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The utility of 18F-Fluoro-deoxy-glucose PET/CT for diagnosis and management of patients with active chronic sarcoidosis

dc.contributor.advisorŠobić-Šaranović, Dragana
dc.contributor.otherObradović, Vladimir
dc.contributor.otherVučinić-Mihailović, Violeta
dc.contributor.otherArtiko, Vera
dc.contributor.otherPekmezović, Tatjana
dc.creatorGrozdić, Isidora T.
dc.date.accessioned2016-01-05T12:05:47Z
dc.date.available2016-01-05T12:05:47Z
dc.date.available2020-07-03T08:53:36Z
dc.date.issued2013-04-26
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=745
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/2384
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:7038/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=44694543
dc.description.abstractCilj ove prospektivne studije je da proceni korisnost pozitronske emisione tomografije u detekciji inflamacije, kliničkom odlučivanju i evaluaciji terapijskog odgovora kod pacijenata sa hroničnom sarkoidozom. Specifični ciljevi su bili: da se utvrdi razlika između nalaza 18-fluor deoksi glukoze sa pozitronskom emisionom tomografijom i sa kompjuterizovanom tomografijom (18F-FDG PET/CT) i multi detektorskog skenera (MDCT); da se uporede nalazi 18F-FDG PET/CT sa nivoima serumskog angiotenzin konvertujućeg enzima (ACE); da se utvrdi značaj 18F-FDG PET/CT rezultata na dalju odluku o promeni terapije; da se uoče razlike između prvog i kontrolnog nalaza 18F- FDG PET/CT i da se koreliraju rezultati kontrolnog 18F-FDG PET/CT i kontrolnih vrednosti ACE sa kliničkim simptomima bolesti. Metodologija: Studijsku populaciju je činilo 90 pacijenata sa hroničnom sarkoidozom (47 ± 12 god. ; 32 muškarca i 58 žena) sa perzistentnim simptomima bolesti koji su upućeni na 18F-FDG PET/CT pregled radi evaluacije raširenosti bolesti. Svi pacijenti su takođe uradili MDCT i biohemijske analize serumskog ACE. Nakon 12 ± 6, 5 meseci od prvog 18F-FDG PET/CT pregleda, obavljen je kontrolni pregled kod pulmologa i prikupljani su podaci o simptomima bolesti, promeni terapije i vrednostima ACE kod ovih pacijenata. Na kontrolni 18F-FDG PET/CT pregled je došlo 30 pacijenata (45 ± 11 god; 10 muškaraca i 20 žena) sa prethodnim patološkim nalazom na prvom 18F-FDG PET/CT, kojima je nakon toga bila promenjena terapija. Rezultati: 18F-FDG PET/CT je detektovao aktivnu inflamaciju kod 74 pacijenta (82%) (SUV max 8,1 ± 3,9). MDCT je bio pozitivan kod još 6 pacijenata (80, 89%). Razlika među ovim dijagnostičkim metodama nije bila značajna (P = 0,238, McNemar-ov test), a njihovo slaganje je bilo osrednje (k = 0,198). Iako je ACE bio značajno viši kod pacijenata sa pozitivnim od onih sa negativnim 18F-FDG PET/CT rezultatom (P = 0,002, Mann–Whitney test), 38 pacijenenata (51%) sa pozitivnim 18F-FDG PET/CT rezultatom je imalo normalne vrednosti ACE. Terapija je uvedena ili promenjena kod 73 pacijenta (81%) koji su imali pozitivan nalaz 18F-FDG PET/CT. I univarijantna i multivarijantna logistička regresija su pokazale da je pozitivan nalaz 18F-FDG PET/CT značajno uticao na promenu terapije (P < 0,001) dok starost, pol, nivo ACE, MDCT rezultat, prethodna terapija nisu imali uticaja...sr
dc.description.abstractThe purpose of this prospective study was to assess the utility of positron emission tomography with 18-fluor fluorodeoxyglucose and with computed tomography (18F-FDG PET/CT) in detection of inflammation, clinical management and evaluation of treatment response of patients with chronic sarcoidosis. Specific aims were to determine differences between 18F-FDG PET/CT and multidetector computed tomography (MDCT) findings, to compare 18F-FDG PET/CT results with serum levels of angiotensinconverting enzyme (ACE), assess whether 18F-FDG PET/CT findings are associated with the decision to change therapy; to asses difference between first and follow up 18F-FDG PET/CT results in order to detect residual activity of the disease and to correlate 18F-FDG PET/CT findings and ACE levels with clinical symptoms of disease. Methods: We studied 90 sarcoidosis patients (47 ± 12 yr. ; 32 men and 58 women) with persistent symptoms who were referred for 18F-FDG PET/CT evaluation to assess the extent of inflammation. They also underwent MDCT and measurement of serum ACE level. After the followup (12 ± 6, 5 mo. after 18F-FDG PET/CT), the clinical status and changes in therapy were analyzed, and 30 patients (45 ± 11 yr. ;10 men and 20 women) with previous positive findings and changed therapy came to follow up 18F-FDG PET/CT examination. Results: 18F-FDG PET/CT detected inflammation in 74 patients (82%), (SUV max 8,1 ± 3,9). MDCT was positive for sarcoidosis in 6 additional patients (80, 89%). The difference between the 2 methods was not significant (P = 0,238, McNemar test), and their agreement was fair (k = 0,198). Although ACE levels were significantly higher in patients with positive than negative 18F-FDG PET/CT results (P = 0,002, Mann– Whitney test), 38 patients (51%) with positive 18F-FDG PET/CT results had normal ACE levels. The therapy was initiated or changed in 73 patients (81%) who showed positive 18F-FDG PET/CT results. Both univariate and multivariate logistic regression analyses indicated that positive 18F-FDG PET/CT results were significantly (P < 0,001) associated with changes in therapy, with no contribution from age, sex, ACE level, CT results, or previous therapy...en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.relationinfo:eu-repo/grantAgreement/MESTD/Basic Research (BR or ON)/175018/RS//
dc.rightsopenAccessen
dc.sourceУниверзитет у Београдуsr
dc.subject18F-FDG PET/CTsr
dc.subject18F-FDG PET/CTen
dc.subjecthronična sarkoidozasr
dc.subjectACEsr
dc.subjectMDCTsr
dc.subjectterapijasr
dc.subjectMDCTen
dc.subjectsarcoidosisen
dc.subjectACEen
dc.subjectclinical managementen
dc.subjecttherapy evaluationen
dc.titlePrediktivni značaj pozitronske emisione tomografije u proceni aktivnosti bolesti kod osoba sa hroničnom sarkoidozomsr
dc.titleThe utility of 18F-Fluoro-deoxy-glucose PET/CT for diagnosis and management of patients with active chronic sarcoidosisen
dc.typedoctoralThesis
dc.rights.licenseBY-NC-ND
dcterms.abstractШобић-Шарановић, Драгана; Обрадовић, Владимир; Пекмезовић, Татјана; Aртико, Вера; Вучинић-Михаиловић, Виолета; Гроздић, Исидора Т.; Предиктивни значај позитронске емисионе томографије у процени активности болести код особа са хроничном саркоидозом; Предиктивни значај позитронске емисионе томографије у процени активности болести код особа са хроничном саркоидозом;
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/10947/Disertacija.pdf


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