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| 1 | Lymphomatous involvement of gastrointestinal tract: Evaluation by positron emission tomography with ^(18)F-fluorodeoxyglucose显示文摘AIM: To demonstrate the 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) findings in patients with non-Hodgkin's lymphoma (NHL) involving the gastrointestinal (GI) tract and the clinical utility of modality despite of the known normal uptake of FDG in the GI tract.METHODS: Thirty-three patients with biopsy-proven gastrointestinal NHL who had undergone FDG-PET scan were included. All the patients were injected with 10-15 mCi FDG and scanned approximately 60 min later with a CTI/Siemens HR (+) PET scanner. PET scans were reviewed and the maximum standard uptake value (SUVmax) of the lesions was measured before and after the treatment,if data were available and compared with histologic diagnoses.RESULTS: Twenty-five patients had a high-grade lymphoma and eight had a low-grade lymphoma. The stomach was the most common site of the involvement (20 patients). In high-grade lymphoma, PET showed focal nodular or diffuse hypermetabolic activity. The average SUVmax±SD was 11.58±5.83. After the therapy,the patients whose biopsies showed no evidence of lymphoma had a lower uptake without focal lesions.The SUVmax±SD decreased from 11.58±5.83 to 2.21±0.78. In patients whose post-treatment biopsies showed lymphoma, the SUVmax±SD was 9.42±6.27. Low-grade follicular lymphomas of the colon and stomach showed diffuse hypermetabolic activity in the bowel wall (SUVmax 8.2 and 10.3, respectively). The SUVmax was 2.02-3.8 (mean 3.02) in the stomach lesions of patients with MALT lymphoma.CONCLUSION: 18F-FDG PET contributes to the diagnosis of high-grade gastrointestinal non-Hodgkin's lymphoma,even when there is the normal background FDG activity. Furthermore, the SUV plays a role in evaluating treatment response. Low-grade NHL demonstrates FDG uptake but at a lesser intensity than seen in high-grade NHL. | Sith Phongkitkarun Vithya Varavithya Toshiki Kazama Silvana C Faria Martha V Mar Donald A Podoloff Homer A Macapinlac | 2005 | World Journal of Gastroenterology2005,11,46: | 6 |
| 2 | Added value of hepatobiliary phase gadoxetic acid-enhanced MRI for diagnosing hepatocellular carcinoma in high-risk patients显示文摘AIM:To determine the added value of hepatobiliary phase(HBP)gadoxetic acid-enhanced magnetic resonance imaging(MRI)in evaluating hepatic nodules in high-risk patients.METHODS:The institutional review board approved this retrospective study and waived the requirement for informed consent.This study included 100 patients at high risk for hepatocellular carcinoma(HCC)and 105hepatic nodules that were larger than 1 cm.A blind review of two MR image sets was performed in a random order:set 1,unenhanced(T1-and T2-weighted)and dynamic images;and set 2,unenhanced,dynamic20-min and HBP images.The diagnostic accuracy,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)were compared for the two image sets.Univariate and multivariate analyses were performed on the MR characteristics utilized to diagnose HCC.RESULTS:A total of 105 hepatic nodules were identified in 100 patients.Fifty-nine nodules were confirmed to be HCC.The diameter of the 59 HCCs ranged from1 to 12 cm(mean:1.9 cm).The remaining 46 nodules were benign(28 were of hepatocyte origin,nine were hepatic cysts,seven were hemangiomas,one was chronic inflammation,and one was focal fat infiltration).The diagnostic accuracy significantly increased with the addition of HBP images,from 88.7%in set 1to 95.5%in set 2(P=0.002).In set 1 vs set 2,the sensitivity and NPV increased from 79.7%to 93.2%and from 78.9%to 91.8%,respectively,whereas the specificity and PPV were not significantly different.The hypointensity on the HBP images was the most sensitive(93.2%),and typical arterial enhancement followed by washout was the most specific(97.8%).The multivariate analysis revealed that typical arterial enhancement followed by washout,hyperintensity on T2-weighted images,and hypointensity on HBP images were statistically significant MRI findings that could diagnose HCC(P<0.05).CONCLUSION:The addition of HBP gadoxetic acidenhanced MRI statistically improved the diagnostic accuracy in HCCs larger than 1 cm.Typical arterial enhancement followed by washout and hypointensity on HBP images are useful for diagnosing HCC. | Sith Phongkitkarun Kuruwin Limsamutpetch Penampai Tannaphai Janjira Jatchavala | 2013 | World Journal of Gastroenterology2013,19,45: | 3 |
| 3 | Assessment of gastrointestinal stromal tumors with computed tomography following treatment with imatinib mesylate显示文摘AIM: To evaluate and characterize the patterns of disease progression of metastatic or unresectable gastrointestinal stromal tumor (GIST) treated with imatinib mesylate, and to determine the prognostic significance associated with disease progression. METHODS: Clinical data and computed tomography (CT) images were retrospectively reviewed in 17 GIST patients who were treated with imatinib mesylate from October 2002 to October 2006. Apart from using size measurement for evaluation of tumor response [Response Evaluation Criteria in Solid Tumors (RECIST) criteria], patterns of CT changes during treatment were evaluated and correlated with clinical data. RESULTS: There were eight non-responders and nine responders. Five patterns of CT change during treatment were found: focal progression (FP), generalized progression (GP), generalized cystic change (GC), new cystic lesion (NC) and new solid lesion (NS). At the end of study, all non-responders showed GP, whereas responders showed cystic change (GC and NC) and response according to RECIST criteria. Overall survival was significantly better in patients with cystic change or response within the RECIST criteria compared with GP patients (P = 0.0271). CONCLUSION: Various patterns of CT change in patients with GIST who responded to imatinib mesylate were demonstrated, and might determine the prognosis of the disease. A combination of RECIST criteria and pattern of CT change are proposed for response evaluation in GIST. | Sith Phongkitkarun Cholada Phaisanphrukkun Janjira Jatchavala Ekaphop Sirachainan | 2008 | World Journal of Gastroenterology2008,14,6: | 2 |
| 4 | Functional CT for Quantifying Tumor Perfusion in Antisngiogenic Therapy in a Rat Modell显示文摘 | Zuxing Kan MD PhD Sith Phongkitkarun MD Satoshi Kobayashi MD | 2005 | Radiology2005,237,: | 1 |