(18)F-FDG-PET Scanning Confirmed Infected Intracardiac Device-Leads with Abiotrophia defectiva.

Abiotrophia species are relatively slow growing pathogens, which may be present as commensal flora. However, invasive infections are frequently reported, like endocarditis, septic arthritis, osteomyelitis, and many other types of infection. In this case report we describe a 65-year-old male patient with an intracardiac device- (ICD-) lead infection caused by Abiotrophia defectiva.

¹²³I-MIBG heart-to-mediastinum ratio is influenced by high-energy photon penetration of collimator septa from liver and lung activity.

Aim: The 123I-metaiodobenzylguanidine (123I-MIBG) late heart-to-mediastinum ratio (H/M) is a well-established prognostic parameter in patients with chronic heart failure (CHF). However, 123I presents imaging problems owing to high-energy photon emission leading to penetration of collimator septa and subsequent reduction in image quality. Most likely this affects the H/M ratio and may subsequently lead to incorrect patient risk classification.

Impact of a predefined mediastinal ROI on inter-observer variability of planar ¹²³I-MIBG heart-to-mediastinum ratio.

Aim: Purpose of this study was to assess the impact of mediastinal region of interest (ROI) definition on intra- and inter-observer variability in relation to collimator type.

Methods: Thirty-five subjects with CHF (80% men, mean age 66 ± 9 years, NYHA 2.4 ± 0.

Predictive factors of isolated tumor cells and micrometastases in axillary lymph nodes in breast cancer.

Introduction: Since the introduction of the sentinel lymph node biopsy (SLNB) in patients with breast cancer, micrometastases and isolated tumor cells are detected frequently in the SLN. As such, they offer an opportunity to study the development of regional metastases in breast cancer.

Patients And Methods: Between June 1999 and November 2010 1418 patients with cT1-2N0 breast cancer underwent SLNB.

Intraoperative ultrasound guidance for excision of non-palpable invasive breast cancer: a hospital-based series and an overview of the literature.

Intraoperative ultrasound (IOUS) can be used in the operation theatre for localization of non-palpable breast cancers. In this prospective cohort study, we compared the yield of IOUS to guidewire localization (GWL). A total of 258 consecutive patients with non-palpable invasive breast cancer underwent breast conserving surgery between 1999 and 2010.

Ultrasound-guided sentinel node procedure for nonpalpable breast carcinoma.

Purpose: Peritumoral and periareolar tracer injection techniques lead to different lymphatic drainage in sentinel lymph node biopsy procedures. In a prospective study, the visualization and identification rates of the ultrasound (US)-guided tracer injection technique for palpable and nonpalpable breast tumors were evaluated.

Methods: In 1262 consecutive patients with cT₁₋₂N0 breast cancer, sentinel lymph node biopsy was performed following peritumoral tracer injection.

Prognostic value of lymph node micrometastases in breast cancer: a multicenter cohort study.

Background: To evaluate the prognostic meaning of lymph node micrometastases in breast cancer patients.

Methods: Between January 2000 and January 2003, 1411 patients with a cT(1-2)N(0) invasive breast carcinoma underwent surgery in 7 hospitals in the Netherlands. Sentinel lymph node biopsy was done in all patients.

Prognostic value of micrometastases in sentinel lymph nodes of patients with breast carcinoma: a cohort study.

Background: The prognostic meaning and thus indication for adjuvant therapy of lymphogenic micrometastases in breast cancer patients is still under debate.

Patients And Methods: From 1999 to 2007, 703 patients with (c)T(1-2)N(0) breast cancer underwent surgery including sentinel lymph node biopsy. Examination of sentinel lymph nodes consisted of hematoxylin and eosin and immunohistochemistry staining following serial sectioning of the sentinel node.

FDG PET in lymphoma: the need for standardization of interpretation. An observer variation study.

Objective: To measure and describe patterns of interobserver variation in visual interpretation of 18-FDG PET in malignant lymphoma.

Methods: Eleven nuclear medicine physicians with different levels of PET experience independently reviewed 37 18F-FDG PET scans of lymphoma patients (10 obtained at presentation, 27 during or after therapy). They were requested to identify and localize suspicious lymphoma sites and to assign a stage to the baseline scans, and to interpret the remaining scans for the presence of viable lymphoma.

The impact on post-surgical treatment of sentinel lymph node biopsy of internal mammary lymph nodes in patients with breast cancer.

Background: Since the introduction of the sentinel lymph node (SLN) biopsy in breast cancer patients there is a renewed interest in lymphatic drainage to the internal mammary (IM) chain nodes. We evaluated the frequency of lymphatic drainage to the IM chain, the rate of SLNs that contain metastases and the clinical implications of IM LN metastases.

Methods: Between June 1999 and April 2005 506 consecutive patients underwent SLN biopsy as a staging procedure for clinically T1-2N0 breast cancer.

Introduction of sentinel node biopsy and stage migration of breast cancer.

Aim: The purpose of this study was to examine in a large population based group of breast cancer patients treated in a regular care setting whether the introduction of the Sentinel Node Biopsy (SNB) led to detection of a higher percentage of patients with positive regional lymph nodes.

Methods: The study includes 3665 early breast cancer patients, aged 30-85 years, diagnosed in the period 1997-2002 and registered at the Regional Cancer Registry of the Comprehensive Cancer Centre Middle Netherlands. During this period the SNB was introduced.

[Adaptation of different neuroprotection devices during carotid stenting procedures].

Carotid artery stenting (CAS) is, apart from surgical endarterectomy, a common method of treatment of atherosclerosis in carotid arteries. Percutaneous angioplasty of carotid artery narrowings has been developing in recent years due to introduction of neuroprotection systems, which significantly reduced number of complications. Nowadays three neuroprotection systems are in common use: filters, temporary occlusion and aspiration systems and flow reversal systems.

