The role of PET in head and neck cancer

4/28/2008 Heidleberg, Germany LG Strauss and A Dimitrakopoulou-Strauss Hell J Nucl Med, January 1, 2008; 11(1): 6-11 PET and PET/CT are the procedures of choice for molecular imaging in the head and neck area. The current data of the literature show, that functional imaging with fluorine-18-deoxyglucose ((18)F-FDG) provides the possibility to obtain information about the viability of malignant lesions. The use of hybrid systems, PET/CT, enables physicians to assess both, morphology and function, and achieve a high diagnostic accuracy exceeding 90%. PET with (18)F-FDG is the most sensitive method to detect tumor recurrence. However, false positive results must be considered due to unspecific changes following treatment, especially radiotherapy. The use of quantitative PET scans as well as the application of a second tracer, enhance the capability of PET to assess questionable masses more accurately. Follow up examinations with PET and (18)F-FDG provide data about early changes in the tumor metabolism due to chemotherapeutic treatment. Studies in patients undergoing surgery and radiotherapy demonstrated, that PET with (18)F-FDG can be used for the prediction of individual survival.

2009-04-16T12:49:02-07:00April, 2008|Archive|

MR Imaging Criteria for the Prediction of Extranodal Spread of Metastatic Cancer in the Neck

4/28/2008 Nagasaki, Japan Y Kimura et al. AJNR Am J Neuroradiol, April 10, 2008 Background and Purpose: The presence of extranodal spread in metastatic nodes significantly affects treatment planning and prognosis of the patient with head and neck cancer. We attempted to evaluate the predictive capability of MR imaging for the extranodal spread in the neck. MATERIALS AND Methods: We retrospectively studied MR images from 109 patients with histologically proved metastatic nodes, of which 39 were positive for extranodal spread. We assessed 47 extranodal spread-positive and 130 extranodal spread-negative metastatic nodes by using the following MR imaging findings as the possible criteria for extranodal spread: 1) nodal size (short-axis diameter); 2) obliterated fat spaces between the metastatic node and adjacent tissues, such as the muscles and skin on T1-weighted images ("vanishing border" sign); 3) the presence of high-intensity signals in the interstitial tissues around and extending from a metastatic node on fat-suppressed T2-weighted images ("flare" sign); and 4) an irregular nodal margin on gadolinium-enhanced T1-weighted images ("shaggy margin"). Multivariate logistic regression analysis was conducted to identify independent predictive criteria for extranodal spread. Results: Nodal size, shaggy margin, and flare sign criteria were independent and significant MR imaging findings suggestive of extranodal spread in the metastatic nodes. We obtained 77% sensitivity and 93% specificity with the flare sign, 65% sensitivity and 99% specificity with the shaggy margin, and 80% sensitivity and 85% specificity with the size criterion (cutoff point = 16 mm). Conclusion: Fat-suppressed T2-weighted and gadolinium-enhanced T1-weighted images are useful [...]

2009-04-16T12:48:42-07:00April, 2008|Archive|

Vaccine May Treat Lung Cancer

4/28/2008 web-based article Salynn Boyles An experimental vaccine that works by training the immune system to kill specific tumor cells is showing promise for the treatment of early lung cancer, researchers report. The immune-system-boosting vaccine targets a protein expressed in certain cancer cells, but not in normal cells, known as MAGE-A3. About 35% of non-small-cell lung cancers (NSCLC) have this protein, which is also present in some melanomas and head and neck cancers. In a trial of early-stage lung cancer patients whose tumors expressed MAGE-A3, treatment with the vaccine was shown to reduce the risk of relapse after surgery. Long-term follow-up results from the early trial of the immunotherapy were presented at the 1st European Lung Cancer conference in Geneva, Switzerland. "The principle behind this approach has potential for many different types of cancer," researcher Johan Vansteenkiste, MD, PhD, tells WebMD. "The principle is that you teach the patient's immune system to eliminate cancer cells that express certain proteins." MAGE-A3 Vaccine The vaccine therapy has not been compared head-to-head with chemotherapy, which is often given to surgically treated lung cancer patients to reduce their risk of relapse. But Vansteenkiste says the immunotherapy-treated patients in the phase II study had outcomes similar to those seen among chemotherapy-treated patients, with almost no side effects. "Many surgically treated lung cancer patients are not able to tolerate the side effects of chemotherapy, either because of their age or because of other health issues," he says. "This approach is a promising alternative." A total [...]

