Metabolic response on post-therapy FDG-PET predicts patterns of failure after radiotherapy for cervical cancer.

Purpose: To determine the patterns of failure in patients with cervical cancer treated with definitive radiotherapy and evaluated for metabolic response with early posttherapy (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET).

Methods And Materials: The records of 238 patients with cervical cancer were reviewed. All patients were treated with a combination of external radiotherapy and intracavitary brachytherapy.

Does patient age and height of fall alone require trauma team activation?

Our American College of Surgeons Level I trauma center uses physiological data and injury patterns to identify fall patients at risk. We hypothesized that height of fall and patient age impacted injury severity and analyzed if they were significant predictors of the need for trauma team activation. Charts were reviewed from July 1, 2004, to June 30, 2007, for age; sex; Injury Severity Score (ISS); height of fall and admission to the intensive care unit, operating room, stepdown unit, floor; or death.

Standard computed tomography of the chest, abdomen, and pelvis is sensitive and cost-effective for the detection of fractures of the shoulder girdle.

Computed tomography of the chest, abdomen, and pelvis (CTCAP) has become the mainstay of diagnosis in stable blunt trauma patients. The purpose of this study was to investigate whether standard CTCAP has adequate sensitivity to identify fractures of the scapula, clavicle, and humeral head to replace routine radiographs of the shoulder. A retrospective chart review was carried out from January 1, 2004, to December 31, 2007, at Morristown Memorial Hospital.

A field test of time-based emergency department quality measures.

Study Objective: We examine practical aspects of collecting time-based emergency department (ED) performance measures.

Methods: Seven measures were implemented in 6 hospitals during 1 year. Structured interviews were used to assess the benefits and burdens of reporting.

Radiofrequency ablation of medically inoperable stage IA non-small cell lung cancer: are early posttreatment PET findings predictive of treatment outcome?

Objective: The purpose of this study was to evaluate initial experience with (18)F-FDG PET/CT after pulmonary radiofrequency ablation of stage IA non-small cell lung cancer to determine whether treatment success or residual disease can be predicted with early postablation PET.

Subjects And Methods: Thirty patients with medically inoperable stage IA non-small cell lung cancer (12 men, 18 women; median age, 76 years; range, 60-87 years) underwent outpatient CT-guided radiofrequency ablation over a 33-month period. Mean tumor size was 2.

How health care organizations are using data on patients' race and ethnicity to improve quality of care.

Context: Racial and ethnic disparities in the quality of health care are well documented in the U.S. health care system.

Quantitative imaging test approval and biomarker qualification: interrelated but distinct activities.

Unlabelled: Quantitative imaging biomarkers could speed the development of new treatments for unmet medical needs and improve routine clinical care. However, it is not clear how the various regulatory and nonregulatory (eg, reimbursement) processes (often referred to as pathways) relate, nor is it clear which data need to be collected to support these different pathways most efficiently, given the time- and cost-intensive nature of doing so. The purpose of this article is to describe current thinking regarding these pathways emerging from diverse stakeholders interested and active in the definition, validation, and qualification of quantitative imaging biomarkers and to propose processes to facilitate the development and use of quantitative imaging biomarkers.

18F-FDG PET/CT for early response assessment in diffuse large B-cell lymphoma: poor predictive value of international harmonization project interpretation.

Unlabelled: PET using (18)F-FDG has prognostic value when performed at the completion of initial chemotherapy in patients with diffuse large B-cell lymphoma (DLBCL). (18)F-FDG PET may also be predictive of outcome when performed during the treatment course of DLBCL, but robust prospective studies and standardization of (18)F-FDG PET interpretation in this setting are lacking.

Methods: In this prospective study, patients with advanced-stage DLBCL were treated with standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy, and (18)F-FDG PET/CT was performed after cycle 2 or 3 and at the end of therapy.

Management of cervical nodal metastasis detected on I-131 scintigraphy after initial surgery of well-differentiated thyroid carcinoma.

Background: The purpose of this study was to evaluate the outcome of patients with differentiated thyroid carcinoma whose posttherapy imaging demonstrated I-131 uptake in cervical lymph nodes.

Methods: In this prospective cohort study, 95 patients who underwent surgery for well-differentiated thyroid carcinoma had evidence of persistent cervical lymph node metastasis on posttherapy I-131 scintigraphy. These patients were evaluated by subsequent I-131 scintigraphy, and treated with additional I-131 therapy or surgical excision of cervical lymph nodes as clinically indicated.

Impact of dedicated brain PET on intended patient management in participants of the national oncologic PET Registry.

Purpose: This study seeks to assess the impact of dedicated brain positron emission tomography (PET) with 2-deoxy-2-[(18)F]fluoro-D-glucose on intended management of patients with primary and metastatic brain tumors.

Procedures: We analyzed demographic characteristics and evaluated change in intended management after PET, using previously described metrics, for patients in the National Oncologic PET Registry (NOPR) undergoing dedicated brain PET. For cases of primary brain tumors, comparisons to the overall NOPR cohort were made.

A phase II comparative study of gross tumor volume definition with or without PET/CT fusion in dosimetric planning for non-small-cell lung cancer (NSCLC): primary analysis of Radiation Therapy Oncology Group (RTOG) 0515.

Background: Radiation Therapy Oncology Group (RTOG) 0515 is a Phase II prospective trial designed to quantify the impact of positron emission tomography (PET)/computed tomography (CT) compared with CT alone on radiation treatment plans (RTPs) and to determine the rate of elective nodal failure for PET/CT-derived volumes.

Methods: Each enrolled patient underwent definitive radiation therapy for non-small-cell lung cancer (≥ 60 Gy) and had two RTP datasets generated: gross tumor volume (GTV) derived with CT alone and with PET/CT. Patients received treatment using the PET/CT-derived plan.

