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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  67. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 89. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 44. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20031111-20031116; Berlin; DOC03dguK10-2 /20031111/
    Publication Date: 2003-11-11
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    Publication Date: 2006-04-21
    Keywords: ddc: 610
    Language: English
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  • 3
    ISSN: 1619-7089
    Keywords: Fluorine-18 fluorodeoxyglucose ; Positron emission tomography ; Technetium-99m methoxyisobutylisonitrile ; Scintimammography ; Breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to compare, in breast cancer patients, the diagnostic accuracy of positron emission tomography (PET) using fluorine-18 fluorodeoxyglucose (FDG) and scintimammography (SMM) using technetium-99m methoxyisobutylisonitrile (MIBI). A total of 20 patients (40 breasts with 22 lesions) were evaluated serially with MIBI and, on the following day, with FDG. For SMM, planar and single-photon emission tomography imaging in the prone position was performed starting at 10 min following the injection of MIBI (740 MBq). For PET, scans were acquired 45–60 min after the injection of FDG (370 MBq) and attentuation correction was performed following transmission scans. Results from SMM and PET were subsequently compared with the histopathology results. True-positive results were obtained in 12/13 primary breast cancers (mean diameter=29 mm, range 8–53 mm) with both FDG and MIBI. False-negative results were obtained in two local recurrences (diameter 〈9 mm) with both FDG and MIBI. In benign disease, FDG and MIBI did not localize three fibrocystic lesions, two fibroadenomas and one inflammatory lesion (true-negative), but both localized one fibroadenoma (false-positive). Collectively, the results demonstrate a sensitivity of 92%, and a specificity of 86%, for primary breast cancer regardless of whether FDG or MIBI was used. In contrast to MIBI scintigraphy, FDG PET scored the axillae correctly as either positive (metastatic disease) or negative (no axillary disease) in all 12 patients. The tumour/non-tumour ratio for MIBI was 1.97 (range 1.43–3.1). The mean standard uptake value (SUV) for FDG uptake was 2.57 (range 0.3–6.2). The diagnostic accuracy of SMM was equivalent to that of FDG PET for the detection of primary breast cancer. For the detection of in situ lymph node metastases of the axilla, FDG seems to be more sensitive than99mTc-MIBI.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1619-7089
    Keywords: Key words: Technetium-99m methoxyisobutylisonitrile ; Scintimammography ; Breast cancer ; Dense breasts ; Mammography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of the trial was to determine the diagnostic accuracy of scintimmammography with technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) in the detection of primary breast cancer and to verify its clinical usefulness. A total of 246 patients with a suspicious breast mass or positive mammogram were included in this prospective European multicentre trial. At 5 min and 60 min (optional) p.i. two lateral prone images were acquired for 10 min each; 30 min p.i. one anterior image was acquired for 10 min. There were 253 lesions (195 palpable and 58 non-palpable), in respect of which histology revealed 165 cancers and 88 benign lesions. Institutional and blinded read results were correlated to core laboratory histopathology results obtained during excisional biopsy. Diagnostic accuracy for the detection of breast cancer was calculated per lesion. The overall sensitivity and specificity of blinded read scintimammography were 71% and 69%, respectively. For palpable lesions, the sensitivity of blinded read and institutional read scintimammography was 83% and 91%, respectively. Sensitivity was not dependent on the density of the breast tissue. Invasive ductal and invasive lobular cancers showed similar sensitivity. The sensitivity and specificity of mammography were 91% and 42%, respectively, and did not depend on the tumour size. In 60% of false-negative mammograms, 99mTc-MIBI was able to diagnose malignancy (true-positive). High-quality imaging with 99mTc-MIBI has a high diagnostic accuracy for the detection of primary breast cancer. Used as a complementary method, scintimammography with 99mTc-MIBI can help to diagnose breast cancer at an earlier stage in patients with dense breasts.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1619-7089
    Keywords: Key words: Fluorine-18 fluorodeoxyglucose ; Positron emission tomography ; Technetium-99m methoxyisobutylisonitrile ; Scintimammography ; Breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to compare, in breast cancer patients, the diagnostic accuracy of positron emission tomography (PET) using fluorine-18 fluorodeoxyglucose (FDG) and scintimammography (SMM) using technetium-99m methoxyisobutylisonitrile (MIBI). A total of 20 patients (40 breasts with 22 lesions) were evaluated serially with MIBI and, on the following day, with FDG. For SMM, planar and single-photon emission tomography imaging in the prone position was performed starting at 10 min following the injection of MIBI (740 MBq). For PET, scans were acquired 45–60 min after the injection of FDG (370 MBq) and attentuation correction was