2009-04-16T12:48:01-07:00April, 2008|Archive|

Possible Viral Links to Lung Cancer Risk Uncovered

4/27/2008 Washington, D.C. Alan Mozes Although smoking is well-established as an independent risk factor for lung cancer, two new studies suggest that two different viral infections might boost a smoker's already substantial risk for developing the disease. While the specific viruses at issue -- human papillomavirus (HPV) and measles -- may not directly cause lung cancer, they seem to aggravate the negative impact of tobacco, American and Israeli researchers say. Both findings were presented Friday by separate research teams attending the European Lung Cancer Conference in Geneva. "In terms of HPV, our finding is pretty controversial," said study author Dr. Arash Rezazadeh, a fellow of medical oncology and hematology at the University of Louisville in Kentucky. "And this is just the beginning of the road. There is much more work to be done. But it's important to know that being infected with this virus does appear to increase lung cancer risk." As for the role of measles, the second study's lead author, Dr. Samuel Ariad, from the department of oncology at Soroka Medical Center in Beer Sheva, Israel, said that infection -- perhaps even asymptomatic infection -- seems to be associated with half of the lung cancer cases he tracked. "Measles virus by itself is unlikely to be carcinogenic," he said. "[But] it probably modifies previous damage to DNA caused by smoking." Both studies specifically focused on the viral impact on non-small cell lung cancer (NSCLC) risk. According to the American Cancer Society, 85 percent to 90 percent of [...]

2009-04-16T12:47:35-07:00April, 2008|Archive|

Hopkins Doctor Urges Early Diagnosis To Avoid Cancer’s Forgotten Killer

4/22/2008 Baltimore, MD staff On average, two Marylanders each day are diagnosed with potentially fatal oral cancers that are often curable if identified and treated early. The Maryland Department of Health and Mental Hygiene’s Office of Oral Health reports that the state ranks in the country’s top 10 for number of deaths caused by oral cancers. Nationally, statistics show that the death rate from these cancers is higher than those of cervical cancer, Hodgkin’s lymphoma, testicular cancer, and thyroid and malignant melanoma. A sore in the mouth that doesn’t heal could be a warning sign of oral cancer, which kills more than 8,000 people a year. Of the 34,000 Americans newly diagnosed with oral cancer annually, only half will be alive in five years. According to the American Dental Association, early diagnosis and treatment could boost that rate to 75 or 80 percent. John O’Brien, 70, who had not smoked a cigarette in 33 years, was adamant about maintaining proper oral hygiene. But, in 2006, O’Brien, a national sales manager for an advertising agency, father of four and a grandfather of five, found a small lump that turned out to be a cancerous tumor at the base of his tongue. After 45 radiation treatments and six chemotherapy sessions, O’Brien says he is grateful to be alive. “I was just in disbelief. Nobody wants to hear that they have cancer,” says O’Brien. "But, for me I was lucky because the doctors caught it quickly.” “Often, oral cancer is not diagnosed [...]

2009-04-16T12:46:11-07:00April, 2008|Archive|

Opening up – Innovative physical therapy helps keep cancer survivor

4/22/2008 Knoxville, TN Kristi L. Nelson A long, deep yawn. A bite of a chocolate bar or crab meat. A vigorous brushing and thorough flossing. For 2 1/2 years, Esther Cahal has forgone these and other small pleasures most people take for granted. An unusual complication from a rare form of particularly aggressive tongue cancer left Cahal's mouth locked shut, able to open barely wide enough to insert her little finger. She stays alive by hooking herself up to a feeding tube unit each night and sleeping in an upright position while she "eats" a liquid nutritional supplement for eight hours through a port in her stomach. A little more than a year ago, Cahal, facing a recurrence of her cancer, "decided that before I die, I'm going to eat again," Cahal said. "If this cancer's going to kill me, at least I'm going to have something good down my throat." But Cahal has had two "clear" scans for cancer - and now an innovative physical therapy treatment is helping open her up to experiencing food again. n It started in February 2004, when Cahal's dentist found an ulcer on the right side of her tongue. She thought the skin was irritated by a tooth, but when the tooth was fixed, the ulcer still didn't heal. So she had a biopsy. "It came back as extremely aggressive cancer," Cahal said. "It was a surprise for everybody, because I didn't have any risk factors." The type of cancer Cahal had [...]

