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Aim: To systematically review the clinical features and outcomes of paediatric patients developing neurological complications associated with a rotavirus infection. Methods: A systematic literature review and meta‐analysis was performed, including articles published from 1984 to 2020. Neurological complications were classified into four groups: encephalitis, cerebellitis, encephalo‐cerebellitis and benign convulsions with mild gastroenteritis (CwG). Results: Out of 68 reports that fulfilled the research criteria, 99 cases of CwG, 39 cases of encephalitis, 18 cases of encephalo‐cerebellitis and five cases of cerebellitis were collected. Ninety‐five patients were from Asia. Median age was 22 (IQR 14–29) months, and the children who developed CwG were significantly younger (19, IQR 12–24 months, p < 0.0001) than the others. Status epilepticus was observed in 23% and 5% of the encephalitis and CwG groups respectively. The most frequently described neuroimaging finding were lesions of the splenium of corpus callosum. Four deaths were reported in the encephalitis group, whereas no fatal events were described in the other groups. Among the surviving children, the encephalo‐cerebellitis group showed the most severe long‐term outcome. All cases of CwG recovered completely. Conclusion: Older age at diagnosis and the development of encephalo‐cerebellitis are associated with a higher risk of long‐term complications. [ABSTRACT FROM AUTHOR]

Purpose: Monitoring disease activity in patients with large vessel vasculitis (LVV) can be challenging. [18F]FDG-PET/CT is increasingly used to evaluate treatment response in LVV. In this systematic review and meta-analysis, we aimed to summarize the current evidence on the value of [18F]FDG-PET/CT for treatment monitoring in LVV. Methods: PubMed/MEDLINE and the Cochrane library database were searched from inception through October 21, 2020. Studies containing patients with LVV (i.e. giant cell arteritis, Takayasu arteritis and isolated aortitis) that received treatment and underwent [18F]FDG-PET/CT were included. Screening, full-text review and data extraction were performed by 2 investigators. The risk of bias was examined with the QUADAS-2 tool. Meta-analysis of proportions and diagnostic test accuracy was performed by a random-effects model and bivariate model, respectively. Results: Twenty-one studies were included in the systematic review, of which 8 studies were eligible for meta-analysis. Arterial [18F]FDG uptake decreased upon clinical remission in longitudinal studies. High heterogeneity (I2 statistic 94%) precluded meta-analysis of the proportion of patients in which the scan normalized during clinical remission. Meta-analysis of cross-sectional studies indicated that [18F]FDG-PET/CT may detect relapsing/refractory disease with a sensitivity of 77% (95%CI 57–90%) and specificity of 71% (95%CI 47–87%). Substantial heterogeneity was observed among the cross-sectional studies. Both variation in clinical aspects and imaging procedures contributed to the heterogeneity. Conclusion: Treatment of LVV leads to reduction of arterial [18F]FDG uptake during clinical remission. [18F]FDG-PET/CT has moderate diagnostic accuracy for detecting active LVV. [18F]FDG-PET/CT may aid treatment monitoring in LVV, but its findings should be interpreted in the context of the clinical suspicion of disease activity. This study underlines the relevance of published procedural recommendations for the use of [18F]FDG-PET/CT in LVV. [ABSTRACT FROM AUTHOR]

