he purpose of this study was to evaluate the usefulness of whole body F-18 FDG PET scan for deceting postoperative recurrence of cancer. One hundred four cancer patients after operation were enrolled(l4 brain tumor, 15 head and neck cancer, 23 gynecologic cancer). Besides conventional images(CI) including CT and MRI, F-18 FDG PET scan was obtained on ECAT EXACT 47 scanner(Siemens-CTI), beginning 60 minutes after injection of 370MBq(10mCi) of F-18 FDG. Regional scan was also obtained with emission image. Transmission images using Ge-68 were carried out for attenuation correction in both whole body and regional images. Findings of PET and CI were confirmed by pathology or clinical follow up. The sensitivity and specificity of PET for detecting recurrence were 94% and 92%, respectively. Contrarily, the sensitivity and specific it of CI were 78% and 68% CI results were negative and PET results were positive in 11 cases. The biopsy or clinical follow-up of those cases confirmed recurrence of tumor. False negative cases of CI were frequent in patients with gynecologic cancers. Also we measured the Serum concentration of tumor markers in patients with gynecologic cancer(CA125), thyroid cancer(thyroglobulin), and colorectal cancer(CEA). The sensitivity and specificity of tumor markers were 71% and 84%, respectively. We conclude that F-18 FDG PET can be used valuably in detecting recurrent foci of a wide variety of malignancy compared to conventional diagnositic methods.
Biopsy ; Brain Neoplasms ; Follow-Up Studies ; Head and Neck Neoplasms ; Humans ; Magnetic Resonance Imaging ; Pathology ; Positron-Emission Tomography ; Recurrence* ; Sensitivity and Specificity ; Thyroid Gland ; Biomarkers, Tumor

PURPOSE: To determine normal postoperative CT findings and tumor recurrence in patients who have under-goneradical cystectomy and urinary diversion. MATERIALS AND METHODS: We retrospectively reviewed the postoperative CTscans of 51 patients who had un-dergone radical cystectomy with urinary diversion, and in analysis speciallyemphasised normal postoperative CT findings and recurrent cancer in the surgical bed. Among these 51 patients, 43had undergone incontinent urinary diversion(Bricker operation), while for six, diversion had been continent (Kockprocedure). Attempts were also made to characterise the CT findings of each procedure according to the location ofthe ileal pouch, the pattern of contrast collection within the pouch, and the morphology of the ileocutaneostomysite. RESULTS: Each urinary diversion procedure demonstrated characteristic postoperative CT appearances. TheBricker procedure revealed a contrast-filled ileal conduit in the right lower quadrant excreting into theileocu-taneostomy site, while the Kock procedure demonstrated layering of contrast and urine within the pouch aswell as artificially intussuscepted afferent and efferent ileal loops at the anastomotic sites. Thirty-three smallsoft tissue density lesions in the surgical bed were seen in 19 patients (37%). Thirty one were bilateral (n=28)or unilateral (n=3) triangular or oval shaped soft-tissue-density lesions and two were unilateral irregular shapedlesions. Follow-up CT scans showed that all triangular or oval-shaped lesions were smaller (n=8) or show no changein size (n=23) ; they were thought to represent postoperative fibrosis or granulation tissue. Two cases ofirregular-shaped soft-tissue-density lesions were seen on follow-up CT scans to be larger, and these wereconfirmed by percutaneous biopsy to be recurrent cancer. CONCLUSION: It is important for the radiologist to befamiliar with normal postoperative CT findings of various urinary diversion procedures as well as to recognize arelatively high incidence (37%) of small soft tissue den-sity lesions in a surgical bed. In our study, smalltriangular or oval-shaped soft-tissue-density lesions in the sur-gical bed (especially when these were bilateral)were thought to represent postoperative fibrosis or granulation tissue, and close follow-up by means of CTscanning rather than an invasive procedure is therefore warranted.
Biopsy ; Cystectomy ; Fibrosis ; Follow-Up Studies ; Granulation Tissue ; Humans ; Incidence ; Recurrence* ; Retrospective Studies ; Tomography, X-Ray Computed ; Urinary Diversion

BACKGROUND/AIMS: Signal transducers and activators of transcription (STATs) are a family of transcription factors that are activated in response to cytokines and growth factors. STAT3 activation has been implicated in modulating the activity of downstream mediators, such as Bcl-xL and matrix metalloproteinase-2 (MMP-2). The aim of this study was to investigate the immunohistochemical expression of STAT3, B-cell lymphoma-extra large (Bcl-xL), and MMP-2 proteins according to histopathological parameters in colon adenocarcinomas, including lymph node metastasis, tumor differentiation, the TNM stage and the tumor size. METHODS: Immunohistochemical staining with monoclonal STAT3, Bcl-xL, and MMP-2 antibodies was performed on paraffin-embedded specimens from 20 colon adenomas and 39 adenocarcinomas. RESULTS: The expression of STAT3, Bcl-xL, and MMP-2 was increased in the adenocarcinomas as compared with the adenomas (p<0.001). STAT3 expression was stronger in tumors with a distant metastasis than in tumors without a distant metastasis (p=0.012). A larger tumor size was related to an increase in STAT3 expression (p=0.035). CONCLUSIONS: STAT3, Bcl-xL, and MMP-2 may play important roles in the tumorigenesis of colorectal carcinoma. STAT3 may be indicative of a poor prognosis due to its correlation with distant metastases and a larger tumor size.
Adenocarcinoma ; Adenoma ; Antibodies ; B-Lymphocytes ; Cell Transformation, Neoplastic ; Colon ; Colorectal Neoplasms ; Cytokines ; Humans ; Intercellular Signaling Peptides and Proteins ; Lymph Nodes ; Matrix Metalloproteinase 2 ; Neoplasm Metastasis ; Prognosis ; Proteins ; Transcription Factors ; Transducers