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Biomedical subjects

M Seltzer

Publications and source records attributed to M Seltzer.

15 recordsLinked to original sources
PubMed2002

The usefulness of F-18 deoxyglucose whole-body positron emission tomography (PET) for re-staging of renal cell cancer.

PURPOSE: The use of whole-body PET for re-staging of renal cell carcinoma has not been investigated. The aim of the current study was to examine the diagnostic accuracy and clinical usefulness of whole-body PET imaging for re-staging of renal cell cancer. PATIENTS AND METHODS: Clinical PET was performed for re-staging in 36 patients with advanced renal cell cancer. Written reports of imaging studies (including CT, MRI, US, plain film and bone scan), patient history, and extensive chart notes were used to define the clinical stage before PET (pre-PET stage). The written PET report was used to define the clinical stage after PET (PET stage). Reports were used to determine the accuracy of PET for re-staging renal cell cancer and for defining biopsy proven lesions. Clinical parameters and biopsy proven lesions served as reference for the accuracy of PET for re-staging renal cell cancer. RESULTS: PET classified the clinical stage correctly in 32/36 patients (89%) and was incorrect in 4/36 (11%) (sensitivity and specificity: 87% and 100%). In 20 patients, 25 suspicious lesions were biopsied within 3.2 +/- 6.7 months of the PET study. Of these, 17 were malignant and 8 were benign. PET correctly classified 21/25 (84%) of the biopsied lesions (sensitivity and specificity: 88% and 75%). CONCLUSION: PET re-stages renal cell cancer with a diagnostic accuracy of 89%. Its diagnostic accuracy for classifying biopsy proven anatomic lesions as malignant or benign was 84%. These findings suggest that PET is useful in characterizing anatomic lesions of unknown significance in patients with renal cell cancer.

Adult↗
PubMed2001

Impact of 18F-FDG PET on managing patients with colorectal cancer: the referring physician's perspective.

UNLABELLED: Whole-body PET imaging with 18F-FDG has been used successfully to stage colorectal cancer. However, the impact of FDG PET on patient management from the referring physician's point of view has not been determined. METHODS: A questionnaire was sent to referring physicians to determine whether and how PET altered the management of colorectal cancer patients. Management changes, when present, were classified as intermodality (e.g., medical to surgical, surgical to radiation, medical to no treatment) or intramodality (e.g., altered medical, surgical, or radiotherapy approach). RESULTS: Of 60 responses from referring physicians, changes in clinical stage were reported for 25 patients (42%). Among these, the disease was upstaged in 20 patients (80%) and downstaged in 5 patients (20%). The PET findings contributed to intermodality management changes in 22 of the 60 patients (37%), intramodality changes in 11 patients (18%), a combination of management changes in 4 patients (7%), and no change in 19 patients (32%). Two of the 60 patients (3%) had other changes, and no response to this question was received for the remaining 2 patients (3%). As a result of PET findings, physicians avoided major surgery in 41% of patients for whom surgery was the intended treatment. CONCLUSION: This survey-based study of referring physicians shows that FDG PET had a major impact on the management of colorectal cancer patients and contributed to changes in clinical stage and major management decisions in >40% of patients.

Adult↗
PubMed1977

Stroke: incidence and risk factors.

The incidence of stroke was estimated prospectively in a total population of 2,502 persons over age 65 who resided in homes for the aged. The incidence in persons born in Asian and African countries was close to that in persons born in European countries. No sex differential was found in either ethnic group, and there was no significant increase in the incidence of stroke with advancing age in either sex. In the European population, prior heart disease was the strongest risk-increasing factor, ranking ahead of hypertension. Diabetes mellitus was not associated with a higher risk of stroke among the women; the findings for the men were inconclusive. In the Afro-Asian population, the risk of stroke was related to heart disease and diabetes mellitus but was not associated with blood pressure. Total serum cholesterol or relative weight was not associated with stroke in either group. The early establishment of programs for the control of hypertension and stroke appears most desirable.

Age Factors↗
PubMed1976

The initial manifestations of acute myocardinal infarction.

A review of 132 consecutive patients 65 years of age and older who had a myocardial infarction showed that two-thirds of them experienced pain at onset. Pain was the only symptom leading to bedside diagnosis in one-fourth of the patients. Pain at onset combined with sudden or increased dyspnea was present in one-fifth of the patients and pain associated with other symptoms in one-sixth. Dyspnea unaccompanied by pain heralded onset of infarction in one-fifth of the patients, and in almost 7 percent, onset was marked only by other symptoms. Cerebral symptoms dominated onset in one-tenth of the patients. Preexisting coronary heart disease, hypertension, or diabetes was not predictive of painless infarction. To avoid pitfalls and facilitate bedside diagnosis of infarction, physicians should be aware of the different clinical presentations of painless infarction in the aged, which occurred in over one-third of the patients in this cohort. They also should suspect the possibility of myocardial infarction in any patient in whom symptoms are not clear, even when they are mild and unobtrusive. Questioning of the elderly patient, his family, or others around him as early as possible after the onset of an acute attack is likely to elicit a history of pain, which may lead to the correct diagnosis.

Acute Disease↗
PubMedDate not supplied

Characterization of hilar lymph node by 18F-fluoro-2-deoxyglucose positron emission tomography in healthy subjects.

One hundred and seventy-nine images were collected from healthy subjects who underwent whole-body 18F-fluoro-2-d-deosyglucose positron emission tomography (FDG-PET) for health examination. Images showing visually increased FDG uptake based on a five-point visual scale in the hilar regions were included for analyses. We evaluated the sizes, standard uptake values (SUV), and lesion-to-background (L/B) ratios of the hilar lymph nodes (HLN). Fifty of 179 (28%) subjects had visually increased FDG uptake in the hilar regions with a total of 84 HLN. By a five-point visual scale, 67 out of 84 (79.8%) HLN were grade 2, 16 out of 87 (19%) were grade 3, and 1 out of 84 (1.2%) was grade 4. The average size of the HLN was 1.55 x 1.46 cm. SUV of the HLN ranged from 1.132-2.975 with an average of 1.8 +/- 0.44. L/B ratio of the HLN ranged from 1.05-2.63 with an average of 1.52 +/- 0.39. Twenty-eight % of healthy subjects who underwent whole-body FDG-PET demonstrated visually increased FDG uptake in the HLN. However, all of the 84 HLN had a size < 2 x 2 cm, SUV < 3.0 and L/B ratios < 3.

Adult↗