151
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Lepper P, Schumann C, Bitar J, Hetzel J, Babiak A, Schrade-Illmann M, Bachbauer M, Stadler P, Hetzel M. Raucheranamnese und Körpergewicht korrelieren nicht mit dem Schweregrad ambulant erworbener Pneumonien – erste CAPNETZ-Daten eines Lokalen Klinischen Zentrums. Pneumologie 2005. [DOI: 10.1055/s-2005-864357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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152
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Schumann C, Babiak A, Lepper P, Mattfeldt T, Hetzel J, Hetzel M. Erhöhung der diagnostischen Wertigkeit endobronchialer Biopsien mit der flexiblen Kryosonde – Vergleich von Kryobiopsie mit der Zangenbiopsie. Pneumologie 2005. [DOI: 10.1055/s-2005-864559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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153
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Schumann C, Hetzel M, Hetzel J, Babiak A, Hanke H, Kamenz J, Schneider M, Lepper P. Erfolgreiche Therapie mit Drotrecogin alfa bei septischem Schock eines splenektomierten Patienten. Pneumologie 2005. [DOI: 10.1055/s-2005-864598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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154
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Kick J, Zimmermann J, Sunder-Plassmann L, Straeter J, Hetzel M, Hetzel J, Babiak A. Neoadjuvante Polychemotherapie beim NSCLC: Ergebnisse einer Fallserie. Pneumologie 2005. [DOI: 10.1055/s-2005-864504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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155
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Hetzel J, Heise D, Hetzel M, Paulat K. Quasi-statisches Modell des Gasaustauschs. Pneumologie 2005. [DOI: 10.1055/s-2005-864392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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156
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Habig T, Lepper P, Hetzel J, Babiak A, Schumann C, Hetzel M. Kryotherapie: Kurativer Therapieansatz bei Karzinoid? Pneumologie 2005. [DOI: 10.1055/s-2005-864552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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157
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Buck AK, Hetzel M, Schirrmeister H, Halter G, Möller P, Kratochwil C, Wahl A, Glatting G, Mottaghy FM, Mattfeldt T, Neumaier B, Reske SN. Clinical relevance of imaging proliferative activity in lung nodules. Eur J Nucl Med Mol Imaging 2004; 32:525-33. [PMID: 15599526 DOI: 10.1007/s00259-004-1706-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2004] [Accepted: 09/12/2004] [Indexed: 11/29/2022]
Abstract
PURPOSE Recently, the thymidine analogue 3'-deoxy-3'[18F]fluorothymidine (FLT) has been introduced for imaging proliferation with positron emission tomography (PET). In this prospective study, we examined the accuracy of FLT for differentiation of benign from malignant lung lesions and for tumour staging. METHODS A total of 47 patients with newly diagnosed pulmonary nodules on chest CT suspicious for malignancy were examined with FLT-PET in addition to routine staging procedures. A total of 43 patients also underwent 2-[18F]fluoro-2-deoxy-D-glucose (FDG) PET imaging. Within 2 weeks, patients underwent resective surgery or core biopsy of the pulmonary lesion. RESULTS Histopathology revealed malignant lung tumours in 32 patients (20 non-small cell lung cancer, 1 small cell lung cancer, 1 pulmonary carcinoid, 1 non-Hodgkin's lymphoma, nine metastases from extrapulmonary tumours) and benign lesions in 15 patients. Increased FLT uptake was exclusively related to malignant tumours. FLT-PET was false negative in two patients with non-small cell lung cancer, in the patient with a pulmonary carcinoid and in three patients with lung metastases. The sensitivity of FLT-PET for detection of lung cancer was 90%, the specificity 100% and the accuracy 94%. Fifteen out of 21 patients with lung cancer had mediastinal lymph node metastases. FLT-PET was true positive in 7/15 patients, resulting in a sensitivity of 53% for N-staging (specificity 100%, accuracy 67%). Clinical TNM stage was correctly identified in 67% (20/30) patients, compared to 85% (23/27) with FDG-PET. CONCLUSION FLT-PET has a high specificity for the detection of malignant lung tumours. Compared with FDG, FLT-PET is less accurate for N-staging in patients with lung cancer and for detection of lung metastases. FLT-PET therefore cannot be recommended for staging of lung cancer.
