Integrated F-choline PET/4DCeCT should be considered as an effective tool to detect PHPT in patients with negative or inconclusive first-line imaging. Choline metabolism is correlated with both calcium level and Ki67 expression in HPTG.

Descending necrotizing mediast initis is a rare diseas e that is usually caused by a spreading, diffuse irfiammatory reaction (phl eginon) to an odontoge nic inf ection or pe rito nsillar abscess. Rep ortedmortality rates rangefrom 25 to 40%. The use of antib iotics and advances in resuscitation pro cedures and critical care techniques have not essentially imp roved survival, and an effective treatm ent has not been clearly established. We rep ort the fi ndings ofour 10-y ear study of21 patients affected by phle gmon and/orfasciitis ofthe neck. The aim ofour contribution is to help define the clinical criteria and diagnos tic procedures that will impro ve the early diagno sis of mediastinal sepsis sec ondary 10 neckfasciitis and 10 suggest optima l treatment approaches. Our experience indicates tha t (1) cervical dra inage alane is sufficient for cases ofcervical phle gm on or mediastin al invo lvement that are limited to a single sup erior mediastinal sp ace and (2) thora cotomy and drainage oft nediastinal collec tions is necessary when mediastinal sepsis is mare extensive.

Purpose: To evaluate the role of 18 F-flurodeoxiglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) in predicting malignancy of thyroid nodules with indeterminate cytology. Patients and methods:We analysed 87 patients who have been scheduled to undergo surgery for thyroid nodule with indeterminate cytology. All patients underwent 18 F-FDG-PET/CT, multiparametric neck ultrasonography (MPUS), and 99m Tc-methoxyisobutylisonitrile scintigraphy ( 99m Tc-MIBI-scan). Histopathology was the standard of reference.We compared the sensitivity (SE), specificity (SP), accuracy (AC), positive (PPV) and negative predictive (

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Thyroid nodule ultrasound-based risk stratification systems (US-RSSs) have been successfully used in adults to predict the likelihood of malignancies. However, their applicability to the paediatric population is unclear, especially in children with a history of radiation exposure, who are at a higher cancer risk. We tested the efficacy of three US-RSSs in this setting by retrospectively applying three classification systems (ACR-TIRADS, ATA and EU-TIRADS) to all paediatric patients referred for thyroid nodules and with a radiation exposure history. We compared the results with a reference standard (pathology or 36-month follow-up); sensitivity, specificity, positive and negative predictive values (PPV and NPV) and accuracy were calculated. A total of 52 patients were included; fourteen of them (27%) had papillary thyroid cancer (PTC) at the final histology. No significant differences across the US-RSSs were detected; specificity (range 95–97%) and NPV (range 88–93%) were particularly elevated. However, ACR-TIRADS, ATA and EU-TIRADS did not indicate the need for a biopsy in six (42.8%), seven (50%) and eight (57%) cases of PTC; in five cases, this lack of indication was due to a small (<1 cm) nodule size. In conclusion, US-RSSs show a high NPV and specificity in paediatric patients, whereas the cytology indication could be improved by reconsidering the dimensional criterion.

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RAI after lymphadenectomy for DTC relapse is significantly associated with better PFS only in patients with Tg-on ≥1 ng/ml.