Displaying publications 1 - 20 of 29 in total

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  1. Fulltext Biliary ascariasis--a letter to the editor
    Shuaib IL, Hayat FZ
    Med J Malaysia, 1995 Sep;50(3):284.
    PMID: 8926912
  2. Fulltext Comparison Between 3D TOF Magnetic Resonance Angiography and Intraarterial Digital Subtraction Angiography in Imaging the Circle of Willis
    Ghazali RM, Shuaib IL
    Malays J Med Sci, 2003 Jan;10(1):37-42.
    PMID: 23365498 MyJurnal
    This study was done compare the accuracy of non-contrast enhanced 3D time of flight magnetic resonance angiography (3D TOF MRA) with intraarterial digital subtraction angiography (IADSA) in depicting the arterial segments of the circle of Willis. 398 arterial segments were analysed from 38 patients who underwent both non-contrast enhanced 3D TOF MRA and IADSA examinations in Hospital Universiti Sains Malaysia from November 1998 to December 2000. Two observers performed blinded retrospective analysis of the IADSA images and Maximum Intensity Projection display of the 3D TOF MRA of the circle of Willis on separate sessions. Non-contrast enhanced 3D TOF MRA was sensitive and specific in depicting the A1, A2, M1, P1 and Anterior Communicating segments of the circle of Willis with a sensitivity ranging from 94.5% to 100% and specificity ranging from 90.5% to 100%. However it was poor in depicting the Posterior Communicating segments with a sensitivity of 21.4%. MIP display of the non-contrast enhanced 3D TOF MRA is sensitive in depicting the anatomy of the circle of Willis except for the PCOM segment. It is thus a reliable method for screening of this arterial circle.
  3. Internal jugular phlebectasia--an unusual cause of neck swelling
    Indudharan R, Quah BS, Shuaib IL
    Ann Trop Paediatr, 1999 Mar;19(1):105-8.
    PMID: 10605529
    We describe a 7-year-old child who presented with a soft fluctuant swelling on the neck which became more prominent during the Valsalva manoeuvre. He underwent adeno-tonsillectomy based on a mistaken diagnosis of ballooning of the pharynx secondary to enlarged adenoids and tonsils obstructing the nasopharyngeal and oropharyngeal airways. Investigations revealed the swelling to be a markedly dilated internal jugular vein. We discuss the diagnostic features and mode of treatment of this condition so as to avoid unnecessary and dangerous surgical intervention.
  4. Fulltext Computer aided detection of breast density and mass, and visualization of other breast anatomical regions on mammograms using graph cuts
    Saidin N, Mat Sakim HA, Ngah UK, Shuaib IL
    Comput Math Methods Med, 2013;2013:205384.
    PMID: 24106523 DOI: 10.1155/2013/205384
    Breast cancer mostly arises from the glandular (dense) region of the breast. Consequently, breast density has been found to be a strong indicator for breast cancer risk. Therefore, there is a need to develop a system which can segment or classify dense breast areas. In a dense breast, the sensitivity of mammography for the early detection of breast cancer is reduced. It is difficult to detect a mass in a breast that is dense. Therefore, a computerized method to separate the existence of a mass from the glandular tissues becomes an important task. Moreover, if the segmentation results provide more precise demarcation enabling the visualization of the breast anatomical regions, it could also assist in the detection of architectural distortion or asymmetry. This study attempts to segment the dense areas of the breast and the existence of a mass and to visualize other breast regions (skin-air interface, uncompressed fat, compressed fat, and glandular) in a system. The graph cuts (GC) segmentation technique is proposed. Multiselection of seed labels has been chosen to provide the hard constraint for segmentation of the different parts. The results are promising. A strong correlation (r = 0.93) was observed between the segmented dense breast areas detected and radiological ground truth.
  5. Automatic white matter lesion segmentation using an adaptive outlier detection method
    Ong KH, Ramachandram D, Mandava R, Shuaib IL
    Magn Reson Imaging, 2012 Jul;30(6):807-23.
