Review of literature and illustrative case series. Abstract. Parathyroid cancer is an uncommon malignant cancer and is associated with a poor prognosis. The staging of parathyroid cancer represents an important issue both at initial diagnosis and after surgery and medical treatment. The role of positron emission tomography/computed tomography (PET/CT) with 1. · Parathyroid cancer is an uncommon malignant cancer and is associated with a poor prognosis. The staging of parathyroid cancer represents an important issue. "Squid's Visit" is a SpongeBob SquarePants episode from season six. In this episode, SpongeBob tries to get Squidward to visit him. Characters. Squidward Tentacles. This is listing service is designed to ensure you are kept informed with what could be considered essential information for our community - a reference point for. F- Fluorodeoxyglucose (1. F- FDG) as an imaging tool in parathyroid cancer is not clearly reported in the literature, although its impact in other cancers is well- defined. The aim of the following illustrative clinical cases is to highlight the impact of PET/CT in the management of different phases of parathyroid cancer. We describe five patients with parathyroid malignant lesions, who underwent FDG PET/CT at initial staging, restaging and post- surgery evaluation. In each patient we report the value of PET/CT comparing its findings with other common imaging modalities (e. CT, planar scintigraphy with 9. Tc- sestamibi, magnetic resonance imaging) thus determining the complementary benefit of FDG PET/CT in parathyroid carcinoma. We hope to provide an insight into the potential role of PET/CT in assessing the extent of disease and response to treatment which are the general principles used to correctly evaluate disease status. Keywords: Parathyroid carcinoma, Positron emission tomography/computed tomography, 1. F- Fluorodeoxyglucose, Restaging, Staging. INTRODUCTIONParathyroid cancer is an uncommon and indolent endocrine malignancy. Clinically, it is characterized by markedly raised serum calcium levels and correlated symptoms (e. PTH) accompanied by osteolytic bone changes and renal impairment[1- 3]. The American Joint Committee on Cancer (AJCC) has neither staged nor planned to stage parathyroid carcinoma in the 7th edition of the AJCC Staging Manual, because of the rarity of the condition[4]. The incidence of parathyroid carcinoma is quite low and is seen with greater frequency in patients with hyperparathyroidism- jaw tumour (HPT- JT) syndrome. The aetiology of parathyroid carcinoma is unknown and mutations in the HRPT2 gene, a single locus associated with HPT- JT, seem to play a crucial role in its pathogenesis. Inactivation of the tumour suppressor gene, HRPT2, can be identified in a large number of parathyroid carcinomas and therefore, germ- line HRPT2 gene mutations may help in the screening of asymptomatic patients[5]. The most effective treatment for parathyroid carcinoma is complete resection of the primary lesion and any subsequent recurrence of disease[6,7]. Parathyroid cancer tends to recur locally at the operative site and spreads via both lymphatic and haematogenous routes. Neck ultrasound and 9. Tc- sestamibi scintigraphy are the most common imaging studies used to detect benign parathyroid adenoma but are also of value in malignant cases[8]. Ultrasound provides general information about the location of the lesion and its structure[9]; whereas, 9. Tc- sestamibi scanning can reveal abnormal and ectopic parathyroid tissue in the neck and elsewhere[1. In cases where malignancy is suspected, higher- resolution anatomical studies are of considerable value[1. Computed tomography (CT) with medium contrast can provide excellent details on the location of the lesion and its relation to other structures, and may also reveal invasion of surrounding structures and enlarged lymph nodes. On the other hand, magnetic resonance imaging (MRI) with gadolinium and fat suppression can provide the best detail of soft tissues of the neck, and can supplement further information, specifically in the setting of preoperative assessment. MRI is considered superior to CT in assessing recurrent disease, where surgical clips in the field can cause significant artefacts on CT images[1. Interest in the fusion of single photon emission CT (SPECT) and CT has increased recently, although the use of SPECT/CT has not been