A Research report submitted to the Faculty of Health Sciences, University of the Witwatersrand in fulfillment of the requirements for the degree of Master of Medicine in the branch of Nuclear Medicine / Objectives: This study aimed to ascertain if there is any clinical value in including brain and extremities in the 18 F-FDG PET/CT imaging of patients with malignant melanoma. Methods: This was a retrospective study done at Charlotte Maxeke Johannesburg Academic Hospital(CMJAH), Johannesburg. All consecutive 18F-PET/CT reports for patients referred to the CMJAH department of Nuclear Medicine for an 18-F-FDG PET/CT study, spanning form 01 January 2008 to 31 December 2013, who have histologically proven malignant melanoma were included in the study. The prevalence of brain and extremity lesions of 18F-FDG PET/CT reports was documented. Hospital records were viewed to see if clinical and histological correlation was done for lesions that were likely malignant; and to also review the impact of 18F-FDG PET/CT findings on patient management. Results: One hundred and fifty nine 18F-FDG PET/CT studies in 121 patients were included for assessment. The median patient age was 54 years (ranging from 16-84 years). Eighteen patients (12%) had lesions in the brain, eight (5.33%) of which were classified as likely benign, five (3.33%) of which were classified as indeterminate. However, nine (5.7%) patients in the whole group did not have brain acquisition and were excluded from the assessment. None of the patients were likely malignant or indeterminate brain lesions underwent further investigation such as radiological correlation with MRI or a pathological correlation. Three patients had change in management as a result of finding of brain lesions on 18F-FDG PET/CT. One patient had radiotherapy of the brain with steroids, in addition to their chemotherapy regimen; another had whole brain palliative radiotherapy, in addition to their chemotherapy regimen to a different regimen. Thirty six patients (37%) had lesions in the extremities, three (8%) of the 36 were classified as likely benign, six (17%) of which were classified as likely malignant, and two (6%) of which were classified as indeterminate. The remaining twenty five (69%) had their primary tumour in the extremities. However , 61 (38%) patients in the whole group did not have acquisition of the extremities. Ninety eight patients had extremity scans. None of the patients with extremity lesions underwent further radiological and or pathological correlation, and none had a change in stage or change in clinical management Conclusion: Our study showed that although there was no change in the clinical staging resulting from the acquisition of extra brain and extremity views on 18F-FDG PET/CT, there was a change in the clinical management of those with brain lesions. There was no change in clinical management of those patients with extremity lesions. The suggested protocol is acquisition of brain views only in patients with additional metastatic lesions after the acquisition of the whole body view(base of skull to mid-thigh). The protocol, however needs validation with a more comprehensive, prospective study / MT2017

Thesis (M.S.)--Medical University of Ohio, 2005. / "In partial fulfillment of the requirements for the degree of Master of Science in Biomedical Sciences." Major advisor: Michael Dennis. Includes abstract. Document formatted into pages: iii, 61 p. Title from title page of PDF document viewed on Aug. 30, 2005. Title at ETD Web site: Assessment of the effect of cancer and its treatment on PET scan F-18 tracer distribution in pre- and post-treatment and its relation to myocardial tissue uptake. Bibliography: pages 53-56.