Prognostic utility of squamous cell carcinoma antigen in carcinoma of the cervix: association with pre- and posttreatment FDG-PET.

Purpose: Squamous cell carcinoma antigen (SCC Ag) is a serum biomarker for squamous cell carcinoma (SCC) of the cervix. We investigated the prognostic significance of SCC Ag levels before and at the completion of chemoradiotherapy and compared these levels with the results of pre- and posttreatment positron emission tomography/computed tomography (PET/CT) using [(18)F]fluorodeoxyglucose (FDG).

Methods And Materials: The records of 63 women who underwent definitive chemoradiotherapy for SCC of the cervix were reviewed.

Gender differences in psychosocial issues affecting low-income, underserved patients' ability to manage cardiovascular disease.

Research Objective: This paper examines the psychosocial challenges that interfere with low-income, underserved patients' ability to manage cardiovascular disease (CVD) and seeks to explore the differences in how men and women manifest these issues.

Study Design: We convened 33 focus group discussions with low-income, underserved heart patients in 10 U.S.

Culture clash: a missed opportunity.

Erasto is a term infant born by vaginal delivery to a gravida 7 para 7 Somalia woman with full prenatal care in the United States. His mother had gestational diabetes. The delivery was complicated by respiratory distress and an urgent admission to the neonatal intensive care unit for further evaluation for possible pulmonary disease and a congenital heart condition.

Lymph node staging by positron emission tomography in cervical cancer: relationship to prognosis.

PURPOSE A previous retrospective study demonstrated that positron emission tomography with [(18)F]fluorodeoxyglucose (FDG-PET) was more sensitive than computed tomography for lymph node staging in patients with cervical cancer; the findings on FDG-PET were strongly associated with progression-free survival. Therefore, a prospective cohort study was initiated to evaluate FDG-PET lymph node staging in a larger patient population. PATIENTS AND METHODS The study was conducted between July 2000 and March 2009.

Anal cancer maximum F-18 fluorodeoxyglucose uptake on positron emission tomography is correlated with prognosis.

Purpose: To evaluate anal cancer uptake of F-18 fluorodeoxyglucose (FDG) measured as the maximum standardized uptake value (SUV(max)) by positron emission tomography (PET) and its correlation with prognostic factors.

Patients And Methods: The study population consisted of 77 patients with stages 0-IIIB anal cancer who underwent pre-treatment FDG-PET. Tumor histology included 65 squamous cell, 11 basaloid, and 1 small cell cancers.

Pelvic lymph node F-18 fluorodeoxyglucose uptake as a prognostic biomarker in newly diagnosed patients with locally advanced cervical cancer.

Background: The objective of the current study was to evaluate the prognostic significance of the maximum standardized uptake value (SUV(max)) of F-18 fluorodeoxyglucose (FDG) as measured by positron emission tomography (PET) in pelvic lymph nodes in patients with cervical cancer.

Methods: The authors studied cervical cancer patients with pelvic lymph node metastasis, as evidenced on FDG-PET, who were treated between November 2003 and October 2008. The maximum dimension and SUV(max) for the most FDG-avid pelvic lymph node (SUV(PLN)) and the SUV(max) of the primary cervical tumor (SUV(cervix)) were recorded from the FDG-PET/computed tomography (CT) scan.

PET and PET/CT reports: observations from the National Oncologic PET Registry.

Unlabelled: Our objective was to identify core elements for inclusion in oncologic PET reports and to evaluate a sample of reports in the National Oncologic PET Registry database.

Methods: A list of desirable elements in PET reports was compiled from American College of Radiology and Society of Nuclear Medicine guidelines. A training set of 20 randomly selected reports was evaluated by the 4-physician panel, and the results were used to formulate a consensus approach for assessing report content and quality.

Creation and piloting of a new hospital capacity assessment tool in a major urban area.

Objectives: Crowded hospital emergency departments (EDs) can undermine the ability of a region's safety net to provide safe, timely care. However, data to measure hospital capacity community-wide is generally unavailable. This study aimed to assess hospital crowding, capacity and patient flow in an urban community using the newly developed hospital capacity assessment tool (HCAT).

Clinical outcomes of definitive intensity-modulated radiation therapy with fluorodeoxyglucose-positron emission tomography simulation in patients with locally advanced cervical cancer.

Purpose: This study aimed to evaluate the toxicity and clinical outcomes for cervical cancer patients treated definitively with intensity-modulated radiation therapy (IMRT) compared with non-IMRT treatment.

Methods And Materials: This prospective cohort study included 452 patients with newly diagnosed cervical cancer treated with curative intent (135 IMRT and 317 non-IMRT). Treatment involved external irradiation and brachytherapy, and 85% of patients received concurrent chemotherapy.

Barriers to effective self-management in cardiac patients: the patient's experience.

Objective: This paper identifies common obstacles impeding effective self-management among patients with heart disease and explores how for disadvantaged patients access barriers interfere with typical management challenges to undermine patients' efforts to care for their illnesses.

Methods: We convened 33 focus group discussions with heart patients in 10 U.S.

NCCN task force: clinical utility of PET in a variety of tumor types.

Use of PET is widespread and increasing in the United States, mainly for oncologic applications. In November 2006, the National Comprehensive Cancer Network (NCCN) gathered a panel of experts to review the literature and develop clinical recommendations for using PET scans in lymphoma and non-small cell lung, breast, and colorectal cancers. However, because its use is not restricted to these diseases, and evidence is accumulating for its application in other types of cancers, NCCN convened a second meeting in December 2008 to expand on the initial report.