The ability of integrated (18)F-fluorodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT) to distinguish between benign and malignant incidental non-secreting adrenal masses was evaluated in cancer patients. Results were compared with those of CT and shift magnetic resonance imaging (MRI). A total of 1832 cancer patients who had undergone FDG PET/CT scans were retrospectively evaluated. Visual interpretation, tumour maximum standardized uptake value (SUV(max)), liver SUV(max) and tumour/liver SUV(max) ratios were correlated with the findings of CT, shift MRI and final diagnosis (based on biopsy or clinical/radiological follow-up). A total of 109 adrenal masses were found: 49 were malignant and 60 were benign on final diagnosis. A tumour/liver SUV(max) ratio threshold of 1.0 was more accurate in differentiating the tumour type than tumour SUV(max) or visual interpretation alone. Diagnostic accuracy of CT and shift MRI (92 - 97%) was similar to that for FDG PET/CT (94 - 97%). In conclusion, FDG PET/CT accurately characterizes adrenal tumours, with excellent sensitivity and specificity. Use of 1.0 as the threshold for the tumour/liver SUV(max) ratio seems to be promising for distinguishing benign from malignant adrenal masses in cancer patients.

During Tc-tetrofosmin SPECT exercise stress tests performed in patients with suspected coronary artery disease, much more attention must be given to unexpected extracardiac uptakes. With 99mTc-tetrofosmin a large variety of different unknown tumors can be detected during MPS.

EinleitungDas Sternoklavikulargelenk (SC-Gelenk) verbindet als einziges Gelenk die obere Extremität mit dem Rumpf. Die relative Inkongruenz der Gelenkflächen und die permanente Beanspruchung bei Bewegungen im Schultergelenk lassen zunächst vermuten, dass Gelenkluxationen regelhaft zu beobachten sind (Rockwood CJ, Wirth MA. Philadelphia: WB Saunders, 2004: 597). Aufgrund seiner komplexen Bandführung ist unter den Gelenken des Schultergürtels das SC-Gelenk jedoch am seltensten von einer Luxation betroffen. Die traumatische Luxation wird in der Regel erst nach erheblichen direkt oder indirekt einwirkenden Kräften beobachtet, wobei 80 % der Fälle auf Verkehrs-und Sportunfälle zurück-zuführen sind. Noch deutlich seltener als die traumatische Luxation ist die atraumatische oder habituelle Luxation. In beiden Fällen wird die häufigere vordere von der selteneren hinteren Luxation unterschieden. Die geschilderte Kasuistik soll die Möglichkeiten der Diagnostik habitueller Luxationen des Sternoklavikulargelenkes erläutern und eine Hilfestellung in der Abwägung der Therapieoptionen geben. Der interessante Fall … Fortschr

No abstract

To evaluate the feasibility of 201Tl single photon emission computed tomography (SPECT) for quantitative detection of myocardial infarction and ischemia, scintigraphic studies were related to angiographic findings. In study A infarct sizes with SPECT were compared with the angiographic infarct sizes of 30 patients. A linear correlation was found for the % infarct of the left ventricular circumference between both methods (r = 0.73; P less than 0.001; mean infarct size 20.7% +/- 10.5% (angio) vs 19.8% +/- 12.9% (SPECT), mean +/- SD). Furthermore, a significant inverse correlation between scintigraphic infarct size and left ventricular ejection fraction (r = -0.87, P less than 0.001) was obtained. In study B exercise/rest 201Tl SPECT was used for quantification of myocardial ischemia. Forty-three patients underwent both stress 201Tl SPECT and biplane exercise left ventriculography. Ischemia was expressed as % defect size of the left ventricular circumference. Sensitivity and specificity for detection of ischemia were 96% and 100% respectively with stress SPECT. Extent of myocardial ischemia correlated significantly with both methods (r = 0.63; SPECT defect = 1.0 angiographic ischemia +2%; P less than 0.001). The regression followed the line of identity and the mean sizes of ischemia were identical (SPECT 12.2 +/- 7.6% vs 14.6 +/- 12.4% ventriculography, mean +/- SD) demonstrating the agreement of both methods. However, there was some intraindividual variance between the scintigraphic and the angiographic study. The sensitivity and specificity in single regions with SPECT were lower compared to the global test results.(ABSTRACT TRUNCATED AT 250 WORDS)