Although mammals are the most commonly utilized laboratory animal, laboratory animal medicine continually seeks to replace them with animals of lower phylogenic classification. Fish are becoming increasingly important as investigators seek alternative animal models for research. Fish can provide an economical and feasible alternative to typical mammalian models; moreover, many fish, which have comparatively short life spans, can easily reproduce in the laboratory. One key area of animal health research in which fish have been underutilized is the field of advanced imaging. Although many images of fish have been captured through the use of computed tomography (CT), radiography, and ultrasonography, these images have been primarily utilized for anatomical study. In addition, fish have never before been studied with positron emission tomography/ computed tomography (PET/CT). My objectives were to determine if these imaging techniques can be used to obtain physiological information from fish, therefore making it more likely that fish can be utilized as replacement animals using these new imaging techniques (CT, PET/CT). I performed two different types of studies to assess the potential application of advanced imaging techniques to fish. In the first experiment, microCT was used to characterize otolith deformity in vitamin C deficient captive-raised red drum and relate the deformity to behavioral and physiological changes. I found that the normal and abnormal fish had statistically significant differences in behavior, cortisol levels, and otolith volume and density. MicroCT assessment of abnormal fish revealed operculum abnormalities, malocclusions, and several types of otolith malformations. Therefore, the affected fish had not only an abnormal skeletal appearance but also significantly abnormal behavior and cortisol responses. In the second experiment, fluorodeoxyglucose-positron emission tomography/ computed tomography (FDG-PET/CT) was used to quantify glucose uptake in select organs prior to carcinogenesis studies in fish. The quantified glucose uptake was compared to published data on humans, mice, and dogs. Rapid, quantifiable glucose uptake was demonstrated, particularly in brain, kidneys, and liver in all imaged fish species. Glucose uptake in the major organ systems of fish was closer to that in humans than uptake in mice or dogs, indicating that fish may serve as an effective alternative animal model for tumor studies using this technology. Other applications for this technique in fish may include metabolism studies and screening for environmental carcinogenesis. I found that both microCT and PET/CT imaging provided useful and meaningful results. In addition, the use of non-invasive scanning allows for re-use of fish, thus reducing the number of animal models used in experiments. These experiments suggest that fish will be good replacement models for mammals using these advanced imaging techniques.

Diss. med. dent. Zürich (kein Austausch). / Literaturverz.

Made available in DSpace on 2014-10-09T12:35:12Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T13:56:12Z (GMT). No. of bitstreams: 0 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Dissertação (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP / FAPESP:11/03138-8

Made available in DSpace on 2014-10-09T12:25:54Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:00:34Z (GMT). No. of bitstreams: 0 / Dissertacao (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Made available in DSpace on 2014-10-09T12:35:12Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T13:56:12Z (GMT). No. of bitstreams: 0 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A tomografia por emissão de pósitrons associada à tomografia computadorizada (PET/CT) é um dispositivo que combina as características de medicina nuclear (PET) e de radiologia (CT) obtendo imagens metabólicas (PET) e anatômicas sobrepostas (CT). Combinando as duas tecnologias de exames, o exame PET / CT permite aos médicos diagnosticar com maior precisão e identificar o câncer, doenças cardíacas e distúrbios cerebrais. O radiofármaco 18FFAc (fluoroacetato) é promissor para a detecção de tumores primários de próstata e de mama, utilizando a técnica de PET/CT. Estudos recentes mostram a eficácia do 18F-FAc na detecção de tumores que têm baixa captação de 18F-FDG (fluordesoxiglicose). O fluoroacetato é um substrato para a acetil-CoA sintase, enzima que metaboliza ácido fluorocitrato que não é mais metabolizado, levando à inibição da aconitase e do ácido tricarboxílico. O objetivo deste trabalho foi desenvolver um radiofármaco emissor de pósitron, 18F-FAc no IPEN-CNEN/SP em um acordo com o Hospital AC-Camargo / São Paulo. O íon fluoreto (18F-) foi produzido, usando os cíclotrons Cyclone 30 e 18 da IBA localizados no IPEN-CNEN/SP, através da irradiação de água enriquecida em 18O com prótons e dose integrada de 30μAh. A marcação do 18F-FAc foi realizada em um módulo de síntese TRACERlab MXFDG (GE), utilizando kits adquiridos da ABX. O controle de qualidade radioquímico de 18F-FAc foi realizado por cromatografia em camada fina TLC-SG 25 folhas de alumínio em tiras (1,5 x 12 cm ) usando como solvente clorofórmio:metanol (1:1). Para o controle de qualidade radionuclídico, amostras de 18F-FAc e 18F-Fluoreto foram analisadas por espectroscopia de raios-gama. A avaliação dos solventes residuais foi realizada por cromatografia em fase gasosa e a análise de kryptofix foi realizada por TLC utilizando tiras de TLC-SG, metanol:clorofórmio (9:1) como solvente e padrões de kryptofix 2.2.2. Os estudos de biodistribuição foram realizados com 18FFAc injetado em camundongos swiss sadios. Um procedimento reprodutível foi desenvolvido para o preparo do 18F-FAc com um rendimento de marcação de 37% (não corrigido) e 52% (corrigido para o decaimento) e estabilidade de 19 horas. A análise de controle de qualidade mostrou que o produto tinha as exigências adequadas para utilização, com pureza radioquímica superior a 99,9%. Os estudos de biodistribuição em animais sadios mostraram a esperada captação em todos os órgãos medidos com eliminação renal e intestinal. / Dissertação (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP / FAPESP:11/03138-8

