MyMedR

18F-FDG PET/CT as a potential predictor of survival in patient with oesophageal cancer: a preliminary result

Fathinul Fikri AS, Dharmendran R, Vikneswaran P, Nordin AJ

Abdom Imaging, 2015 Aug;40(6):1457-64.

PMID: 25576048 DOI: 10.1007/s00261-014-0343-2

A study was undertaken to investigate the value of pretreatment PET-CT in predicting survival in patients with oesophageal cancer (OC).

Matched MeSH terms: Esophageal Neoplasms/radionuclide imaging*; Esophagus/radionuclide imaging

Localization and prediction of malignant potential in recurrent pheochromocytoma/paraganglioma (PCC/PGL) using 18F-FDG PET/CT

Fikri AS, Kroiss A, Ahmad AZ, Zanariah H, Lau WF, Uprimny C, et al.

Acta Radiol, 2014 Jun;55(5):631-40.

PMID: 24037430 DOI: 10.1177/0284185113504330

To our knowledge, data are lacking on the role of 18F-FDG PET/CT in the localization and prediction of neuroendocrine tumors, in particular the pheochromocytoma/paraganglioma (PCC/PGL) group.

Matched MeSH terms: Adrenal Gland Neoplasms/radionuclide imaging*; Pheochromocytoma/radionuclide imaging*

Fulltext Problem based review: The patient with a pyrexia of unknown origin

Woolley AK, Hedger NA, Veettil RP

Acute Med, 2013;12(2):107-10.

PMID: 23732136

Pyrexia of unknown origin (PUO) is a frequent presentation to the Acute Medical Unit, and is a source of significant morbidity, both the psychological burden of an uncertain diagnosis and prognosis and untreated complications of the underlying pathology. We present a problem based review of the management of PUO, illustrated by a patient who recently presented to our unit with fever and systemic malaise after returning from abroad and in whom no cause could be found for more than two months. We describe a structured approach making use of complex modern techniques such as Positron Emission Tomography-Computed Tomography (PET-CT) which ultimately provided the diagnosis for our patient.

Matched MeSH terms: Aorta/radionuclide imaging

Fulltext Sex estimation using subpubic angle from reconstructed three-dimensional computed tomography pelvic model in a contemporary Malaysian population

Mohd Ali SH, Omar N, Shafie MS, Nik Ismail NA, Hadi H, Nor FM

Anat Cell Biol, 2020 Mar;53(1):27-35.

PMID: 32274246 DOI: 10.5115/acb.19.135

Research in forensic anthropology is recent in Malaysia due to limited access to documented skeletal collections. However, advanced imaging techniques provide virtual bone samples for use in morphometric studies to establish population-specific standards by virtual anthropology. This study examined sexual dimorphism in the subpubic angle using a three-dimensional computed tomography model of the pelvis, in a contemporary Malaysian population. The sample comprised multidetector computed tomography (MDCT) scans of 50 male and 50 female adults. Segmentation of the MDCT scans was performed using 3D Slicer, and four landmarks were acquired using Stratovan Checkpoint for the subpubic angle measurement. The technical error of measurement (TEM), relative TEM, and coefficient of reliability (R) exhibited high reliability in measurements. Results showed that the subpubic angle in males was 68.6°±7.6° and in females 87.4°±6.5°. The subpubic angle in females was significantly larger than in males (P<0.001). Inverse correlation was found between the subpubic angle and age, in both males (r=-0.449, P<0.01) and females (r=-0.385, P<0.01). The overall accuracy of sex estimation using the subpubic angle was 94% (P<0.001). The subpubic angle, with a demarcating point of 78.6°, showed a sensitivity and specificity of 94% in the classification of female individuals. In conclusion, sex estimation using the subpu bic angle is highly accurate, with a high degree of expected sensitivity and specificity in the Malaysian population.

Matched MeSH terms: Radionuclide Imaging

Fulltext Diagnostic challenge in diagnosing bilateral breast metastases from mediastinal neuroendocrine tumor: A case report

Chan KH, Lee CH, Sharif SZ, Hayati F, Sallapan S

Ann Med Surg (Lond), 2020 Dec;60:438-441.

PMID: 33251002 DOI: 10.1016/j.amsu.2020.11.035

Background: Metastatic neuroendocrine tumours (NETs) to the breast are very rare entities.

Case presentation: A 26-year-old lady presented with anterior neck swelling with symptoms of superior vena cava syndrome for 6 months. Imaging study revealed a mediastinal mass which was preceded with core biopsy which was consistent with high-grade small cell NETs. Despite second-line adjuvant chemotherapy and radiotherapy, her disease became advanced which was confirmed via restaging scan. There were bilateral breast lesions discovered during the scan which was deemed to be metastatic NETs histologically. Despite prompt initiation of treatment, she succumbed 1 year after the radiotherapy due to disease progression.

