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PubMedDate not supplied

Positron emission tomography-computed tomography imaging characteristics of an inferior vena cava tumor thrombus with magnetic resonance imaging correlation.

Thrombus of the renal vein or inferior vena cava is a known complication of renal cell carcinoma (RCC). Accurate discrimination between bland and malignant thrombus can have significant implications toward clinical management. Distinguishing between these 2 entities is not usually possible with enhanced computerized tomography (CT) or magnetic resonance imaging. This case reports the role of combined positron emission tomography-CT imaging in the accurate detection of recurrent RCC after partial nephrectomy and surgically proven tumor thrombus in the renal vein and inferior vena cava.

Carcinoma, Renal Cell↗
PubMed1992

[The demonstration and staging of bladder carcinoma. A comparative study between magnetic resonance tomography, computed tomography and radioimmunoscintigraphy].

The purpose of the present study was to compare the effectiveness of MRI, CT and radioimmunoscintigraphy in the staging and detection of bladder cancers in 28 patients. We distinguish two groups: Group I included the tumour stages CIS-T3A and the second group the deep infiltrative tumours T3B-T4. MRI was slightly superior to CT in respect of tumour staging (75% correct results as compared to 63%). No understaging occurred with MRI, whereas in 22% of the cases the stage of the tumour was underestimated using CT diagnostics. Overstaging occurred in 25% of the MRI and 15% of the CT-diagnostics, respectively. RIS cannot distinguish the tumour groups, and hence this method is useful only for the detection of the primary tumour and metastases. In 77% of cases the tumour was detected and in 15% the tumour could be safely excluded.

Adult↗
PubMed1985

Oblique hilar tomography, computed tomography, and mediastinoscopy for prethoracotomy staging of bronchogenic carcinoma.

Preoperative oblique hilar tomography was used to evaluate hilar lymph nodes in 150 patients with clinically resectable bronchogenic carcinoma. CT was also used in the evaluation of mediastinal lymph nodes in 50 of these patients. Subsequently, all patients underwent mediastinoscopy and/or thoracotomy. Hilar and mediastinal nodes were evaluated for the presence of metastasis, and these findings were then correlated with the radiographic findings of oblique hilar tomography and CT. CT was found to be a reliable method for prethoracotomy staging of bronchogenic carcinoma and for selecting patients for mediastinoscopy. The sensitivity of CT for evaluation of mediastinal nodal metastasis was 83% and the specificity was 90%. Thus patients with negative mediastinal CT need not undergo mediastinoscopy prior to thoracotomy, while mediastinoscopy and biopsy should be done in patients with enlarged mediastinal nodes on CT. Oblique hilar tomography is an accurate method for evaluation of hilar adenopathy and for predicting mediastinal involvement by extrapolation.

Adult↗
PubMedDate not supplied

[Magnetic resonance tomography, computed tomography and ultrasonic diagnosis of hemangiomas of the liver].

The paper is concerned with the potentialities of modern radiation methods in the diagnosis of liver hemangiomas. USI, CT, angiography and MR-tomography (MRT) were used for investigation of 64 patients with liver hemangiomas. The diagnostic potentialities and the role of each of the above methods in the diagnostic algorithm in liver hemangiomas were studied. The results of the investigation have shown that MRT possesses a higher informative value than USI and CT in the diagnosis of liver hemangiomas and can even replace angiography in the verification of diagnosis.

Adult↗
PubMed2005

The accuracy of endoscopic ultrasonography with fine-needle aspiration, integrated positron emission tomography with computed tomography, and computed tomography in restaging patients with esophageal cancer after neoadjuvant chemoradiotherapy.

BACKGROUND: Patients with esophageal cancer who receive neoadjuvant chemoradiotherapy are restaged with computed tomography (CT), endoscopic ultrasound with fine needle aspiration (EUS-FNA), and integrated positron emission computed tomography (FDG-PET/CT), and the results affect treatment. METHODS: This is a prospective trial on a consecutive series of patients who had initial chest, abdomen, and pelvis CT scan; EUS-FNA; and fluoro-2-deoxy- d -glucose (FDG)-integrated PET/CT; neoadjuvant chemoradiotherapy; repeat staging tests; pathologic staging; and, if appropriate, resection with lymphadenectomy. The primary objective was to assess the accuracy of these 3 tests in restaging patients after neoadjuvant therapy. RESULTS: There were 48 patients (41 men), and 41 underwent Ivor Lewis esophagogastrectomy with lymphadenectomy. The accuracy of each test for distinguishing pathologic T4 from T1 to T3 disease is 76%, 80%, and 80% for CT scan, EUS-FNA and FDG-PET/CT, respectively. The accuracy for nodal disease was 78%, 78%, and 93% for CT scan, EUS-FNA and FDG-PET/CT, respectively ( P = .04). FDG-PET/CT correctly identified M1b disease in 4 patients, falsely suggested it in 4 patients, and missed it in 2 patients, whereas for CT, it was 3, 3, and 3 patients. Fifteen (31%) patients were complete responders, and FDG-PET/CT accurately predicted complete response in 89% compared with 67% for EUS-FNA ( P = .045) and 71% for CT ( P = .05). CONCLUSIONS: FDG-PET/CT is more accurate than EUS-FNA and CT scan for predicting nodal status and complete responders after neoadjuvant therapy in patients with esophageal cancer. FDG-PET/CT and CT alone provide targets for biopsy, but results are often falsely positive.