Made available in DSpace on 2014-10-09T12:25:54Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:00:34Z (GMT). No. of bitstreams: 0 / No Brasil e no mundo a medicina nuclear vem ganhando destaque com as técnicas diagnósticas que permitem o estudo metabólico de doenças, alterando significativamente o gerenciamento dos pacientes. Essa tecnologia inovadora vem trazendo expectativas tanto para os setores especializados como para a sociedade. Nesse trabalho foi estudada a utilização do radiofármaco 18F-FDG na região metropolitana de São Paulo e nas áreas adjacentes, bem como a estrutura do mercado atual e das dificuldades a serem superadas com o aumento da demanda do 18F-FDG. A pesquisa contou com uma análise do mercado de radiofármacos internacional e das principais alterações que vem ocorrendo nessa área no Brasil nos últimos anos. Foram realizadas entrevistas com profissionais atuantes na área de medicina nuclear e coleta de dados através de questionário enviado para os centros consumidores do radiofármaco na região coberta pela pesquisa. As entrevistas expressaram as opiniões dos entrevistados sobre as transformações nesse setor e as tendências futuras e os dados coletados no questionário serviram de complementação a utilização do radiofármaco nos equipamentos do tipo Single Photon Emission Computed Tomography (SPECT), Positron Emission Tomography (PET) e Positron Emission Tomography / Computer Tomography (PET/CT). O maior uso do 18F-FDG tem sido para o diagnóstico oncológico nos equipamentos do tipo PET e PET/CT. Essa utilização deverá crescer nos próximos anos, podendo se expandir para outras especialidades como neurologia e cardiologia. Apesar de restrita atualmente as cidades de São Paulo e Rio de Janeiro deverá haver uma expansão dessa modalidade diagnóstica nos outros Estados do país que começam a estruturar produção do radioisótopo. A recente alteração na constituição que permite a produção e comercialização de radioisótopos de meia-vida curta também deverá aumentar o interesse da iniciativa privada nesse mercado, que internacionalmente possui projeções otimistas de crescimento. Existe também uma expectativa que a aprovação dos planos de saúde para a cobertura dos exames utilizando 18F-FDG no PET impulsione esse mercado ainda mais, repetindo a experiência internacional. Os recentes investimentos realizados pelo IPEN para aumentar a produção do 18F-FDG deverá garantir a oferta com confiabilidade, para a região Sudeste e Sul do país. / Dissertacao (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Orientadores: Gustavo Antonio de Souza, Sophie Françoise Mauricette Derchain / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T16:26:27Z (GMT). No. of bitstreams: 1 Dragosavac_Sanja_M.pdf: 1871037 bytes, checksum: 792409d11e54caa65d34f4ecbee851f0 (MD5) Previous issue date: 2011 / Resumo: O exame PET/CT com FDG-18F é um método de diagnóstico por imagem, útil em oncologia. O câncer de ovário é o câncer ginecológico de maior letalidade, sendo a terceira neoplasia mais freqüente do trato genital feminino no Brasil. O objetivo deste estudo foi avaliar o PET/CT com FDG-18F em pacientes com suspeita de recidiva de carcinoma de ovário e descrever a distribuição das lesões encontradas. Sujeitos e Métodos: Foram incluídas neste estudo retrospectivo 45 mulheres com suspeita de recidiva de câncer de ovário. As pacientes foram encaminhadas para clínica PET/CT Campinas de novembro 2006 até novembro de 2010, por aumento do CA-125, sintomas clínicos e/ou alterações na ultrassonografia (US), tomografia (TC) ou ressonância (RM). Para a confirmação da recidiva, 15 pacientes foram submetidas à cirurgia e 30 foram acompanhadas por um período mínimo de seis meses. Resultados: Quarenta e duas pacientes foram diagnosticadas com recidiva e três não apresentaram evidência de doença durante o período de acompanhamento. O CA-125 estava aumentado em 34 pacientes, 14 apresentavam sintomas clínicos e 23 tinham alterações em US, TC ou RM. Trinta e oito pacientes apresentaram o exame PET/CT positivo, todas com recidiva confirmada. Três pacientes apresentaram