Conclusion: High suspicion of an index is needed for diagnosis when patients with known primary NETs present with suspicious breast lesions. Triple assessment is mandatory, however histopathology assessment and immunohistochemistry staining are the mainstay of diagnosis.

Matched MeSH terms: Radionuclide Imaging

Fulltext New concepts of hepatic amoebiasis

Balasegaram M

Ann Surg, 1972 Apr;175(4):528-34.

PMID: 4259839

Matched MeSH terms: Radionuclide Imaging

Internal radiation dosimetry of orally administered radiotracers for the assessment of gastrointestinal motility

Yeong CH, Ng KH, Abdullah BJJ, Chung LY, Goh KL, Perkins AC

Appl Radiat Isot, 2014 Dec;94:216-220.

PMID: 25222875 DOI: 10.1016/j.apradiso.2014.08.009

Radionuclide imaging using (111)In, (99m)Tc and (153)Sm is commonly undertaken for the clinical investigation of gastric emptying, intestinal motility and whole gut transit. However the documented evidence concerning internal radiation dosimetry for such studies is not readily available. This communication documents the internal radiation dosimetry for whole gastrointestinal transit studies using (111)In, (99m)Tc and (153)Sm labeled formulations. The findings were compared to the diagnostic reference levels recommended by the United Kingdom Administration of Radioactive Substances Advisory Committee, for gastrointestinal transit studies.

Matched MeSH terms: Radionuclide Imaging

Production and first use of 153SmCl3-ion exchange resin capsule formulation for assessing gastrointestinal motility

Yeong CH, Abdullah BJ, Ng KH, Chung LY, Goh KL, Sarji SA, et al.

Appl Radiat Isot, 2012 Mar;70(3):450-5.

PMID: 22178699 DOI: 10.1016/j.apradiso.2011.11.056

We produced an enteric-coated gelatine capsule containing neutron-activated (153)Sm-labelled resin beads for use in gastrointestinal motility studies. In vitro test in simulated gastrointestinal environment and in vivo study on volunteers were performed. Scintigraphic images were acquired from ten volunteers over 24h while blood and urine samples were collected to monitor the presence of (153)Sm. All the capsules remained intact in stomach. This proved to be a safe and practical oral capsule formulation for whole gut transit scintigraphy.

Matched MeSH terms: Radionuclide Imaging

Polymyoclonus, laryngospasm, and cerebellar ataxia associated with adenocarcinoma and multiple neural cation channel autoantibodies

Lim SY, Mason WP, Young NP, Chen R, Bower JH, McKeon A, et al.

Arch. Neurol., 2009 Oct;66(10):1285-7.

PMID: 19822786 DOI: 10.1001/archneurol.2009.203

OBJECTIVE:
To describe and provide audiovisual documentation of a syndrome of polymyoclonus, laryngospasm, and cerebellar ataxia associated with adenocarcinoma and multiple neural cation channel autoantibodies.

DESIGN:
Case report with video.

SETTING:
University hospitals. Patient A 69-year-old woman presented with subacute onset of whole-body tremulousness and laryngospasm attributed to gastroesophageal reflux.

RESULTS:
Further evaluation revealed polymyoclonus, cerebellar ataxia, and laryngospasm suspicious of an underlying malignant neoplasm. Surface electromyography of multiple limb muscles confirmed the presence of polymyoclonus. The patient was seropositive for P/Q-type voltage-gated calcium channel antibody; subsequently, whole-body fluorine 18 fluorodeoxyglucose positron emission tomography and cervical lymph node biopsy revealed widespread metastatic adenocarcinoma. Follow-up serologic evaluation revealed calcium channel antibodies (P/Q type and N type) and potassium channel antibody.

CONCLUSIONS:
We highlight the importance of recognizing polymyoclonus. To our knowledge, this is also the first description of a syndrome of polymyoclonus, laryngospasm, and ataxia associated with adenocarcinoma and these cation channel antibodies.

Matched MeSH terms: Adenocarcinoma/radionuclide imaging; Brain Neoplasms/radionuclide imaging

Pre-ablative diagnostic whole-body scan following total thyroidectomy for well-differentiated thyroid cancer: is it necessary?

Teoh CM, Rohaizak M, Chan KY, Jasmi AY, Fuad I

Asian J Surg, 2005 Apr;28(2):90-6.

PMID: 15851360

This study reviewed the incidence of positive pre-ablative diagnostic scan after total thyroidectomy and the efficacy of the current ablative dose. The predictive factors for outcome using a standard ablative dose and postoperative complications of total thyroidectomy were also examined.