Purpose: Polymyalgia rheumatica (PMR) can be difficult to diagnose. Whole-body [18F]FDG-PET/CT allows for a comprehensive evaluation of all relevant articular and extra-articular structures affected by PMR. We aimed to summarize current evidence on the diagnostic value of [18F]FDG-PET/CT for a diagnosis of PMR. Methods: PubMed/MEDLINE and the Cochrane Library database were searched from inception through May 31, 2020. Studies containing patients with PMR who underwent [18F]FDG-PET/CT were included. Screening and full-text review were performed by 3 investigators and data extraction by 2 investigators. Risk of bias was examined with the QUADAS-2 tool. Diagnostic test meta-analysis was performed with a bivariate model. Results: Twenty studies were included in the systematic review, of which 9 studies (n = 636 patients) were eligible for meta-analysis. [18F]FDG positivity at the following sites was associated with a diagnosis of PMR: interspinous bursae (positive likelihood ratio (LR+) 4.00; 95% CI 1.84–8.71), hips (LR+ 2.91; 95% CI 2.09–4.05), ischial tuberosities (LR+ 2.86; 95% CI 1.91–4.28), shoulders (LR+ 2.57; 95% CI 1.24–5.32) and sternoclavicular joints (LR+ 2.31; 95% CI 1.33–4.02). Negative likelihood ratios (LR−) for these sites, as well as the greater trochanters, were all less than 0.50. Composite [18F]FDG-PET/CT scores, as reported in 3 studies, provided a pooled LR+ of 3.91 (95% CI 2.42–6.32) and LR− of 0.19 (95% CI 0.10–0.36). Moderate to high heterogeneity was observed across the studies, mainly due to differences in patient selection, scanning procedures and/or interpretation criteria. Conclusion: Significant [18F]FDG uptake at a combination of anatomic sites is informative for a diagnosis of PMR. [18F]FDG-PET/CT might be an important diagnostic tool in patients with suspected PMR. This study also highlights the need for adherence to published procedural recommendations and standardized interpretation criteria for the use of [18F]FDG-PET/CT in PMR. [ABSTRACT FROM AUTHOR]

Background: Left ventricular assist devices (LVADs) are increasingly used for the treatment of advanced heart failure. LVADs improve quality of life and decrease mortality, but the driveline carries substantial risk for major infections. These device-related LVAD and driveline infections are difficult to diagnose with conventional imaging. We reviewed and analysed the current literature on the additive value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) imaging for the diagnosis of LVAD-related infections." Materials/methods: We performed a systematic literature review using several databases from their inception until the 31st of December, 2019. Studies investigating the diagnostic performance of FDG-PET/CT in patients with suspected LVAD infection were retrieved. After a bias risk assessment using QUADAS-2, a study-aggregate meta-analysis was performed on a per examination-based analysis. Results: A total of 10 studies were included in the systematic review, eight of which were also eligible for study-aggregate meta-analysis. For the meta-analysis, a total of 256 FDG-PET/CT scans, examining pump/pocket and/or driveline infection, were acquired in 230 patients. Pooled sensitivity of FDG-PET/CT was 0.95 (95% confidence interval (CI) 0.89–0.97) and pooled specificity was 0.91 (95% CI 0.54–0.99) for the diagnosis of device-related infection. For pump/pocket infection, sensitivity and specificity of FDG-PET/CT were 0.97 (95%CI 0.69–1.00) and 0.93 (95%CI 0.64–0.99), respectively. For driveline infection, sensitivity and specificity were 0.96 (95%CI 0.88–0.99) and 0.99 (95%CI 0.13–1.00) respectively. Significant heterogeneity existed across studies for specificity, mostly caused by differences in scan procedures. Predefined criteria for suspicion of LVAD and/or driveline infection were lacking in all included studies. Conclusions: FDG-PET/CT is a valuable tool for assessment of device-related infection in LVAD patients, with high sensitivity and high, albeit variable, specificity. Standardization of FDG-PET/CT procedures and criteria for suspected device-related LVAD infections are needed for consistent reporting of FDG-PET/CT scans. [ABSTRACT FROM AUTHOR]