reported in parathyroid carcinoma to date. F- fluorodeoxyglucose positron emission tomography (FDG PET) has mainly been used in adenoma cases, and very few reports exist on its use in parathyroid carcinoma[1. The aim of this short report is to describe the impact of PET/CT in parathyroid cancer at different phases of the disease. PET/CT and image analysis. All patients involved in the study underwent whole- body 1. F- FDG PET/CT. A dedicated PET/CT scanner (Biograph 1. HR, by Siemens Medical Solutions, Illinois, United States) was used. The PET component is a high- resolution scanner with a spatial resolution of 4. The CT portion of the scanner is the Somatom Sensation 1. Together with the PET system, the CT scanner is used both for attenuation correction of PET data and for localization of 1. F- FDG uptake in PET images. All patients were advised to fast for at least 6 h before the integrated PET/CT examination. Each patient’s blood glucose level was obtained prior to tracer injection. The threshold of blood glucose level for FDG injection was below 1. L. After injection of about 3 MBq of 1. F- FDG per kilogram of body weight, the patients rested for a period of about 6. Emission images ranging from the proximal femur to the base of the skull were acquired for 2- 3 min per bed position. Acquired images were reconstructed using the attenuation weighted - ordered subset expectation maximization (OSEM) iterative reconstruction, with 2 iterations and 8 subsets. The Gaussian filter was applied to the image after reconstruction along the axial and transaxial directions. The data were reconstructed over a 1. Processed images were displayed in coronal, transverse, and sagittal planes. PET/CT images were also assessed quantitatively using the maximum standardized uptake value (SUVmax). All PET/CT scans were performed in our Institutions and two nuclear medicine specialists read all images. At visual analysis, increased FDG uptake on the basis of either highly suspicious or definite CT morphologic changes and not corresponding to physiological uptake patterns was recorded as positive for recurrence/metastases. In contrast, the absence of uptake, out of normal physiological sites, was used to define a negative PET/CT scan. The support of lesions was given by a SUVmax greater than 2. CASE REPORTStaging. Patient one: A 5. Laboratory tests showed raised serum calcium and parathyroid hormone (PTH) levels to 3. L (normal, 2. 1. 0- 2. L)and 7. 30 μg/L (normal, 8- 7. L), respectively. Neck ultrasound demonstrated the presence of an abnormal and larger left inferior parathyroid gland. A double- phase SPECT study of the neck and chest, obtained after 1. Tc- sestamibi, demonstrated no evidence to suggest a parathyroid adenoma. CT scan of the neck, thorax and abdomen demonstrated a lesion in the left inferior parathyroid gland and multiple nodules in the right lung. A confirmatory combined PET/CT scan was performed 6. Mega. Bequerel (MBq) FDG. This showed a lesion in the left parathyroid, corresponding to the enhancing nodule seen on the previous CT scan, and right plural metastasis. SUVmax at the main lesion was 1. No other FDG- avid lesions were seen in the rest of the body (Figure 1). The patient underwent left inferior parathyroidectomy with ipsilateral thyroid lobectomy and central compartment lymph node sampling. Histological biopsy of the parathyroid lesion revealed a parathyroid carcinoma (oxyphil cell carcinoma). The genetic analysis for HRPT2 mutation was negative. Staging. Right: At Maximum intensity projection the parathyroid and pleural involvements are visible; Central and left: High 1. F- Fluorodeoxyglucose- uptake is clearly displayed corresponding to the left parathyroid gland and right pleura in coronal, transverse.. Restaging. Patient two: A 6. Laboratory tests showed raised serum calcium and PTH levels (3. L and 8. 99 μg/L, respectively). A 9. 9m. Tc- sestamibi parathyroid scan reported a positive increase in tracer in the right inferior parathyroid glands between early and delayed images (Figure 2. A). He underwent right thyroid lobectomy associated with right parathyroidectomy due to intraoperative evidence of a large lesion (mean diameter 4 cm) that infiltrated adjacent structures. The histological analysis revealed a right parathyroid carcinoma that infiltrated the nearest organs (thyroid gland and omolateral recurrent nerve). Three months after surgery, laboratory tests showed a reduction in calcium (2. L) and PTH levels, although higher than the normal value (9. L). A second 9. 