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158
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Schirrmeister H, Hetzel M, Hetzel J, Habig T, Schumann C, Bommer M, Blum P, von Beauvais H, Babiak A. Challenging manifestations of malignancies. Case 3. Fibrinous tracheitis: an uncommon manifestation of Hodgkin's lymphoma. J Clin Oncol 2004; 22:3642-3. [PMID: 15337814 DOI: 10.1200/jco.2004.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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159
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Hetzel M, Arslandemir C, Schirrmeister H. Bone scanning in lung cancer: Authors' reply. West J Med 2004. [DOI: 10.1136/bmj.329.7459.231-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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160
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Hetzel M, Hetzel J, Arslandemir C, Nüssle K, Schirrmeister H. Reliability of symptoms to determine use of bone scans to identify bone metastases in lung cancer: prospective study. BMJ 2004; 328:1051-2. [PMID: 15117792 PMCID: PMC403846 DOI: 10.1136/bmj.328.7447.1051] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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161
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Hetzel M, Hetzel J, Schumann C, Marx N, Babiak A. Cryorecanalization: a new approach for the immediate management of acute airway obstruction. J Thorac Cardiovasc Surg 2004; 127:1427-31. [PMID: 15116003 DOI: 10.1016/j.jtcvs.2003.12.032] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Endobronchial cryotherapy is an established recanalization method for stenoses of the respiratory tract. However, previous applications of cryotherapy have not been immediately effective, requiring a second clean-up procedure several days later to finally obtain sufficient recanalization. In this study we demonstrate a newly developed cryoprobe allowing recanalization of tumor stenoses during a single intervention. METHODS In this prospective study flexible bronchoscopy was used for cryorecanalization of 60 patients with high-grade stenoses of the respiratory tract from exophytic tumors. Tumor tissue was frozen on the tip of the probe and subsequently removed from the surrounding respiratory tract tissue through retraction of the probe. Procedures were carried out on sedated, spontaneously breathing, intubated patients. RESULTS Fifty (83%) of 60 patients were successfully or partially successfully treated. Tumor bleeding occurred in 6 patients but was stopped with argon plasma coagulator treatment in all patients not requiring rigid bronchoscopy. CONCLUSION Cryorecanalization with the newly developed cryoprobe permits effective, safe, and inexpensive therapy of endobronchial stenoses of the respiratory tract.
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162
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Halter G, Buck AK, Schirrmeister H, Wurziger I, Liewald F, Glatting G, Neumaier B, Sunder-Plassmann L, Reske SN, Hetzel M. [ 18 F] 3-deoxy-3′-fluorothymidine positron emission tomography: alternative or diagnostic adjunct to 2-[ 18 f]-fluoro-2-deoxy- d -glucose positron emission tomography in the workup of suspicious central focal lesions? J Thorac Cardiovasc Surg 2004; 127:1093-9. [PMID: 15052207 DOI: 10.1016/j.jtcvs.2003.09.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND 2-[(18)F]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography has been established as a standard diagnostic imaging method in the preoperative workup of suspicious pulmonary focal lesions, showing a sensitivity of more than 90% and a specificity of about 80%. Determination of malignant pulmonary lesions with FDG positron emission tomography depends on the assessment of glucose metabolism. However, false-positive findings can occur in inflammatory processes, such as sarcoidosis or pneumonia. The thymidine analogue 3-deoxy-3[(18)F]-fluorothymidine (FLT) is a new positron emission tomography tracer that more specifically targets proliferative activity of malignant lesions. The objective of this study was to determine whether FLT positron emission tomography, in comparison with FDG positron emission tomography, provides additional information in the preoperative workup of central pulmonary focal lesions. METHODS In this prospective study FLT and FDG positron emission tomography examinations were performed as a part of the preoperative workup in 20 patients with histologically confirmed bronchial carcinoma, 7 patients with benign lesions, and 1 patient with an atypical carcinoid. Results were compared with final pathologic findings. RESULTS For staging of the primary tumor, FLT positron emission tomography revealed a sensitivity of 86% and a specificity of 100% compared with a sensitivity of 95% and a specificity of 73% for FDG positron emission tomography. For N staging, the sensitivity of FLT positron emission tomography was 57% and the specificity was 100%, and for FDG positron emission tomography, the sensitivity was 86% and the specificity was 100%, respectively. CONCLUSIONS Our preliminary findings indicate specific FLT uptake in malignant lesions. The number of false-positive findings in FDG positron emission tomography might be reduced with FLT positron emission tomography. Therefore positron emission tomography imaging with FLT represents a useful supplement to FDG in assessing the malignancy of central pulmonary focal lesions.
