|
1
|
Sagnes J, Battistella P, Paunet T, Mariano-Goulart D, Kucharczak F. Evaluation of 18-FDG PET diagnostic capabilities for cancer screening in heart transplant patients, a retrospective study. Medicine (Baltimore) 2023; 102:e35296. [PMID: 37773869 PMCID: PMC10545140 DOI: 10.1097/md.0000000000035296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/29/2023] [Indexed: 10/01/2023] Open
Abstract
Evaluate 18-FDG positron emission tomography (PET) diagnostic capabilities for cancer screening in heart transplant patients. We conducted an anonymized retrospective observational study of heart transplant patients followed in the University Hospital of Montpellier, France. We analyzed 303 18-FDG PET from 158 patients. We compared demographic and clinical characteristics through uni- and multivariate analysis: in the cancer-free group, comparisons were made between the PET false positive (FP) group versus true negative (TN), and in the cancer group, comparisons were made between the PET false negative (FN) group versus true positive (TP). Out of the 303 exams, we found 245 TN, 26 TP, 26 FP and 6 FN. The sensitivity rate was calculated at 81%, the specificity rate at 90%, the positive predictive value at 50%, and the negative predictive value at 97%. The multivariate analysis showed an association between FP diagnosis and graft-PET delay (P value = .046, OR = 5.14, 95% CI [1.18-32.4]) and creatine reactive protein (CRP) ≥ 10 mg/L (P value = .042, OR = 4.21, 95% CI [1.02-17.2]). The estimated probability of FP by logit regression was 0.48 with 95% CI [0.21-0.77] when graft-PET delay ≥ 6 years and CRP ≥ 10 mg/L. No significative statistical link was found for the demographic or clinical characteristics in the FN group of patients with cancer, except for sex (all FN were men). 18-FDG PET performed very well in the follow-up of heart transplant patients for neoplasia screening, with better specificity than sensitivity. However, the study showed that almost 50% of FP can be predicted by considering only the graft-PET delay and CRP.
Collapse
Affiliation(s)
- Julie Sagnes
- Nuclear Medicine Department, Lapeyronie Hospital, Montpellier University Hospitals, Montpellier, France
| | - Pascal Battistella
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Montpellier University Hospitals, PhyMedExp, INSERM, CNRS, Montpellier University, Montpellier, France
| | - Tom Paunet
- Nuclear Medicine Department, Lapeyronie Hospital, Montpellier University Hospitals, Montpellier, France
| | - Denis Mariano-Goulart
- Nuclear Medicine Department, Lapeyronie Hospital, Montpellier University Hospitals, Montpellier, France
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Montpellier University Hospitals, PhyMedExp, INSERM, CNRS, Montpellier University, Montpellier, France
| | - Florentin Kucharczak
- Nuclear Medicine Department, Lapeyronie Hospital, Montpellier University Hospitals, Montpellier, France
- Department of Biostatistics, Epidemiology, Public Health and Methodological Innovation, Nîmes University Hospital, Nîmes, France
| |
Collapse
|
|
2
|
Perrone MA, Cimini A, Ricci M, Pizzoferro M, Garganese MC, Raponi M, Schillaci O. Myocardial Functional Imaging in Pediatric Nuclear Cardiology. J Cardiovasc Dev Dis 2023; 10:361. [PMID: 37754790 PMCID: PMC10531976 DOI: 10.3390/jcdd10090361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/03/2023] [Accepted: 08/22/2023] [Indexed: 09/28/2023] Open
Abstract
The role of nuclear medicine in pediatric cardiology has grown rapidly over the years, providing useful functional and prognostic information and playing a complementary role to morphological imaging in the evaluation of myocardial perfusion, cardiovascular inflammation and infections, and cardiac sympathetic innervation. The aim of this narrative review is to summarize and highlight the most important evidence on pediatric nuclear cardiology, describing clinical applications and the possibilities, advantages, and limitations of nuclear medicine techniques. Moreover, a special focus will be given to the minimization of radiation exposure in pediatric nuclear cardiology imaging, a critical topic in children.
Collapse
Affiliation(s)
- Marco Alfonso Perrone
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
- Division of Cardiology and CardioLab, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Andrea Cimini
- Nuclear Medicine Unit, St. Salvatore Hospital, 67100 L’Aquila, Italy
| | - Maria Ricci
- Nuclear Medicine Unit, Cardarelli Hospital, 86100 Campobasso, Italy
| | - Milena Pizzoferro
- Division of Nuclear Medicine, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | | | - Massimiliano Raponi
- Health Directorate, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| |
Collapse
|
|
3
|
Cascone R, Carlucci A, Messina G, Noro A, Bove M, Natale G, Sagnelli C, Opromolla G, Martone M, Santoriello C, Santoriello E, Verolino P, Creta M, Vicidomini G, Fiorelli A, Santini M, Sica A. Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients. Healthcare (Basel) 2021; 9:healthcare9060770. [PMID: 34205526 PMCID: PMC8235016 DOI: 10.3390/healthcare9060770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/20/2022] Open
Abstract
A significant part of all neoplasms growing in anterior mediastinum are lymphomas (25%). Achieving a correct diagnosis and a clear definition of a lymphoma’s subtype is crucial for beginning chemotherapy as soon as possible. However, most patients present a large mediastinal mass that compresses vessels and airway, with serious cardiorespiratory repercussions. Therefore, having multiple tools available to biopsy the lesion without worsening morbidity becomes fundamental. Patients enrolled in this study were unfit for a surgical biopsy in general anesthesia and the need to begin chemotherapy as fast as possible prompted us to avoid percutaneous fine needle aspiration to prevent diagnostic failures. Our observational study included 13 consecutive patients with radiological findings of anterior mediastinal mass. Ultrasonography was performed directly in the theatre to mark the lesion and to localize vessels and vascularized neoplastic tissue. Open biopsy was carried out in spontaneous breathing with a laryngeal mask and with short-acting medications for a rapid anesthesia, performing an anterior mediastinotomy. The mean operative time was 33.4 ± 6.2 min and spontaneous respiration was maintained throughout the procedure. No complications were reported. All patients were discharged in the first or second postoperative day after a chest X-ray (1.38 ± 0.5 days). The diagnostic yield of this approach was 100%. With the addition of ultrasonography right before the procedure and with spontaneous breathing, anterior mediastinotomy still represents a useful tool in critical patients that could hardly tolerate a general anesthesia. The diagnostic yield is high, and the low postoperative morbidity allows a rapid onset of chemotherapy.
Collapse
Affiliation(s)
- Roberto Cascone
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Annalisa Carlucci
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Gaetana Messina
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Antonio Noro
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Mary Bove
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Giovanni Natale
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-33938107860 or +39-08119573375
| | - Giorgia Opromolla
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Mario Martone
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Carlo Santoriello
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Elena Santoriello
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Pasquale Verolino
- Plastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, 80131 Naples, Italy;
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Giovanni Vicidomini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Mario Santini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| |
Collapse
|