Gynecologic cancers are among the most common cancers in women and are a significant cause of mortality in women worldwide. FDG-PET images play a critical role in several areas of oncology and are an essential tool for the diagnosis and staging of gynecologic cancer, providing information about tumor metabolism. Aim: The aim of this study was to investigate the relationship between tumor differentiation, type of malignancy, and glucose metabolism in patients with confirmed gynecologic cancer. Materials and Methods We performed a retrospective review of 60 consecutive patients (ages 31-76) with histopathologically confirmed gynecologic cancer who underwent PET-CT in our department between January 2021 and March 2022. Quantitative data on glucose metabolism were collected using the maximum standardized uptake value normalized by lean body mass (SULmax). We reviewed a total of 60 patients with a mean age of 60±9 years, and a median of 62. Results: 14 patients were diagnosed with cervical cancer, 20 with endometrial cancer, and 26 with ovarian cancer; 13 patients had well- differentiated cancer, 11 had moderately differentiated cancer, and 36 had poorly differentiated cancer. A positive correlation was observed between the measured SULmax and the degree of tumor differentiation, indicating higher glucose uptake in poorly differentiated cancer. When examining the relationship between the type of cancer and SULmax, we found that endometrial cancer exhibited the highest mean SULmax (8.36±6.75), followed by ovarian cancer and cervical cancer. Additionally, we noted that glucose uptake was higher in patients aged over 62 years. Regardless of the tumor differentiation, the findings in endometrial cancer showed the highest mean SUVmax values in all grades of tumor differentiation. Conclusion: Our study showed that glucose consumption correlates not only with the degree of differentiation but also with age and type of tumor, with the highest values in patients older than 62 years with endometrial cancer. Given the correlation between glucose consumption and tumor aggressiveness, this finding may be important for prognostic evaluation of patients with gynecologic malignancies.
Myocardial perfusion imaging (MPI) is an important non-invasive imaging method, which allows the assessment of perfusion in the cells of the myocardial wall. The images are obtained after administration of a radiopharmaceutical at rest and/or after maximal stress (physical effort or pharmaceutical stress). Infarction areas or scars will not show any uptake of the radiopharmaceutical, neither in rest nor at stress (fixed defects), while the ischemic area will show reduced uptake at stress with recovery to normal perfusion at rest (reversible defects). MPI is a complex technique and it requires an experienced team to foresee, avoid, correct or minimize the artifacts that might appear in all the phases of the study In this paper, we will present the most important categories of artifacts, based on the category of problem where they were generated. We will also present some solutions for limiting these artifacts or for recognizing and minimizing their effect for those which cannot be avoided.
There are more than one technique used to evaluate the kidney, besides the standard ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), there is also renal scintigraphy. The renal nuclear medicine procedures are grouped as in vitro (urine counting wells, basic probe detectors for clearance studies) and in vivo procedures (static and/or dynamic examinations done with planar gamma cameras, and single-photon emission computed tomography (SPECT) to determine kidney parameters or for cortical imaging). Renal scintigraphy has been a useful tool, since the early 1950s, in the diagnosis and management of many pathological changes (e.g. obstructive/nonobstructive uropathies, renal inflammatory diseases, tumours, renal hypertension, and renal transplant viability). [1] the kidney, especially in measuring function renal in INTRODUCTION The radionuclide investigation of the kidney includes detection of renal afflictions and measurements of quantitative indices that estimate the renal perfusion and function. Ultrasound and computed tomography are commonly used for the evaluation of renal structural anatomy, and the role of nuclear renal imaging in is more for functional analysis, anatomical imaging (e.g. cortical imaging).[1,2] less radionuclide imaging" or Renal scintigraphy, also known as a "renal scan" or "renal “renography” includes various investigations that use different radioisotopes to evaluate renal blood flow, renal split function, and the renal excretion performance of both. It yields specific and often unachievable information by using other imaging procedures. [2] Clinical indications for renal scintigraphy (adapted from Nuclear Medicine: The Requisites, 4th ed): [3-5] 1. Blood flow abnormalities 26 lesion and a 2. Function quantification (reduced performance of one or both kidneys) a. Differential function b. Glomerular filtration rate (GFR), effective renal plasma flow (EPRF) 3. Cirrhosis of the kidney(s) 4. Differentiation between a mass column of Bertin 5. In infants with abnormalities of the urinary tract to study the urinary flow 6. Obstruction: ureteropelvic junction, ureteral 7. Pyelonephritis: both acute and chronic tubule- interstitial nephritis and parenchymal scarring 8. Renal failure: acute and chronic 9. Renal artery stenosis with/without renovascular hypertension 10. Renal vein thrombosis 11. Surgical: 1 Carol Davila Central Emergency Military Hospital, Bucharest
