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  1. Effect of iterative reconstruction algorithm levels on noise index and figure-of-merit in CT pulmonary angiography examinations
    Harun HH, Karim MKA, Abbas Z, Sabarudin A, Muniandy SC, Ibahim MJ
    J Xray Sci Technol, 2020;28(5):893-903.
    PMID: 32741801 DOI: 10.3233/XST-200699
    PURPOSE: To evaluate the influence of iterative reconstruction (IR) levels on Computed Tomography (CT) image quality and to establish Figure of Merit (FOM) value for CT Pulmonary Angiography (CTPA) examinations.

    METHODS: Images of 31 adult patients who underwent CTPA examinations in our institution from March to April 2019 were retrospectively collected. Other data, such as scanning parameters, radiation dose and body habitus information from the subjects were also recorded. Six different levels of IR were applied to the volume data of the subjects. Five circles of the region of interest (ROI) were drawn in five different arteries namely, pulmonary trunk, right pulmonary artery, left pulmonary artery, ascending aorta and descending aorta. The mean Signal-to-noise ratio (SNR) was obtained, and the FOM was calculated in a fraction of the SNR2 divided by volume-weighted CT dose index (CTDIvol) and SNR2 divided by the size-specific dose estimates (SSDE).

    RESULTS: Overall, we observed that the mean value of CTDIvol and SSDE were 13.79±7.72 mGy and 17.25±8.92 mGy, respectively. Notably, SNR values significantly increase with increase of the IR level (p 

  2. Fulltext Ectopic Germinoma: A Delayed Diagnosis With Serial Magnetic Resonance Imaging Features
    Azmi MI, Rahim NH, Ang YP, Adzman S, Muniandy SC
    Cureus, 2021 Dec;13(12):e20760.
    PMID: 35111446 DOI: 10.7759/cureus.20760
    Germinoma arising from intracranial off-midline structures is considered ectopic. Although basal ganglia germinoma is a rare occurrence, it is more commonly seen in the Asian population, particularly among boys. Here, we report a case of an adolescent boy who presented with hemiplegia and delayed diagnosis of basal ganglia germinoma with progression on serial magnetic resonance imaging (MRI). Several signal changes have been described during the early stage of the disease such as T2-weighted patchy hyperintense signal, cerebral hemiatrophy, and signal change on susceptibility-weighted imaging. 11C-methionine positron emission tomography is an additional imaging technique that can reveal ectopic germinoma. Follow-up MRI revealed small cystic changes, and the latest imaging showed progression into a large multicystic lesion with mass effect. The patient underwent surgery, and histopathological examination revealed basal ganglia germinoma. We highlight the serial MRI changes that were suggestive of basal ganglia germinoma in this case.
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