Objective To evaluate the performance of contrast-enhanced mammography (CEM) compared to magnetic resonance imaging (MRI) for estimating residual tumor size after neoadjuvant chemotherapy (NAC) in women with newly diagnosed breast cancer. Methods The institutional review board approved this study. This prospective study included women with newly diagnosed breast cancer who underwent breast CEM and MRI at the end of the last cycle of NAC and before definitive surgery. Size of residual malignancy on post-NAC CEM and MRI was compared with surgical pathology. Agreements and correlations of CEM and MRI measurements with histological size were assessed. Results Thirty-three patients were included with a mean age of 45 years (range 22–76). The sensitivity, specificity, and positive and negative predictive value for detection of residual disease of CEM were 76%, 87.5%, 95%, and 86.4%, and those of MRI were 92%, 75%, 92%, and 75%. Comparing CEM to MRI, the mean difference was −0.8 cm, concordance coefficient was 0.7, and Pearson correlation was 0.7 (p = 0.0003). The concordance coefficient between measurements of each imaging modality and pathologic tumor size was 0.7 for CEM and 0.4 for MRI. Pearson correlation was 0.8 for CEM and 0.5 for MRI. Mean differences between CEM, MRI, and residual histopathological tumor size were 0.8 cm and 1.8 cm, respectively. Conclusions CEM has good correlation and agreement with histopathology for measuring residual disease after NAC. CEM was comparable to MRI, showing high positive predictive value and specificity for detecting residual disease.
O câncer de mama é um dos mais prevalentes nas mulheres. A mamografia é um excelente método com impacto comprovado na redução da mortalidade pelo câncer de mama. Porém, não é um método perfeito, apresentando alguns pontos fracos, principalmente no rastreamento de mulheres com mamas densas, estadiamento e avaliação de tratamento. A ressonância magnética mamária mostrou a necessidade e importância da avaliação funcional mamária. Descrevemos dois métodos de avaliação funcional mamária e demonstramos nossa experiência com a mamografia digital com contraste e com a imagem molecular mamária realizada em gama-câmara específica. Estes dois métodos já estão disponíveis em nosso meio e apresentam resultados promissores na detecção de lesões mamográficas ocultas, confirmação de lesões suspeitas e redução de biópsias desnecessárias, podendo assim melhorar o estudo mamário, principalmente nos pontos falhos da mamografia.
ObjectiveTo show the initial (first-year) experience with 68Ga-PSMA PET/CT
at a clinic in Brazil.Materials and MethodsOver a one-year period, 96 examinations with 68Ga-PSMA PET/CT (85
related to prostate cancer and 11 related to kidney cancer) were performed
in 90 patients.ResultsIn the prostate and kidney cancer patients alike, the main clinical
indication for 68Ga-PSMA PET/CT was suspicion of recurrence
during follow-up (in 65.8% and 63.0% of the cases, respectively). Among the
prostate cancer patients, 38.5% of those with a prostate specific antigen
(PSA) < 0.5 ng/mL tested positive for recurrence on 68Ga-PSMA
PET/CT, compared with 71.0% of those with a PSA of 0.5-0.99, 85.7% of those
with a PSA of 1.0-1.99, and 92.6% of those with a PSA > 1.99.ConclusionAlthough 68Ga-PSMA PET/CT is a technique that has only recently
been applied in clinical settings, despite its high cost,
68Ga-PSMA PET/CT shows great promise as a tool in the clinical
management of patients with kidney and prostate cancer, especially in those
with prostate cancer whose PSA levels are elevated even after treatment.
O presente artigo teve como objetivo identificar os principais artefatos que podem ser gerados na cintilografia de perfusão miocárdica executada em gama câmara dedicada ao estudo cardíaco com detectores CZT através da análise de exames de cintilografia de perfusão miocárdica realizados no nosso serviço. Dentre os possíveis artefatos que podem ser gerados na CZT durante a cintilografia de perfusão miocárdica destacam-se os artefatos de movimentação do paciente, posicionamento inadequado no aparelho, atenuações, captações extra cardíacas e artefatos causados por condições cardíacas préexistentes. Na prática diária é essencial saber os tipos de artefatos que podem ocorrer na cintilografia de perfusão miocárdica, para que os mesmos possam ser reconhecidos e corrigidosquando possívelvisando a melhoria na qualidade do nosso exame.
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