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Rak jelita grubego jest jednym z najcześciej wystepujących nowotworow zlośliwych w Polsce i na świecie. Coraz cześciej stosowaną i uznaną w onkologii metodą diagnostyczną jest badanie PET/CT — jedna z najnowocześniejszych metod diagnostyki obrazowej. Dzieki polączeniu obrazowania anatomicznego (CT) z obrazowaniem metabolicznym (PET) umozliwia wczesną identyfikacje zmian rozrostowych, dokladną ocene stopnia zaawansowania nowotworu. W diagnostyce wznowy raka jelita grubego badanie PET/CT z zastosowaniem fluorodeoksyglukozy ( 18 F-FDG) ma udowodnioną wartośc kliniczną. Informacje uzyskane w badaniu w istotnym stopniu wplywają na podejmowane decyzje terapeutyczne. W przypadku planowanej metastazektomii metoda ta pozwala precyzyjniej niz inne ocenic stopien zaawansowania wznowy, zlokalizowac wszystkie ogniska nawrotu, a co za tym idzie, pozwala uniknąc niepotrzebnych zabiegow. Standardowo wykonywane badanie 18 F-FDG PET/CT, polegające na wykonaniu badania tomografi i komputerowej tzw. low dose bez podania dozylnego środka kontrastującego, a nastepnie rejestracji PET i wykonaniu fuzji obu obrazow, nie dostarcza jednak wystarczających informacji dotyczących oceny stosunku guza bądź nacieku do narządow sąsiednich oraz naczyn, niezbednych do pelnej oceny operacyjności wznowy, dostepnych w badaniu tomografi ikomputerowej z zastosowaniem dozylnego środka kontrastującego. Wykonanie badania 18 F-FDG PET/CT wg schematu low dose CT, PET, a nastepnie CT z dozylnym podaniem środka kontrastującego umozliwia uzyskanie na podstawie jednego badania wszystkich niezbednych informacji dotyczących operacyjności zmiany i moze w przyszlości stac sie badaniem z wyboru w diagnostyce wznowy raka jelita grubego.

Multidrug chemotherapy increases the efficacy of the treatment, but at the same time rises its cardiotoxicity. The majority of cardiac complications are caused by anthracyclines.Radiation therapy may intensify cardiotoxicity. The aim of this study was to determine early changes of cardiac function using radionuclide ventriculography in patients with breast cancer and to compare the toxicity of AC and AT chemotherapy programs.The study included 71 patients with breast cancer between the ages of 38 and 71 years. All patients after surgery were qualified for chemotherapy, and for 37 (52%) of them subsequent irradiation treatment was planned.Patients received chemotherapy according to the scheme: AC- 47 patients (66%) and AT - 24 patients (34%). Patients were irradiated using a photon beam (4 to 6 MeV) and an electron beam (6-15 MeV). In all patients, before and six months after the treatment, radionuclide ventriculography was performed.In all 71 patients a reductions in left ventricular ejection fraction (EF) and in peak filling rate (PFR) as well as an increase in the end-systolic and end-diastolic volumes (ESvol,EDvol) were observed. AC chemotherapy, where cumulative anthracycline dose was higher, significantly decreased left ventricular ejection fraction and PFR and increased ESvol. AfterAT chemotherapy the EF reduction proved to be smaller. Radiotherapy did not significantly lower the value of EF as compared to the group of patients who underwent chemotherapy.Radionuclide ventriculography is a useful method of evaluating the cardiotoxicity of the treatment. Early indicators of myocardial damage are EF, PFR, ESvol and EDvol.AC chemotherapy, where the average cumulative dose of anthracyclines was higher, caused more cardiotoxic effects than AT chemotherapy.Applying additional radiotherapy did not significantly increase the cardiotoxicity of the treatment.

BACKGROUND: Positron emission tomography (PET) combined with computer tomography (CT) using 68 Ga-DOTATATE is a promising method for the evaluation of patients with recognised or suspected neuroendocrine tumours (NET). The aim of this study was to assess the diagnostic value of 68 Ga-DOTATATE PET/CT in the visualisation of the expression of somatostatin receptors (SSTR) and identification of new lesions. MATERIAL AND METHODS: Between December 2009 and January 2011 ninety-seven patients with confirmed (88 cases) or suspected (9 cases) NET underwent 68 Ga DOTATATE PET/CT. The primary, confirmed or suspected, NET localizations were: GEP tumours — 71 patients; medullary thyroid carcinoma — 4 patients; cancer of an unknown primary — 14 patients; and NET in other localisations — 8 patients. PET/CT acquisitions were performed using standard techniques, 45 to 60 minutes after the intravenous injection of 111–185 MBq 68 Ga-DOTATATE. RESULTS: 68 Ga-DOTATATE PET/CT detected the presence of lesions demonstrating the somatostatin receptor affinity in 50 of the 97 patients (51.5%) and was negative in 47 patients (48.5%). Among 14 patients with metastatic unknown primary cancer, in 5 patients (45.5%) the primary tumour site was identified, and in 4 patients with medullary thyroid cancer distant metastases with SSTR expression were localized in only one patient. CONCLUSIONS: Our findings confirm the diagnostic role of 68 Ga-DOTATATE PET/CT as an accurate method of identifying primary tumours and distant metastases. It provides information on tumour cell receptors status, which has a significant bearing on planning target radionuclide therapy. Overall, 68 Ga-DOTATATE PET/CT can be used in staging, re-staging, and in regular follow up of oncology patients. Nuclear Med Rev 2011; 14, 1: 16–20

Bone scan remains the most frequently requested investigation in any nuclear medicine department. The main reason for this is the exquisite sensivity of the bone scan for lesion detection, combined with clear visualisation of the whole skeleton. The isotope bone scan is now generally accepted as initial investigation of choice in the search for bone metastases from most tumours. 13583 bone scans for metastases were performed in our institution in 1998-2002 years. The frequency of bone metastases was highest in breast, prostate and lung cancer (53,9%, 58,6% and 29,5% respectively). Future progress depends on further advances in specificity of radiotracers and improvements of image acquisition and processing.

Thyroglossal duct remnants (TGDR), most often cysts, are the most common type of developmental abnormalities of the thyroid gland. In about 1 to 2% of TGDR neoplastic transformation occurs. Papillary carcinoma of the thyroid may be encountered in over 90% of such cases. Two cases of primary papillary carcinoma of the thyroid in TGDR in young girls are presented. The diagnostic and therapeutic problems are shared, and up-to-date management guidelines in similar cases are discussed.