Positron emission tomography combined with computed tomography (PET/CT) enables assessment of not only anatomical and structural but also metabolic changes in tumor mass. F-fluoroethyl tyrosine (F-FET) PET/CT is based on evaluation of transport of F-labeled tyrosine in tissues. We present a clinical case of a patient with a newly diagnosed brain tumor, demonstrating the capabilities ofF-FET PET/CT in assessing the reliable volume and degree of tumor anaplasia, which is important when choosing the treatment approach for a patient.
The study objective is to evaluate the diagnostic capabilities of complex method based on the use of 18 F-fluoroethyltyrozine positron emission tomography (PET) combined with computed tomography (CT) and CT perfusion in the differential diagnosis of glial brain tumors.Materials and methods. One hundred and two patients with glial brain tumors were included in the study. Depending on the degree of malignancy patients were divided into 2 groups: group 1–38 (37.26 %) patients with grade I–II tumors; group 2–64 (62.74 %) patients with grade III–IV tumors. Perfusion CT was performed in 20 (52.6 %) patients from the group with grade I–II tumors and 37 (57.8 %) patients from the group with grade III–IV gliomas. The sensitivity and specificity of such indicators as the maximum standardized uptake value (maxSUV) and the tumor to brain ratio (TBR), in combination with CT perfusion indicators (cerebral blood flow (CBF), cerebral blood volume (CBV), vascular permeability (FED) were studied.Results. The highest diagnostic accuracy was demonstrated by the following parameters: maxSUV 1 (sensitivity and specificity 81 and 82 %, threshold value 2.51, AUC 0.87); TBR 1 (sensitivity and specificity 90.6 and 81.6 %, threshold value 2.07, AUC 0.89). The comprehensive evaluation of CT perfusion and 18 F-fluoroethyltyrozine PET / CT parameters: sensitivity and specificity of TBR 1 + CBF – 97.1 and 94.4 %, respectively; TBR 1 + CBV – 96.6 and 94.4 %, respectively; TBR 1 + FED – 94.6 and 92.3 %, respectively.Conclusion. According to results of obtained analysis, an increase in diagnostic accuracy was revealed for all studied parameters with complex use of two methods – 18 F-fluoroethyltyrozine PET / CT and CT perfusion, in differential diagnosis of glial brain tumors.
Introduction. Gestational trophoblastic neoplasias are rare tumors, which consist of about 1% of gynecological cancers. High rate of diagnostic and treatment mistakes leads to late diagnosis, metastatic appearance, resistance to chemotherapy, poor prognosis.
Aim. To demonstrate possibilities of 18F-FDG PET/CT to find resistant lesions of gestational trophoblastic neoplasias.
In the article, we analyze several medical reports to illustrate advantages of 18F-FDG PET/CT for evaluation of resistant gestational trophoblastic neoplasias.
Background. Salvage radiation therapy is the “gold standard” of treatment for patients with recurrent prostate cancer after radical prostatectomy. However, the results of the effectiveness of salvage radiation therapy in patients with regional recurrences are significantly lower than in patients with local one of prostate cancer, and, as a rule, the progression of the disease more often continues lymphogenic, affecting the next barrier of lymph outflow – retroperitoneal lymph nodes.Aim. To develop a new more effective radical method of salvage radiation therapy in patients with regional relapses of prostate cancer after radical prostatectomy.Materials and methods. The radiotherapy department of the N. N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russia has developed a new method of hypofractionation salvage radiation therapy of patients with regional recurrences of prostate cancer after radical prostatectomy, which includes treatment not only to regional recurrences, the bed of prostate and regional lymph nodes of the pelvis, but also and prophylactic radiation treatment to retroperitoneal lymph nodes.Results. 25 patients were treated with prophylactic radiation treatment to retroperitoneal lymph nodes from 2018 to 2021. The median follow-up of patients was 19 (7–22) months. In all patients, radiotherapy was performed in combination with hormone therapy with analogues of luteinizing hormone releasing hormone with a median duration of administration of 8 (6–10) months. All patients were treated without interruption according to the previously planned dosimetric treatment plans. At the end of the course of radiation therapy, none of the patients had any pronounced negative effects of the III–IV degree (according to the RTOG /EORTC scale). The 1-year local and biochemical control of the disease were 100 and 88 %, respectively.Conclusions. Initial data assessing the safety of the newly developed salvage radiation therapy technique in hypofractionation mode with additional prophylactic of retroperitoneal lymph nodes demonstrate good tolerability. However, further study and randomized phase III clinical trial are required to determine clinical efficacy.
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