The Egyptian Journal Nuclear Medicine最新文献

{"title":"18F-FDG PET/CT in Staging Pediatric Rhabdomyosarcoma; Added benefits in comparison to conventional imaging.","authors":"E. El-kholy, M. Rezk","doi":"10.21608/egyjnm.2019.46176","DOIUrl":"https://doi.org/10.21608/egyjnm.2019.46176","url":null,"abstract":"Purpose: The aim was to evaluate the added value of 18F-FDG PET/CT in initial staging of pediatric Rhabdomyosarcoma patients in comparison to other conventional images. Materials and methods: This is a retrospective study including total 112 patients with pathologically proven RMS (52 female, 60 males; mean age, 5.8 years, with predominant embryonal type), Results of PET/CT were compared with computed tomography and/or MRI. Max SUV of the primary lesion, lymph nodes and distant metastases were evaluated in an individual and lesion analysis. Clinical follow-up (mean 27 months), and histo-pathological data were served as the standard of reference. Results: Among 112 patients, 45 (40%) patients proved metastatic byPET/CT, and 5 was Indeterminate. For primary tumor site, both diagnostic CT and FDG PET/CT show comparable results. Extremities were the most common primary site in metastatic patients & Alveolar type was more prevalent pathology among metastatic patients. Initial PET/CT upstages 13 patients (11.6%). Additional 50 lesions were determinate by PET/CT (21 nodal, 16 osseous, 3 peritoneal, 5 soft tissue nodules, 5 bone marrow involvement).Unusual site of metastases were detected by both modalities, includes suprarenal, spermatic cord and IVC thrombosis in individual patients .The sensitivity and PPV for PET/CT were higher than CT for nodal, osseous, soft tissue & peritoneal metastases.Conclusion: The current study showed that 18FDG-PET/CT is useful in initial staging of RMS patients as compared to CTregarding nodal, bone, bone marrow, soft tissue and peritoneal metastatic lesions, except for pulmonary deposits.","PeriodicalId":202063,"journal":{"name":"The Egyptian Journal Nuclear Medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128816051","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":"Added Value of SPECT/CT to Planar Bone Scan in Evaluation of Suspicious Metastatic Bony Lesions in Breast Cancer.","authors":"M. Eloteify, G Abdelhafez, M Bashank, G. Mostafa","doi":"10.21608/egyjnm.2019.46179","DOIUrl":"https://doi.org/10.21608/egyjnm.2019.46179","url":null,"abstract":"Introduction: Planar bone scan (PBS) is a standard modality for detecting skeletal metastasis. Although PBS is very sensitive, it lacks specificity, especially when a solitary or few atypical osseous lesions depicted. The addition of SPECT/CT can greatly enhance diagnostic accuracy and help reclassify non-conclusive findings on PBS. In this work, we evaluated the added value of SPECT/CT in characterization of equivocal osseous lesions seen on conventional PBS in breast cancer patients. Materials and Methods: This prospective study recruited patients known to have breast cancer referred for conventional planar bone scanning (PBS).Immediately after PBS was acquired, planar images were reviewed. If two nuclear medicine physicians agreed on the non-conclusive nature of the lesion(s), a targeted SPECT/CT was acquired in the same day, to cover the suspected area. Diagnostic performance indices from both modalities (PBS&SPECT/CT) were compared against the reference standard (clinical/imaging follow-up for at least 6-12 months). Results: A total of 83 breast cancer patients were included in this study (81 females, 2 males) with median age 52 years (range: 32-84). The sensitivity, specificity and accuracy for PBS versus SPECT/CT were 89% vs. 100%, 30%vs. 87% &57%vs. 93%; respectively; (P = 0.125, <0.0001, <0.0001); respectively. SPECT/CT changed management in 36% of breast cancer patients by down-staging and upstaging their skeletal disease status. Egyptian J. Nucl. Med., Vol. 18, No. 1, June 2019 41 Conclusion: Skeletal SPECT/CT offers an important diagnostic advantage over planar bone scan for characterization of inconclusive osseous lesions in patients with breast cancer and could significantly impact patient management.","PeriodicalId":202063,"journal":{"name":"The Egyptian Journal Nuclear Medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124628207","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":"Impact of 18F-FDG PET/CT Dual Time Point Imaging in Lymphoma Patients with Lung Lesions.","authors":"M. Mehesen, H. Fathy","doi":"10.21608/egyjnm.2019.46181","DOIUrl":"https://doi.org/10.21608/egyjnm.2019.46181","url":null,"abstract":"The aim of: this