologists and oncologists focusing on this issue are also absolutely necessary to avoid misdiagnosis. Only this complex approach can lead to excellent outcomes in patients with UCD.
- Publication type
- Systematic Review MeSH
Obrazový přehled předkládá soubor nejčastějších forem manifestace tuberkulózy a jejich projevech v skiagrafickém obrazu, obrazu výpočetní tomografie a dále také obrazu v hybridním zobrazení PET/CT. Jsou popsány typické formy sekundární tuberkulózy, včetně závažných forem charakteru plieni miliámí tuberkulózy, tuberkulózy infiltrativní, formy s rozpadem pod obrazem fibrokavemózní tuberkulózy, tuberkulózni pleuritidy a perikarditidy, dále i méně časté manifestace typu systémové miliámí tuberkulózy, tuberkulózni lymfadenitidy, tuberkulózy gastrointestinální a formy izolované tuberkulózy v ledvinách nebo v oblasti páteře.
Pictorial review presents the sample of the most frequent forms of tuberculous manifestation, and their appearances on plain radiograph, computed tomography and hybrid imaging with PET/CT. There are described typical forms of secondary tuberculosis, including the clinically severe forms, like pulmonary miliary tuberculosis, infiltrative tuberculosis, tuberculosis with the cavitation including fibrocavemous tuberculosis, tuberculous pleuritis, tuberculous pericarditis. The rarer forms are displayed like systemic miliary tuberculosis, tuberculous lymphadenitis, intestinal tuberculosis, and forms of isolated tuberculosis of kidneys and vertebral column.
- MeSH
- Humans MeSH
- Positron Emission Tomography Computed Tomography MeSH
- Pleurisy diagnostic imaging pathology MeSH
- Lung diagnostic imaging pathology MeSH
- Tuberculosis, Pulmonary diagnostic imaging classification physiopathology pathology MeSH
- Tomography, X-Ray Computed MeSH
- Disease Progression MeSH
- Radiography, Thoracic MeSH
- Tuberculosis, Gastrointestinal diagnostic imaging pathology MeSH
- Tuberculosis, Lymph Node diagnostic imaging pathology MeSH
- Tuberculosis, Spinal diagnostic imaging pathology MeSH
- Tuberculosis * diagnostic imaging classification physiopathology pathology MeSH
- Pericarditis, Tuberculous diagnostic imaging pathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
V přehledovém článku jsou předloženy základní informace o využití hybridního spojení pozitronové emisní tomografie a magnetické rezo- nance při zobrazování dětských pacientů, jsou vyloženy základní technické aspekty zobrazení, logistika vyšetření i aspekty specifické pro děti. Souhrnně jsou představeny zásadní infikace v dětském věku, kdy v diagnostice PET/MR mohou hrát významnou roli.
Manuscript reviews general information about use of hybrid imaging using positron emission tomography and magnetic resonance imaging in pediatric patients. The basic technical aspects, logistic and specific aspects in children are explained. There are summarized the mot serious indications of PET/MRI in children, when this kind of imaging might play the important role.
- Keywords
- PET/MR,
- MeSH
- Electronic Data Processing classification methods MeSH
- Child MeSH
- Epilepsy diagnostic imaging MeSH
- Humans MeSH
- Magnetic Resonance Imaging methods MeSH
- Multimodal Imaging * methods instrumentation MeSH
- Neoplasms diagnostic imaging MeSH
- Positron-Emission Tomography methods MeSH
- Radiopharmaceuticals administration & dosage MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