Adenocarcinoma↗
PubMedDate not supplied

Improvement of sensitivity and interrater reliability to detect acute stroke by dynamic perfusion computed tomography and computed tomography angiography.

OBJECTIVE: To assess the benefits of additional computed tomography perfusion (CTP) and computed tomography angiography (CTA) on the detection of early stroke, vessel occlusion, estimated infarct size, and interrater reliability. METHODS: Sixty-seven consecutive patients underwent nonenhanced computed tomography (CT) imaging, CTA, and CTP. The final diagnosis of stroke was made from follow-up neuroimaging. A first diagnosis was made on-site by the physician on duty. Three experienced neuroradiologists blinded to follow-up findings analyzed the data set off-line, evaluated CT for signs of acute stroke, and subsequently evaluated CTP and CTA for infarction-related perfusion deficits and vessel abnormalities. RESULTS: Computed tomography perfusion and CTA increased the time from CT start to diagnosis from 2 minutes to 10 minutes. Sensitivity to detect acute stroke increased significantly in all investigators from 0.46-0.58 to 0.79-0.90 compared with CT (<0.005). The interrater weighted kappa value increased from 0.35 to 0.64. Estimation of infarct size was not improved. CONCLUSION: Computed tomography perfusion and CTA provide an effective add-on to standard CT in acute stroke imaging by significantly increasing the sensitivity and reliability of infarct detection.

Acute Disease↗
PubMed2002

Detection of recurrent or persistent nasopharyngeal carcinomas after radiotherapy with technetium-99m methoxyisobutylisonitrile single photon emission computed tomography and computed tomography: comparison with 18-fluoro-2-deoxyglucose positron emission tomography.

BACKGROUND: The diagnostic accuracy of technetium-99m methoxyisobutylisonitrile (Tc-MIBI) single photon emission computed tomography (SPECT) and computed tomography (CT) of the head and neck for differentiating recurrent or residual nasopharyngeal carcinomas (NPC) from benign lesions after radiotherapy was compared with positron emission tomography (PET) with 18-fluoro-2-deoxyglucose (FDG). METHODS: Thirty six NPC patients underwent head and neck CT, Tc-MIBI SPECT, and FDG-PET four months after radiotherapy to differentiate recurrent or residual NPC from benign lesions. Histopathologic examinations of nasopharyngeal biopsies were performed for all 36 patients. No patients had multiple foci of NPC. RESULTS: Based on biopsy results, the sensitivity, specificity, and accuracy of CT for differentiating recurrent or residual NPC from benign lesions were 73%, 88%, and 83%, respectively. The sensitivity, specificity, and accuracy of Tc-MIBI SPECT were 73%, 96%, and 89%, respectively. The sensitivity, specificity, and accuracy of FDG-PET were 100%, 96%, and 97%, respectively. Combination CT and Tc-MIBI SPECT for 28 NPC patients with congruent results showed the same sensitivity, specificity, and accuracy of 100%, 96%, and 96%, respectively, as FDG-PET for differentiating recurrent or residual NPC from benign lesions. In eight patients with incongruent results between CT and Tc-MIBI SPECT, FDG-PET correctly differentiated two benign lesions and six recurrent or residual NPCs. CONCLUSIONS: In detecting recurrent or residual NPC, FDG-PET is the best tool. However, combined use of CT and Tc-MIBI SPECT can result in the same accuracy as FDG-PET.

Adolescent↗
PubMedDate not supplied

Detection of cervical lymph node metastases in nasopharyngeal carcinomas: comparison between technetium-99m methoxyisobutylisonitrile single photon emission computed tomography and computed tomography.

The aim of this study was to compare the effectiveness of technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) single photon emission computed tomography (SPECT) and computed tomography (CT) of head and neck in evaluating cervical lymph node (LN) metastasis in nasopharyngeal carcinomas (NPC). Fifty NPC patients with suspected cervical LN metastases underwent Tc-99m MIBI SPECT and CT of the head and neck to evaluate cervical LN metastases. Among the 50 patient.s cervical LN lesion were confirmed by biopsy histopathological results in 40 patients. For 22 LN lesions with discordant results between Tc-99m MIBI SPECT and CT Tc-99m MIBI SPECT could correctly detect 5 metastatic and 7 benign LN lesions, while could correctly detect 5 metastatic and 6 benign LN lesions. Tc-99m MIBI SPECT and CT could correctly detect all of the 18 metastatic LN lesions. Tc-99m MIBI SPECT showed a better specificity but a lower sensitivity for detecting cervical LN metastases in NPC when compared with CT. The combined use of Tc-99m MIBI SPECT and CT could increase the accuracy, compared with the single use of either Tc-99m MIBI SPECT or CT, to detect cervical LN metastases in NPC.

