Contribution of whole-body (18)FDG PET imaging in the management of cervical cancer

in Gynecologic Oncology (2002), 87(1), 90-97

OBJECTIVE: The objective of this study was to assess the contribution of [(18)F]fluoro-2-deoxy-D-glucose positron emission tomography ((18)FDG PET) imaging in the management of cervical cancer. METHODS ... [more ▼]

OBJECTIVE: The objective of this study was to assess the contribution of [(18)F]fluoro-2-deoxy-D-glucose positron emission tomography ((18)FDG PET) imaging in the management of cervical cancer. METHODS: Fully corrected whole-body PET was performed in 60 patients (pts) with proven cervical cancer. In pretreatment staging, 22 pts underwent PET in addition to routine protocol including International Federation of Obstetrics and Gynecology (FIGO) staging and pelvic magnetic resonance imaging (MRI). Eighteen of them had pelvic lymphadenectomy. After treatment, PET was performed in 38 pts routinely followed up by clinical and radiological examinations. Results of PET and routine protocols were compared to final diagnoses, including histological findings in 31 pts and clinical outcomes in the other cases. Median follow-up time was 12 +/- 7.3 months. RESULTS: In all but 2 patients (FIGO stage IA), both PET and MRI detected the primary tumor. In 6 pts, MRI alone noted loco-regional tumor spread but PET localized 9 unsuspected extrapelvic nodal sites (6 para-aortic, 2 mediastinal, and 1 supra-clavicular). However, PET missed 8 microscopic pelvic nodal metastases. In 18% of the patients, PET staging significantly influenced the treatment choices. In follow-up, PET accurately diagnosed a recurrent disease in 13 pts with falsely negative or equivocal conventional imaging (CI). Ten patients with a negative PET were still in complete remission after a minimal follow-up time of 12 months. Overall, the agreement of PET with final diagnosis was significantly better than that of routine protocol (P < 0.05). CONCLUSIONS: Whole-body (18)FDG PET appears useful in the management of cervical cancer, in particular for staging extrapelvic metastases or optimally detecting a recurrence. MRI is better indicated for evaluating the loco-regional status of the disease. [less ▲]

Clinical severity of knee osteoarthritis poorly predicts long-term radiographic outcomes

in Arthritis and Rheumatism (2002, September), 46(number 9 (suppl.)), 153

Baseline measurement of urine pyridinoline and deoxypyridinoline is correlated with 3-year hip osteoarthritis progression

in Arthritis and Rheumatism (2002, September), 46(number 9 (suppl.)), 149

Increased uptake of the apoptosis-imaging agent (99m)Tc recombinant human annexin V in human tumors after one course of chemotherapy as a predictor of tumor response and patient prognosis

in Clinical Cancer Research : An Official Journal of the American Association for Cancer Research (2002), 8(9), 2766-2774

Purpose: Many anticancer therapies exert their therapeutic effect by inducing apoptosis in target tumors. We evaluated in a Phase I study the safety and the feasibility of Tc-99m-Annexin V for imaging ... [more ▼]

Purpose: Many anticancer therapies exert their therapeutic effect by inducing apoptosis in target tumors. We evaluated in a Phase I study the safety and the feasibility of Tc-99m-Annexin V for imaging chemotherapy-induced apoptosis in human cancers immediately after the first course of chemotherapy. Experimental Design: Fifteen patients presenting with lung cancer (n = 10), lymphoma (n = 3), or breast cancer (n = 2) underwent Tc-99m-Annexin V scintigraphy before and within 3 days after their first course of chemotherapy. Tumor response was evaluated by computed tomography and F-18-fluoro-2-deoxy-D-glucose positron emission tomography scans, 3 months in average after completing the treatment. Median follow-up was 117 days. Results: In all cases, no tracer uptake was observed before treatment. However, 24-48 h after the first course of chemotherapy, 7 patients who showed Tc-99m-Annexin V uptake at tumor sites, suggesting apoptosis, had a complete (n = 4) or a partial response In = 3). Conversely, 6 of the 8 patients who showed no significant posttreatment tumor uptake had a progressive disease. Despite the lack of tracer uptake after treatment, the 2 patients with breast cancer had a partial response. Overall survival and progression-free survival were significantly related to tracer uptake in treated lung cancers and lymphomas (P < 0.05). No serious adverse events were observed. Conclusions: Our preliminary results demonstrated the feasibility and the safety of Tc-99m-Annexin V for imaging apoptosis in human tumors after the first course of chemotherapy. Initial data suggest that early Tc-99m-Annexin V tumor uptake may be a predictor of response to treatment in-patients with late stage lung cancer and lymphoma. [less ▲]

Influence of daily regimen calcium and vitamin D supplementation on parathyroid hormone secretion

in Calcified Tissue International (2002), 70(2), 78-82

Calcium and vitamin D supplementation has been shown to reduce secondary hyperparathyroidism and play a role in the management of senile osteoporosis. In order to define the optimal regimen of calcium and ... [more ▼]

