Medicina Nuclear e Radioterapia

Aim: The aim of this study is to detect the value of 18F-FDG PET/CT in detecting local recurrence or distant metastases in patient who underwent radical nephrectomy for renal cell carcinoma.

Materials and Methods: This retrospective study includes 88 patients diagnosed to have renal cell carcinoma underwent radical nephrectomy. Both 18F-FDG PET/CT and CT scan were done in the post-operative period for follow up. Sites of the relapse were categorized into local recurrence and distant metastasis. The final diagnosis of disease status was made on subsequent follow up by conventional imaging CT and 18F-FDG PET/CT with histopathology confirmation for all of the cases.

Results: PET/CT was positive and detected recurrence in 48/88 patients, of which confirmed to be recurrence via biopsy 46/48 and was negative in 40/88 patients, 3 of them were falsely negative. 11/48 had local renal bed recurrence and 35/48 patients had distant metastases. PET/CT classified: 46/48 of cases to be true-positive, 2/48 false-positive and 3/40 false-negatives. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 93.9%, 94.9%, 94.3%, 95.8%, and 92.5%, respectively.

Conclusion: 18F-FDG PET/CT scan proved its efficiency in post-surgical renal cell carcinoma patients as a follow up tool in local recurrence and distant metastasis. In particular detection of renal bed recurrence and bone metastasis. This can be considered as a base for future studies with larger population number.

