scholarly journals 15 YEARS OF PARAGANGLIOMA: Imaging and imaging-based treatment of pheochromocytoma and paraganglioma

2015 ◽  
Vol 22 (4) ◽  
pp. T135-T145 ◽  
Author(s):  
Frédéric Castinetti ◽  
Alexander Kroiss ◽  
Rakesh Kumar ◽  
Karel Pacak ◽  
David Taieb
Keyword(s):  
Functional Imaging ◽  
Surgical Intervention ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Review Article ◽  
Whole Body ◽  
Anatomical Imaging ◽  
Imaging Algorithms ◽  
Near Future

Although anatomic imaging to assess the precise localization of pheochromocytomas/paragangliomas (PHEOs/PGLs) is unavoidable before any surgical intervention on these tumors, functional imaging is becoming an inseparable portion of the imaging algorithm for these tumors. This review article presents applications of the most up-to-date functional imaging modalities and image-based treatment to PHEOs/PGLs patients. Functional imaging techniques provide whole-body localization (number of tumors present along with metastatic deposits) together with genetic-specific imaging approaches to PHEOs/PGLs, thus enabling highly specific and sensitive PHEO/PGL detection and delineation that now greatly impact the management of patients. Radionuclide imaging techniques also play a crucial role in the prediction of possible radioactive treatment options for PHEO/PGL. In contrast to previous imaging algorithms used for either assessement of these patients or their follow-up, endocrinologists, surgeons, oncologists, pediatricians, and other specialists require functional imaging before any therapeutic plan is outlined to the patient, and follow-up, especially in patients with metastatic disease, is based on the periodic use of functional imaging, often reducing or substituting for anatomical imaging. In similar specific indications, this will be further powered by using PET/MR in the assessment of these tumors. In the near future, it is expected that PHEO/PGL patients will benefit even more from an assessement of the functional characteristics of these tumors and new imaging-based treatment options. Finally, due to the use of new targeting moieties, gene-targeted radiotherapeutics and nanobodies-based theranostic approaches are expected to become a reality in the near future.

scholarly journals Emerging Functional Imaging Biomarkers of Tumour Responses to Radiotherapy

Cancers ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 131 ◽  
Author(s):  
Alan Campbell ◽  
Laura M. Davis ◽  
Sophie K. Wilkinson ◽  
Richard L. Hesketh
Keyword(s):  
Functional Imaging ◽  
Imaging Techniques ◽  
Biological Effects ◽  
Treatment Options ◽  
Early Response ◽  
Whole Body ◽  
Imaging Biomarkers ◽  
Biological Processes ◽  
Tumour Burden ◽  
Non Invasive

Tumour responses to radiotherapy are currently primarily assessed by changes in size. Imaging permits non-invasive, whole-body assessment of tumour burden and guides treatment options for most tumours. However, in most tumours, changes in size are slow to manifest and can sometimes be difficult to interpret or misleading, potentially leading to prolonged durations of ineffective treatment and delays in changing therapy. Functional imaging techniques that monitor biological processes have the potential to detect tumour responses to treatment earlier and refine treatment options based on tumour biology rather than solely on size and staging. By considering the biological effects of radiotherapy, this review focusses on emerging functional imaging techniques with the potential to augment morphological imaging and serve as biomarkers of early response to radiotherapy.

scholarly journals Imaging in polymyalgia rheumatica

Reumatismo ◽  
2018 ◽  
Vol 70 (1) ◽  
pp. 51 ◽  
Author(s):  
N. Possemato ◽  
C. Salvarani ◽  
N. Pipitone
Keyword(s):  
Polymyalgia Rheumatica ◽  
Morning Stiffness ◽  
Imaging Techniques ◽  
Review Article ◽  
Inflammatory Disorder ◽  
Chronic Inflammatory Disorder ◽  
Pet Ct ◽  
Ct And Mri

Polymyalgia rheumatica (PMR) is a chronic, inflammatory disorder of unknown cause clinically characterized by pain and prolonged morning stiffness affecting the shoulders and often the pelvic girdle and neck. Imaging has substantially contributed to defining PMR as a disease mainly involving extra-articular structures. This review article analyses the role of the different imaging techniques in the diagnosis and follow-up of patients with PMR with particular emphasis on the role of ultrasound, PET/CT and MRI.

Imaging techniques used in the diagnosis, staging, and follow-up of patients with myeloma

2005 ◽  
Vol 46 (7) ◽  
pp. 716-724 ◽  
Author(s):  
M. E. Mulligan
Keyword(s):  
Imaging Techniques ◽  
Staging System ◽  
Review Article ◽  
Imaging Modalities ◽  
Resonance Imaging ◽  
Advanced Imaging ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Initial Staging

Radiologists play a central role in the diagnosis, initial staging, follow-up, and restaging of patients with myeloma. This review article attempts to familiarize the reader with all the various types of myeloma, their imaging appearances and useful imaging strategies. The staging system for myeloma patients has been updated and now includes findings from advanced imaging modalities. Radiologists have a vast array of imaging modalities at their disposal to aid them in diagnosis, staging, and follow-up. Currently, conventional radiographic skeletal surveys, magnetic resonance imaging, and F-18 FDG PET/CT examinations are the most useful instruments.