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163
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Halter G, Buck AK, Schirrmeister H, Aksoy E, Liewald F, Glatting G, Neumaier B, Mühling B, Nüssle-Kügele K, Hetzel M, Sunder-Plassmann L, Reske SN. Lymph Node Staging in Lung Cancer Using [18F]FDG-PET. Thorac Cardiovasc Surg 2004; 52:96-101. [PMID: 15103582 DOI: 10.1055/s-2004-817844] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Mediastinal lymph node staging is essential to determine treatment options in patients with NSCLC. Positron emission tomography (PET) detects increased glucose uptake in malignant tissue using the glucose analogue 2-[(18)F]fluoro-2-deoxy-D-glucose (FDG). PATIENTS AND METHODS In the present study were evaluated 155 patients with focal pulmonary tumors who underwent both preoperative computed tomography (CT) and FDG-PET scanning (116 malignant and 39 benign lesions). RESULTS Findings in 155 patients included 116 malignant and 39 benign lesions. For N-staging, FDG-PET showed a sensitivity of 88%, a specificity of 91%, and an accuracy of 89%. Corresponding figures for CT were 77%, 76%, and 77%, respectively. CONCLUSIONS FDG-PET is an effective, noninvasive method for staging thoracic lymph nodes in patients with lung cancer and is superior to CT scanning in the assessment of hilar and mediastinal nodal metastases. With regard to operability, FDG-PET could differentiate reliable between patients with N1/N2 disease and those with unresectable N3 disease.
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164
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Ukena D, Schroeder M, Dittrich I, Guschall WR, Ko YD, Welte T, Hetzel M, Appel T, Schütte W. Chemotherapie des nicht kleinzelligen Bronchialkarzinoms (NSCLC) Stadium IIIB/IV mit Paclitaxel und Carboplatin: Wöchentliche versus 3-wöchentliche Therapie. Pneumologie 2004. [DOI: 10.1055/s-2004-819732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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165
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Lepper PM, Held TK, Trautmann M, Hetzel M. Kapsel-spezifische Antikörper fördern die Phagozytose von Klebsiella pneumoniae. Pneumologie 2004. [DOI: 10.1055/s-2004-819500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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166
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Lepper PM, Hetzel J, Wellinghausen N, Habig T, Schneider EM, Hetzel M. Der erste Fall einer Adiaspiromykose in Deutschland. Pneumologie 2004. [DOI: 10.1055/s-2004-819697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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167
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Woehrle H, Wiede S, Schöps A, Dahlbender R, Hetzel M. Psychopathologische Auffälligkeiten bei Patienten mit Schlafapnoesyndrom: Eine prospektive Evaluation mittels Fragebögen. Pneumologie 2004. [DOI: 10.1055/s-2004-819630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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168
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Woehrle H, Hetzel M, Koenig W. Schlafapnoe und kardiale Risikomarker. Pneumologie 2004. [DOI: 10.1055/s-2004-819725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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169
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Hetzel M, Hetzel J, Schumann C, Lepper P, Woehrle H, Habig T, Babiak A. Kryorekanalisation – Eine neue Methode zur Sofortrekanalisation von Tumorstenosen der Atemwege. Pneumologie 2004. [DOI: 10.1055/s-2004-819658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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170
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Babiak A, Bommer M, Blum P, v Beauvais H, Lepper P, Habig T, Hetzel J, Schumann C, Hetzel M. Pseudomembranöse Tracheitis bei M. Hodgkin – ein Fallbericht. Pneumologie 2004. [DOI: 10.1055/s-2004-819680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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171
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Lepper PM, Habig T, Babiak A, Hetzel J, Schumann C, Trautmann M, Hetzel M. Beta-Laktam-Kreuzresistenzen bei Pseudomonas aeruginosa treten gehäuft in Phasen mit exzessivem Imipenem-Verbrauch auf. Pneumologie 2004. [DOI: 10.1055/s-2004-819499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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172
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Schumann C, Hetzel J, Esser C, Babiak A, Lepper P, Woehrle H, Hetzel M. In- und expiratorische Resistance versus FIV1 und FEV1 in der Beurteilung der Reversibilität der Atemwegsobstruktion bei COPD. Pneumologie 2004. [DOI: 10.1055/s-2004-819610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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173
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Hetzel M, Arslandemir C, Hetzel J, Schirrmeister H. Skelettdiagnostik beim Bronchialkarzinom: Eine prospektive Kohortenstudie zur Evaluation der aktuell gültigen Leitlinien. Pneumologie 2004. [DOI: 10.1055/s-2004-819551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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174
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Babiak A, Schumann C, Lepper P, Habig T, Hetzel J, Möller P, Hetzel M. Die transbronchiale Kryosondenbiopsie – Ergebnisse einer Pilotstudie. Pneumologie 2004. [DOI: 10.1055/s-2004-819638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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175
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Lepper PM, Habig T, Schumann C, Hetzel J, Babiak A, Putzke C, Geldner G, Essig A, Trautmann M, Hetzel M. Diagnostik pulmonaler Candida-Infektionen auf der Intensivstation – Daten der 1. Ulmer Candida Studie (UCS). Pneumologie 2004. [DOI: 10.1055/s-2004-819498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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