1/19. Spectroscopic imaging of bone marrow composition in vertebral bodies.The proton spectroscopic imaging technique that uses read gradient during acquisition was used for the measurement of the proton spectra in the lumbar and thoracic part of the spine of a patient with breast cancer without known skeletal metastases. The bone marrow fat/water ratios were evaluated in the same location before and after chemotherapy treatment. The results were corrected for relaxation effects. The fat/water ratios showed a significant increase as a consequence of the bone marrow degradation process due to chemotherapy. The proposed spectroscopic imaging technique offers rapid acquisition of proton spectra from large volumes of the vertebral bodies.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
2/19. Positron emission tomography for detecting clinically occult surgically resectable metastatic ovarian cancer.BACKGROUND: The specific indications for PET imaging in patients with ovarian cancer have yet to be precisely defined. While PET has limited sensitivity for detecting small-volume (<1 cm) metastatic disease, accurate identification of larger tumor nodules may have a significant impact on clinical management and the selection of patients for cytoreductive surgery. CASES: The cases of two patients with suspected recurrent Stage IIIC serous ovarian cancer based solely on elevated CA125 levels and one patient with an apparent Stage IC poorly differentiated ovarian sex cord-stromal tumor who had macroscopic surgically resectable disease (>1 cm) identified by PET after negative or equivocal computed tomography are presented. CONCLUSION: PET imaging may be a useful technique for identifying potentially surgically resectable, macroscopic metastatic ovarian cancer when computed tomography findings are negative or equivocal.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
3/19. A long-term survivor of leiomyosarcoma around the right side of the base of the skull: effective radiotherapy combined with intra-arterial chemotherapy.We report a rare case of a leiomyosarcoma that developed around the right side of the base of the skull in a 51-year-old woman. The patient consulted our hospital complaining of pain in the right side of her neck and upper right arm in August 1994. A leiomyosarcoma, originating around the right side of the neck and base of the skull was diagnosed. Initially, surgery was planned, but invasion into the spinal canal was discovered. Curative resection of the leiomyosarcoma around the right side of the base of the skull was not possible. Therefore, external beam radiotherapy (EBRT) combined with intra-arterial chemotherapy and hyperthermia was employed. After the treatment, the tumor decreased in size to 45% of its initial volume, and, simultaneously, her symptoms completely disappeared. The patient initially remained clinically free of the disease, but showed reaggravations at the primary tumor site 3 years and 3 months, and 4 years and 11 months, after the first treatment. The reaggravations were treated with EBRT combined with intra-arterial chemotherapy. As a result, she survived for 5 years and 7 months after the first treatment.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
4/19. Redistribution of radiocolloid uptake after focal hepatic radiation.A woman with colonic carcinoma metastatic to the liver received 2,200 rad external beam radiation to the right hepatic lobe. A repeat liver scan, 2 months after conclusion of radiation therapy, showed a shift in the distribution of radiocolloid uptake to the left lobe and spleen. This altered pattern was likely related to the large volume of hepatic tissue included in the radiation portal, with damage to the radiated area. The clinician must be alert to abnormalities induced not only by neoplastic disease, but by the therapy utilized.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
5/19. ifosfamide is an active drug for chemotherapy of metastatic cystosarcoma phyllodes.Metastases from cystosarcoma phyllodes are rare, and treatment generally is ineffective. Four patients were treated with ifosfamide (alone in three and combined with doxorubicin in one). Two patients had complete remissions that lasted 26 and 61 months. One other patient had a partial response that lasted 13 months. The complete responders were both treated as soon as metastases appeared, when they had only a small volume of disease. This appears to represent a significant improvement on other described regimens for this condition, and further trials of ifosfamide are warranted. Close follow-up of patients at high risk for metastases is suggested.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
6/19. Use of LeVeen pleuroperitoneal shunt for refractory high-volume chylothorax.We present a case of intractable high-volume (> 2L/d) chylothorax after transhiatal esophagectomy treated successfully with the simultaneous insertion of both Denver (Denver Biomedical, Golden, CO) and LeVeen (Becton-Dickinson, Rutherford, NJ) pleuroperitoneal shunts. The patient initially had chemoradiotherapy for a T4N1 squamous cell carcinoma of the thoracic esophagus. Re-staging showed a dramatic shrinkage of tumor, and a transhiatal esophagectomy was performed. Sequential bilateral thoracotomies were performed on postoperative days 19 and 26 for attempted control of high-volume chylothorax, but these were unsuccessful. Subsequent pleuroperitoneal shunt insertion was used, which immediately controlled the effusion. A shunt study was performed shortly after hospital discharge, which showed an occluded Denver shunt and a patent LeVeen shunt. The patient succumbed to metastatic carcinoma 18 months after discharge, but no pleural effusion had recurred.- - - - - - - - - - ranking = 6keywords = volume (Clic here for more details about this article) |