Adult↗
PubMed2001

Occult primary tumors of the head and neck: accuracy of thallium 201 single-photon emission computed tomography and computed tomography and/or magnetic resonance imaging.

OBJECTIVE: To determine the accuracy of thallium 201 single-photon emission computed tomography (thallium SPECT) and computed tomography and/or magnetic resonance imaging (CT/MRI) in the detection of occult primary tumors of the head and neck. DESIGN: Study of diagnostic tests. SETTING: National Cancer Institute, Amsterdam, the Netherlands. PATIENTS AND METHODS: Thirty-two patients with a neck node metastasis of an epithelial tumor and negative findings by mirror examination at initial presentation were included in the study. Twenty-nine patients underwent thallium SPECT and CT/MRI before examination under general anesthesia (EUA). In 3 patients only thallium SPECT was performed before EUA. Histological confirmation of an occult primary tumor during EUA was used as the gold standard. Negative radiodiagnostic and nuclear findings in the upper aerodigestive tract in the presence of a primary carcinoma other than of the head and neck were interpreted as true-negative findings. RESULTS: For thallium SPECT the following results were recorded: sensitivity, 67%; specificity, 69%; accuracy, 69%; positive predictive value, 33%; and negative predictive value, 90%. In 1 patient, thallium whole body scan indicated a primary carcinoma beyond the mucosal lining of the upper aerodigestive tract. The CT/MRI results were as follows: sensitivity, 71%; specificity, 73%; accuracy, 72%; positive predictive value, 45%; and negative predictive value, 89%. CONCLUSIONS: Thallium SPECT and CT/MRI showed comparable results for detection of occult primary tumors of the head and neck. A potential advantage of thallium SPECT is that it allows total body screening.

Adult↗
PubMed2005

Usefulness of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography and computed tomography in the evaluation of cervical lymph node metastasis.

The aim of this study was to compare the effectiveness of technetium-99m methoxyisobutylisonitrile ((99m)Tc-MIBI) single-photon emission computed tomography (SPECT) and computed tomography (CT) in evaluating cervical lymph node metastasis of head and neck cancer. Histopathologic results of 166 cervical lymph node levels in 31 neck-dissected patients were compared with pre-operative CT and (99m)Tc-MIBI SPECT findings about cervical lymph node metastasis, retrospectively. Sensitivity, specificity and predictability of CT and (99m)Tc-MIBI SPECT were 68.2, 93.1 and 89.8 per cent and 59.1, 87.5 and 83.7 per cent, respectively. When analysing CT and(99m)Tc-MIBI SPECT together, sensitivity and specificity were 86.4 and 99.3 per cent, respectively. The combined use of (99m)Tc-MIBI SPECT and CT could increase the accuracy of cervical lymph node metastases detection, compared with separate use of either (99m)Tc-MIBI SPECT or CT.

Adult↗
PubMed1992

A comparison of gallium-67 single photon emission computed tomography and computed tomography in mediastinal Hodgkin's disease.

The role of gallium-67 single photon emission computed tomography (Ga-67 SPECT) in the assessment of mediastinal Hodgkin's disease was evaluated prospectively. Ga-67 SPECT and computed tomography (CT) were compared and correlated with clinical findings at initial presentation in 30 patients, 6 weeks after treatment, and 6 months later in 20 of the 30 patients. At initial presentation, active disease was detected on both imaging modalities on all occasions. 6 weeks after treatment CT showed residual mediastinal abnormality in 7 patients, whereas Ga-67 SPECT showed abnormal mediastinal tracer uptake in 3 patients. 6 months later CT showed residual mediastinal abnormality in 5 patients whereas all the Ga-67 SPECT studies were negative. Ga-67 SPECT imaging is a useful tool in assessing response to therapy in mediastinal Hodgkin's disease.

Adult↗
PubMedDate not supplied

[Potentialities of conventional computed tomography and computed tomography angiography in evaluation of local spread of central type lung cancer].

To define the potentialities of conventional computed tomography (CCT) and contrast-enhanced computed tomography (CECT) in the the evaluation of spread of central-type lung cancer, 141 patients were studied. The results of the studies were compared with the data of surgical interventions in 86 patients. The analysis of their efficiency was based on the examination of the accuracy, sensitivity, and specificity of each technique. Analyzing the findings showed that the potentialities of CECT exceeded those of CCT. There were the most manifest differences in the accuracy and sensitivity of these techniques. This was due to the fact that CECT was the leading imaging of vessels, such as the pulmonary artery, superior cava, aorta, which in turn greatly reduced the number of false-negative and false-positive conclusions. No great differences were found in the efficiency of the techniques when the invasion of the trachea, esophagus, and vertebral column was determined.

Aged↗