Calcium and vitamin D supplementation has been shown to reduce secondary hyperparathyroidism and play a role in the management of senile osteoporosis. In order to define the optimal regimen of calcium and vitamin D supplementation to produce the maximal inhibition of parathyroid hormone secretion, we have compared the administration of a similar amount of Ca and vitamin D, either as a single morning dose or split in two doses, taken 6 hours apart. Twelve healthy volunteers were assigned to three investigational procedures, at weekly intervals. After a blank control procedure, when they were not exposed to any drug intake, they received two calcium-vitamin D supplement regimens including either two doses of Orocal D3 (500 mg Ca and 400 IU vitamin D) 6 hours apart or one water-soluble effervescent powder pack of Cacit D3 in a single morning dose (1000 mg Ca and 880 IU vitamin D). During the three procedures (control and the two calcium-vitamin D supplementations), venous blood was drawn every 60 minutes for up to 9 hours, for serum Ca and serum PTH measurements. The order of administration of the two Ca and vitamin D supplementation sequences was allocated by randomization. No significant changes in serum Ca were observed during the study. During the 6 hours following Ca and vitamin D supplementation, a statistically significant decrease in serum PTH was observed with both regimens, compared with baseline and with the control procedure. Over this period of time, no differences were observed between the two treatment regimens. However, between the sixth and the ninth hour, serum PTH levels were still significantly decreased compared with baseline with split dose Orocal D3 administration, while they returned to baseline value with the Cacit D3 preparation. During this period, the percentage decrease in serum PTH compared with baseline was significantly more pronounced with Orocal D3 than with Cacit D3 (P = 0.0021). We therefore conclude that the administration of two doses of 500 mg of calcium and 400 IU of vitamin D3 6 hours apart provides a more prolonged decrease in serum PTH levels than the administration of the same total amount of Ca and vitamin D as a single morning dose in young healthy volunteers. This might have implications in terms of protection of the skeleton against secondary hyperparathyroidism and increased bone resorption and turnover in elderly subjects. [less ▲]

Comparative In Vitro Activity of Amphotericine B, Itraconazole, Voriconazole and Posaconazole against Aspergillus fumigatus

Poster (2001, December)

Background. New azoles have been successfully used as treatment of invasive aspergillosis. The purpose of this study was to compare the in vitro activity of posaconazole (Posa) with that of amphotericin B ... [more ▼]

Background. New azoles have been successfully used as treatment of invasive aspergillosis. The purpose of this study was to compare the in vitro activity of posaconazole (Posa) with that of amphotericin B (AmB), itraconazole (Itra) and voriconazole (Vor) against A. fumigatus isolates according to NCCLS method (M38-P), and to compare visual and spectrophotometric readings for MIC determination. Methods. A total of 106 A. fumigatus isolates were selected as follows: 88 clinical isolates from colonized patients, 18 from patients with invasive aspergillosis and 7 environmental isolates. Their in vitro susceptibility was evaluated by the NCCLS microdilution method (M38-P) in RPMI 1640 medium. Determination of results was made by visual and spectrophotometric readings (630 nm) after 48 hours incubation at 35 degreesC. Three A. fumigatus reference strains (IHEM 5734, 6149 and 13935) were included as control. Results. 1. Geometric mean MICs/MIC90 (microg/ml) obtained by visual reading were respectively 0.66/1 (AmB), 0.37/0.5 (Itra), 0.27/0.5 (Vor) and 0.02/0.03 (Posa). 2. MIC values were comparable by spectrophotometric and by visual readings for all antifungal agents tested (p>.05) and did not depend on the isolates origin (p>.05). 3. Posaconazole had the lowest MICs (p< 0.001). 4. The itraconazole-resistant reference strain did not give cross resistance with voriconazole and posaconazole. CONCLUSIONS: Among azoles, posaconazole had a better in vitro activity against A. fumigatus than did voriconazole or itraconazole. Spectrophotometric reading could replace the less standardized visual reading for NCCLS microdilution method and MIC values obtained were comparable among all A. fumigatus isolates. [less ▲]

Early (3-month) changes in serum osteocalcin and urinary C-telopeptide of type I collagen could be of interest to identify postmenopausal osteoporotic women with the highest risk to present new vertebral deformities

in Arthritis and Rheumatism (2001), 44(Suppl.1), 257

Tibial subchondral sclerosis is significantly correlated with long-term (3-year) radiological progression of knee osteoarthritis

in Arthritis and Rheumatism (2001), 44(Suppl.1), 139

Radiographic severity of knee osteoarthrits is highly correlated with future progression of the disease

in Clinical Rheumatology (2001), 5(Suppl.1), 412

Tibial subchondral sclerosis is significantly correlated with long-term (3-year) radiological progression of knee osteoarthritis

in Clinical Rheumatology (2001), 5(Suppl.1), 412