2009-04-16T12:45:36-07:00April, 2008|Archive|

Understanding the biological basis of autofluorescence imaging for oral cancer detection

4/21/2008 Austin, TX I Pavlova et al. Clin. Cancer Res., April 15, 2008; 14(8): 2396-404 Purpose: Autofluorescence imaging is increasingly used to noninvasively identify neoplastic oral cavity lesions. Improving the diagnostic accuracy of these techniques requires a better understanding of the biological basis for optical changes associated with neoplastic transformation in oral tissue. Experimental Design: A total of 49 oral biopsies were considered in this study. The autofluorescence patterns of viable normal, benign, and neoplastic oral tissue were imaged using high-resolution confocal fluorescence microscopy. Results: The autofluorescence properties of oral tissue vary significantly based on anatomic site and pathologic diagnosis. In normal oral tissue, most of the epithelial autofluorescence originates from the cytoplasm of cells in the basal and intermediate regions, whereas structural fibers are responsible for most of the stromal fluorescence. A strongly fluorescent superficial layer was observed in tissues from the palate and the gingiva, which contrasts with the weakly fluorescent superficial layer found in other oral sites. Upon UV excitation, benign inflammation shows decreased epithelial fluorescence, whereas dysplasia displays increased epithelial fluorescence compared with normal oral tissue. Stromal fluorescence in both benign inflammation and dysplasia drops significantly at UV and 488 nm excitation. Conclusion: Imaging oral lesions with optical devices/probes that sample mostly stromal fluorescence may result in a similar loss of fluorescence intensity and may fail to distinguish benign from precancerous lesions. Improved diagnostic accuracy may be achieved by designing optical probes/devices that distinguish epithelial fluorescence from stromal fluorescence and by using excitation wavelengths in the [...]

2009-04-16T12:44:48-07:00April, 2008|Archive|

Swedish tobacco tied to premature death

4/21/2008 Gothenburg, Sweden, staff A form of moist Swedish tobacco known as snus has been linked to premature death in users, a new longitudinal study has found. Dr. Ann Roosaar at the Odontological Institute said the study found snus -- it rhymes with moose -- posed a significant health risk to those who used it even when compared to normal tobacco, the Swedish news agency TT reported Saturday. "Even if smoking is without question a much greater threat to health than snus our research rejects the view that the use of Swedish snus is in principle without risk," the researcher said. The study examined the use of snus in the Swedish municipalities of Enkoping and Habo during a 30-year period, along with residents' use of other tobacco products and alcohol. Snus is generally used by placing a pinch of it inside the mouth under the upper lip. Inhabitants' mouths were examined prior to the study and its final results indicated that snus users were more likely to have mouth and throat cancers than non-snus users, the news agency said.

2009-04-16T12:44:27-07:00April, 2008|Archive|

Qiagen keeps purchase powder dry for now

4/19/2008 Hilden, Germany Patricia Gugau and Mantik Kusjanto Qiagen plans to keep its powder dry for major acquisitions for now as it focuses on integrating its $1.6 billion purchase of rival Digene, its finance chief said. "We still have sufficient firepower (for purchases)," Roland Sackers told Reuters in an interview. But Qiagen first wanted to integrate Digene, which has made it the second-largest molecular diagnostics company in the world after Roche. Digene helped boost cash flow at Qiagen, which has a high equity-to-assets ratio of 50 percent, he said. Qiagen also had a credit line for an undisclosed amount. Digene's flagship product is a test for detecting human papilloma virus (HPV), the cause of almost all cervical cancers. The market for HPV testing is estimated at more than $1 billion. In the HPV field, Digene is the market leader. Roche and smaller rival Third Wave Technologies are also tapping the lucrative and fast-growing market. Digene shares were up 0.8 percent at 1240 GMT, compared with a 0.2 percent rise in pan-European DJ Stoxx drug index. Sackers said the company was still in talks about payments from health authorities in Europe for its HPV test kits, which have proven to be more accurate than the traditional Pap smear test. Only private health insurers have been willing to pay for its HPV test kits in Europe. "I believe there will be a breakthrough," he said. Qiagen also dominates the genetic test kit industry. They are used to isolate nucleic acid -- [...]

2009-04-16T12:43:59-07:00April, 2008|Archive|

Introgen Therapeutics phase 3 study of cancer drug confirms earlier findings

4/19/2008 London, England press release Introgen Therapeutics Inc. said Monday its Advexin phase three clinical trial data in patients with recurrent head and neck cancer has confirmed earlier phase two results of the drug's efficacy. 'Advexin provides therapeutic benefit by restoring p53 tumor suppressor function which is blocked in the majority of head and neck cancers,' Robert E. Sobol, senior vice president, medical and scientific affairs, Introgen said in a statement. A comprehensive analysis of Introgen's phase three data and additional studies of Advexin will be presented at medical conferences later this year. These and other data will be the basis for regulatory submissions in the United States and in Europe as previously reported, the company said.

2009-04-16T12:43:24-07:00April, 2008|Archive|
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