Shunting with gravitational valves—can adjustments end the era of revisions for overdrainage-related events?

2012 ◽  
Vol 117 (6) ◽  
pp. 1197-1204 ◽  
Author(s):  
Florian Baptist Freimann ◽  
Christian Sprung
Keyword(s):  
Unsolved Problem ◽  
Surgical Intervention ◽  
Statistical Significance ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Opening Pressure ◽  
Shunt Insertion ◽  
New Generation ◽  
Valve Pressure

Object Overdrainage of CSF remains an unsolved problem in shunt therapy. The aim of the present study was to evaluate treatment options on overdrainage-related events enabled by the new generation of adjustable gravity-assisted valves. Methods The authors retrospectively studied the clinical course of 250 consecutive adult patients with various etiologies of hydrocephalus after shunt insertion for different signs and symptoms of overdrainage. Primary and secondary overdrainage were differentiated. The authors correlated the incidence of overdrainage with etiology of hydrocephalus, opening valve pressure, and patient parameters such as weight and size. Depending on the severity of overdrainage, they elevated the opening pressure, and follow-up was performed until overdrainage was resolved. Results The authors found 39 cases (15.6%) involving overdrainage-related problems—23 primary and 16 secondary overdrainage. The median follow-up period in these 39 patients was 2.1 years. There was no correlation between the incidence of overdrainage and any of the following factors: sex, age, size, or weight of the patients. There was also no statistical significance among the different etiologies of hydrocephalus, with the exception of congenital hydrocephalus. All of the “complications” could be resolved by readjusting the opening pressure of the valve in one or multiple steps, avoiding further operations. Conclusions Modern adjustable and gravity-assisted valves enable surgeons to set the opening pressure relatively low to avoid underdrainage without significantly raising the incidence of overdrainage and to treat overdrainage-related clinical and radiological complications without surgical intervention.

scholarly journals Echocardiographic Advances in Dilated Cardiomyopathy

2021 ◽  
Vol 10 (23) ◽  
pp. 5518
Author(s):  
Andrea Faggiano ◽  
Carlo Avallone ◽  
Domitilla Gentile ◽  
Giovanni Provenzale ◽  
Filippo Toriello ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Imaging Techniques ◽  
Standard Technique ◽  
Research Area ◽  
New Developments ◽  
Long Term Follow Up ◽  
And Performance ◽  
Near Future

Although the overall survival of patients with dilated cardiomyopathy (DCM) has improved significantly in the last decades, a non-negligible proportion of DCM patients still shows an unfavorable prognosis. DCM patients not only need imaging techniques that are effective in diagnosis, but also suitable for long-term follow-up with frequent re-evaluations. The exponential growth of echocardiography’s technology and performance in recent years has resulted in improved diagnostic accuracy, stratification, management and follow-up of patients with DCM. This review summarizes some new developments in echocardiography and their promising applications in DCM. Although nowadays cardiac magnetic resonance (CMR) remains the gold standard technique in DCM, the echocardiographic advances and novelties proposed in the manuscript, if properly integrated into clinical practice, could bring echocardiography closer to CMR in terms of accuracy and may certify ultrasound as the technique of choice in the follow-up of DCM patients. The application in DCM patients of novel echocardiographic techniques represents an interesting emergent research area for scholars in the near future.

scholarly journals Zinner’s Syndrome: A Rare Diagnosis of Dysuria Based on Imaging

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ahmed Ibrahimi ◽  
Abdelmoughit Hosni ◽  
Idriss Ziani ◽  
Fatima Zahra Laamrani ◽  
Hachem El Sayegh ◽  
...  
Keyword(s):  
Seminal Vesicle ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Pelvic Mass ◽  
Upper Urinary Tract ◽  
Perineal Pain ◽  
Voiding Symptoms ◽  
Magnetic Resonance Imaging Mri ◽  
Zinner’S Syndrome

Zinner’s syndrome is a rare congenital malformation of the seminal vesicle and ipsilateral upper urinary tract, due to developmental arrest in early embryogenesis of the Müllerian duct. Clinical presentation is nonspecific and includes voiding symptoms such as dysuria, ejaculatory disorders, and hypogastric or perineal pain. The diagnosis is made with imaging techniques, notably Magnetic Resonance Imaging (MRI) which remains the gold standard exam for diagnosis confirmation and therapeutic management. Treatment options depend on the severity of symptoms, the size of the cyst, and the complications. Herein, we report a rare case of a 33-year-old young patient who presented recurrent dysuria and ejaculatory disorders for the last 5 years. Imaging studies revealed an empty left renal fossa, with cystic pelvic mass related to the seminal vesicle and which was compatible with the diagnosis of Zinner’s syndrome. The patient underwent successful laparoscopic removal of the cyst and seminal vesicle, with total disappearance of urinary and sexual complaints with a 3-year follow-up.

scholarly journals Pre-interruptive intracoronal resorption: clinical and radiographic follow-up

