Addition of [ F]Fluorodeoxyglucose Positron Emission Tomography With Computed Tomography to Cross-Sectional Imaging Improves Staging and Alters Management in Hepatocellular Carcinoma.

In this work, we characterize the value of positron emission tomography (PET) with computed tomography (CT) in combination with cross-sectional imaging for staging and prognostication of hepatocellular carcinoma (HCC) patients. In this retrospective cohort study, HCC patients underwent PET-CT after initial staging with contrast-enhanced CT or magnetic resonance imaging (MRI). The benefit of PET-CT was measured by the identification of new HCC lesions, and potential harm was quantified by the number of false positives and subsequent diagnostic evaluation.

Should a radiological diagnosis of hepatocellular carcinoma be routinely confirmed by a biopsy? No.

Modern multiphase diagnostic imaging allows diagnosis of hepatocellular carcinoma with high specificity in a large proportion of cases. Additional aspects of tumor biology also can be evaluated noninvasively through observation of tumor behavior (growth rate, satellites, vascular invasion) and other indicators of tumor biology (avid uptake of fluorodeoxyglucose, high circulating levels of tumor markers such as alphafetoprotein). Routinely requiring biopsy confirmation for diagnosis of HCC exposes many patients to unnecessary risk, may delay diagnosis, and in some cases leads to withholding of potentially beneficial treatment.

Long-term outcomes in patients with treated childhood hydrocephalus.

Object: The goal in this study was to determine the long-term effects of childhood hydrocephalus.

Methods: A patient-reported survey completed by 1953 participants was used to collect data in a subgroup of 1459 individuals who had been treated for hydrocephalus in childhood. Data on shunt complications, including total shunt revisions and infections, were examined in those whose hydrocephalus had been diagnosed at least 10 years earlier (718 patients).