The carapacial scute pattern is a conserved trait in sea turtles that provides taxonomic information, although hatchlings with aberrant scute numbers are commonly described in all extant species. These anomalies have been associated with reduced individual fitness, but very little is known about their occurrence in the juvenile and adult portion of the population. Here, we compared the frequencies of major non‐modal scute patterns (i.e. number of vertebral/coastal scutes ≠ 5, MNMSP) in hatchling, juvenile and adult loggerhead turtles (Caretta caretta) from the Central Tyrrhenian Sea. 20.5% of the analysed hatchlings exhibited MNMSP (N = 1047, range 0–52%). These individuals were significantly lighter than modals, but no other morphological difference was observed. Hatchlings from relocated nests (N = 241) had a lower rate of scute variation compared to those from natural nests (N = 806, MNMSP frequencies 10.37 and 23.57% respectively). The proportion of MNMSP decreased in early juveniles (12.1%, N = 149, SCLst < 41 cm) and even further in late juveniles/adults (4.8%, N = 124, SCLst > 41 cm). These results are coherent with those from previous studies and suggest that individuals with modal scute pattern may have a greater survival rate. However, selection against abnormal scute patterns may not occur within the first few days of life, as previously suggested, but it is probably a much slower process that may require several years. It is unlikely that alterations of the scute pattern affect survival directly; they may be a phenotypic expression of underlying morphological or physiological anomalies that stem from environmental stressors similar to those causing scute variations during embryonic development. [ABSTRACT FROM AUTHOR]

Purpose: The localization of hyperfunctioning parathyroid gland(s) (HPTG) in patients with primary hyperparathyroidism (PHPT) with negative or inconclusive first-line imaging is a significant challenge. This study aimed to evaluate the role of integrated 18F-choline PET/4D contrast-enhanced computed tomography (4DCeCT) in these patients, compare its detection rate and sensitivity with those of 18F-choline PET/CT and (4DCeCT), and analyse the association between choline metabolism and morphological, biochemical and molecular parameters of HPTG.Methods: We prospectively enrolled 44 PHPT patients with negative or inconclusive first-line imaging. 18F-Choline PET/CT and 4DCeCT were performed at the same time, and integrated 18F-choline PET/4DCeCT images were obtained after coregistration. Experienced physicians examined the images. The SUVratio and degree of contrast enhancement were recorded for each positive finding. Histopathology, laboratory and multidisciplinary follow-up were used as the standard of reference. Both the detection rates and sensitivities of the three imaging modalities were calculated retrospectively. Immunohistochemistry was performed to evaluate the molecular profile of HPTGs.Results: 18F-Choline PET/4DCeCT was positive in 32 of 44 patients with PHPT (detection rate 72.7%), and 31 of 31 surgically treated patients (sensitivity 100%). These results were significantly (p < 0.05) better than those of 18F-choline PET/CT (56.8% and 80%, respectively) and those of 4DCeCT (54.5 and 74%, respectively). A significant correlation between SUV and calcium level was found. In a multivariate analysis, only calcium level was significantly associated with 18F-choline PET/4DCeCT findings. SUVratio and Ki67 expression were significantly correlated.Conclusion: Integrated 18F-choline PET/4DCeCT should be considered as an effective tool to detect PHPT in patients with negative or inconclusive first-line imaging. Choline metabolism is correlated with both calcium level and Ki67 expression in HPTG. [ABSTRACT FROM AUTHOR]