prospective study was to assess the role of dual time imaging PET/CT study in characterization of the lung lesions in lymphoma patients with lung lesion. Patients and methods: The study was conducted on 28 lymphoma patients. Scan 1 (early image) was performed at 50 min and scan 2 (delayed image) at 110 min after FDG IV injection. The majority of final decisions were reached based on clinical and radiological follow up and the minority was pathologically based. SUV max was calculated at early and delayed images. The difference between early and delayed SUV max (D-SUV max) and the retention index (RI-SUV max) were estimated. Then their cut-off values were evaluated using area under the curve (AUC) from receiver operating characteristic (ROC) analysis. Also, the median quantitative analysis for these parameters was used. Results: Thedelayed SUV max cut-off value of 4.9 giving sensitivity of 90% and specificity of 72% (P=0.004). The cut-off value of D-SUV max of 0.55 yielding a sensitivity of 90% and specificity of 78% (P=0.001). Using 7.5% as a cut-off value of RI-SUV max had sensitivity of 80% and specificity of 67% (P=0.04). The delayed SUV max and D-SUV max had AUCs (0.825 & 0.894 respectively) which is statistically greater than of early SUV max (0.789). The D-SUV max has the largest AUC between the four indices. The median quantitative analysis for Delayed-SUV max was 4.9 (P=0.003), D-SUV max was 0.50 (P=0.001), RI-SUV max was 0.75 (P=0.01). Conclusion: The delayed time point PET/CT imaging is additive technique with higher sensitivity and specificity to characterize lung lesions in lymphoma patients.","PeriodicalId":202063,"journal":{"name":"The Egyptian Journal Nuclear Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121274117","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":"Pitfalls in 18F-FDG PET/CT in Malignant Lymphoma.","authors":"H. Moustafa, A. Badawy, M. Gamal","doi":"10.21608/egyjnm.2019.46175","DOIUrl":"https://doi.org/10.21608/egyjnm.2019.46175","url":null,"abstract":"","PeriodicalId":202063,"journal":{"name":"The Egyptian Journal Nuclear Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122213176","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":"Diagnosis and Management of Pulmonary Carcinoids.","authors":"L. Zidan","doi":"10.21608/egyjnm.2019.46174","DOIUrl":"https://doi.org/10.21608/egyjnm.2019.46174","url":null,"abstract":"Neuro-Endocrine: Tumours (NETs) are rare slowly growing malignancies that arise from neuroendocrine cells, which can be found anywhere in the human body. Broncho-pulmonary neuroendocrine tumours (bpNETs) represents approximately about 20-30 % of NETs and about 25% of all lung cancers (1, 2) . Recently the prevalence of bpNETs has increased, this may be attributed to early disease detection and/or improved survival (3) . Broncho-pulmonary neuroendocrine tumours are classified according to their degree of differentiation into well and poorly differentiated forms, depends on the mitotic index and presence of necrosis. The well-differentiated pulmonary carcinoid, include the low grade which is the typical carcinoid (TC). While, the intermediate-grade which is the atypical carcinoid (AC). The poorly differentiated group include large cell neuroendocrine carcinomas (LCNEC) and small cell lung cancer (SCLC) (4, 5) . Although there is some similarities between the two groups, the behaviour of pulmonary carcinoids are completely different from that of SCLC and LCNEC (6) . Pulmonary carcinoid tumours are uncommon malignancies, which appeared to be increasing overtime. Diagnosis and management depends on accurate histological classification that also can predict the prognosis. Contrast enhanced CT is the first recommended investigation, 68Ga-dotatate–PET/CT should be done for well differentiated tumours, while FDG PET/CT is useful with tumours of high proliferation index.","PeriodicalId":202063,"journal":{"name":"The Egyptian Journal Nuclear Medicine","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129710269","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":"Restaging and Follow up of Seminomatous and Non Seminomatous Testicular Tumors Using F18 FDG PET/CT.","authors":"E. El-kholy, H. Fathy, N. Elliethy","doi":"10.21608/egyjnm.2019.46184","DOIUrl":"https://doi.org/10.21608/egyjnm.2019.46184","url":null,"abstract":"Aim: to evaluate the role of FDG PET/CT in restaging and follow up of Seminomatous and non Seminomatous testicular tumors. Materials and methods: 54 patients (mean age: 34.2 ±11.8) with pathologically proven testicular cancer in whom FDG PET/CT were retrospectively assessed. Total 89 PET/CT studies were conducted in comparison to diagnostic CT. Pathological and clinical/radiological follow-up for 6-15 months duration served as standards of reference. Results: Seminomas type was more prevalent (64.8%). 