    PMID: 22578927 DOI: 10.1016/j.mri.2012.01.007
    White matter (WM) lesions are diffuse WM abnormalities that appear as hyperintense (bright) regions in cranial magnetic resonance imaging (MRI). WM lesions are often observed in older populations and are important indicators of stroke, multiple sclerosis, dementia and other brain-related disorders. In this paper, a new automated method for WM lesions segmentation is presented. In the proposed method, the presence of WM lesions is detected as outliers in the intensity distribution of the fluid-attenuated inversion recovery (FLAIR) MR images using an adaptive outlier detection approach. Outliers are detected using a novel adaptive trimmed mean algorithm and box-whisker plot. In addition, pre- and postprocessing steps are implemented to reduce false positives attributed to MRI artifacts commonly observed in FLAIR sequences. The approach is validated using the cranial MRI sequences of 38 subjects. A significant correlation (R=0.9641, P value=3.12×10(-3)) is observed between the automated approach and manual segmentation by radiologist. The accuracy of the proposed approach was further validated by comparing the lesion volumes computed using the automated approach and lesions manually segmented by an expert radiologist. Finally, the proposed approach is compared against leading lesion segmentation algorithms using a benchmark dataset.
  6. Wavelet energy-guided level set-based active contour: a segmentation method to segment highly similar regions
    Achuthan A, Rajeswari M, Ramachandram D, Aziz ME, Shuaib IL
    Comput Biol Med, 2010 Jul;40(7):608-20.
    PMID: 20541182 DOI: 10.1016/j.compbiomed.2010.04.005
    This paper introduces an approach to perform segmentation of regions in computed tomography (CT) images that exhibit intra-region intensity variations and at the same time have similar intensity distributions with surrounding/adjacent regions. In this work, we adapt a feature computed from wavelet transform called wavelet energy to represent the region information. The wavelet energy is embedded into a level set model to formulate the segmentation model called wavelet energy-guided level set-based active contour (WELSAC). The WELSAC model is evaluated using several synthetic and CT images focusing on tumour cases, which contain regions demonstrating the characteristics of intra-region intensity variations and having high similarity in intensity distributions with the adjacent regions. The obtained results show that the proposed WELSAC model is able to segment regions of interest in close correspondence with the manual delineation provided by the medical experts and to provide a solution for tumour detection.
  7. Perforation of oesophagus and aorta by an unusual migratory fish bone: case report
    Alam AM, Shuaib IL, Hock LC, Bah EJ
    Nepal Med Coll J, 2005 Dec;7(2):150-1.
    PMID: 16519087
    This report describes a migratory fish bone which was not found during 1st surgery causing perforation to the superior part of the arch of aorta. The patient presented with feeling of something stucked in her throat after eating fish subsequently followed by progressive excruciating pain in the neck. During 2nd surgery the fish bone was found to have migrated from the superior aspect of the arch of aorta to the anterolateral aspect of the arch of aorta after piercing the aortic lumen. We report a case of migratory fish bone which was not found during 1st surgery. The clinical examination of the throat revealed no foreign body. The CT scan of the neck and upper thorax demonstrated a 1cm linear foreign body part of which had perforated into the superior part of the arch of aorta with mediastinal hematoma. The most likely cause was a fish bone. The patient's condition slowly deteriorated, median sternotomy and exploration of mediastinum then followed. Unfortunately no fish bone was found and only mediastinal hematoma was discovered. After the first operation the patient condition did not improve and repeat CT scan of the neck and upper thorax was done 3 days later. A similar foreign body has now moved from the superior aspect of the arch of aorta to the anterolateral aspect of arch of aorta. Exploration was done again and this time the fish bone was found.
  8. Fulltext Diagnostic Performance of (68)Ga-DOTATATE PET/CT, (18)F-FDG PET/CT and (131)I-MIBG Scintigraphy in Mapping Metastatic Pheochromocytoma and Paraganglioma
    Tan TH, Hussein Z, Saad FF, Shuaib IL
    Nucl Med Mol Imaging, 2015 Jun;49(2):143-51.
    PMID: 26085860 DOI: 10.1007/s13139-015-0331-7
    To evaluate the diagnostic performance of (68)Ga-DOTATATE (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT), (18)F-FDG PET/CT and (131)I-MIBG scintigraphy in the mapping of metastatic pheochromocytoma and paraganglioma.
  9. Alpha shape theory for 3D visualization and volumetric measurement of brain tumor progression using magnetic resonance images
    Hamoud Al-Tamimi MS, Sulong G, Shuaib IL
    Magn Reson Imaging, 2015 Jul;33(6):787-803.