Resumen Objetivo Los sarcomas uterinos son tumores raros con mal pronóstico debido a las altas tasas de recurrencia. El papel actual de la 18F-FDG PET/TC en la vigilancia posterior a la terapia aún no está establecido. Material y metodos Cuarenta y una mujeres con sarcoma uterino se sometieron a 73 estudios 18F-FDG PET/TC para la reestadificación en la presunta recurrencia o durante el seguimiento en pacientes asintomáticos. Los resultados histopatológicos y/o el seguimiento clínico/de imágenes durante al menos 12 meses se consideraron el estándar de referencia. Se calculó la precisión diagnóstica y el impacto clínico de la 18F-FDG PET/TC. Resultados treinta y tres estudios 18F-FDG PET/TC fueron positivos, mientras que los 40 estudios restantes fueron negativos. La sensibilidad general, la especificidad, el valor predictivo positivo (VP+), el valor predictivo negativo (VP-) y la precisión de la 18F-FDG PET/TC fueron del 88%, 98%, 97%, 91% y 93%. Considerando pacientes con sospecha clínica o radiológica de recidiva (n = 47) y durante el seguimiento (n = 26) la sensibilidad y especificidad, VP+, VP− y precisión de 18F-FDG PET/TC fueron del 89%, 100%, 100%, 86% y 94%, y 80%, 95%, 80%, 95% y 92% respectivamente. La 18F-FDG PET/TC tuvo un impacto clínico positivo en 9/73 (12%) estudios y cambió el manejo clínico en 8/41 (20%) pacientes. Conclusion La 18F-FDG PET/TC es un método preciso para la detección y localización de recidivas a distancia en pacientes con sarcoma uterino con buena sensibilidad y especificidad e impacto significativo en la toma de decisiones clínicas. Abstract Purpose Uterine sarcomas are rare tumors with poor prognosis due to the high recurrence rates. The current role of 18F-FDG PET/CT in the post-therapy surveillance is not established yet. Materials and Methods Forty-one women with uterine sarcoma underwent 73 18F-FDG PET/CT for restaging in suspected recurrence or during follow-up in asymptomatic patients. Histopathology results and/or clinical/imaging follow-up for at least 12 months were considered the reference standard. The diagnostic accuracy and clinical impact of 18F-FDG PET/CT was calculated. Results Thirty-three 18F-FDG PET/CT were positive, while the remaining 40 studies were negative. The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 18F-FDG PET/CT were 88%, 98%, 97%, 91% and 93%, respectively. Considering patients with clinical or radiological suspicion of recurrence (n = 47) and those during follow-up (n = 26), sensitivity, specificity, PPV, NPV and accuracy of 18F-FDG PET/CT were 89%, 100%, 100%, 86% and 94%, and 80%, 95%, 80%, 95% and 92%, respectively. 18F-FDG PET/CT had a positive clinical impact in 9/73 (12%) studies and changed the clinical management in 8/41 (20%) patients. Conclusions 18F-FDG PET/CT seems to be an accurate method for detection and localization of local and distant recurrence in patients with uterine sarcoma with good sensitivity and specificity and significant impact on clinical decision making. [ABSTRACT FROM AUTHOR]

Background Opportunistic invasive fungal infections (IFIs) comprise a heterogeneous spectrum of pathogens, whose early diagnosis remains challenging. Candida spp. and Aspergillus spp, the most frequent pathogens in immunocompromised patients, frequently affect lungs, liver, bone and skin. Aim To evaluate the impact of 18F-FDG PET/CT in the management of immunocompromised patients with IFI. Design A single-center retrospective study included 51 immunocompromised patients with IFI diagnosis undergoing 83 18F-FDG PET/CTs. Methods Twenty-nine 18F-FDG PET/CTs were performed for primary work-up in 29 treatment-naïve patients. Fifty-four PET/CTs were performed during follow-up to confirm IFI suspicion in 22 patients who had anti-fungal drug therapy before PET/CT. When available, histological and/or microbiological criteria were used to assess IFI diagnosis. Results Aspergillus spp. and Candida spp. were the most frequent microorganisms responsible for IFI in our population. 18F-FDG PET/CT sensitivity, specificity, positive and negative predictive values, and global accuracy were 93%, 81%, 95%, 72% and 90%, respectively. 18F-FDG PET/CT influenced the diagnostic work-up at primary staging in 16/29 patients (55%) by assessing the extent of infection and targeting the diagnostic procedure. 18F-FDG PET/CT results during treatment induced anti-fungal drugs dosage increase and/or new drugs addition in 8/54 cases (15%) and contributed to the reduction of anti-fungal drugs dosage or treatment withdraws in 17 cases (31%). Conclusions We recommend the utilization of 18F-FDG PET/CT to improve the primary staging work-up of immunocompromised patients with IFI and to assess treatment effectiveness or disease relapse. Both 18F-FDG PET/CT and conventional imaging should be integrated into a well-defined imaging diagnostic algorithm considering the clinical context and both strengths and limitations of each diagnostic modality. [ABSTRACT FROM AUTHOR]

