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Cancer
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Elyce Cardonick, Charlotte Maggen, Puja Patel
The staging of lymphoma is based on history and physical examination, hematologic and biochemical testing, bone marrow biopsy, and radiologic imaging. Currently, women with stages I and II receive combination modality treatment, so full staging during pregnancy is unlikely to change the recommended treatment during the course of pregnancy and can be delayed to the postpartum period. Image staging in non-pregnant patients includes a chest x-ray and CT. In the pregnant woman, a two-view chest x-ray is suggested. A chest MRI can assess lymphadenopathy, and the information gained is comparable to a CT [59]. MRI can also evaluate the bone marrow and detect splenic involvement that may be undetectable with CT. Abdominal ultrasound can evaluate the spleen depending on size of gravid uterus. Diffusion weighted whole body MRI is a safer alternative during pregnancy [39]. After delivery a PET scan can be performed. Pet scan is avoided in pregnancy as fludeoxyglucose crosses the placenta and involves radiation as well.
Germ-Cell Cancer of the Testis and Related Neoplasms
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
PET images are dependent on the uptake of a radiolabeled fluorodeoxyglucose (FDG) by metabolically active tissue. A theoretical advantage of this technique when compared with CT or MRI is the possibility of detecting malignant infiltration of normal-size lymph nodes. However, lesions less than 5 mm cannot be visualized. PET scans may be difficult to obtain and may be costly. There is no validated role for PET scans in staging of germ-cell tumors.45,46 PET scans have been utilized in assessment of patients following chemotherapy to assess for residual disease. This is particularly true of seminomas where it may be useful to help decide if a patient should undergo surgery or surveillance following chemotherapy.47,48 The sensitivity of detection of a lesion over 3 cm in diameter is approx. 80% with a high negative predictive uptake value (94%).49
Tumour-specific disease response criteria
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Metabolic activity measurements from fluorodeoxyglucose positron emission tomography (FDG PET) are part of the current response assessment standards for haematological malignancies. Attempts at incorporation into the most recent revision of response evaluation criteria in solid tumours (RECIST) are hindered by difficulties in standardization of acquisition and interpretation (4). Consensus recommendations regarding standardization of FDG PET-CT in clinical trials have been outlined in a Cancer Imaging Program of the National Cancer Institute workshop (5). Recommendations include (1) use of the same PET-CT scanner throughout a particular trial for the same patient, (2) consistency in patient preparation such as fasting for a minimum of 4 hours prior to the examination and patient serum glucose concentration less than 200 mg/dL, (3) constant tracer dose ± 20% radioactivity, and (4) consistent time between tracer injection and PET imaging at 60 ± 10 min. Similarly, when 99mTechnetium bone scans are used for bone metastasis assessment, a consistent 180 min ± 10 min between tracer injection and image acquisition is essential.
Digital PET/CT with 18F-FACBC in early castration-resistant prostate cancer: our preliminary results
Published in Expert Review of Medical Devices, 2022
Luca Filippi, Oreste Bagni, Orazio Schillaci
All the patients underwent PET/CT with 18F-FACBC according to present imaging guidelines [15]. All patients fasted for at least 4 hours before PET/CT scan and were asked to avoid any significant physical exercise 24 hours prior to the scan. Whole body PET/CT scan was performed, from the skull base to the proximal thigh, starting at 3–5 minutes after the intravenous (i.v.) injection of 370 MBq of 18F-FACBC. PET/CT scans were performed with a digital Biograph Vision PET/CT system (Siemens Healthcare; Erlangen, Germany). A CT scan from proximal thigh to skull base was performed with slice thickness of 1.0 mm, pitch factor 1, bone, and soft tissue reconstruction kernels and maximum of 120 keV and 90 mAs by applying CARE kV and CARE Dose. After CT scanning, a whole-body PET (proximal thigh to skull base) was acquired at 3–5 min post tracer administration in 3D (matrix: 440 × 440) with a zoom factor of 1.0. Digital PET was acquired on a Siemens Biograph Vision 450 with an axial FOV of 197 mm using continuous-bed motion (FlowMotion®) with a bed speed of 0.9 mm/s (equivalent to approximately 2 min/bed position). Reconstruction was conducted with a TrueX + TOF algorithm and Gauss-filtered to a transaxial resolution of 2 mm at FWHM (full width at half maximum). Attenuation correction was performed using the low-dose non-enhanced computed tomography data.
Do you understand English?
Published in Journal of Communication in Healthcare, 2021
Finally, someone called my son's name and led us to a cramped consultation room. He sat down at the desk and signaled me to sit on an empty chair by the door. I do not remember exactly how the doctor started the conversation, but he introduced himself as Dr … , asking me if I knew why my son was getting the scans. I told him we just learned on Friday that he had cancer. He interrupted me, instructing me that he needed to go through the Consent Form. The Consent Form should be quite standard for any imaging test, the doctor added, but this was my first time reading one at the Radiology Department as a caregiver. The form started with the purpose of a PEC/CT scan, the benefits of the scans, and the risks from getting the scans. One part under the Potential Risks caught my attention. It said, ‘Exposure to radiation during a PET/CT scan can slightly increase your risk of developing cancer in the future.’
Simlukafusp alfa (FAP-IL2v) immunocytokine is a versatile combination partner for cancer immunotherapy
Published in mAbs, 2021
Inja Waldhauer, Valeria Gonzalez-Nicolini, Anne Freimoser-Grundschober, Tapan K Nayak, Linda Fahrni, Ralf J. Hosse, Danny Gerrits, Edwin J. W. Geven, Johannes Sam, Sabine Lang, Esther Bommer, Virginie Steinhart, Elisabeth Husar, Sara Colombetti, Erwin Van Puijenbroek, Markus Neubauer, J. Mark Cline, Pradeep K. Garg, Gregory Dugan, Federica Cavallo, Gonzalo Acuna, Jehad Charo, Volker Teichgräber, Stefan Evers, Otto C. Boerman, Marina Bacac, Ekkehard Moessner, Pablo Umaña, Christian Klein
The PET/CT procedure is described in detail in the supplement. All studies involving this animal were approved by the Wake Forest University Institutional Animal Care and Use Committee and conducted in accordance with the US Animal Welfare Act and the Department of Health and Human Services regulations (Office of Laboratory Animal Welfare assurance number #A-3391-01). Wake Forest University is accredited by the Association for the Assessment and Accreditation of Laboratory Animal Care. This rhesus monkey was provided with appropriate veterinary care and social and environmental enrichment. Briefly, an 11-year-old rhesus monkey with confirmed spontaneously occurring invasive ductal carcinoma with vascular invasion was treated with 0.5 mg/kg of FAP-IL2v mixed with tracer amounts of FAP-IL2v radiolabeled with zirconium-89 (89Zr) as previously described.46 PET scans were conducted on the day of administration and 3 days (67 hours) and 6 days (154 hours) after injection. On-treatment tumor biopsy for assessment of immune cell infiltration was performed on Day 3 following the PET scan.