9m. Squid's Visit | Encyclopedia Sponge. Bobia. Episode Information [edit]"Squid's Visit" is a Sponge. Bob Square. Pants episode from season six. In this episode, Sponge. Bob tries to get Squidward to visit him. Characters. Synopsis. The episode opens with the employees at the Krusty Krab doing nothing as the restaurant closes. Squidward says he has nothing to do tonight. Sponge. Bob really wants Squidward to visit his house, but Squidward does not want to. He says that he prefers the comfort of his own home over Sponge. Bob's "dirty little hovel." At the pinapple, Patrick suggests to Sponge. Bob to "borrow" something of Squidward's to make him come to the house to get it back. This gives Sponge. Bob an idea. While Squidward is cooking, Sponge. Bob steals his vaccum cleaner in order for him come to the pineapple to get it back. Squidward puts his dinner in the oven and then comes to Sponge. Bob's house and sees, to his shock, that Sponge. Bob made an exact replica of his living room. Squidward is now getting very annoyed and demands his vacuum, but Sponge. Bob ignores him, trying to do everything he can to ensure Squidward stays. Squidward sits on the exact replica of his chair and sees his coffee table, his food, his Art of the Clarinet book, and his pillow Sponge. Bob was fluffing. It looks like the one Squidward's Mother made for him. Then Squidward sees his hallway, and he sees the chip in the painting from when he moved into his own house. Then he walks into his bathroom. He sees his medicine cabinet and his rash cream. But when Sponge. Bob shows up, Squidward screams and he slips on the rash cream too many times and his head falls into the toilet, knocking himself out. Squidward wakes up and thinks he had a dream about himself visiting Sponge. Bob, but much to his horror, he isn't dreaming. Squidward screams in anguish. He lies to Sponge. Bob that he has to go to the bathroom again, but instead, he runs upstairs, looking for his vacuum cleaner. When Squidward opens the door and turns on the light, he finds out he is in the gallery room and spots all 4. Squidward becomes scared, but then he gets mad. He looks for the vacuum cleaner in the closet and finds it, but it is stuck in the closet. Squidward pulls it until his vacuum comes out. The vacuum hits Squidward and he crashes into the wall, tilting his self- portraits. He falls down the stairs, and he spits out the vacuum. He then walks out of Sponge. Bob's house, but when he goes outside, he realizes that his house had vaporized due to a fire. Squidward had forgotten to bring the casserole which was later on fire and caused Squidward's house to burn up. Sponge. Bob then tells Squidward to stay at his house. Squidward imagines what it would be like. He winds up staying at the pineapple with him indoors and Sponge. Bob and Gary sleeping outside. Production. Music( ‣ ) Associated production music( • ) Original music( ◦ ) Sponge. Bob music ‣ Wahini Wobble - Nicolas Carr, Sage Guyton, Jeremy Wakefield [title card]‣ Nautical Hijinx - Nicolas Carr, Barry Anthony [opening]‣ Nude Sting - Nicolas Carr [Squidward leaves quickly]‣ Hello Blues - Sage Guyton, Jeremy Wakefield [Sponge. Bob wants Squidward to visit him]‣ Hawaiian Cocktail - Richard Myhill [Sponge. Bob crying]‣ Steel Sting - Jeremy Wakefield [2. Comic Walk - Sidney Torch [Squidward refuses to visit Sponge. Bob]‣ Lap Steel - Nicolas Carr [Hawaiian sting]‣ Bashful Eyes - Kapono Beamer [Sponge. Bob asks Patrick if Squidward's ever visited his house]‣ Harp Ding - Nicolas Carr ["That's it!"]‣ Fruity Flute - Harry Bluestone [Squidward making a casserole]‣ The Jitters - Raymond C. Jones [pepper shaker flies through air]‣ Comic Walk - Nicolas Carr ["Not on the rug!"]‣ Tension Bits - Nicolas Carr, Sage Guyton, Jeremy Wakefield [Sponge. Bob "borrowed" Squidward's vacuum cleaner]‣ The Pollywog Strut - Nicolas Carr, Barry Anthony [Squidward calls Sponge. Bob]‣ Dramatic Impact 2 - Ivor Slaney [Squidward gasps]‣ Boring Morning - Nicolas Carr, Steve Marston [exact replica of Squidward's living room]‣ Unease - Dick Stephen Walter ["How did he do it?"]‣ Romantic Ending [#3. Harry Bluestone, Emil Cadkin [stitch signature]‣ Drama Link (b) - Hubert Clifford [Squidward screams]‣ Steel Sting (a) - Jeremy Wakefield ["I'll find the vacuum myself."]