Purpose: To compare mutation analysis of cytology specimens and Tc-MIBI thyroid scintigraphy for differentiating benign from malignant thyroid nodules in patients with a cytological reading of follicular neoplasm. Methods: Patients ≥18 years of age with a solitary hypofunctioning thyroid nodule (≥10 mm), normal thyrotropin and calcitonin levels, and a cytological diagnosis of follicular neoplasm were prospectively enrolled. Mutation analysis and Tc-MIBI scintigraphy were performed and patients were subsequently operated on to confirm or exclude a malignant lesion. Mutations for KRAS, HRAS and NRAS and for BRAF and translocations of PAX8/PPARγ, RET/PTC1 and RET/PTC3 were investigated. Static thyroid scintigraphic images were acquired 10 and 60 min after intravenous injection of 200 MBq of Tc-MIBI and visually assessed. Additionally, the MIBI washout index was calculated using a semiquantitative method. Results: In our series, 26 % of nodules with a follicular pattern on cytology were malignant with a prevalence of follicular carcinomas. Tc-MIBI scintigraphy was found to be significantly more accurate (positive likelihood ratio 4.56 for visual assessment and 12.35 for semiquantitative assessment) than mutation analysis (positive likelihood ratio 1.74). A negative Tc-MIBI scan reliably excluded malignancy. Conclusion: In patients with a thyroid nodule cytologically diagnosed as a follicular proliferation, semiquantitative analysis of Tc-MIBI scintigraphy should be the preferred method for differentiating benign from malignant nodules. It is superior to molecular testing for the presence of differentiated thyroid cancer-associated mutations in fine-needle aspiration cytology sample material. [ABSTRACT FROM AUTHOR]

Current systematic review evaluated the efficacy of topical isoflavones to relieve vaginal symptoms in menopausal women. MEDLINE (1966 to January 2014), Scopus (1990 to January 2014), and the Cochrane Central Register of Controlled Trials (The Cochrane Library issue 1, 2013) were searched using keywords ‘isoflavone and vagina’. Relevant studies were reviewed by two independent reviewers. Only randomised controlled trials (RCTs) were included in the systematic review. Out of 115 potentially relevant publications, four studies met the inclusion criteria. Topical isoflavones showed beneficial effects on dyspareunia, vaginal dryness and maturation value. Based on only one trial, the result of conjugated equine oestrogen cream (0.3 mg/day) was similar to use of isoflavone vaginal gel and superior to that of placebo gel. However, drawing any definite conclusion was difficult because of the limited number of RCTs, the small sample sizes, weak methodology and considerable heterogeneity of the included studies. [ABSTRACT FROM PUBLISHER]

Several articles have assessed the role of preoperative serum thyroglobulin (Tg) as predictor of malignancy of thyroid nodules, with particular focus on nodules with indeterminate cytology. However, the role of serum Tg as diagnostic marker remains unclear. The aim of the study was to perform a systematic review to add more evidence-based data on this topic. A comprehensive literature search was conducted to find relevant published articles on this topic. MeSH terms were: "thyroglobulin" and "predict * ". In order to include only recent serum Tg assay methods, we analyzed the timeframe between 2001 and July 31st, 2014. To expand our search, references of the retrieved articles were also screened. Thirteen studies, including 3 580 patients, were analyzed. Nine out of these studies reported data on thyroid nodules with prior indeterminate cytology. Preoperative serum Tg levels demonstrated suboptimal accuracy in discriminating malignant from benign nodules due to a significant overlap of values between these groups. However, most articles demonstrated a statistically significant difference in mean or median serum Tg between patients with cancer and benign lesions correlated to final histology. Furthermore, most studies reported Tg as independent predictor of malignancy. According to the most recent literature, the preoperative measurement of Tg alone fails to discriminate thyroid cancers from benign lesions. However, our data show that Tg is an independent predictor of malignancy; as a consequence, the presurgical determination of Tg should be considered in patients with thyroid nodules, especially when cytology is indeterminate. [ABSTRACT FROM AUTHOR]