    PMID: 25865822 DOI: 10.1016/j.mri.2015.03.008
    Resection of brain tumors is a tricky task in surgery due to its direct influence on the patients' survival rate. Determining the tumor resection extent for its complete information via-à-vis volume and dimensions in pre- and post-operative Magnetic Resonance Images (MRI) requires accurate estimation and comparison. The active contour segmentation technique is used to segment brain tumors on pre-operative MR images using self-developed software. Tumor volume is acquired from its contours via alpha shape theory. The graphical user interface is developed for rendering, visualizing and estimating the volume of a brain tumor. Internet Brain Segmentation Repository dataset (IBSR) is employed to analyze and determine the repeatability and reproducibility of tumor volume. Accuracy of the method is validated by comparing the estimated volume using the proposed method with that of gold-standard. Segmentation by active contour technique is found to be capable of detecting the brain tumor boundaries. Furthermore, the volume description and visualization enable an interactive examination of tumor tissue and its surrounding. Admirable features of our results demonstrate that alpha shape theory in comparison to other existing standard methods is superior for precise volumetric measurement of tumor.
  10. OPTIMIZATION OF RADIATION DOSE IN CT IMAGING: ESTABLISHING THE INSTITUTIONAL DIAGNOSTIC REFERENCE LEVELS AND PATIENT DOSE AUDITING
    Razali MASM, Ahmad MZ, Shuaib IL, Osman ND
    Radiat Prot Dosimetry, 2020 Jun 13;188(2):213-221.
    PMID: 31885043 DOI: 10.1093/rpd/ncz278
    The aim of this study was to propose local diagnostic reference levels (LDRLs) for the most common computed tomography (CT) examinations (including contrast and non-contrast scan phase) performed at Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia (USM), Malaysia. A retrospective CT dose survey of 1488 subjects from January 2015 until December 2018 was performed at AMDI USM, Malaysia. The proposed DRLs were established at 50th and 75th percentile of dose distribution for all dose metrics (CT dose index [CTDI]; CTDIvol, CTDIw and dose-length product). The proposed LDRLs were compared with national DRLs and other established DRLs. The 10 most common CT examinations at AMDI were thorax-abdomen-pelvis (TAP) CT (46%), followed by pelvis CT (17%), abdomen-pelvis CT (10%), brain/head CT (9%) and other CT protocols. The local DRLs were established using the third quartile values of dose distribution and were categorized based on CT region protocols. Most of the proposed DRLs were exceeded the national DRLs (63%) and other international DRLs (67%). From the dose auditing, almost half of the recent dose data (for year 2018) exceeded the proposed local DRLs and the unusual dose were observed in TAP, brain/head and pelvis CT examinations. The unusual higher dose could be due to higher mAs settings, higher number of scan phase for contrast study and higher pitch factor. The local DRLs should be established for dose optimization and reduction of the occurrence of excessive radiation exposure to the patients. The establishment of the Ads and LDRLs should also consider all the factors that affect the variation in DRLs such as CT technology, scanning protocols and population characteristics. The local dose distribution should always be revised for improvement of the current local practice.
  11. Investigation of mass attenuation coefficient of almond gum bonded Rhizophora spp. particleboard as equivalent human tissue using XRF technique in the 16.6-25.3 keV photon energy
    Ababneh B, Tajuddin AA, Hashim R, Shuaib IL
    Australas Phys Eng Sci Med, 2016 Dec;39(4):871-876.
    PMID: 27628943 DOI: 10.1007/s13246-016-0482-6
    This paper reports the novel use of almond gum as a binder in manufacturing Rhizophora spp. particleboard. X-ray fluorescence spectroscopy was employed for analysis under photon energy range of 16.6-25.3 keV. Results showed that almond gum-bonded Rhizophora spp. particleboard can be used as tissue-equivalent phantom in diagnostic radiation. The calculated mass attenuation coefficients of the particleboards were consistent with the values of water calculated using XCOM program for the same photon energies, with p values of 0.056, 0.069, and 0.077 for samples A8, C0, and C8, respectively. However, no direct relationship was found between the percentage of adhesive and the mass attenuation coefficient. The results positively supported the use of almond gum as a binding agent in the fabrication of particleboards, which can be used as a phantom material in dosimetric and quality control applications.
