Radiologia Brasileira最新文献

{"title":"Preoperative evaluation of prostate cancer by ⁶⁸Ga-PMSA positron emission tomography/computed tomography: comparison with magnetic resonance imaging and with histopathological findings.","authors":"Camila Edith Stachera Stasiak,&nbsp;Athos Cardillo,&nbsp;Sergio Altino de Almeida,&nbsp;Rosana Souza Rodrigues,&nbsp;Paulo Henrique Rosado de Castro,&nbsp;Daniella Braz Parente","doi":"10.1590/0100-3984.2022.0122-en","DOIUrl":"10.1590/0100-3984.2022.0122-en","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the accuracy of preoperative positron emission tomography/computed tomography with ⁶⁸Ga-labeled prostate-specific membrane antigen (⁶⁸Ga-PSMA PET/CT) for staging prostate cancer and compare it with magnetic resonance imaging (MRI) using histopathology of surgical specimens as the gold standard.</p><p><strong>Materials and methods: </strong>In this retrospective study, 65 patients with prostate cancer were analyzed.</p><p><strong>Results: </strong>The accuracy of ⁶⁸Ga-PSMA PET/CT for tumor detection was 95%, and that of MRI was 91%. There was no difference between ⁶⁸Ga-PSMA PET/CT and MRI regarding localization of the lesion. The sensitivity of ⁶⁸Ga-PSMA PET/CT for detecting extraprostatic extension was quite low (14%). For detection of seminal vesicle invasion, ⁶⁸Ga-PSMA PET/CT showed a sensitivity of 57% and accuracy of 91%. There was a moderate correlation between the maximum standardized uptake value (SUVmax) and the serum level of prostate-specific antigen (<i>p</i> < 0.01; ρ = 0.368) and between the SUVmax and the International Society of Urological Pathology (ISUP) grade (<i>p</i> < 0.01; ρ = 0.513).</p><p><strong>Conclusion: </strong>⁶⁸Ga-PSMA PET/CT is a promising tool for detecting and evaluating the primary tumor, which can alter the staging and management of the disease.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10567085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PSMA-PET in the early stages of prostate cancer.","authors":"Felipe de Galiza Barbosa","doi":"10.1590/0100-3984.2023.56.4e2-en","DOIUrl":"10.1590/0100-3984.2023.56.4e2-en","url":null,"abstract":"1. Attending Radiologist in the Department of Radiology and Nuclear Medicine of the Hospital Sírio-Libanês and Americas Group, São Paulo, SP, Brazil. Email: felipegaliza@gmail.com. https://orcid.org/0000-0002-3986-1778. In the relentless quest to improve the management of prostate cancer, great advances have been made and improved upon in the diagnostic and therapeutic fields, especially in the last decade. After the role of magnetic resonance imaging (MRI) in locoregional evaluation had been consolidated, the advent of prostate-specific membrane antigen positron emission tomography (PSMA-PET) brought transformations that provided a new perspective on the disease and its management. This advanced imaging method has distinguished itself as a revolutionary tool, redefining the scenario of biochemical recurrence, advanced metastatic disease, and, more recently, the initial staging of patients with prostate cancer(1). Its greater precision in detecting metastatic lesions has increased the accuracy of the diagnosis and guided therapeutic decisions, opening new possibilities for the customization of practice in view of the latest therapeutic advances. Compared with conventional imaging methods, such as computed tomography (CT), MRI, and bone scintigraphy, PSMAPET has greater sensitivity and specificity for detecting metastatic disease(2,3). This increase in accuracy comes from the combination of the molecular component of PET and the structural component of CT/MRI, given that PSMA is overexpressed in neoplastic cells within the prostate. That added accuracy is essential to avoid understaging and to allow the therapeutic intervention to be implemented early, thus increasing the likelihood of treatment success and potentially reducing morbidity by averting unnecessary treatments. In the clinical scenario of the initial staging of prostate cancer, the value of PSMA-PET is more significant in the evaluation of nonprostatic disease such as pelvic lymph node involvement (N), as well as distant, bone and visceral metastases (M1a, M1b, and M1c, respectively), for which conventional methods have major limitations. This assumed advantage of PSMA-PET has become an ally in the therapeutic decision-making process. However, the use of PSMA-PET in the preoperative evaluation of the prostate is a topic that is still under exploration, especially in comparison with the currently available method with higher spatial resolution (MRI) and with histopathological correlation. Therefore, this is a highly relevant, current topic that deserves to be investigated in greater depth in order to improve the diagnostic approach and perhaps to be replicated in scenarios of earlier disease detection. This editorial congratulates the initiative of Stasiak et al.