Displaying all 13 publications

  1. Ho E, Abdullah B, Tang A, Nordin A, Nair A, Lim G, et al.
    Biomed Imaging Interv J, 2008 Oct;4(4):e44.
    PMID: 21611021 DOI: 10.2349/biij.4.4.e44
    To date, the College of Radiology (CoR) does not see any clear benefit in performing whole body screening computed tomography (CT) examinations in healthy asymptomatic individuals. There are radiation risk issues in CT and principles of screening should be adhered to. There may be a role for targeted cardiac screening CT that derives calcium score, especially for asymptomatic medium-risk individuals and CT colonography when used as part of a strategic programme for colorectal cancer screening in those 50 years and older. However, population based screening CT examinations may become appropriate when evidence emerges regarding a clear benefit for the patient outweighing the associated radiation risks.
    Matched MeSH terms: Whole Body Imaging
  2. Saw, A.
    Malays Orthop J, 2007;1(2):1-2.
    Musculoskeletal tumour is much less common compared to tumours of epithelial origin. Most of these tumours are benign, with only about 1% malignant in nature. A general orthopaedic surgeon may only come across a malignant primary bone or soft tissue tumour a few times in his entire medical career. The current recommendation is for these conditions to be investigated and treated in centres with musculoskeletal oncology service. Careful clinical evaluation with appropriate plain radiography can provide adequate information for definitive diagnosis and treatment for most cases, especially the benign tumours. For some other cases, further investigations will be necessary. Magnetic resonance imaging (MRI) can provide excellent details on anatomical location of a tumour and delineate vital structures that may have been distorted by the lesion. For primary malignant tumours, computerized tomography scanning is still the gold standard for evaluation of pulmonary metastasis, and bone scan can allow early detection of distant metastasis to other bones. Whole body MRI has recently been recommended for tumour staging but the potential benefit for musculoskeletal tumour is not that convincing. PET may be very helpful for follow up detection of tumour recurrence but its role in diagnosis and staging of musculoskeletal tumours is still being evaluated...
    Matched MeSH terms: Whole Body Imaging
  3. Hishar, H., Salasiah, M., Fathinul Fikri, A. S., Nordin, A. J.
    A shift to administration of optimal dose of 18F-FDG between 4 and 5 MBq/kg from the current practice of higher doses potentially yields a reasonable-to-excellent PET image. For this purpose, whole-body MIP images of 32 patients (23 men, 9 women, age 51.9 ± 13.7 years), administered with 18F-FDG (activity 5.3 ± 0.5 MBq/kg, 45 minutes uptake time) for whole-body PET/CT examinations, were evaluated. Image quality was assessed visually by two radiologists using a three-point scoring scale: poor, reasonable and excellent. The interobserver agreement revealed a kappa value higher than 0.7. Therefore, the utilisation of 18F-FDG dose between 4 and 5MBq/kg is considered an optimum dose for whole-body PET/CT examination.
    Matched MeSH terms: Whole Body Imaging
  4. 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: Whole Body Imaging
  5. Wong TH, Amir Hassan SZ
    Med. J. Malaysia, 2015 Dec;70(6):356-7.
    PMID: 26988209
    This is a case of follicular thyroid carcinoma with extensive lung, bone and brain metastases. Multi-modality treatments including total thyroidectomy, modified radical neck dissection, cranial radiotherapy and Iodine-131 (RAI) therapy were instituted. Post RAI therapy planar whole body scan showed RAI avid metastases in the skull, cervical spine, bilateral lungs and abdomen. With the use of SPECTCT imaging, rare adrenal metastasis and additional rib metastasis were identified. Besides, management strategy was altered due to detection of non-RAI avid brain and lung metastatic lesions.
    Matched MeSH terms: Whole Body Imaging
  6. Mahaletchumy T, AbAziz A
    World J Nucl Med, 2017 Oct-Dec;16(4):303-310.
