Angelina Cistaro

Prediction of 2 years-survival in patients with stage I and II non-small cell lung cancer utilizing 18 F-FDG PET/CT SUV quantification

Abstract Background. The purpose of the study was to evaluate the correlation between the maximum standardized uptake value (SUVmax), size of primary lung lesion, disease-free survival (DFS) and overall survival (OS) in patients with stage I and II non-small cell lung cancer (NSCLC) in 2 years follow-up. Patients and methods. Forty-nine patients with stage I-II NSCLC were included in this study. Pre-surgical 2-deoxy- 2-[18F]fluoro-D-glucose positron-emission tomography (18F-FDG PET/CT) study was performed for all patients. The relationship between SUVmax, tumour size and clinical outcome was measured. The cut-off value for SUVmax and tumour size with the best prognostic significance, probability of DFS and the correlation between SUVmax and the response to therapy were calculated. Results. There was a statistically significant correlation between SUVmax and DFS (p = 0.029). The optimal cut-offs were 9.00 for SUVmax (p = 0.0013) and 30mm for tumour size (p = 0.0028). Patients with SUVmax > 9 and primary lesion size > 30 mm had an expected 2years-DFS of 37.5%, while this rose to 90% if the tumour was <30 mm and/or SUVmax was <9. Conclusions. In stage I-II, SUVmax and tumour size might be helpful to identify the subgroup of patients with high chance for recurrence.

Adrenal Gland Cancers

Adrenal gland cancers refer to a heterogeneous group of neoplasms involving the cortex and adrenal medulla. They include adenoma, myelolipoma, pheochromocytoma, metastases, adrenocortical carcinoma, neuroblastoma, and lymphoma. Neuroblastoma is the most common extracranial solid tumor of childhood and accounts for about 8 % of all cancers in the pediatric population. Adrenal cortical carcinoma and pheochromocytoma are, by contrast, very rarely seen in children. Adrenal masses are currently evaluated by means of CT and MRI, which are of high sensitivity but low specificity. The primary role of FDG-PET is to differentiate benign from malignant adrenal neoplasms and to monitor the response to therapy.

Nuclear Medicine in the Management of Patient with Kidneys Intracystic Infection

Nuclear medicine plays an important role in the evaluation of inflammatory processes for many years. The tools used, starting from the gamma camera, passing through the SPECT, up to the latest PET scan, have increased diagnostic accuracy in this difficult field. Even the more specific radiotracers that are being used are a goal in further improving the appropriateness of nuclear medicine in this area. Many studies have shown that positron emission tomography with 2-deoxy- 2-[fluorine-18]fluoro-D-glucose integrated with computed tomography (18F-FDG-PET/CT), commonly used in the oncology field, has also the features to study some diseases with inflammatory origin which are usually difficult to identify using traditional diagnostic techniques. Indeed the activated inflammatory cells accumulate FDG with high concentration depending upon the degree of stimulation that is a function of inflammatory activity. In particular some recent papers have suggested that FDG-PET is a very promising tool in the diagnosis of the infected kidney and liver cysts in autosomal dominant polycystic kidney disease (ADPKD). Basing on our large personal experience, we report images of some suggestive clinical cases and the major works written in the literature about this specific clinical setting. At last limits, advantages and potential of this diagnostic examination, together with some new future development, are reported in this chapter.