(4), authors of the article “Preoperative evaluation of prostate cancer by 68Ga-PSMA positron emission tomography/computed tomography: comparison with magnetic resonance imaging and with histopathological findings”, published in","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10567090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal pitfalls in ⁶⁸Ga-PSMA PET/CT.","authors":"Írline Cordeiro de Macedo Pontes,&nbsp;Anthony Reis Souza,&nbsp;Eduardo Kaiser Ururahy Nunes Fonseca,&nbsp;Akemi Osawa,&nbsp;Ronaldo Hueb Baroni,&nbsp;Adham do Amaral E Castro","doi":"10.1590/0100-3984.2023.0003","DOIUrl":"10.1590/0100-3984.2023.0003","url":null,"abstract":"<p><p>Prostate-specific membrane antigen (PSMA) is a transmembrane protein expressed in normal prostate cells and overexpressed in prostate cancer. Consequently, it is an important tool in the evaluation of prostate cancer, including the staging of high-risk patients and the assessment of biochemical recurrence. Despite the \"specific\" designation, benign musculoskeletal conditions, such as fractures, osteodegenerative changes, and fibrous dysplasia, can also show PSMA uptake, which can lead to misinterpretation of the imaging findings. Therefore, radiologists must be aware of these potential pitfalls, understand their causes, and fully analyze their morphologic features on unfused computed tomography (CT) and magnetic resonance imaging scans to correctly interpret the examination. In this pictorial essay, we review the basic characteristics of the ⁶⁸Ga-PSMA positron-emission tomography/CT (PET/CT) radiotracer, discuss potential causes of false-positive findings on ⁶⁸Ga-PSMA PET/CT in the musculoskeletal system, and illustrate the corresponding imaging findings.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10567088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase-sensitive T1 inversion recovery imaging and its impact on the detection of cortical demyelinating lesions in patients with multiple sclerosis.","authors":"Fabiano Reis","doi":"10.1590/0100-3984.2023.56.4e3","DOIUrl":"10.1590/0100-3984.2023.56.4e3","url":null,"abstract":"","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10567092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new sign in paracoccidioidomycosis neuroimaging.","authors":"José Daniel Vieira de Castro","doi":"10.1590/0100-3984.2023.56.4e4-en","DOIUrl":"10.1590/0100-3984.2023.56.4e4-en","url":null,"abstract":"","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10567089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interrater reliability for the detection of cortical lesions on phase-sensitive inversion recovery magnetic resonance imaging in patients with multiple sclerosis.","authors":"Marco Aurelio Gralha de Caneda,&nbsp;Marjana Reis Lima Rizzo,&nbsp;Gabriela Furlin,&nbsp;Abraão Kupske,&nbsp;Bruna Bressan Valentini,&nbsp;Rafaela Fiss Ortiz,&nbsp;Camila Batista de Oliveira Silva,&nbsp;Maria Cecilia Aragon de Vecino","doi":"10.1590/0100-3984.2022.0116","DOIUrl":"10.1590/0100-3984.2022.0116","url":null,"abstract":"<p><strong>Objective: </strong>To assess the reliability of phase-sensitive inversion recovery (PSIR) magnetic resonance imaging (MRI) and its accuracy for determining the topography of demyelinating cortical lesions in patients with multiple sclerosis (MS).</p><p><strong>Materials and methods: </strong>This was a cross-sectional study conducted at a tertiary referral center for MS and other demyelinating disorders. We assessed the agreement among three raters for the detection and topographic classification of cortical lesions on fluid-attenuated inversion recovery (FLAIR) and PSIR sequences in patients with MS.