Advances in Nuclear Oncology:: Diagnosis and Therapy by Emilio Bombardieri, John Buscombe, Giovanni Lucignani, Otmar

By Emilio Bombardieri, John Buscombe, Giovanni Lucignani, Otmar Schober

The diagnostic and healing achievements in radiopharmaceuticals and nuclear drugs instrumentation ? puppy, SPECT, MR, CT and their hypbrids PET-CT and SPECT-CT

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To this end, both direct and indirect signs are sought. A direct sign of a brain tumor is an area with a density (CT) or signal (MRI) different from that of normal cerebral tissue, including changes secondary to contrast media infusion. Such changes in density or signal occur secondary to the structural features of neoplasms. X-ray computed tomography, magnetic resonance imaging and magnetic resonance spectroscopy For many years, X-ray CT with contrast enhancement has been the gold standard for the diagnosis of brain tumors due to its ability to ascertain the presence of a brain lesion, to define its dimension and relation with surrounding 27 brain structures, to assess perilesional edema, and to define the presence of multiple brain lesions.

Other symptoms are focal neurological deficits, which can show the localization of the tumor. 7 Unfortunately, as mentioned above, tumor misclassification can occur with morphologic imaging techniques. The first crucial step to achieving correct diagnosis through histological evaluation is to target the biopsy to the most malignant region within the tumor. Especially gliomas can be regionally extremely heterogeneous, so biopsy-targeting is of crucial importance for a correct grading of the tumor and for subsequent management planning, otherwise sampling errors may lead to malignancy-grade underestimation.

15 All meningiomas show loss of chromosome 22q, a feature common to neurofibromatosis type 2. 16 Adenomas of the pituitary gland are often composed of well differentiated cells that produce anterior pituitary hormones, which can cause syndromes of hormone excess as in acromegaly and gigantism for growth hormone-, galactorrhea for prolactin-, and Cushing’s syndrome for adrenocorticotropic hormone-producing tumors. They can also be non-secreting, and all can cause hormonal misbalances or other symptoms due to the compression of surrounding structures, such as hormonal deficiencies and visual problems due to compression of the optic chiasm.

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