  12. Fulltext Natural history of giant cell tumour of the bone
    Faisham WI, Zulmi W, Mutum SS, Shuaib IL
    Singapore Med J, 2003 Jul;44(7):362-5.
    PMID: 14620730
    The clinical presentation and behaviour of giant cell tumours of bone vary. The progression of the disease and metastases are unpredictable, but the overall prognosis is good. We describe the natural history and different clinical presentations of two cases of giant cell tumour of bone where the patients had refused the initial treatment and presented several years later with the disease.
  13. Evaluation of a new predictive equation for automated calculation of size-specific dose estimate (SSDE) in CT imaging
    Osman ND, Abdulkadir MK, Shuaib IL, Nasirudin RA
    Radiography (Lond), 2024 Jan;30(1):237-244.
    PMID: 38035439 DOI: 10.1016/j.radi.2023.11.012
    INTRODUCTION: The adoption of size-specific dose estimate (SSDE) in clinical practice is still limited owing to the tedious and complex manual measurement of individual patient size for the clinical calculation of SSDE. Thus, the automation of SSDE is imperative. This study aims to evaluate a predictive equation for the automated calculation of SSDE.

    METHODS: A user-friendly software was developed to accurately predict the individual size-specific dose estimation of paediatric patients undergoing computed tomography (CT) scans of the head, thorax, and abdomen. The software includes a calculation equation developed based on a novel SSDE prediction equation that used a population's pre-determined percentage difference between volume-weighted computed tomography dose index (CTDIvol) and SSDE with age. American Association of Physicists in Medicine (AAPM RPT 204) method (manual) and segmentation-based SSDE calculators (indoseCT and XXautocalc) were used to assess the proposed software predictions comparatively.

    RESULTS: The results of this study show that the automated equation-based calculation of SSDE and the manual and segmentation-based calculation of SSDE are in good agreement for patients. The differences between the automated equation-based calculation of SSDE and the manual and segmentation-based calculation are less than 3%.

    CONCLUSION: This study validated an accurate SSDE calculator that allows users to enter key input values and calculate SSDE.

    IMPLICATION FOR PRACTICE: The automated equation-based SSDE software (PESSD) seems a promising tool for estimating individualised CT doses during CT scans.

  14. Clinical determinants of fluorodeoxyglucose positron emission tomography/computed tomography in differentiated thyroid cancer patients with elevated thyroglobulin and negative (131)iodine whole body scans after (131)iodine therapy
    Shamim SE, Nang LB, Shuaib IL, Muhamad NA
    Malays J Med Sci, 2014 May;21(3):38-46.
    PMID: 25246834
    A cross-sectional prospective study has been conducted on differentiated thyroid cancer (DTC) patients using negative (131)Iodine ((131)I) whole body scans and elevated thyroglobulin (Tg) levels. The main objective of this research was to determine the prevalence of the conversion of differentiated to dedifferentiated thyroid cancer patients during follow up at the Hospital Kuala Lumpur. It has been demonstrated that fluorodeoxyglucose (FDG) uptake is inversely proportional to the iodine concentration and to differentiation of the cells.
  15. Referral of epileptic patients in North East Coast of West Malaysia an area with poor MRI coverage: an analysis
    Mohamed Y, Alias NN, Shuaib IL, Tharakan J, Abdullah J, Munawir AH, et al.
    Southeast Asian J. Trop. Med. Public Health, 2006 Nov;37(6):1199-208.