Matched MeSH terms: Thyroid Neoplasms/radionuclide imaging*; Neoplasm, Residual/radionuclide imaging*

Illuminating Insights: Clinical Study Harnessing Pharmacoscintigraphy for Permeation Study of Radiolabeled Nimesulide Topical Formulation in Healthy Human Volunteers

Sharma N, Khanna K, Kumar N, Karwasra R, Janakiraman AK, Rajagopal MS

Assay Drug Dev Technol, 2023 Oct;21(7):325-330.

PMID: 37801663 DOI: 10.1089/adt.2023.053

An alternative to oral administration for the delivery of therapeutic substances is the topical route, which frequently has comparable efficacy but may have a better tolerability profile. Gamma scintigraphy is a noninvasive technique that involves the application of radioactive substances to conduct biodistribution studies of therapeutic substances delivered through various routes. Nimesulide (NSD) was radiolabeled with technetium pertechnetate (Technetium99m [99mTc]) and this radiolabeled drug complex (99mTc-NSD) was used to prepare a topical gel formulation. The permeation of the radiolabeled drug from the topical gel was determined by gamma scintigraphy on human volunteers. The region of interest was calculated for the quantification of permeated radiolabeled drugs. This was observed that the mean percentage permeation of 99mTc-NSD was found to be 0.32 ± 0.22 to 36.37 ± 2.86 at 5 and 240 min. It was demonstrated that gamma scintigraphy may be a noninvasive and reliable technique for the determination of drug permeation through topical routes.

Matched MeSH terms: Radionuclide Imaging

Primary non-Hodgkin's lymphoma of the terminal ileum with enterovesical fistula: a case report

Nuruddin RN, Rathakrishnan V

Australas Radiol, 1990 Aug;34(3):268-70.

PMID: 2275692

A case of primary non-Hodgkin's lymphoma of the terminal ileum with enterovesical fistula is reported. A 50-year-old Malay man presented with haematuria, dysuria and per-rectal bleeding. Intravenous urogram, double contrast enema and an MDP bone scintigram showed a fistulous communication between the bladder and distal ileum. At laparotomy, a large tumour attaching the terminal ileum to the dome of the bladder was found. Histopathological examination of resected small bowel revealed a diffuse histiocytic non-Hodgkin's lymphoma of the small bowel. The bladder mucosa was shown to be normal.

Matched MeSH terms: Radionuclide Imaging

Fulltext Paget's disease with craniofacial and skeletal bone involvement

Rai NP, Anekar J, Mustafa SM, Devang Divakar D

BMJ Case Rep, 2016 Sep 01;2016.

PMID: 27587747 DOI: 10.1136/bcr-2016-216173

Paget's disease is a metabolic disorder of bone caused due to defect in the remodelling process and is very common in western countries but is very rare in Asians and Africans. It was first described by a British scientist Sir James Paget in 1877. It can be monostotic or polyostotic depending on the number of bones involved. It most commonly affects older people of more than 50 years. Disease involvement can be symptomatic or asymptomatic depending on the extent of the disease process. Diagnosis of Paget's disease can be made by raised serum alkaline phosphatase levels, radiological examination and by radioisotope bone scans.

Matched MeSH terms: Radionuclide Imaging

Fulltext Optimising the scan delay for arterial phase imaging of the liver using the bolus tracking technique

Chan R, Kumar G, Abdullah B, Ng Kh, Vijayananthan A, Mohd Nor H, et al.

Biomed Imaging Interv J, 2011 Apr;7(2):e12.

PMID: 22287986 MyJurnal DOI: 10.2349/biij.7.2.e12

To optimize the delay time before the initiation of arterial phase scan in the detection of focal liver lesions in contrast enhanced 5 phase liver CT using the bolus tracking technique.

Matched MeSH terms: Radionuclide Imaging

Fulltext Musculoskeletal MRI protocol

Tan S, Suraya A, Sa'don S, Ruzi A, Zahiah M

Biomed Imaging Interv J, 2010 Apr-Jun;6(2):e16.

PMID: 21611037 MyJurnal DOI: 10.2349/biij.6.2.e16

The authors propose a musculoskeletal (MSK) magnetic resonance imaging (MRI) protocol using selected sequences for common orthopaedic indications. Selected sequences allow optimal visualisation of the indicated pathology while screening for other common conditions. The authors emphasise the need for standard positioning of the patient and standard orientation of scan planes to facilitate comparison with follow-up scans.

Matched MeSH terms: Radionuclide Imaging

Fulltext Mastoiditis secondary to mycobacterium abscessus imaged with gallium-67 scintigraphy

Vijayananthan A, Arumugam A, Kumar G, Harichandra D

Biomed Imaging Interv J, 2008 Apr;4(2):e23.