Fluorine-18-fluorodeoxyglucose (F-18-FDG) is the most used positron emitter radiopharmaceutical worldwide. This glucose analogue allows to study the glucose metabolism which is often increased in many tumors. Nowadays the diagnostic performance of positron emission tomography/computed tomography (PET/CT) using F-18-FDG in different tumors is well known. On the other hand, to date, there is an increasing interest for the use of PET tracers other than F-18-FDG in oncology, because they allow to study different metabolic pathways or receptor expression. The aim of this review is to summarize the scientific literature about the diagnostic performance of PET/CT using tracers other than F-18-FDG in oncology through an evidence-based approach. In particular, the results of meta-analyses (representing the highest level of evidence) on the diagnostic performance of PET tracers other than F-18-FDG in different tumors are described. Furthermore, recommendations for the use of different PET tracers in oncology are provided based on existing literature data. [ABSTRACT FROM AUTHOR]

Objective: Parathyroid scintigraphy using (99m)Tc-MIBI is not currently considered a valuable diagnostic tool for the localization of involved glands in patients with secondary hyperparathyroidism (SHPT). However, published data about its diagnostic accuracy are discordant and a meta-analysis about this topic is still lacking. The aim of our study is to meta-analyze the published data about the diagnostic performance of (99m)Tc-MIBI parathyroid scintigraphy in patients with SHPT. Methods: A comprehensive computer literature search of studies published in PubMed/MEDLINE, Scopus and Embase databases through September 2011 and regarding the diagnostic accuracy of (99m)Tc-MIBI parathyroid scintigraphy in patients with SHPT was carried out. Only articles in English language in which at least 10 patients with SHPT underwent planar (99m)Tc-MIBI parathyroid scintigraphy were selected. Pooled sensitivity, pooled specificity and area under the ROC curve on a per lesion-based analysis were calculated to measure the diagnostic accuracy of (99m)Tc-MIBI parathyroid scintigraphy in SHPT patients. Results: Twenty-four studies comprising 471 patients were included in this meta-analysis. The pooled sensitivity and specificity of (99m)Tc-MIBI parathyroid scintigraphy in detecting hyperplastic glands in SHPT patients were 58 % [95 % confidence interval (95 % CI) 52-65 %] and 93 % (95 % CI 85-100 %), respectively, on a per lesion-based analysis. Area under ROC curve was 0.75. Conclusions: In patients with SHPT and diffuse or nodular hyperplasia, planar parathyroid scintigraphy using (99m)Tc-MIBI has demonstrated an inadequate diagnostic accuracy. Therefore, it should not be considered as a first-line diagnostic imaging method in the pre-surgical detection of hyperplastic parathyroid glands. [ABSTRACT FROM AUTHOR]

Inflammatory bowel diseases (IBD) are a group of pathological conditions characterized by chronic inflammation of the gastrointestinal tract, including Crohn's disease and ulcerative colitis. To date, imaging of IBD is based on several radiological techniques such as barium studies, magnetic resonance imaging, and computed tomography (CT). Endoscopy is the gold standard for the assessment of the large bowel and proximal small intestine in patients with IBD allowing the biopsy of the visualized bowel. Positron emission tomography (PET) and PET/CT with Fluorine-18-fluoro-2-deoxy-D-glucose (FDG) is a functional imaging method used to detect abnormalities in glucose metabolism in a variety of disorders. FDG accumulates mainly in tumours, but increased uptake and retention has been shown also in lesions with a high concentration of inflammatory cells, such as granulocytes and activated macrophages. Recent literature data demonstrate that FDG-PET and PET/CT may be useful noninvasive tools for identifying and localizing active IBD. In patients with an established diagnosis of IBD, FDG-PET and PET/CT may provide information about disease activity, location and extent of the disease within the intestinal tract, allowing early recognition of disease relapse and possible complications. Furthermore, these techniques may play a role in assessing the treatment response to medical therapy in patients with IBD. [ABSTRACT FROM AUTHOR]