    PMID: 17333778
    Advances in neuroimaging techniques, particularly Magnetic Resonance Imaging (MRI), have proved invaluable in detecting structural brain lesions in patients with epilepsy in developed countries. In Malaysia, a few electroencephalography facilities available in rural district hospitals run by trained physician assistants have Internet connections to a government neurological center in Kuala Lumpur. These facilities are more commonly available than MRI machines, which require radiological expertise and helium replacement, which may problematic in Southeast Asian countries where radiologists are found in mainly big cities or towns. We conducted a cross-sectional study over a two year period begining January 2001 on rural patients, correlating EEG reports and MRI images with a clinical diagnosis of epilepsy to set guidelines for which rural patients need to be referred to a hospital with MRI facilities. The patients referred by different hospitals without neurological services were classified as having generalized, partial or unclassified seizures based on the International Classification of Epileptic Seizures proposed by the International League Against Epilepsy (ILAE). The clinical parameters studied were seizure type, seizure frequency, status epilepticus and duration of seizure. EEG reports were reviewed for localized and generalized abnormalities and epileptiform changes. Statistical analysis was performed using logistic regression and area under the curve. The association between clinical and radiological abnormalities was evaluated for sensitivity and specificity. Twenty-six males and 18 females were evaluated. The mean age was 20.7 +/- 13.3 years. Nineteen (43.2%) had generalized seizures, 22 (50.0%) had partial seizures and 3 (6.8%) presented with unclassified seizures. The EEG was abnormal in 30 patients (20 with generalized abnormalities and 10 localized abnormalities). The MRI was abnormal in 17 patients (38.6%); the abnormalities observed were cerebral atrophy (5), hippocampal sclerosis (4), infarct/gliosis (3), cortical dysgenesis (2) and tumors (2). One patient had an arachnoid cyst in the right occipital region. Of the 17 patients with an abnormal MRI, 14 had an abnormal EEG, this difference was not statistically significant. There was no significant associaton between epileptographic changes and MRI findings (p = 0.078). EEG findings were associated with MRI findings (p = 0.004). The association between an abnormal EEG and an abnormal MRI had a specificity of 82.4%, while epileptogenic changes had a specificity of 64.7% in relation to abnormal MRI findings. This meants that those patients in rural hospitals with abnormal EEGs should be referred to a neurology center for further workup and an MRI to detect causes with an epileptic focus.
  16. A study of the factors related to intima-media thickness of the common carotid artery amongst rural middle age individuals in Hospital Universiti Sains Malaysia
    Yunus R, Ariff AR, Shuaib IL, Jelani AM, Alias NA, Abdullah J, et al.
    Southeast Asian J. Trop. Med. Public Health, 2006 Jul;37(4):806-11.
    PMID: 17121310
    There is very little data regarding the factors related to intima-media thickness (IMT) of the common carotid artery in normal individuals in those with non-insulin diabetes mellitus and perimenopausal women in Southeast Asian countries. Ultrasound imaging evaluating the carotid artery IMT in those with diabetes and those on hormone replacement therapy (HRT) was performed beginning in August 2000 for a period of nearly two years at the Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. A total of 153 participants were included. Significant differences between the women on HRT and not on HRT were IMT and systolic blood pressure. When comparing those with non-insulin dependent diabetes mellitus (NIDDM) and normal individuals, the significant differences were IMT, total cholesterol level, systolic blood pressure and diastolic blood pressure. IMT was high in those with NIDDM but not in those on HRT. Both those with NIDDM and those on HRT had associated dyslipidemia and systolic hypertension.
  17. Diagnostic cerebral angiography in spontaneous intracranial haemorrhage: a guide for developing countries
    Abu Bakar I, Shuaib IL, Mohd Ariff AR, Naing NN, Abdullah JM
    Asian J Surg, 2005 Jan;28(1):1-6.
    PMID: 15691788
    OBJECTIVE: Spontaneous intracranial haemorrhage constitutes 18-40% of all stroke cases. Indications for cerebral angiography to find underlying potentially treatable vascular abnormalities are not clear. This study determined which intracranial haemorrhage patients need cerebral angiography by correlating computed tomography (CT) findings, age and hypertension history with cerebral angiography findings.

    METHODS: A total of 54 patients (8-79 years) with intracranial haemorrhage who underwent both CT examination and six-vessel cerebral angiography were studied over a 2-year period. Cerebral angiography was repeated within 6 weeks if the first angiogram was negative.

    RESULTS: Angiography detected vascular lesions in 50% of cases (aneurysm 38.9% and arteriovenous malformation, AVM, 11.1%). In the aneurysm group, angiographic yield was 34.3% whereas in the AVM group, it was 37.9%. Subarachnoid haemorrhage (SAH) combined with other types of haemorrhage (such as intracerebral haemorrhage, ICH) was not significantly correlated with the likelihood of finding a vascular lesion, both aneurysm and AVM (p = 0.157). Age less than 50 years had significant correlation (p = 0.021) in the AVM group as well as in the aneurysm group (p < 0.001). A history of hypertension was associated with both aneurysm (p = 0.039) and AVM (p = 0.008). No patients with deep intracerebral haematoma had vascular lesions. The presence of an intravascular haemorrhage (IVH) had significant correlation with aneurysm (p = 0.008) but not AVM. There was no significant difference in mean age between patients with and without a vascular lesion (p = 0.134).