7/19. Catecholamine-secreting metastatic carcinoid as differential diagnosis in pheochromocytoma: clinical, laboratory, and imaging clues in the search for the lurking neuroendocrine tumor (NET).Catecholamine-secreting metastatic carcinoid should be considered in differential diagnosis of malignant pheochromocytoma. Paroxysmal functioning or hormonally silent gastroenteropancreatic neuroendocrine tumors (GEP NETs) require repeat biochemical measurements and sensitive anatomic and functional imaging studies overlapping those for malignant pheochromocytoma. This report presents clinical, laboratory, and radiologic findings in a patient presenting with heart rate variability; vasoactive headaches reactive to ethanol, tyramine and tryptophan; labile blood pressure; diaphoresis; diarrhea; abdominal pain; unexplained pancreatitis; joint pain; and paroxysmal flushing with pallor. GI studies (including endoscopic ultrasound) and multiple imaging modalities (including 2D CT, MRI with gadolinium, [18]FDG PET/CT, [123I]MIBG, and SRS [111In]octreotide [OctreoScan]) were not diagnostic. 24-h BP, Holter and 30-day cardiac event monitors plus urinary biochemical studies consistently suggested catecholamine-synthesizing NET. NIH plasma metanephrines studies and [6]-[18F]Fluorodopamine PET ruled out malignant pheochromocytoma (pheo). Repeated studies showed persistently abnormal GEP NET biomarkers and urinary catecholamines. capsule endoscopy revealed suspicious submucosal lesions throughout the small intestine. Dual-phase 64-slice multidetector computed tomography (MDCT) with 3D volumetric reconstruction of the abdomen and pelvis revealed multiple diffuse liver metastases and three extrahepatic lesions consistent with metastatic carcinoid. In combination, intensive biochemical testing repeated over time, dual-phase 64-slice MDCT with 3D image reconstruction and volume-rendering (VR) technique, and advanced radionuclide imaging are required to detect NETs' sporadic or paroxysmal functioning, rule out extra-adrenal pheochromocytoma, and localize and characterize metastatic carcinoid. If pheochromocytoma is ruled out, yet symptoms and biochemical markers for catecholamine excess are present, then carcinoid and other amine-precursor-uptake decarboxylation (APUD) tumors must remain in the differential diagnosis.- - - - - - - - - - ranking = 2keywords = volume (Clic here for more details about this article) |
8/19. Possible modification of metastasis from adenocarcinoma of the prostate by colchicine: a case report.Laboratory data indicate that colchicine has an antimetastatic effect in tissue culture and in tumor-transplantation experiments in animals. The present case report reveals a lack of perineural and capsular invasion as well as distant metastases from a large adenocarcinoma of the prostate in a 63-year-old patient who had taken colchicine daily for 25 years prior to lesion discovery. Failure to demonstrate metastasis was unexpected both because of lesion size (estimated volume 4.4 ml) as well as its histopathology (Gleason pattern 3S, grade 6). colchicine may have inhibited metastasis of activated Ki-ras oncogenes during oncogenesis along neural microtubules in the area because of the known inhibitory effect of this drug on particle transport along the microtubule component of the cytoskeleton. colchicine at therapeutic doses for gout may simultaneously inhibit metastasis of other types of malignancies in man.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
9/19. maintenance of metabolic alkalosis despite saline administration in the presence of ascites.The administration of more than 15 L of saline over 10 days did not correct the metabolic alkalosis (plasma total CO2 35 mEq/L) of a patient with ascites secondary to ovarian carcinoma. weight gain was more than 6 kg and urine chloride concentration remained less than 15 mEq/L. The tubular avidity for chloride and sodium which maintains metabolic alkalosis persisted in the face of saline administration, perhaps because of "ineffective" volume expansion.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
10/19. The role of interstitial therapy in present day radiotherapy.The role of interstitial therapy in the treatment of malignant tumors is discussed. With interstitial therapy, the tumor is accurately localized under general anesthesia, irradiation is limited to the tumor-bearing volume of tissues with minimal irradiation of normal structures, and treatment time is shorter than with external beam therapy. Disadvantages include its rather limited clinical application, more complicated dosimetry, the higher level of technical skill required in the surgical procedure, and radiation exposure of operator and personnel. Interstitial therapy is indicated for relatively small well differentiated primary tumors and in cases where the primary and lymph node metastases are in close proximity. A combination of interstitial and external beam therapy is recommended for advanced tumors and in cases of unsatisfactory implants. Seven illustrative cases are presented. It is recommended that improved afterloading techniques and surgical and nonsurgical procedures (e.g.,suspension laryngoscope) be developed so that this type of therapy can be extended to all cases requiring high doses and a small volume of radiation.- - - - - - - - - - ranking = 2keywords = volume (Clic here for more details about this article) |
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