Purpose: The aim of our study was to assess the feasibility and usefulness of 2-[(18)F]-fluoro-2-deoxy-D: -glucose positron emission tomography computed tomography ([(18)F]FDG-PET/CT) in patients affected by retroperitoneal fibrosis.Materials and Methods: We retrospectively evaluated 25 patients studied in two centers: 18 underwent [(18)F]FDG-PET/CT as initial evaluation, three during follow-up, three during steroid therapy, and one to re-evaluate the disease. Among the group who underwent initial evaluation, ten underwent a second [(18)F]FDG-PET/CT after steroid therapy.Results: [(18)F]FDG-PET/CT was positive in 18 patients and negative in seven. Among the ten patients who underwent a second study after steroid therapy, six showed complete metabolic response, three partial response, and one no significant maximum standardized uptake value (SUV(max)) reduction.Conclusion: Our preliminary results show that [(18)F]FDG-PET/CT is feasible and suitable for evaluating retroperitoneal fibrosis and is useful in assessing therapy response. Larger studies are desirable to confirm these findings and to determine the appropriate position of [(18)F]FDG-PET/CT in the diagnostic flow chart for this disease. [ABSTRACT FROM AUTHOR]

Objective: To systematically review and meta-analyse literature data on the diagnostic performance of fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) in patients with Ewing sarcoma family tumours (ESFT).Materials and Methods: PubMed/MEDLINE, Embase and Scopus databases were searched for articles that evaluated FDG-PET and PET/CT in patients with ESFT from inception to 31 May 2011. Studies that fulfilled the three following criteria were included in the systematic review: FDG-PET or PET/CT performed in patients with ESFT; articles about the diagnostic accuracy of FDG-PET and PET/CT; sample size of at least 10 patients with ESFT were included. Studies in which there were sufficient data to reassess sensitivity and specificity of FDG-PET or PET/CT in ESFT were included in the meta-analysis, excluding duplicate publications. Finally, pooled sensitivity, pooled specificity and area under the receiver operating characteristic (ROC) curve of FDG-PET or PET/CT in ESFT were calculated.Results: We found 13 studies comprising a total of 342 patients with ESFT. The main findings of the studies included are presented. The meta-analysis of five selected studies provided these results about FDG-PET and PET/CT in ESFT: pooled sensitivity: 96% (95% confidence interval [CI] 91-99%); pooled specificity: 92% (95% CI 87-96%); area under the ROC curve: 0.97.Conclusion: With regard to the staging and restaging of patients with ESFT, the sensitivity, specificity and accuracy of FDG-PET and PET/CT are high; the combination of FDG-PET or PET/CT with conventional imaging is a valuable tool for the staging and restaging of ESFT and has a relevant impact on the treatment strategy plan. [ABSTRACT FROM AUTHOR]

Aim The aims of the present study were: (i) to evaluate the focal incidental colorectal uptake of 18F-fluorodeoxyglucose ([18F]FDG) and to correlate it with colonoscopy and histological findings; (ii) to evaluate the relationship between the presence/absence of neoplastic disease and clinical data and the anatomical site of [18F]FDG uptake; and (iii) to compare our results with those reported for incidental colorectal uptake of [18F]FDG in the literature and those obtained from various screening programmes for colorectal cancer. Method The database of 6000 patients referred for [18F]FDG positron emission tomography/computed tomography (PET-CT) to our centre was retrospectively reviewed for incidental colorectal uptake of [18F]FDG. Patients with focal uptake were selected and the aetiology of PET findings was verified with a subsequent colonoscopy and histopathological analysis when available. Results Incidental colorectal uptake of [18F]FDG was seen in 144 (2.4%) patients, of whom 64 (1.1%) had focal uptake; 48 out of these 64 patients underwent colonoscopy, which showed malignant tumours in 12 (25%), premalignant lesions in 19 (40%), non-neoplastic lesions in six (12%) and lesions not confirmed by colonoscopy in 11 (23%). Our data agreed with previously published data. Statistical analysis did not show any significant relationship between the presence/absence of neoplastic disease and patient sex or age, type of primary disease and anatomical site of [18F]FDG uptake. Comparing our data with various screening programmes, a significant difference was found only with series in which colonoscopy was performed in patients at high risk for colorectal cancer. Conclusion Focal incidental colorectal uptake of [18F]FDG is observed in about 1% of PET/CT studies and carries a high risk of neoplastic disease. A PET-CT report should suggest colonoscopy when abnormal findings are reported. [ABSTRACT FROM AUTHOR]