performed following transmission scans. Results from SMM and PET were subsequently compared with the histopathology results. True-positive results were obtained in 12/13 primary breast cancers (mean diameter=29 mm, range 8–53 mm) with both FDG and MIBI. False-negative results were obtained in two local recurrences (diameter 〈9 mm) with both FDG and MIBI. In benign disease, FDG and MIBI did not localize three fibrocystic lesions, two fibroadenomas and one inflammatory lesion (true-negative), but both localized one fibroadenoma (false-positive). Collectively, the results demonstrate a sensitivity of 92%, and a specificity of 86%, for primary breast cancer regardless of whether FDG or MIBI was used. In contrast to MIBI scintigraphy, FDG PET scored the axillae correctly as either positive (metastatic disease) or negative (no axillary disease) in all 12 patients. The tumour/non-tumour ratio for MIBI was 1.97 (range 1.43–3.1). The mean standard uptake value (SUV) for FDG uptake was 2.57 (range 0.3–6.2). The diagnostic accuracy of SMM was equivalent to that of FDG PET for the detection of primary breast cancer. For the detection of in situ lymph node metastases of the axilla, FDG seems to be more sensitive than 99mTc-MIBI.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1619-7089
    Keywords: Breast cancer ; Scintimammography ; Technetium-99m methoxyisobutylisonitrile ; Mammography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of the study was to compare the diagnostic accuracy of scintimammography with technetium-99m methoxyisobutylisonitrile (MIBI; SMM) in the detection of primary breast cancer with that of mammography (MM) and magnetic resonance imaging (MRI). Fifty-six patients with suspected lesions detected by palpation or MM were included in the study. Within the 4 weeks preceding excisional biopsy, MM and MRI were performed in all patients. Between 5 and 10 min after the injection of 740 MBq99mTc-MIBI, SMM in the prone position was performed. In the total group of 56 patients, 43 lesions were palpable, while 13 were non-palpable but were detected by MM. Breast cancer was confirmed by histopathology in 27 of the patients (22 palpable and 5 non-palpable carcinomas). The tumour size ranged from 6 to 80 mm in diameter. For non-palpable lesions, the sensitivity of SMM, MM and MRI was 60%, 60% and 100%, respectively, while the specificity was 75%, 25% and 50%, respectively. For palpable breast lesions, all methods showed high sensitivity (SMM 91%, MM 95%, MRI 91%) but SMM demonstrated significantly higher specificity (SMM 62%, MM 10%, MRI 15%). In two mammographically negative tumours (dense tissue), SMM showed a positive result. In comparison to MRI, one additional carcinoma could be diagnosed by SMM. It may be concluded that for palpable breast lesions, the diagnostic accuracy of SMM is superior to that of MM and MRI. Through the complementary use of SMM it is possible to increase the sensitivity for the detection of breast cancer and multicentric disease. In patients in whom the status of a palpable breast mass remains unclear, SMM may help to reduce the amount of unnecessary biopsies.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1433-0563
    Keywords: Key words Prostate cancer ; Palliation ; Radionuclides ; Schlüsselwörter Prostatakarzinom ; Palliation ; Radionuklidtherapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei Patienten mit fortgeschrittenem Prostatakarzinom ist die suffiziente Therapie schmerzhafter Knochenmetastasen primäres, interdisziplinäres Behandlungsziel. Vorrangig erscheint die Erhaltung der Lebensqualität, nicht die Lebensverlängerung. Neben einer oralen Schmerzmedikation und lokalen Schmerzbestrahlung bieten systemische Radionuklidtherapien hilfreiche, risikoarme nuklearmedizinische Therapiealternativen in der Palliation schmerzhafter, multilokulärer osteoplastischer Knochenmetastasen. In Abhängigkeit vom gewählten Radiopharmazeutikum werden Ansprechraten und Schmerzreduktion in 65–80 % beschrieben. Die Dauer der Schmerzlinderung liegt im Mittel bei 6–12 Wochen. Während dieser Zeit kann die nebenwirkungsreiche, morphinhaltige Schmerzmedikation deutlich reduziert und in einigen Fällen ganz abgesetzt werden, was wiederum die Lebensqualität verbessert. Nach Abklingen der geringgradigen Myelodepression kann die Radionuklidtherapie wiederholt werden. Nachteilig bleibt allein der zweitägige stationäre Aufenthalt aufgrund geltender Strahlenschutzverordnung.
    Notes: Summary For patients with advanced prostate cancer efficient therapy of painfull bony lesions is the primary goal of interdisciplinary treatment strategies. Preservation of quality of life appears to be the main aim rather than prolongation of life. Apart from oral pain relief and local irradiation systemic treatment with radionuclides offers low-risk radiotherapeutic strategies for the palliation of painful, multifocal osteoplastic bone metastases. Depending on the radiopharmaceutical substance chosen response and reduction of pain are described in 65–80 %. The duration of pain relief lasts between 6–12 weeks. During this time the morphine based medication can be reduced and in some cases withdrawn which positively effects quality of life. After improvement of myelosuppression treatment with radionuclides can be repeated. Patients have to be hospitalized for two days because of protection from radiation procedures.
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