Light Amplification by Stimulated Emission of Radiation (Laser) is an acronym for Light Amplification by Stimulated Emission of Radiation. The light emitted by a laser is monochromatic, collimated, and coherent. A laser is a device that emits this type of light. Some physiotherapists employ low-level laser therapy (LLLT) to treat various musculoskeletal conditions. LLLT is a non-invasive light source treatment that emits a single wavelength. It doesn't produce any heat, sound, or vibration. Photobiology or biostimulation are other terms for the same thing. LLLT is thought to impact connective tissue cell function (fibroblasts), speed up connective tissue repair, and act as an anti-inflammatory agent. In the therapy of musculoskeletal problems, lasers with wavelengths ranging from 632 to 904 nm are employed. The use of tailored low power laser beams or light energy to the cells is referred to as LLLT. Light having wavelengths in the red to near infrared part of the spectrum is used because these wavelengths may penetrate skin, soft tissues, and hard tissues. The therapy is painless and does not induce any sensations or burns on the skin. LLLT is also known as cold laser treatment since it does not produce heat. The beam penetrates deep into tissues without raising their temperature, causing a photobiostimulative (regenerative) response. The molecules and atoms of cells in the damaged area are stimulated by the absorbed laser energy. Unlike medication, which may just cover the pain, Low Level Laser Therapy tackles the underlying source of pain originating from a traumatic injury. It has no negative effects and can be used in conjunction with other treatments advised by a doctor. LLLT is a highly effective pain reduction treatment for sports injuries and other intense physical activity. LLLT has a number of advantages, including the fact that it is a non-invasive therapy that is simple to administer and has fewer side effects – and it does not require prescription. In the affected area, LLLT lessens and possibly eliminates discomfort. LLLT allows for a quicker recovery from injuries and a quicker return to sports. Lasers with a low power output beams are non-invasive and do not cause tissue damage. LLLT improves cellular function, neuron regeneration, lowers inflammation, and speeds up recovery by using pulse or continuous-wave emission. In LLLT, red beam or near infrared lasers are employed. The wavelength, treatment duration, dosage, and application site all influence the efficiency of LLLT. Clinical outcomes will differ depending on the depth of the target tissue. Low Level Laser Therapy has been shown to have a number of therapeutic benefits, including a reduction in pain due to the stimulation of the body's natural pain killers, endorphins; reduced inflammation and swelling due to the suppression of inflammatory enzymes; improved lymphatic drainage to increase circulation and speed the healing process; muscle tightness following an injury is relaxed to provide improved mobility; and an increase in the speed and quality of woundhealing and tissue repair. The immune system and neuronal function are improved, and bone regeneration is facilitated by promoting fibroplastic and osteoblastic synthesis. Low Level Laser Therapy is used to treat sports injuries. When sports injuries occur, they are frequently unpleasant, and full recovery might take months. Soft tissue injuries involving ligaments, tendons, and muscles can be severe. The discomfort you're in (especially if you're still doing sports training) might slow down the healing process and affect your current and future physical performance. Inflammation is the body's response to trauma, which is marked by partial or complete loss of function as a result of the injury. The inflammatory stage of healing is the first step of recovery, and it is during this stage that cell proliferation and tissue regeneration begin. An overreaction, on the other hand, slows down the healing process. LLLT mediates and resolves the inflammatory phase of an injury, as well as speeding up the overall healing process to increase function and mobility. Overuse or acute injuries acquired through involvement in high-impact and high-intensity sports are common causes of sports injuries (physically demanding non-sporting activities can result in similar injuries). Jumpers knee, frozen shoulder, tennis elbow, muscular strain and ligament injury, bursitis, and tendon sheath inflammation are just a few of the sports problems that react well to Low Laser Light Therapy. Low Level Laser Therapy has been shown to be effective in the treatment of tendinopathy in studies. Golf, martial arts, basketball, running, aerobics, dancing, tennis, squash, volleyball, football, rugby, and cricket are just a few examples of sports where active participation might result in injury. The majority of these sports have one thing in common: they are all repeated actions involving pressures and loads that enhance the risk of injury. Golfers, for example, can develop tendinitis in their elbows or knees as a result of the repeated requirement to stabilise the hip axis' rotation at the start of a swing. Lower back injuries are common in golf, and they are caused by the bending over posture, as well as pivoting and twisting motions. LLLT is an effective therapeutic technique for reducing pain in adult patients with musculoskeletal problems, according to a systematic review and meta-analysis published in 2017. They also found that sticking to the dosages recommended by the World Association of Laser Therapy (WALT) boosted effectiveness. The data on the effectiveness of laser therapy for shoulder pain or acute or chronic neck pain was ambiguous, according to a 2017 study titled "Effective treatment options for musculoskeletal pain in primary care: A comprehensive analysis of existing evidence." In the case of knee discomfort, low-level laser therapy may complement exercise and/or surgical treatment. How well does LLLT work for other conditions? Low-level laser therapy has been shown to reduce pain and speed healing in a variety of orthopaedic diseases (orthopaedic refers to the human musculoskeletal system as well as the body's connective tissues, tendons, and ligaments). Sprains and strains, whiplash injuries, muscular back discomfort, and tendonitis are examples of these conditions. Osteoarthriti, rheumatoid arthritis, frozen shoulder, neck and back pain, epicondylitis, carpal tunnel syndrome, tendinopathy, fibromyalgia, plantar fasciitis, post tibial fracture surgery, herpetic neuralgia, trigeminal neuralgia, and diabetic neuropathy are among the chronic conditions where LLLT is effective. Contraindications The North American Association for Laser Therapy lists the following as contraindications: Eyes: Laser beams should not be aimed directly into the eyes, and everyone in the room should wear suitable safety spectacles. Cancer: Do not treat any known primary carcinoma or secondary metastases unless the patient is receiving chemotherapy, in which case LLLT can be used to minimise adverse effects such mucositis. LLLT, on the other hand, may be considered for palliative relief in terminally sick cancer patients. Pregnancy: Avoid treating the growing foetus directly. Epileptics should be aware that low-frequency pulsed visible light (less than 30 Hz) can cause seizures in photosensitive epileptics. The side effects of LLLT have been observed to be similar to those experienced by patients who were given placebo devices in clinical trials.

COVID-19 is a systemic viral disease with respiratory tropism, highly contagious, poorly immunizing declared a pandemic on 03/11/2020 by the WHO. In the emergency of this pandemic, the overflow of the capacities of the health systems, the rapid spread of the virus, mortality and ignorance have forced many imaging procedures differently except CT of the lungs, considered essential. Therefore, with the resumption of activities, the question of the semiology of pulmonary lesions arises in other imaging modalities such as scintigraphy. The objective of this presentation is to report in a didactic approach the different aspects observed in lung scintigraphy in COVID-19 patients.