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We compare atomic structure and dynamics of free and supported metallic clusters via molecular dynamics simulations using tight-binding semiempirical potentials for metal-metal interactions and a potential fitted to ab initio calculations for the metal-supported ones, the support being essentially the MgO(100) surface in the case of a nonreactive metal-oxide interface. The structural transition for free Ni, Pd, Pt, Cu, Ag, Au clusters with noncrystalline structures (mainly icosahedral and decahedral) at small sizes to FCC truncated octahedrons for larger sizes is reported as well as the variation of the critical size of transition from 3d to 5d metals. In the case of Pd clusters on the MgO(100) surface, we analyze the substrate-induced modifications in morphology and atomic structure and follow their evolution as a function of cluster size. The mechanism of strain release by misfit interfacial dislocations in 3D clusters is described at the atomic level. Dynamics of growth and melting of free silver clusters are discussed and some effects of the oxide substrate in melting transition are pointed out, notably the delay in melting induced by the epitaxial relation with the support. [ABSTRACT FROM AUTHOR]

Introduction: Gallium-68 somatostatin receptor (SMSR) positron emission tomography (PET) is a valuable diagnostic tool for patients with neuroendocrine tumors (NET). To date, a meta-analysis about the diagnostic accuracy of this functional imaging method is lacking. Aim(s): To meta-analyze published data about the diagnostic performance of SMSR PET or PET/CT in patients with NET. Materials and methods: A comprehensive literature search of studies published in PubMed, Scopus and Embase databases through October 2011 and regarding SMSR PET or PET/CT in patients with NET was carried out. Only studies in which SMSR PET or PET/CT were performed in patients with thoracic and/or gastroenteropancreatic (GEP) NET were selected (medullary thyroid tumors and paragangliomas were excluded from the analysis). Pooled sensitivity, pooled specificity and area under the ROC curve were calculated to measure the diagnostic accuracy of SMSR-PET or PET/CT in NET. Results: Seventeen studies comprising 587 patients were included in this meta-analysis. The pooled sensitivity and specificity of SMSR PET or PET/CT in detecting NET were 93% (95% CI, 91-95%) and 91% (95% CI, 82-97%), respectively, on a per patient-based analysis. The area under the ROC curve was 0.96. Conclusion: In patients with suspicious thoracic and/or GEPNET, SMSR PET or PET/CT demonstrated high sensitivity and specificity. These accurate techniques should be considered as first-line diagnostic imaging methods in patients with suspicious NET. [ABSTRACT FROM AUTHOR]

Introduction: Ectopic ACTH syndrome (EAS) occurs in about 5-10% of ACTH-dependent hypercortisolism and, in up to 15% of cases, is related to occult neoplasms. Aim(s): We report one case of EAS highlighting the usefulness of Nuclear Medicine imaging in pre- and intraoperative localization of the ACTH-secreting neoplasm. Materials and methods: A 66-year-old male patient was diagnosed in 2010 with ACTH-dependent hypercortisolism. Pituitary MRI was negative, while a chest-abdomen CT scan described a 7-mm nodule in the upper lobe of the right lung. Bilateral Inferior Petrosal Sinus Sampling (BIPSS) showed no evidence of center-periphery ACTH gradient. An Octreoscan did not reveal any area of pathological hyperuptake. Treatment with ketoconazole and lanreotide was started with clinical benefit. In July 2011, the patient underwent a PET/CT scan with 68Ga-DOTANOC that revealed mild hyperuptake of the lung nodule. Results: In September 2011, the patient underwent radio-guided surgery using a hand-held gamma probe 24 h after i.v. administration of 111In-pentetreotide. The pulmonary nodule was identified, confirmed by the gamma probe and surgically removed. Pathology confirmed a typical bronchial carcinoid with positive ACTH expression. Conclusion: This case underlines how the integration of traditional diagnostic tools with both Nuclear Medicine imaging and intraoperative techniques can guarantee an improvement in the diagnostic and therapeutic management of neuroendocrine neoplasms. [ABSTRACT FROM AUTHOR]