‣ The Creature (b) - Gregor F. Narholz [replica of Squidward's hallway]‣ Drama Link (c) - Hubert Clifford ["Okay, Squiddy, don't get creeped out."]‣ Cockney Capers - Ray Davies* [replica of Squidward's bathroom]‣ Grass Skirt Chase - Sage Guyton, Jeremy Wakefield [rash cream]‣ Mists of Illusion - Gilbert Vinter [Squidward knocked out]‣ Vibe Sting - Nicolas Carr [Squidward wakes up]‣ Lap Steel - Nicolas Carr ["So, are you enjoying your stay at Chez Sponge?"]‣ Tales from the Swamp (c) - Ron Goodwin [Squidward screams]‣ Cartoon Sting 1 - "Will you excuse me for a moment?"‣ Chinese Mystery - Nino Nardini ["I got to find that vacuum and get out of here!"]‣ Drama Link (d) - Hubert Clifford [Squidward screams]‣ Old Creepy Feeling - John Scott ["He copied all 4. Tension Bits - Nicolas Carr, Sage Guyton, Jeremy Wakefield [".. Old Creepy Feeling - John Scott ["He even got the rug right."]‣ Cartoon Sting 2 - Squidward finds his vacuum cleaner‣ Cartoon Sting 1 - Squidward's vacuum cleaner gets caught in his mouth‣ Solo Steel - Jeremy Wakefield [Squidward's house burned down]‣ Shock (f) - Dave Hewson [Squidward begins to get crazy]‣ Musical Box (c) - Dave Hewson [Squidward goes crazy]‣ Scary Strings 3 - Harry Bluestone, Emil Cadkin ["Care for some casserole?"]‣ Steel Licks (d) - Jeremy Wakefield ["Squidward, you okay?"]‣ Solo Steel 4 - Jeremy Wakefield ["Replica sweet replica."]‣ Steel Licks - Jeremy Wakefield [ending]Release. Reception. I can turn into a skyscraper! This section is too short. You can help the Encyclopedia Sponge. Bobia by expanding it. Trivia. Timeline. After "Help Wanted," "Tea at the Treedome," "Scaredy Pants," "Life of Crime," "Krusty Love," "Sailor Mouth," "The Curse of Bikini Bottom," and "Enchanted Tiki Dreams". Before "Nature Pants," "Squeaky Boots," "The Chaperone," "I Was a Teenage Gary," "SB- 1. Sleepy Time," "Can You Spare a Dime?," "Party Pooper Pants," "Sponge. Bob Meets the Strangler," "Patrick Smart. Pants," "Whale of a Birthday," "New Digs," "Breath of Fresh Squidward," "Not Normal," "Pineapple Fever," "That Sinking Feeling," "A Friendly Game," "Fiasco!," "Patrick Star Checks His Instaclam," and possibly "House Fancy" and "Salsa Imbecilicus". Possibly in Summer. Timecards. This was the fourth episode to premiere during the Nickelodeon's "Deep Sea Danger Zone" marathon. The episode's title card's background is the color of Sponge. Bob's house, while the wording is the color of Squidward's house. The title card for this episode is very similar to "Pineapple Fever.". There are two games based on the episode that can be played online. The games are Cook It n' Book It and Squidward's Sizzlin' Scare which are are based on looking for the vacuum and the burning casserole. Sponge. Bob invites Squidward to visit "La Casa de Esponja" and Bob Esponja is Sponge. Bob's Spanish name. Sponge. Bob and Squidward's shift ends in clear daylight in this episode, although in earlier episodes, such as "Pizza Delivery" and "Graveyard Shift," their shift ends close to sunset. However, this may be a day with different hours or simply a longer day. Sponge. Bob claims that Squidward had never been to his house, despite him entering his house on several occasions. Squidward, along with Sandy, Patrick, and Mr. Krabs, go to his house to welcome him home in "Nature Pants.". Squidward comes in to feed Gary in "I Was a Teenage Gary.". Squidward comes in along with other Bikini Bottomites to complain about Sponge. Bob's presence in their dreams in "Sleepy Time.". In "Can You Spare a Dime?," he enters Sponge. Bob's house so he can stay there for as long as he wanted. Squidward goes to Sponge. Bob's parties at his home in two episodes, "Party Pooper Pants" and "Sponge. Bob Meets the Strangler.". In "That Sinking Feeling," he enters Sponge. Bob's house to see where the noise he was hearing was coming from. In "Earworm," he enters Sponge. Bob's house to stop Sponge. Bob's earworm problem. Squidward comes in to complain about Sponge. Bob and Patrick's loudness while they are playing golf in "A Friendly Game.". In "Fiasco!," he comes in with the Police to complain about Sponge. Bob's, Patrick's, and Plankton's behaviors. In "Don't Look Now" he enters Sponge. Bob's home to scare him and Patrick, although they did not know it was him.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
November 2017
Categories |