The use of scintimammography for detecting the recurrence of loco-regional breast cancer: histopathologically proven results.

Background: 99mTc tetrofosmin scintimammography has been shown to be an accurate diagnostic test in patients with a symptomatic breast lesion and for whom a non-diagnostic mammogram has been obtained. Since a physical examination and conventional imaging modalities have their limitations in the detection of recurrent breast cancer, and survival is related to the extent of recurrent disease, complementary imaging modalities are warranted.

Aim: To evaluate the role of 99mTc tetrofosmin scintimammography in detecting the recurrence of loco-regional breast cancer.

Cost-effectiveness of dual-head 18F-fluorodeoxyglucose PET for the detection of recurrent laryngeal cancer.

The study is based upon 80 patients, suspected of having recurrent laryngeal cancer, who underwent an 18F-FDG PET study on a coincidence camera and a laryngoscopic biopsy under general anaesthesia. The potential value of 18F-FDG PET in the detection of local relapses of laryngeal cancer after radiotherapy by use of a coincidence camera was prospectively assessed, and a cost-effectiveness analysis was performed retrospectively. The effectiveness of 18F-FDG PET is reflected in sensitivity and specificity, positive predictive value (PPV) and negative predictive value (NPV) using comparison with the biopsy results as a gold standard.

F-18-fluoro-deoxy-glucose positron-emission tomography scanning in detection of local recurrence after radiotherapy for laryngeal/ pharyngeal cancer.

Background: The objective of this investigation was to determine whether F18-fluoro-deoxy-glucose (FDG) positron-emission tomography (PET) could differentiate between local recurrence and late radiation effects after radiotherapy for laryngeal/pharyngeal cancer.

Methods: In a prospective study of 75 patients (67 larynx, eight oro/hypopharynx), 160 laryngoscopies and 109 FDG PET scans were performed on the head and neck region. The mean follow-up time after the first FDG PET scan was 23 months (minimum 1 year).

Interferon-alpha induced changes in CEA expression in patients with CEA-producing tumours.

Enhancement of antigen expression could result in improved tumour targeting using antibodies directed to the antigen. In this study we performed radioimmunoscintigraphy using 99mTc-CEA-Scan to analyse the effect of interferon-alpha (IFN-alpha) in enhancing the expression of carcinoembryonic antigen (CEA) in ten patients with CEA-producing tumours. Furthermore, we investigated the feasibility of a future therapeutic study with this antibody fragment labelled with rhenium-186.

Assessment of renal artery stenosis: comparison of captopril renography and gadolinium-enhanced breath-hold MR angiography.

Aim: To determine the accuracy of captopril renography (CR) and gadolinium-enhanced breath-hold magnetic resonance (MR) angiography in the diagnosis of 50-99% renal artery stenosis (RAS).

Materials And Methods: Forty-three patients with possible RAS, of whom 53% had renal function impairment (creatinine >130 micromol/l), were included.(99m)Tc-mercaptoacetyl triglycine (MAG(3)) renography was performed after an oral dose of 25 mg captopril.

FDG positron emission tomography in head and neck cancer: pitfall or pathology?

Purpose: Fluorodeoxyglucose (FDG) positron emission tomography (PET) is a functional imaging technique used for imaging and staging malignant diseases. In many oncologic situations, however, abnormal changes seen on the PET studies are not caused by tumor, which is especially true in the head and neck region. The authors present an overview of the phenomena that may confound the interpretation of the images in head and neck cancer.

Detection of malignant breast tumours in dense breast tissue: results of 99mTc-tetrofosmin scintimammography related to surgery.

Aims: To assess the contribution of 99mTechnetium tetrofosmin (99mTc-TF) scintimammography for staging of breast lesions in patients with a suspicious or non-diagnostic mammogram to reduce unnecessary surgical procedures in future.

Methods: Fifty patients with suspicious physical examinations and/or mammography underwent 99mTc-TF breast imaging.

Results: Scintimammography with 99mTc-TF was positive in 37 patients (36 true positive, one false positive) and negative in 13 patients (12 true negative, one false negative).

Towards quality assurance of the sentinel node procedure in malignant melanoma patients: a single institution evaluation and a European survey.

The status of the regional lymph node (LN) is a critical component in staging patients with malignant melanoma. Biopsy of the first tumour-draining LN (sentinel node, SN) may replace routine elective LN dissection. However, until now, the applied methods have differed widely.

[Full working capacity instead of threatened retirement. Thrombendarterectomy in chronic thromboembolic pulmonary hypertension].

History And Clinical Findings: A 56-year-old man in marked right heart failure (stage III-IV of the New York Heart Association classification) and severe pulmonary hypertension was admitted to a rehabilitation clinic for therapeutic and social-medical assessment. On physical examination the important features were markedly distended neck veins, tachycardia at rest (90/min), a loud 2nd pulmonary sound and dyspnea.

Investigations And Diagnosis: Non-invasive tests (ECG, echocardiography, abdominal ultrasound and lung functions) confirmed right heart failure; invasively obtained haemodynamic data indicated its severity.

Primary oligoarthritis in a parent of a child with meningococcal group B sepsis and meningitis.

The mother of an eight-month-old child with meningitis presented with petechiae on her trunk and lower extremities, fever, and oligoarthritis. Although pathogens were never revealed by Gram stain nor cultured from the aspirated joint fluid, the diagnosis was primary meningococcal arthritis. This diagnosis was based on the simultaneous occurrence of Neisseria meningitidis group B infection in her son and the clinical presentation.