    CONCLUSION: Cerebral angiography is justified in patients with ICH accompanied by pure SAH (p = 0.001). Other factors associated with finding a vascular lesion were a history of hypertension and the presence of IVH. Diagnostic cerebral angiography is indicated for patients with ICH and SAH and IVH with a history of hypertension, regardless of age.

  18. Analysis of pediatric subdural empyema outcome in relation to computerized tomography brain scan
    Md Ralib AR, Ariff AR, Shuaib IL, Naing NN, George PJ, Abdullah JM
    Southeast Asian J. Trop. Med. Public Health, 2004 Jun;35(2):434-44.
    PMID: 15691152
    A cross-sectional study was conducted to predict the outcome in patients with subdural empyema, using initial and post-treatment CT scan brain parameters. Data collection was done on those children who were diagnosed to have subdural empyema by CT scan of the brain with contrast, who underwent burrhole evacuation, from February 2000 until April 2002. Numerous factors, such as coma or loss of unconsciousness at diagnosis, age, types of antibiotic, microbiology, extension of empyema, associated cerebral infarction and ventriculitis, were analyzed. Poor prognosis was associated with loss of consciousness, and hypodensity by CT scan at presentation (p < 0.005). Patients with an extensive subdural empyema will have a good outcome if they are treated early and aggressively with antibiotics and burrhole evacuation.
  19. CT scan in minor head injury: a guide for rural doctors
    Abdul Latip LS, Ahmad Alias NA, Ariff AR, Shuaib IL, Abdullah J, Naing NN
    J Clin Neurosci, 2004 Nov;11(8):835-9.
    PMID: 15519858 DOI: 10.1016/j.jocn.2003.12.017
    Minor head injury in a developing country like Malaysia is managed by primary care physicians and/or medical assistants in district hospitals. These patients are seen initially in their local hospitals, which have at least an X-ray machine for the purpose of screening. This study aimed to guide these physicians to manage these patients at a primary care level. A cross-sectional study was conducted and the study revealed significant predictors of significant computed tomographic (CT) findings. The presence of a Glasgow coma scale (GCS) score of 14 or 13 was associated with the risk of developing significant CT findings compared to patients with a GCS of 15 (p<0.001). Thirty-seven out of 50 patients with GCS of 14 or 13 developed clinically significant brain injury on CT scan. Similarly, the presence of skull fracture was associated with the risk of developing CT abnormalities (p<0.001). Forty-two out of 51 patients with skull fracture developed clinically significant CT findings. Vomiting was associated with developing CT abnormalities (p=0.017). Twenty-seven out of 40 patients with vomiting showed significant CT findings. Soft tissue injury was also found to be associated with developing CT abnormalities (p=0.007). Therefore, we propose reclassifying minor head injury based on the GCS score. Patients with a GCS score of 15 were classified as having mild head injury, while patients with a GCS score of 13 or 14 were at higher risk of developing brain injury and therefore categorized as high risk mild head injury. This group requires emergency CT scan examination, especially when associated with non-motor vehicle accidents, abnormal central nervous system (CNS) examination, craniofacial injuries or skull fractures. They should be referred to a general surgical unit which can treat head injuries or a neurosurgical tertiary centre.
  20. Fulltext Erratum to: Diagnostic Performance of (68)Ga-DOTATATE PET/CT, (18)F-FDG PET/CT and (131)I-MIBG Scintigraphy in Mapping Metastatic Pheochromocytoma and Paraganglioma
    Tan TH, Lee BN, Hussein Z, Saad FF, Shuaib IL
    Nucl Med Mol Imaging, 2016 Mar;50(1):98.
    PMID: 26941869 DOI: 10.1007/s13139-015-0351-3
    [This corrects the article DOI: 10.1007/s13139-015-0339-z.].
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