achados inconclusivos na PET/CT, todas com doença. Quatro exames de PET/CT eram negativos, sendo que uma paciente teve recidiva confirmada e as demais permaneceram sem evidências de doença durante o acompanhamento. Onze pacientes com CA-125 elevado apresentavam resultados de US, TC ou RM normais. Todas tiveram doença confirmada, sendo que a PET/CT detectou recidiva em nove e foi inconclusiva em duas. Entre as onze pacientes com CA- 125 normal, foram detectadas metástases na PET/CT em oito. As metástases mais freqüentes foram diagnosticadas em linfonodos, sendo localizados na região pélvica e abdominal em 30 pacientes, na região torácica em 16 e em sete pacientes, na região cervical. Implantes pélvicos e abdominais foram detectados em 27 pacientes. Outros locais de metástases foram fígado (n=7), baço (n=2), pleura (n=2), pulmão (n=2) e osso (n=2). O exame PET/CT detectou lesões não suspeitas em 20 das 45 pacientes (44,4%). A PET/CT detectou um novo tumor primário de tireoide numa paciente sem recidiva de carcinoma de ovário. Conclusão: O exame PET/CT foi útil para avaliação da extensão da recidiva de carcinoma de ovário. A recidiva acometeu mais freqüentemente os linfonodos, sendo a maioria localizada na região pélvica e abdominal. Metástases em linfonodos torácicos foram um achado freqüente nesta população estudada / Abstract: 18F-FDG PET/CT is a diagnostic method useful in oncology. Ovarian cancer is the third most frequent cancer of the female genital tract in Brazil, however, it has the highest mortality of all gynecological cancers. The aim of this study was to evaluate the use of 18F-FDG PET/CT in patients with suspected ovarian cancer recurrence and describe the distribution of metastasis. Methods: Fortyfive female patients with suspicion of ovarian cancer recurrence were included in this retrospective study. They were referred to PET/CT Campinas clinic from November 2006 to November 2010, because of elevated CA-125, clinical suspicion of ovarian cancer recurrence, or alterations detected on ultrasound (US), computed tomography (CT) or magnetic resonance imaging (MRI). PET/CT results were compared with histologic findings (n=15) or clinical followup for at least six months (n=30). Results: Forty-two patients were confirmed with ovarian cancer recurrence. Three patients remained free of disease during clinical follow-up. CA-125 was elevated in a total of 34 patients, 14 patients had clinical symptoms of disease and 23 presented with alterations on US, CT and MRI. Thirty eight patients had positive PET/CT scan, all with confirmed disease. Three patients had equivocal PET/CT findings and in all three, recurrence was confirmed. Four patients had negative PET/CT scan: one with confirmed recurrence and three free from disease during follow-up. Nine out of 11 patients with elevated CA-125 and normal conventional imaging had positive PET/CT scan and two had equivocal findings. There were eleven patients with normal CA-125 levels, eight presented with positive PET/CT scan. Lymph nodes were the most frequent site of relapse of disease, most being in the pelvic/abdominal region (n=30) and others in thoracic (n=16) or cervical region (n=7). Peritoneal implants were found in 27 patients. Distant sites of metastasis included liver (n=6), spleen (n=2), pleura (n=2), lung (n=2) and bone (n=2). PET/CT detected unsuspected lesions in 20/45 patients (44.4%). One patient with PET/CT negative for ovarian cancer recurrence was diagnosed with primary papillary carcinoma of the thyroid. Conclusion: 18F-FDG PET/CT was a useful tool for evaluation of the extension of ovarian cancer recurrence. In the current series, lymph nodes were the most frequent site of relapse of disease, with supradiaphragmatic lymph node metastasis in large number of cases / Mestrado / Oncologia Ginecológica e Mamária / Mestre em Ciências da Saúde

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第18907号 / 社医博第65号 / 新制||社医||9(附属図書館) / 31858 / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 川上 浩司, 教授 富樫 かおり, 教授 武藤 学 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM