{"title":"Grading of skull base meningiomas by combined perfusion: arterial spin labeling and T2* dynamic susceptibility perfusion","authors":"Lamya Eissa, Omneya Gamaleldin, Mohamed Hossameldin Khalifa","doi":"10.1186/s43055-024-01275-2","DOIUrl":"https://doi.org/10.1186/s43055-024-01275-2","url":null,"abstract":"Conventional MRI has no distinction between high- and low-grade meningiomas, which has a crucial for choice of therapeutic plan, especially skull base meningiomas which need more meticulous endoscopy-approached surgery. The aim of our study was to evaluate role of perfusion by arterial spin labeling and dynamic susceptibility perfusion in grading of skull base meningiomas. The relative arterial spin labeling (ASL), tumor blood flow (TBF), and tumor blood volume (TBV) ratios showed significant differences between low- and high-grade meningiomas. MRI perfusion is a useful in differentiation between low- and high-grade meningiomas. There is significant correlation between ASL and DSC perfusion supporting possibility of using ASL in clinical practice as an alternative technique to DSC perfusion, particularly for patients with renal impairment where no contrast injection needed.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"52 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141152145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asmaa Ahmed Abdelzaher, Mohamed Yehia Ahmed Elbarmelgi, Hatem Mohamed Said El Azizi, Alaa Sayed Mohamed, Mohamed A. Abdelatty, Heba Allah Mounir Azzam
{"title":"3D endoanal ultrasound versus external phased array MRI in detection and evaluation of anal sphincteric lesions","authors":"Asmaa Ahmed Abdelzaher, Mohamed Yehia Ahmed Elbarmelgi, Hatem Mohamed Said El Azizi, Alaa Sayed Mohamed, Mohamed A. Abdelatty, Heba Allah Mounir Azzam","doi":"10.1186/s43055-024-01270-7","DOIUrl":"https://doi.org/10.1186/s43055-024-01270-7","url":null,"abstract":"The anal sphincteric complex is formed by internal and external sphincters making two partially overlapping tubes around the anal canal. Anal sphincteric lesions represent a spectrum of entities with different patients’ presentations and surgical managements. Endoanal ultrasound has an increasing role in detection and evaluation of anal sphincteric lesions as compared to MRI of the anal canal. The aim of this work was to compare between the 3D EAUA and external phased array MRI in detection and evaluation of anal sphincteric lesions. There is almost perfect agreement of 97.92% (Κw = 0.972) between 3D EAUS and external phased array MRI in the detection of the internal anal sphincter lesions and fair agreement of 66.67% (Κw = 0.37) in the detection of the external anal sphincteric lesions. 3D EAUS and external phased array MRI are comparable imaging techniques in the detection of the internal anal sphincter lesions, while the MRI could detect more external sphincteric lesions than EAUS.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"26 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140942534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Naglaa Sabry El-Sawy Deif Allah, Randa Hossein Abdallah, Mohammed Sobhi Hassan, Suzan Farouk Ibrahim
{"title":"Role of diffusion weighted imaging with background body signal suppression (DWIBS) in diagnosis of breast masses and correlation with histopathological findings","authors":"Naglaa Sabry El-Sawy Deif Allah, Randa Hossein Abdallah, Mohammed Sobhi Hassan, Suzan Farouk Ibrahim","doi":"10.1186/s43055-024-01260-9","DOIUrl":"https://doi.org/10.1186/s43055-024-01260-9","url":null,"abstract":"Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is the important tool in breast imaging. However, two major limitations are represented by its specificity and by the injection of contrast material. Diffusion weighted imaging (DWI) provides important functional information without the need for contrast material. A newly introduced diffusion weighted imaging with background suppression (DWIBS) sequence is an accurate and rapid tool for the identification and characterization of breast lesions, with its short examination time, high lesion-to-background contrast and lack of need for intravenous contrast agents. To assess the role of DWIBS sequence in the evaluation of indeterminate and suspicious breast masses and to compare its accuracy with DCE-MRI in correlation with histopathological findings. Thirty-five patients were included in the study, referred from sono-mammography clinic to MRI unit for further MRI assessment of probably benign, suspicious and malignant looking breast masses (BIRADS 3, BIRADS 4 & BIRADS 5) on sono-mammography imaging results. MRI breast protocol which included DCE-MRI and DWIBS sequences were obtained for characterization and were verified by core needle biopsy or excisional biopsy. The results were statistically analyzed. Sensitivity, specificity, diagnostic accuracy (DA), positive predictive value (PPV) and negative predictive value (NPV) were calculated for DCE-MRI and DWIBS. Apparent diffusion co-efficient (ADC) values were calculated with ADC ≤ 1.2 × 10−3 mm2/s was considered suspicious for malignancy. The results were then compared with the histological findings. Thirty-five female patients had 39 breast masses included in our study. By DCE-MRI, 8 (20.5%) masses were categorized as benign and 31(79.5%) masses were categorized as malignant. By DWIBS sequence, 7 (17.9%) masses were categorized as benign and 32 (82.1%) masses were categorized as malignant. By histopathology, 14 (35.9%) masses were benign and 25 (64.1%) masses were malignant. DCE-MRI obtained accuracy, sensitivity, specificity, PPV and NPV values of 84.6, 100, 57.1, 80.6 and 100%, respectively. DWIBS sequences obtained accuracy, sensitivity, specificity, PPV and NPV values of 82.1, 100, 50, 78.1and 100%, respectively. DWIBS can be added to DCE-MRI, as complementary tool to make radiologist more confident about the diagnosis. It can also be used instead of DCE-MRI sequences in certain circumstances such as in cases of renal impairment.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"23 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140931770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dalia Bayoumi, Farah Ahmed Shokeir, Rasha Karam, Aya Elboghdady
{"title":"Validity of dynamic contrast-enhanced magnetic resonance imaging of the breast versus diffusion-weighted imaging and magnetic resonance spectroscopy in predicting the malignant nature of non-mass enhancement lesions","authors":"Dalia Bayoumi, Farah Ahmed Shokeir, Rasha Karam, Aya Elboghdady","doi":"10.1186/s43055-024-01267-2","DOIUrl":"https://doi.org/10.1186/s43055-024-01267-2","url":null,"abstract":"Breast cancer is the commonest cancer affecting women worldwide. So, it is important to accurately detect and classify different breast lesions. Noninvasive methods for tissue characterization have increased interest, particularly for early diagnosis. Non-mass enhancement (NME) breast lesions are described in magnetic resonance imaging (MRI) as the presence of enhancement without space-occupying lesions. Several studies have described that certain characteristics can be used as new indicators of malignancy in breast NME lesions. We aimed to study the role of multiparametric-MRI (Mp-MRI) as diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) in assessment of NME lesions and to suggest which one offers the greatest diagnostic accuracy. This retrospective study was conducted from March 2017 to December 2023 on 220 NME breast lesions. All lesions were analyzed to study the features of benign and malignant NME lesions using different MRI techniques including dynamic contrast-enhanced MRI (DCE-MRI), DWI, and MRS. Breast MRI was performed at 1.5 Tesla, findings were correlated with histopathological results of all cases. Patients’ mean age was 46.56 years with 220 NME breast lesions (54 were benign and 166 were malignant). Invasive ductal carcinoma with ductal carcinoma in situ was the most malignant type representing 93 cases. We found that segmental distribution, heterogeneous enhancement, type III curve, restricted diffusion, lower apparent diffusion coefficient, and positive choline peak were more with malignancy (P = 0.008, 0.02, 0.004, 0.001, and < 0.001). We detected that Mp-MRI has higher diagnostic accuracy than DCE-MRI and combined other functional sequences (DWI, MRS), it was 91.2% with sensitivity 89.9%, specificity 87.8%, positive predictive value 89.2%, and negative predictive value 82.2%. Functional MRI techniques, such as DWI and MRS, can provide helpful information in assessment of NME lesions. They have high diagnostic accuracy, sensitivity, and specificity in characterizing NME breast lesions as benign or malignant. However, DCE-MRI is mandatory for lesion characterization and delineation of its nature and cannot be replaced by them alone in cases of lesion visualization. So, multiparametric-MRI can improve the diagnostic accuracy of NME breast lesions when combined with dynamic contrast-enhanced MRI and can help in reducing negative biopsy rates.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"130 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140931834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Investigating white matter changes in auditory cortex and association fibres related to speech processing in noise-induced hearing loss: a diffusion tensor imaging study","authors":"Mohd Khairul Izamil Zolkefley, Norhidayah Abdull, Rajeev Shamsuddin Perisamy, Muzaimi Mustapha, Daud Adam, Muhamad Ariff Muhamad Noordin","doi":"10.1186/s43055-024-01266-3","DOIUrl":"https://doi.org/10.1186/s43055-024-01266-3","url":null,"abstract":"This study explores the impact of noise-induced hearing loss (NIHL) on the microstructural integrity of white matter tracts in the brain, focusing on areas involved in speech processing. While the primary impact of hearing loss occurs in the inner ear, these changes can extend to the central auditory pathways and have broader effects on brain function. Our research aimed to uncover the neural mechanisms underlying hearing loss-related deficits in speech perception and cognition among NIHL patients. The study included two groups: nine bilateral NIHL patients and nine individuals with normal hearing. Advanced diffusion tensor imaging techniques were employed to assess changes in the white matter tracts. Regions of interest (ROIs), including the auditory cortex, cingulum, arcuate fasciculus, and longitudinal fasciculus, were examined. Fractional anisotropy (FA) values from these ROIs were extracted for analysis. Our findings indicated significant reductions in FA values in NIHL patients, particularly in the left cingulum, right cingulum, and left inferior longitudinal fasciculus. Notably, no significant changes were observed in the auditory cortex, arcuate fasciculus, superior longitudinal fasciculus, middle longitudinal fasciculus, and right inferior longitudinal fasciculus, suggesting differential impacts of NIHL on various white matter tracts. The study's findings highlight the importance of considering association fibres related to speech processing in treating NIHL, as the broader neural network beyond primary auditory structures is significantly impacted. This research contributes to understanding the neurological impact of NIHL and underscores the need for comprehensive approaches in addressing this condition.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"147 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140931772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neeti Ajay Gupta, Anjitha Subash, Rucha P. Bhalde, Avinash A. Gutte
{"title":"Dynamic vertebral artery occlusion aka bow hunter syndrome causing posterior fossa stroke in a young adult: a case report","authors":"Neeti Ajay Gupta, Anjitha Subash, Rucha P. Bhalde, Avinash A. Gutte","doi":"10.1186/s43055-024-01265-4","DOIUrl":"https://doi.org/10.1186/s43055-024-01265-4","url":null,"abstract":"Bow Hunter syndrome (BHS) is a rare, but important cause of posterior circulation stroke. It is also known as Rotational vertebral artery syndrome and is caused by transient dynamic vertebro-basilar insufficiency on movement of the neck in the presence of certain soft tissue or bone anomalies in the cranio-vertebral region. We present a case of Bow hunter syndrome in an 18-year-old adult male who presented with vomiting, occipital headache and loss of balance, with findings of posterior circulation stroke on imaging. Medical causes of young stroke, including vasculitis and clotting disorders were ruled out, following which a diagnostic conventional angiography and CT angiography was performed. The cause of vascular compromise in our case was the presence of vertebral anomalies, in particular, the presence of a partial ponticulus posticus with formation of an incomplete arcuate foramen. He was treated with cervical spine immobilisation and C1–C2 fixation. In addition, our patient had a single posterior inferior cerebellar artery (PICA) on the side of the dynamic insufficiency, which lead to bilateral cerebellar infarcts. Our case is unique because it demonstrates a combination of osseous and vascular developmental anomalies resulting in posterior circulation stroke. Though uncommon, BHS should be considered in the list of differentials in otherwise unexplained cases of posterior circulation stroke. Conventional angiography with dynamic manoeuvres is the modality of choice for documenting the rotational vertebral artery occlusion.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"152 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140889584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pushpak N. Patil, Rajendra Chavan, Shivani S. Borse
{"title":"Correction: Imaging in a rare case of cerebral phaeohyphomycosis caused by Cladophialophora bantiana in a renal transplant patient: a case report and the literature review","authors":"Pushpak N. Patil, Rajendra Chavan, Shivani S. Borse","doi":"10.1186/s43055-024-01263-6","DOIUrl":"https://doi.org/10.1186/s43055-024-01263-6","url":null,"abstract":"<p><b>Correction to: Patil et al. Egypt J Radiol Nucl Med 55: 59 (2024). </b><b>https://doi.org/10.1186/s43055-024-01229-8</b></p><br/><p>Following the publication of the original article, a typesetting error caused an incorrect reference in the abstract. The first sentence of the Abstract reads: Cerebral phaeohyphomycosis is a rare and potentially life-threatening fungal infection caused by dematiaceous fungi (Nosanchuk and Casadevall in Antimicrob Agents Chemother 50(11):3519–3528, 2006).</p><br/><p>The correct reference is as follows:</p><br/><p>Cerebral phaeohyphomycosis is a rare and potentially life-threatening fungal infection caused by dematiaceous fungi (Levin TP, Baty DE, Fekete T, Truant AL, Suh B. Cladophialophora bantiana brain abscess in a solid-organ transplant recipient: Case report and review of the literature. J Clin Microbiol. 2004;42(9):4374–4378. https://doi.org/10.1128/jcm.42.9.4374-4378.2004).</p><p>The original article has been corrected.</p><h3>Authors and Affiliations</h3><ol><li><p>Department of Radiology, King Edward Memorial Hospital, Pune, Maharashtra, India</p><p>Pushpak N. Patil & Shivani S. Borse</p></li><li><p>Anushka MRI & CT Scan Center, King Edward Memorial Hospital, Pune, Maharashtra, India</p><p>Rajendra Chavan</p></li><li><p>Department of Radiodiagnosis, Healthway Hospital, Old Goa, Goa, 403 110, India</p><p>Pushpak N. Patil</p></li></ol><span>Authors</span><ol><li><span>Pushpak N. Patil</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Rajendra Chavan</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li><li><span>Shivani S. Borse</span>View author publications<p>You can also search for this author in <span>PubMed<span> </span>Google Scholar</span></p></li></ol><h3>Corresponding author</h3><p>Correspondence to Pushpak N. Patil.</p><h3>Publisher's Note</h3><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p><p><b>Open Access</b> This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.</p>\u0000<p>Reprints a","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140889490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara T. Alharbi, Mona Alrehaili, Ahmed Alhujaily, Aysam Adnan Almashni, Abdulrahman Almughathawi
{"title":"Unusual location of pleomorphic xanthoastrocytoma: a case report","authors":"Sara T. Alharbi, Mona Alrehaili, Ahmed Alhujaily, Aysam Adnan Almashni, Abdulrahman Almughathawi","doi":"10.1186/s43055-024-01262-7","DOIUrl":"https://doi.org/10.1186/s43055-024-01262-7","url":null,"abstract":"Pleomorphic xanthoastrocytoma is a rare astrocytic tumor often diagnosed at a young age. Typically, they appear as supratentorial cortical tumors, frequently involving the temporal lobe with few reported rare locations. The prognosis is favorable following surgical excision; however, recurrence, dissemination, and anaplastic transformation occurred in some cases. A 50-year-old female presented with convulsions and an altered consciousness. Imaging showed a periventricular mixed solid and cystic lesion. Histopathological examination revealed features of pleomorphic xanthoastrocytoma WHO grade 2 without necrosis or mitotic activity. This report highlights the classic imaging findings of pleomorphic xanthoastrocytoma but in an atypical periventricular location. Although rare, pleomorphic xanthoastrocytoma should be considered in the differential diagnosis of mixed solid and cystic periventricular lesions.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"11 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140889614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epiglottis calcification: forgotten cause of dysphagia in elderly population","authors":"Namdev Seth, Dushyant Varshney, Saumya Verma","doi":"10.1186/s43055-024-01264-5","DOIUrl":"https://doi.org/10.1186/s43055-024-01264-5","url":null,"abstract":"Dysphagia is a relatively common clinical issue in elderly population with numerous causes, which are divided into oropharyngeal and substernal categories. Most of the causes of dysphagia can be diagnosed easily with clinical and radiological examinations. However, we encountered a rare cause of dysphagia in an elderly patient, which can be missed easily during diagnostic workup, that entity is epiglottis calcification. A 91-year-old male presented with complaints of recurrent aspirations and difficulty in swallowing. Physical examination revealed no abnormalities in the oral cavity, pharynx and nose. Flexible fiberoptic laryngoscopic examination was performed, which mildly swollen and posteriorly moved epiglottis with limited mobility during swallowing. Computed tomography scan of the larynx revealed significant asymmetric amorphous calcification of the free edge of the aryepiglottic, pharyngoepiglottic, and epiglottis folds. Although dysphagia is a common problem in elderly, it has serious complications such as recurrent aspirations, pneumonia and nutritional deficiency. One of the rare causes of dysphagia in elderly is epiglottic calcifications, which impairs its flexibility and the functionality, and may predispose to difficulty in swallowing and recurrent aspirations.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"66 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140889583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohamed Elgazzar, Tary Salman, Eman Abdelsameea, Mohamed Akl, Nabil Omar, Mohamed Abdel-Samiee, Shrif Abas, Mohmoud Elsakhawy, Ahmed Elsherif, Ibrahim Abdelkader, Dina Elazab, Nermine Ehsan, Mohamed Mohamady, Mohamed El-Kassas, Hazem Metwaly Omar
{"title":"Hepatocellular carcinoma in hepatitis C virus patients treated with direct acting antivirals (DAAs) and patients not exposed to DAAs: a large center comparative study","authors":"Mohamed Elgazzar, Tary Salman, Eman Abdelsameea, Mohamed Akl, Nabil Omar, Mohamed Abdel-Samiee, Shrif Abas, Mohmoud Elsakhawy, Ahmed Elsherif, Ibrahim Abdelkader, Dina Elazab, Nermine Ehsan, Mohamed Mohamady, Mohamed El-Kassas, Hazem Metwaly Omar","doi":"10.1186/s43055-024-01249-4","DOIUrl":"https://doi.org/10.1186/s43055-024-01249-4","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the first cause of cancer in Egypt. Recently, HCC developed post direct-acting antivirals (DAAs) differ in some characteristics from those developed without DAAs exposure regarding the biological features and behavior of HCC. We aimed to assess the epidemiological, clinical, laboratory, and radiological findings besides the biological behavior of HCC patients post DAAs in comparison to HCC not exposed to DAAs. An analytic cross-sectional research was performed at the National Liver Institute which is a tertiary multidisciplinary HCC center. Subjects included hepatitis C virus patients and were allocated into two groups: group I included 2036 HCC cases post-DAA treatment and group II included 6338 HCC cases who did not receive DAAs. Subjects were examined to evaluate clinical, laboratory, and radiological findings. Tumor staging was done using the BCLC staging system. Group II showed a more advanced Child–Pugh score, FIB-4 index, and MELD score than Group I (P = 0.001). The multiplicity of hepatic focal lesions was elevated in group I than in group II (P = 0.033). AFP level was significantly elevated in group I than in group II (p = 0.012). Portal vein invasion was significantly elevated in group I than in group II patients (P = 0.001). Extrahepatic spread of HCC was significantly elevated in group I than in group II (P = 0.001). Infiltrative lesions were significantly elevated in group I than in group II (P = 0.002). Our study detected that the behavior in HCC post DAAs treatment is more aggressive in respect of the number of lesions, PV invasion; local and distant metastasis, and serum AFP level than in patients unexposed to DAAs. Strict surveillance in cirrhotic patients treated with DAA should be followed according to the international guidelines for early diagnosis and treatment of HCC.","PeriodicalId":11540,"journal":{"name":"Egyptian Journal of Radiology and Nuclear Medicine","volume":"116 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}