    PMID: 29033679 DOI: 10.4103/1450-1147.215496
    The incremental value of single-photon emission computed tomography-computed tomography (SPECT-CT) over planar bone scintigraphy and SPECT in detecting skeletal lesions in breast cancer patients and its effect on patient management is assessed in this study. This is a prospective study which was conducted over 1-year duration. Whole-body planar scintigraphy, SPECT, and SPECT-CT were performed in 85 breast cancer patients with total of 128 lesions. Correlative imaging and clinical follow-up was used as the reference standard. McNemar's multistep analysis was performed for each patient and each lesion. On patient-wise analysis, 47 patients had equivocal diagnosis on planar bone scintigraphy, 28 on SPECT, and eight on SPECT-CT. On lesion-wise analysis, there were 72 equivocal lesions on planar bone scintigraphy, 48 on SPECT, and 15 on SPECT-CT. Overall, SPECT-CT resulted in a significant reduction in the proportion of equivocal diagnosis on both patient-wise (P < 0.004) and lesion-wise basis (P < 0.004), irrespective of the skeletal region involved. The sensitivity on a per-patient basis was 43%, 58%, and 78% for planar bone scintigraphy, SPECT, and SPECT-CT, respectively. Similarly, the specificity was 85%, 92%, and 94% for planar bone scintigraphy, SPECT, and SPECT-CT, respectively. Patient management was correctly altered in 32% of the patients based on SPECT-CT interpretation. Our data suggest that adding SPECT-CT to whole-body imaging significantly improves sensitivity and specificity in diagnosing bone metastases and significantly reduces the proportion of equivocal diagnosis in all regions of the skeleton. The most important outcome is derived from the accurate alteration in patient management clinically by down- and up-staging of patients and a more precise identification of metastatic extent.
    Matched MeSH terms: Whole Body Imaging
  7. Wong TH, Tan TH, Chin SC, Lee BN
    Med. J. Malaysia, 2018 06;73(3):181-182.
    PMID: 29962506
    Recently, encapsulated follicular variant of papillary thyroid carcinoma has been reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) to emphasize the benign nature of this entity. In our institution, we have assessed 455 patients treated with radioiodine ablation for differentiated thyroid carcinoma and 20 of them were retrospectively found to fulfill the new NIFTP criteria. There was no evidence of metastasis on post radioiodine whole body scans for NIFTP cases and these patients were in remission subsequently. The benign features of these patients' whole body scans and good clinical outcome following treatment further support NIFTP as a low risk thyroid neoplasm.
    Matched MeSH terms: Whole Body Imaging
  8. Khoo ACH, Chen SL
    World J Nucl Med, 2019 9 14;18(3):301-303.
    PMID: 31516376 DOI: 10.4103/wjnm.WJNM_43_18
    Follicular thyroid cancers are known to spread hematogenously to the bones and lungs and rarely presenting with massive angioinvasion. We report a case of a middle-aged female who had undergone total thyroidectomy for minimally invasive follicular thyroid cancer with angioinvasion in 2014. She was noted to have a large tumor thrombus extending from the superior vena cava to the right atrium on whole body scan post-Iodine-131 (131I) remnant ablation therapy. We discuss the various imaging modalities, treatment options, and difficulties in managing such massive angioinvasion in patients with well-differentiated thyroid cancers.
    Matched MeSH terms: Whole Body Imaging
  9. Hani AF, Prakasa E, Nugroho H, Affandi AM, Hussein SH
    Conf Proc IEEE Eng Med Biol Soc, 2012;2012:4398-401.
    PMID: 23366902 DOI: 10.1109/EMBC.2012.6346941
    Psoriasis is a common skin disorder with a prevalence of 0.6 - 4.8% around the world. The most common is plaques psoriasis and it appears as red scaling plaques. Psoriasis is incurable but treatable in a long term treatment. Although PASI (Psoriasis Area and Severity Index) scoring is recognised as gold standard for psoriasis assessment, this method is still influenced by inter and intra-rater variation. An imaging and analysis system called α-PASI is developed to perform PASI scoring objectively. Percentage of lesion area to the body surface area is one of PASI parameter. In this paper, enhanced imaging methods are developed to improve the determination of body surface area (BSA) and lesion area. BSA determination method has been validated on medical mannequin. BSA accuracies obtained at four body regions are 97.80% (lower limb), 92.41% (trunk), 87.72% (upper limb), and 83.82% (head). By applying fuzzy c-means clustering algorithm, the membership functions of lesions area for PASI area scoring have been determined. Performance of scoring result has been tested with double assessment by α-PASI area algorithm on body region images from 46 patients. Kappa coefficients for α-PASI system are greater than or equal to 0.72 for all body regions (Head - 0.76, Upper limb - 0.81, Trunk - 0.85, Lower limb - 0.72). The overall kappa coefficient for the α-PASI area is 0.80 that can be categorised as substantial agreement. This shows that the α-PASI area system has a high reliability and can be used in psoriasis area assessment.
    Matched MeSH terms: Whole Body Imaging/methods*
  10. 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.
