Though more accurate compared to ultrasound for evaluating the axillary lymph node status FDG-PET/CT is only as sensitive as ultrasound when it comes to the detection of axillary lymph node metastases. Due to the low sensitivity FDG-PET/CT cannot act as a substitute for Sentinel lymph node biopsy. FDG-PET/CT is able to detect previously unknown locoregional extra-axillary lymph node metastases.
BackgroundClearly stated national recommendations for physical activity (PA) are available in many nations. Yet, their impact on national level policy-making might be considered modest at best. This paper analyses the approach selected to curtail this problem in Germany.Main textAcademics, government institutions and relevant stakeholders worked in collaboration to produce a series of national recommendations for PA and PA promotion published in 2016. Since their publication, these recommendations have achieved a measurable political impact through a systematic approach focused on dissemination and implementation strategies. For example, the German Conference of Health Ministers has acknowledged the national recommendations, endorsed their dissemination and proposed that they are included in measures within the Federal Prevention Act.ConclusionSince their publication, the national recommendations have yielded satisfactory political impact. The contributing aspects might partially be explained by the Multiple Streams Approach.
PET/MRI is superior to PET/CT in terms of tracing back a PET focus to a morphological correlate. For this reason PET/MRI enhances diagnostic certainty for lesions<10 mm and improves pretherapeutic lesion dosimetry in DTC.
There is a slight increase of the FDG accumulation of axillary lymph nodes between 60 and 90 min after FDG administration. This increase did not translate into a statistical significant enhancement of the diagnostic accuracy of FDG-PET/CT for the detection of axillary lymph nodes. Especially due to false-positive results a delayed FDG-PET/CT scan 90 min after FDG administration is not able to enhance the diagnostic accuracy for the detection of lymph node metastases.
Tumor standardized uptake values (SUVs) vary with the interval between 18 F-FDG injection and image acquisition. This paper presents a simple method using a single reference point to make appropriate time corrections for tumor SUVs. Methods: The reference point method was algebraically deduced from observations made by Beaulieu et al., who found that tumor SUVs behaved linearly over time (;30 to 75 min after 18 F-FDG injection). Eighteen patients with breast cancer were dynamically examined with PET/CT (;60 and 80 min after 18 F-FDG injection). Maximum SUV was calculated by applying 2 different iterative reconstruction methods (high-definition reconstruction and attenuation-weighted ordered-subsets expectation maximization). Reference points for time corrections were given, and errors for corrections obtained with the reference point method were calculated. Results: Variations in the reconstruction algorithm strongly influenced the coordinates of the reference point. Time corrections using the reference point method were more accurate at higher tumor SUVs (.8 at highdefinition reconstruction and .6 at attenuation-weighted ordered-subsets expectation maximization) than at lower ones. Conclusion: A common origin of tumor SUVs over time exists in breast cancer. In combination with the linear behavior of tumor SUVs between approximately 30 and 80 min, such a reference point allows for straightforward time corrections of tumor SUVs. Parameters for image reconstruction must be considered because they influence the coordinates of the reference point.
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