2017 ◽  
Vol 65 (3) ◽  
pp. 282-285 ◽  
Author(s):  
Sâmila Gonçalves BARRA ◽  
Maria Isabel de Oliveira e Brito VILLALOBOS ◽  
Cláudia Valéria de Sousa Resende PENIDO ◽  
Angela Christina Barroso RECCHIONI ◽  
Maria Augusta Portella Guedes VISCONTI
Keyword(s):  
Surgical Intervention ◽  
Treatment Options ◽  
Panoramic Radiograph ◽  
Conservative Approach ◽  
Dental Clinic ◽  
Routine Examination ◽  
Caucasian Girl ◽  
Radiolucent Lesion ◽  
Unerupted Teeth

ABSTRACT Pre-interruptive intracoronal resorption is a radiolucent lesion localized in dentin, immediately below the amelodentin junction of unerupted teeth. It is rare, asymptomatic, and of idiopathic etiology, generally diagnosed in routine radiographs or in those for orthodontic purposes. A conservative approach, with radiographic follow-up is the treatment recommended until the tooth erupts, and then the intervention is made. However, in cases with symptoms or progression of the lesion, surgical intervention is advisable. To report a case of pre-interruptive intracoronal resorption, with a conservative approach, showing the clinical and radiographic follow-up of this condition. The patient, a nine-year-old Caucasian girl, presented to the Dental Clinic for routine examination. An initial panoramic radiograph was requested, which showed an intracoronal radiolucence in tooth 45 that had not yet erupted. Clinical and radiographic follow-up was made until the affected tooth was completely established in the oral cavity. The treatment recommended for pre-interruptive intracoronal resorption is to have knowledge of the phenomenon, associate its probable etiology and radiographic aspect, as well as its prevalence, occurrence and treatment options, by considering a conservative approach when there are no symptoms.

scholarly journals Imaging of Multiple Myeloma

2019 ◽  
Vol 191 (09) ◽  
pp. 805-816
Author(s):  
Aleksander Kosmala ◽  
Thorsten Bley ◽  
Bernhard Petritsch
Keyword(s):  
Computed Tomography ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Imaging Techniques ◽  
Therapy Monitoring ◽  
Whole Body ◽  
Emission Computed Tomography ◽  
Cross Sectional ◽  
Therapeutic Implications

Background Multiple myeloma is a malignant hematological disease characterized by uncontrolled proliferation of monoclonal plasma cells mainly in the bone marrow. Imaging plays a crucial role in diagnosis and follow-up. Method This literature review provides information about multiple myeloma, its precursor diseases, and available imaging techniques. Advantages and limitations as well as possible prognostic and therapeutic implications of the different imaging methods are presented in the context of the current literature. Results and Conclusion Cross-sectional imaging has replaced conventional X-ray skeletal survey. Widely available whole-body computed tomography is routinely used to detect osteolytic lesions. Magnetic resonance imaging is the most sensitive technique to identify bone marrow infiltration and is recommended in multiple myeloma precursor diseases. Positron emission computed tomography combines morphological and functional imaging. It is mainly used for follow-up, therapy monitoring, and response evaluation. Key points:  Citation Format

Just the Tip: Resection of a Narcotic Catheter-Tip Granuloma: 2-Dimensional Operative Video

2018 ◽  
Vol 17 (2) ◽  
pp. E52-E52 ◽  
Author(s):  
Joanna Elizabeth Gernsback ◽  
John Paul G Kolcun ◽  
Glen Manzano
Keyword(s):  
Spinal Cord ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Inflammatory Mass ◽  
Opioid Dose ◽  
Neurologic Deficits ◽  
Minimal Improvement ◽  
Catheter Tip ◽  
Catheter Replacement

Abstract The catheter tip “granuloma” is a rare inflammatory mass that forms in about 3% of patients with an intradural catheter, most commonly from a morphine pump. It has also been seen with other narcotic pumps, narcotic-non-narcotic combinations, and baclofen pumps. Mass formation is associated with increased opioid dose and concentration. It typically presents with increasing pain requiring increasing doses of medication, with minimal improvement, although it may present with neurologic deficits or be asymptomatic. On MRI, it appears as a round, rim-enhancing lesion that is low intensity with a hypointense rim on both T1 and T2. In the absence of neurologic deficits, there are many treatment options, ranging from a temporary stopping of the pump to catheter replacement. When the lesion presents with neurologic deficits, surgical intervention, beyond catheter replacement or repositioning, is indicated. A laminectomy is performed, with intradural exploration and careful resection of the mass, which is likely adherent to the spinal cord. Postoperative worsening of symptoms is common due to the mass being densely adherent to the spinal cord, requiring spinal cord manipulation. This worsening is usually temporary, and many patients make excellent recoveries. We present a case of a hydromorphone pump inflammatory mass, which initially presented with increasing pain, then progressive neurologic deficits, requiring referral and mass resection. We achieved only a partial resection due to the lesion's adherent nature. This surgical video demonstrates our intradural technique for resection of this rare and technically difficult mass, with 6-mo patient follow-up. The patient has consented to this case report.

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