DSpace community: 附設醫院核子醫學部

Prevalence of Concomitant Atherosclerotic Arterial Diseases in Patients with Significant Cervical Carotid Artery Stenosis in Taiwan

title: Prevalence of Concomitant Atherosclerotic Arterial Diseases in Patients with Significant Cervical Carotid Artery Stenosis in Taiwan abstract: BACKGROUNDS: Atherosclerotic stenosis of extracranial carotid arteries is an important cause of ischemic stroke in Taiwan, an ethnic Chinese population. Concurrent atherosclerotic arterial disease is an important issue in the management of patients with carotid stenosis, but its prevalence and extent are unknown. METHODS: One hundred and sixty-three consecutive patients with angiographically proven significant cervical carotid artery stenosis (>or=50% stenosis) were enrolled in this study. Angiography was done to document concurrent coronary, renal, and limb artery stenosis. Clinical symptoms and signs were also correlated with the angiographic findings. RESULTS: One or more significant concurrent arterial stenotic disease was found in 73% of the patients. The most frequent were coronary artery disease, found in 68% of the patients, while renal artery stenosis and limb artery stenosis were found in 20% and 21% of the patients, respectively. Age, diabetes, history of angina pectoris, intermittent claudication, and asymmetric arm blood pressures were significantly associated with the presence of concurrent arterial stenosis. However, 41% of the patients with concurrent coronary artery disease did not have any clinical symptoms or history of myocardial infarction. CONCLUSIONS: Our data indicated that concurrent advanced and extensive arterial disease is common in patients with significant cervical carotid stenosis, and also suggest the importance of global evaluation of systemic atherosclerosis in these patients to achieve optimal management.

F-18 Fdg Pet/Ct Illustrating Tumor Invasion in the Ivc from Adrenocortical Carcinoma

title: F-18 Fdg Pet/Ct Illustrating Tumor Invasion in the Ivc from Adrenocortical Carcinoma abstract: Tumor thrombus in the inferior vena cava (IVC) is a rare complication of adrenocortical carcinoma (ACC). We present a right ACC that was found on a routine health checkup and was confirmed by simultaneous measurements of late-afternoon serum cortisol and ACTH levels in a 65-year-old woman. Preoperative F-18 FDG PET/CT revealed intense F-18 FDG uptake in the right adrenal region with tumor invasion in the IVC. This PET result was also confirmed by subsequent abdominal MRI. The patient then had a right adrenalectomy with IVC thrombectomy. Pathologic analysis of the right adrenal tumor and the thrombus from the IVC was consistent with ACC.

WHOLE-BODY F-18 FDG PET FOR HEPATOCELLULAR CARCINOMA PATIENTS AFTER INTERVENTIONAL TREATMENT

title: WHOLE-BODY F-18 FDG PET FOR HEPATOCELLULAR CARCINOMA PATIENTS AFTER INTERVENTIONAL TREATMENT abstract: For hepatocellular carcinoma (HCC) patients after primary treatment, conventional anatomical imagings may not be reliable in detecting residual , recurrent or metastatic lesions. The aim of this retrospective study was to evaluate the usability of FDG PET in the follow-up of HCC patients after prior interventional treatments. The database consisted of 10 male and 2 female (age range, 46-82 years; mean age, 63.4 +/- 11.7 years) who had received primary HCC treatments and underwent FDG PET scans at the National Taiwan University Hospital. The accuracy of FDG PET detection was determined by the histopathological results or other clinical evidences afterwards. Of the 22 lesions, FDG PET studies were able to detect 8 (8/10 , 80%) intrahepatic lesions and 8 (8/12, 66.7%) extrahepatic lesions. The lesion based detection rate of FDG PET is 72.7% (16/22). FDG PET was able to detect at least 1 lesion in 11 patients. The 6 false negative lesions in 6 patients include 2 intrahepatic lesions, 1 brain lesion, 1 sphenoid sinus lesion and 2 multiple subcentimeter pulmonary lesions. FDG PET scan is able to provide valuable auxiliary information for the follow up of HCC patients clinically suspicious of recurrence if their conventional image findings are not unambiguous.

Gallium-67 scintigraphy and f-18 fluorodeoxyglucose position emission tomography in posttransplant lymphoproliferative disorder

title: Gallium-67 scintigraphy and f-18 fluorodeoxyglucose position emission tomography in posttransplant lymphoproliferative disorder abstract: A 21-year-old man, who underwent heart transplantation 5 years earlier because of dilated cardiomyopathy, was admitted for recent onset of intermittent abdominal pain and poor appetite. Whole-body Ga-67 scintigraphy showed intense gastrointestinal uptake. Fluorodeoxyglucose position emission tomography (FDG PET) revealed hypermetabolism in the left lower neck, mediastinum, stomach, and extensively in a bowel loop. The histologic findings of a gastric biopsy through endoscopy disclosed the typical "starry sky" appearance of Burkitt's lymphoma. Based on these findings, the patient was diagnosed as having a posttransplant lymphoproliferative disorder. Chemotherapy was then arranged for subsequent treatment.