PMID: 21614326 MyJurnal DOI: 10.2349/biij.4.2.e23

Atypical mycobacterium is rarely seen as a cause of chronic mastoiditis but has been increasingly recognized over the past few years. Mycobacterium abscessus is the most pathogenic and chemotherapy-resistant, rapid-growing mycobacterium of all the four groups. This paper presents a case of a 57-year-old woman who had chronic mastoiditis with recurrent exacerbations. The initial computed tomography (CT) findings showed the presence of an inflammatory process and she was treated with the appropriate antibiotics. The patient subsequently underwent a tissue biopsy when she presented with another exacerbation. At this time, the CT scan did not identify the ongoing exacerbation, but the Gallium-67 scintigraphy did.

Matched MeSH terms: Radionuclide Imaging

Fulltext Spiral CT angiography in an infant with a hypoplastic aortic arch

Man Harun S, Faridah Y

Biomed Imaging Interv J, 2006 Apr;2(2):e11.

PMID: 21614223 MyJurnal DOI: 10.2349/biij.2.2.e11

The advent of multislice computed tomography (CT) has revolutionised the performance of body CT and allowed the development of CT angiography (CTA). CTA is a robust and minimally invasive method of visualizing the arterial vascular system. The newer generation of multidetector scans has allowed for shorter scanning times with no respiratory misregistration at peak vascular opacification following peripheral contrast injection. The volume of data obtained from these scans can be further manipulated to generate two-dimensional (2D) and three-dimensional (3D) images with no increase in radiation to the patient. Hence, CTA has gained popularity and importance as the alternative diagnostic tool especially for ill patients in which conventional angiography is inadvisable.We present an infant with coarctation of the aorta and hypoplastic aortic arch, in which CT angiography was used to pinpoint the diagnosis. The CT findings were subsequently confirmed at surgery.

Matched MeSH terms: Radionuclide Imaging

Fulltext Physiological uptake in FDG PET simulating disease

Ahmad Sarji S

Biomed Imaging Interv J, 2006 Oct;2(4):e59.

PMID: 21614339 MyJurnal DOI: 10.2349/biij.2.4.e59

Many potential pitfalls and artefacts have been described in PET imaging that uses F-18 fluorodeoxyglucose (FDG). Normal uptake of FDG occurs in many sites of the body and may cause confusion in interpretation particularly in oncology imaging. Clinical correlation, awareness of the areas of normal uptake of FDG in the body and knowledge of variation in uptake as well as benign processes that are FDG avid are necessary to avoid potential pitfalls in image interpretation. In this context, optimum preparation of patients for their scans can be instituted in an attempt to reduce the problem. Many of the problems and pitfalls associated with areas of normal uptake of FDG can be solved by using PET CT imaging. PET CT imaging has the ability to correctly attribute FDG activity to a structurally normal organ on CT. However, the development of combined PET CT scanners also comes with its own specific problems related to the combined PET CT technique. These include misregistration artefacts due to respiration and the presence of high density substances which may lead to artefactual overestimation of activity if CT data are used for attenuation correction.

Matched MeSH terms: Radionuclide Imaging

Fulltext Clinical use of PET/CT in thyroid cancer diagnosis and management

Sundram F

Biomed Imaging Interv J, 2006 Oct;2(4):e56.

PMID: 21614336 MyJurnal DOI: 10.2349/biij.2.4.e56

The incidence of thyroid cancer is low, but when it occurs, it is mainly of the papillary histopathological type. Although PET/CT has a limited role in the diagnosis, it plays a significant role in the overall post-surgery management of a patient with thyroid cancer. This follow-up role is important, especially in patients with elevated serum thyroglobulin, but negative radioiodine whole body scans. There is increasing evidence that PET/CT should be a part of routine care in the Tg positive Radioiodine scan negative patient.

Matched MeSH terms: Radionuclide Imaging

Fulltext An Unusual Association between Unilateral Intracranial Vessels Occlusion with Iron Deficiency Anaemia and Alpha-Thalassemia Trait: A Case Report

Lee YY, Bhaskar S

Case Rep Med, 2011;2011:271560.

PMID: 22229036 DOI: 10.1155/2011/271560

We report a 33-year-old Malay woman presented with acute left dense hemiparesis and an NIHSS score of 11/15. Computed tomography (CT) scan brain showed a massive right middle cerebral artery (MCA) territory infarct. The right internal carotid artery (ICA) and right proximal MCA were shown occluded from digital substraction angiography (DSA). Carotid dissection, carotid canal anomaly, and intercavernous communication were systematically ruled out. She had no risk factors for atherosclerosis. The connective tissue screening and thrombophilic markers were negative. However, she was anaemic on admission and subsequent investigations revealed that she had alpha-thalassemia and iron deficiency anaemia. The right ICA remained occluded from a repeat CT cerebral angiogram after one year, but otherwise she was neurologically stable. This case illustrates an unusual association between intracranial vessel occlusion with iron deficiency anaemia and alpha-thalassemia trait.

Matched MeSH terms: Radionuclide Imaging

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