Moranchel GL, Pineda GLF, Casarrubias RM

Language: Spanish
References: 15
Page: 107-120
PDF size: 237.07 Kb.

ABSTRACT

Objective: To determine the diagnostic performance of computed tomography (CT) as part of the study protocol of patients with unexplained weight loss.
Materials and Methods: Cohort, ambispective study was made in the department of Internal Medicine, Specialty Hospital Antonio Fraga Mouret, CMN La Raza, Mexico City, in patients with unexplained weight loss recorded in the database during 9 years. A descriptive analysis with frequency distribution of variables was performed and sensitivity, specificity and predictive values were calculated, as well as χ² for the evaluation and comparison of the diagnostic performance of CT.
Results: The CT has a sensitivity and specificity greater than 80%, so it is considered useful to guide a firm diagnosis; mainly in the group of patients with high suspicion of malignancy. If the cause is organic, non-malignant, it is considered a very specific (100%) study enabling us to rule out disease in those subjects with any finding.
Conclusions: The advantages of computed tomography allow it to be validated as the imaging study in unexplained weight loss that provides the most data to the final diagnosis.

REFERENCES

1. Jia-Min Wu, Ming-Hsien Lin, Li-Ning Peng, Liang-Kung Chen,et al. Evaluating diagnostic strategy of older patients withunexplained unintentional body weight loss: A hospitalbasedstudy. Arch Gerontol Geriatrics 2011; 53: e51-e54.doi.org/10.1016/j.archger.2010.10.016.

2. Bilbao-Garay J, Barba R, Losa-García JE, Martin H, et al.Assessing clinical probability of organic disease in patientswith involuntary weight loss: a simple core. Eur L InternMed 2002; 13: 240-45. https://doi.org/10.1016/s0953-6205(02)00032-8.

3. Hernández JL, Riancho JA, Matorras P, González-Macías J.Clinical evaluation for cancer in patients with involuntaryweight loss without specific symptoms. Am J Med 2003; 114:631-637. https://doi.org/10.1016/s0002-9343(03)00115-3.

4. Lankisch P, Gerzmann M, Gerzmann J.F, Lehnick D.Unintentional weight loss: diagnosis and prognosis. Thefirst prospective follow-up study from a secondary referralcenter. J Intern Med 2003; 249: 41-46. https://doi.org/10.1046/j.1365-2796.2001.00771.x.

5. Bouras E.P, Lange S.M, Scolapio J.S. Rational approach topatients with unintentional weight loss. Mayo Clin Proc2001; 76: 923-929. doi: 10.4065/76.9.923.

6. Chang JL, Katz PR, Ambrose P. Weight loss in nursing patient:prognostic implications. J Fam Pract 1990; 30: 671-674.

7. Rolland Y, Kim MJ, Gammack JK. Office management ofweight loss in older persons. Am J Med 2006; 119: 1019-1026. doi: 10.1016/j.amjmed.2006.02.039.

8. Vanderschueren S, Geens E, Bobbaers H. The diagnosticspectrum of unintentional weight loss. Eur J Int Med 2005;16: 160-164. doi: 10.1016/j.ejim.2005.01.004.

9. Alibhai S, Greenwood C, Payerre H. An approach to themanagement of unintentional weight loss in elderlypeople. Can Med Assoc J 2005; 172: 773-780. doi: 10.1503/cmaj.1031527.

10. Prado CMM, Birdsell LA, Baracos VE. The emerging role ofcomputerized tomography in assessing cancer cachexia.Curr Op Support Palliat Care 2009; 3: 269-275. doi:10.1097/SPC.0b013e328331124a.

11. Basu S, Mallath M. Understanding and fighting cancer cachexiasyndrome: can PET help? Nucl Med Commun 2012;33: 671-672. doi: 10.1097/MNM.0b013e328352216f.

12. Shen W, Chen J, Gantz M, Velasquez G, et al. A single MRIslice does not accurately predict visceral and subcutaneousadipose tissue changes during weight loss. Obesity(Silver Spring) 2012; 20 (12): 2458-63. doi: 10.1038/oby.2012.168.

13. McGrath CL, Kelley ME, Holtzheimer PE, Dunlop BW,Craighead WE, et al. Toward a neuroimaging treatmentselection biomarker for major depressive disorder. JAMAPsychiatry 2013; 70(8):821-9. doi: 10.1001/jamapsychiatry.2013.143.

14. American Cancer Society: Cancer Facts and Figures 2013.Atlanta, Ga: American Cancer Society, 2013.

15. Mawlawi O, Townsend DW. Multimodality imaging: anupdate on PET/CT technology. Eur J Nucl Med Mol Imaging2009; 36 Suppl 1: S15-29. doi: 10.1007/s00259-008-1016-6.