Impact of Fdgpet on Patient Management

FDG-PET imaging allows the detection of unsuspected metastases in 13% to 36% of patients and has a clinical impact in 14% to 65%.267,268,270,272,273,275-279

In the study by Delbeke et al.,267 PET altered surgical management in 28% of the patients, in one-third by initiating surgery and in two-thirds by avoiding surgery.

Meta et al.280 analyzed the answers to questionnaires that were sent to 60 referring physicians and concluded that PET had an impact on the clinical management in 65% of their patients (80% upstaged and 20% downstaged). In a study of 51 patients Ruers et al.281 found that clinical management decisions based on conventional diagnostic methods were changed in 20% of patients based on the findings of FDG-PET imaging, especially by detecting unsuspected extrahepatic disease.

Strasberg et al.282 demonstrated a higher long-term overall survival (OS) at 3 years (70%) and higher disease-free rates in patients selected for curative resection who had a PET study than those who did not have PET included in their workup (30% to 64%).

Current PET/CT fusion images can further affect clinical management283-287 by guiding therapy toward a less invasive and more efficient surgical procedure or by guiding a biopsy to an FDG-avid region of the tumor. Additionally, it can provide better maps than CT alone to modulate the field and dose of radiation therapy.

A Disquistion On The Evils Of Using Tobacco

A Disquistion On The Evils Of Using Tobacco

Among the evils which a vitiated appetite has fastened upon mankind, those that arise from the use of Tobacco hold a prominent place, and call loudly for reform. We pity the poor Chinese, who stupifies body and mind with opium, and the wretched Hindoo, who is under a similar slavery to his favorite plant, the Betel but we present the humiliating spectacle of an enlightened and christian nation, wasting annually more than twenty-five millions of dollars, and destroying the health and the lives of thousands, by a practice not at all less degrading than that of the Chinese or Hindoo.

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