Tumors diagnosis

Unfortunately, the reality of the situation is not so simple. However large the arsenal of weapons that clinicians may have at their disposal, there are more than 40 kinds of tumors that cannot be cured at all nowadays by any medical approach. Thus, for such tumors, diagnosis means unstoppable slides to death. The situation is scarcely better for about 40 other tumors, mainly when they are so spread out over the whole body that surgery and radiotherapy cannot be used, so that chemotherapy and immunotherapy have to be employed. 

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The most common malignancy associated with PEM is SCLC [32], but several other tumors have also been associated with PEM [32,38,39]. The Hu antibody is the most common associated antibody, but several other antibodies are found in isolated PEM (Table 1). In the majority of cases, PEM precedes the tumor diagnosis, but when the cancer is already acknowledged, PEM often predicts tumor progression or relapse [32]. 

Linke R, Schroeder M, Helmberger T, Voltz R. Antibody-positive paraneoplastic neurologic syndromes Value of CT and PET for tumor diagnosis. Neurology 2004 63(2) 282-286. 

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MR specdoscopy is used extensively in clinical praedee to help cUfferendate tumor fi om non-tumor lesions in the brain. The Cho/Cr and NAA/Cho rados can be udlized to help accomplish this task (Poptani et al., 1995 Moller-Hartmann et al., 2002). Increased Cho/Cr and decreased NAA/Cho are posidve inkUcadons of a brain tumor (Poptani et al., 1995 Moller-Hartmann et al., 2002). The lipid and lactate peaks are more variable in tumor and non-tumor lesions but can also aid in tumor diagnosis. There are a number of disease processes, such as muldple sclerosis plaques, that cannot always be cUf-ferendated by specdoscopy fi om a brain tumor. 

There are several methods, visual, quantitative, and semiquantitative, to determine the tumor uptake of FDG. Visual assessment is commonly used in tumor diagnosis and staging, and is based on differences in contrast between tumor and adjacent tissue. This is a simplified method requiring only a single static image at a set time after injection and can be equally applied to assess the therapeutic response of the tumor. In the visual technique, it is important to adjust the image intensities of the tumor and adjacent tissues to the same gray or color scale. 

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Holzinger A, Dingle S, Bejarano PA, et al. Monoclonal antibody to thyroid transcription factor-1 production, characterization, and usefulness in tumor diagnosis. Hybridoma. 1996 15 49-53. 

Miettinen M, Fetsch JF. Distribution of keratins in normal endothelial cells and a spectrum of vascular tumors implications in tumor diagnosis. Hum Pathol. 2000 31 1062-1067. 

Ordonez NG. Application of mesothelin immunostaining in tumor diagnosis. Am Surg Pathol. 2003 27 1418-1428. 

McKeever PE. Laboratory methods in brain tumor diagnosis. In Nelson JS, Mena H, Parisi J, et al, eds. Principles and Practice of Neuropathology. 2nd ed. New York Oxford University Press 2003 272-297. 

Ginj, M., and Maecke, H.R. (2004) Radiome-tallo-labeled peptides in tumor diagnosis and therapy, Met Ions Biol Syst 42, 109-142. 

Besides the merits of coordination complexes for diagnostic imaging, few applications of tumor diagnosis are in clinical use. The need for radiotracers binding specifically to epitopes expressed on tumor cells has grown over the past decade, promoting new labeling techniques, by which technetium is attached to biomolecules. 

Among the chelate units used for peptide labeling, the Tc-HYNIC and Tc-tricarbonyl cores have gained importance. A freeze-dried kit formulation for the preparation of " Tc-EDDA-HYNlC-D-Phe(l), Tyr(3)-octreotide, another somatostatin analog for tumor diagnosis, has recently been published (von Guggenberg et al. 2004). 

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