30% of patients did not develop metastases during their course of disease. While 38 patients develop metastatic lesions (31 had abdominal nodal deposits and 5 patients had distant sites and 2 patients presented by both).The lung was the most common site for distant metastases. All 33 patients with recurrent lesions had regional abdominal nodal deposits, while distant metastasis was more detected in 9 patients with Non Seminomatous pathology. FDG PET/CT had higher sensitivity, specificity, and accuracy of 94%, 86.5%, and 92.5% versus 76%, 85% 83%; for diagnostic CT in per patients analysis. A total of 90 lesions were reported, (62 nodal & 28 distant) metastatic lesions were analyzed. PET/CT showed good accuracy for the detection of residual/recurrent Seminomatus lesions, with an overall sensitivity and specificity of 94.7 % and 93.3 %, respectively compared to 89.2% and 56.2% for diagnostic CT, their size mean + SD (3.9+-3.1) and SUV max (7+-6.3).Non Seminomatus distant metastases showed comparable results for both PET/CT and diagnostic CT with false negative results in small sized (mainly lung lesions). 25 patients had single PET/CT; its results with diagnostic CT were comparable in 20 patients (84%), while 29 patients with repeated 64 PET/CT studies had comparable analysis to diagnostic CT in 22 patients (~76%). In the other 7 patients (~24%), a higher value of PET/CTin assessment of therapy response was noted. PET/CT shows CMR in 5 patients that remain stationary in CT based on size difference analysis. Conclusion: The current study showed that 18FDG-PET/CT is useful in re-staging & assessment of response on patients with Germ cell testicular tumor as compared to CT regarding Seminomatous abdominal nodal lesions and non Seminomatous distant disease.","PeriodicalId":202063,"journal":{"name":"The Egyptian Journal Nuclear Medicine","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127879515","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":"The Value of Added CT-based Attenuation Correction Technique in the Era of Contemporary High Technology Gated 99mTc-MIBI Myocardial Perfusion Scintigraphy.","authors":"M. Y., H. E.","doi":"10.21608/egyjnm.2018.46230","DOIUrl":"https://doi.org/10.21608/egyjnm.2018.46230","url":null,"abstract":"Background: accurate selection of the patients with known or suspected coronary artery disease (CAD) who will benefit from additional CT-based attenuation correction (CT-AC) images to gated 99m Tc -MIBI myocardial perfusion scintigraphy (MPS) is mandatory to compromise the increased sensitivity demand for the unnecessary radiation doses exposure concerns. Aim of the work: to evaluate the value of added CT-AC to gated MPS in the clinical diagnosis of CAD for appropriate selection of the patient who will benefit from this additive technique. Patients and methods: 90 patients (53, SD ± 12 year-old, 66%males) were retrospectively included in the study. Two days protocol gated MPS and additional CT-AC images were performed for all patients. The final clinical diagnosis was reached by consensus after interpreting the gated MPS images and correlating them with the clinical risk factors and other available cardiac diagnostic modalities. Comparison was done between the final diagnosis and the CT-AC images to evaluate the performance of the latter. Results: 159 segmental perfusion defects were elicited; 93 (58%) and 66 (42%) perfusion defects were finally interpreted as attenuation artifact and true ischemic defects respectively. The CT-AC images show good performance with 100% sensitivity and specificity in the inferior and lateral walls perfusion defects while it shows poor performance in the anterior and septal walls due to false positive results resulting in reduced specificity of 75 %. Egyptian J. Nucl. Med., Vol. 17, No. 2, December 2018 35 Conclusion: CT-AC is a fast and easy technique for accurate diagnosis of the inferior and lateral walls perfusion defects which will be potentially useful if the final clinical diagnosis cannot be reached. Whereas high false positive result is seen in anterior and septal wall defects with diminished specificity which may need additional other AC methods.","PeriodicalId":202063,"journal":{"name":"The Egyptian Journal Nuclear Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130158728","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}