</p><p><strong>Results: </strong>We recruited 71 patients with MS. The PSIR sequences detected 50% more lesions than did the FLAIR sequences. For detecting cortical lesions, the level of interrater agreement was satisfactory, with a mean free-response kappa (κ_FR) coefficient of 0.60, whereas the mean κ_FR for the topographic reclassification of the lesions was 0.57. On PSIR sequences, the raters reclassified 366 lesions (20% of the lesions detected on FLAIR sequences), with excellent interrater agreement. There was a significant correlation between the total number of lesions detected on PSIR sequences and the Expanded Disability Status Scale score (ρ = 0.35; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>It seems that PSIR sequences perform better than do FLAIR sequences, with clinically satisfactory interrater agreement, for the detection and topographic classification of cortical lesions. In our sample of patients with MS, the PSIR MRI findings were significantly associated with the disability status, which could influence decisions regarding the treatment of such patients.</p>","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10567094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O papel da cine-ressonância magnética na avaliação da contratilidade uterina em pacientes com endometriose infiltrativa profunda","authors":"L. R. M. F. D. Souza, P. Cardia","doi":"10.1590/0100-3984.2023.56.3e1","DOIUrl":"https://doi.org/10.1590/0100-3984.2023.56.3e1","url":null,"abstract":"","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43579295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Edema ósseo tibial no impacto osteomeniscal: como podemos contribuir?","authors":"Carolina Freitas Lins, M. H. Nogueira-Barbosa","doi":"10.1590/0100-3984.2023.56.3e3","DOIUrl":"https://doi.org/10.1590/0100-3984.2023.56.3e3","url":null,"abstract":"","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44033722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excisão assistida a vácuo de lesões mamárias no descalonamento cirúrgico: onde estamos?","authors":"Beatriz Medicis Maranhão Miranda, A. Bitencourt","doi":"10.1590/0100-3984.2022.0078","DOIUrl":"https://doi.org/10.1590/0100-3984.2022.0078","url":null,"abstract":"Resumo A excisão assistida a vácuo de lesões mamárias tem sido cada vez mais utilizada na prática clínica. A sua maior aceitação e disponibilidade, em associação ao uso de agulhas mais calibrosas, permitiu a retirada de quantidade maior de amostra, reduzindo substancialmente a taxa de subestimação diagnóstica e aumentando, assim, a confiabilidade final dos resultados do procedimento. Essas características resultam em potencial descalonamento cirúrgico, em casos selecionados, e ganham força em um cenário em que se visa a redução de custos, taxa de subestimação e tratamento excessivo, porém, sem comprometer a qualidade no cuidado com o paciente. O objetivo deste trabalho é revisar os parâmetros técnicos e as indicações clínicas atuais para realização de excisão assistida a vácuo em lesões mamárias.","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67400883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nova classificação das neoplasias gliais segundo a Organização Mundial da Saúde 2021, com enfoque radiológico","authors":"Renata Tarraf Fernandes, Gustavo Ramos Teixeira, Esther Cecin Mamere, Gabriela Alencar Bandeira, Augusto Elias Mamere","doi":"10.1590/0100-3984.2022.0089","DOIUrl":"https://doi.org/10.1590/0100-3984.2022.0089","url":null,"abstract":"Resumo O propósito deste ensaio iconográfico é descrever e discutir as novas recomendações da Organização Mundial da Saúde de 2021, referente aos gliomas dos tipos adulto e infantil, e suas principais diferenças com a classificação anterior (2016), exemplificadas com imagens de nove casos de pacientes atendidos nas nossas instituições. Recentemente, há uma crescente significância dos marcadores moleculares no diagnóstico e classificação dos gliomas e tumores do sistema nervoso central, principalmente pela correlação com o comportamento biológico e o prognóstico. É importante que os neurorradiologistas estejam familiarizados com a nova classificação dos tumores do sistema nervoso central para a prática clínica, na avaliação e emissão de laudos e opiniões nas imagens dos pacientes com gliomas.","PeriodicalId":20842,"journal":{"name":"Radiologia Brasileira","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43495599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}