    Matched MeSH terms: Whole Body Imaging
  11. Subapriya Suppiah, Andi Anggeriana Andi Asri, Fathinul Fikri Ahmad Saad, Hasyma Abu Hassan, Norhafizah Mohtarrudin, Chang, Wing Liong, et al.
    Introduction: Suspicious adnexal masses need to be investigated thoroughly as it may represent ovarian cancer, which is the fourth most common gynaecological cancer in Malaysia. Conventional cross sectional imaging may reveal non-specific findings, thus lead to unnecessary biopsies. 18F-Fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) has emerged as a useful tool, for characterization of indeterminate adnexal masses. Most studies have been conducted in Western population, and little information is available in Asian population in general and Malaysian population in particular. Methods: Prospective study of women with suspicious adnexal masses, referred to the Centre for Nuclear Diagnostic Imaging, Universiti Putra Malaysia to undergo pre-operative whole-body contrast-enhanced 18F-FDG PET/CT scans from January 2014 to January 2016. Subjects underwent Contrast-Enhanced Computed Tomography (CECT) scans followed by positron emission tomography (PET) scans using a hybrid scanner. Two radiologists analyzed the CECT and PET/CT images by consensus; blinded to the HPE results. Then the PET/CT findings were correlated with HPE results as the gold standard. Results: 11 whole-body PET/CT scans and 18 adnexal masses (12 HPE-proven malignant lesions and 6 benign lesions) were analyzed. The sensitivity, specificity, PPV, and NPV of CECT alone compared to PET/CT was 91.7%, 50.0%, 78.6%, and 75.0% vs. 91.7%, 100%, 100% and 85.7% respectively. Conclusions: Improved diagnostic accuracy for characterizing benign and malignant adnexal masses can be achieved using contrast-enhanced 18F-FDG PET/CT, making it a potential investigation of choice which can help in treatment planning.
    Matched MeSH terms: Whole Body Imaging
  12. Caunter G, Faeez Md Noh MS, Safri LS, Kumar K, Md Idris MA, Harunarashid H, et al.
    EJVES Short Rep, 2019;44:19-22.
    PMID: 31453386 DOI: 10.1016/j.ejvssr.2019.06.003
    Introduction: The development of metastatic renal cell carcinoma (RCC) many years after a nephrectomy is not common but has been reported. A metastasis appearing as a hypervascular tumour, mimicking an arteriovenous malformation (AVM), is a highly unusual phenomenon, with a biopsy required for diagnostic confirmation. Surgery is an option for a solitary metastatic lesion amenable to complete excision, with proven survival benefits. However, widespread metastatic disease carries a very poor prognosis, and is best treated with systemic agents such as anti-angiogenic drugs or tyrosine kinase inhibitors.

    Report: A 58 year old man developed an AVM mimicking a vascular tumour within his left brachioradialis muscle 10 years after a nephrectomy for RCC. Ultrasound and magnetic resonance imaging did not reveal any suspicious features of the vascular lesion.The lesion was successfully removed surgically, and was later proven histopathologically to be metastatic RCC. Further imaging showed widespread metastatic disease, and the patient survived only 15 months after receiving tyrosine kinase inhibitor therapy.

    Discussion: This case report aims to highlight a few important points: RCC metastases may be hypervascular, mimicking an AVM. A long disease free interval does not necessarily exclude recurrence or metastasis, as in this case, therefore long term surveillance is recommended. A high index of suspicion must be maintained to avoid delay in treatment, and biopsy of any suspicious lesion for histological examination is mandatory, albeit after many years of cancer remission. Whole body imaging with computed tomography or positron emission tomography computed tomography may detect clinically occult recurrence or metastases, and is important to guide further treatment.

    Matched MeSH terms: Whole Body Imaging
  13. Rashid SN, Bouwer H, O'Donnell C
    Forensic Sci Med Pathol, 2012 Dec;8(4):430-5.
    PMID: 22477359 DOI: 10.1007/s12024-012-9332-3
    Fistula formation following pelvic surgery and radiotherapy, including ureteric-arterial fistulas (UAF), is well documented, however, ureteric-arterial-enteric fistula is extremely rare. Conventional autopsy is usually required for the definitive diagnosis of pelvic vascular fistulas although an accurate diagnosis can still be complicated and challenging. The role of post-mortem computed tomography (PMCT) as an adjunct to conventional autopsy is well documented in the literature. One of the limitations of PMCT is the diagnosis of vascular conditions. Post-mortem computed tomography angiography (PMCTA) is a recently introduced technique that can assist in detecting such pathology. We present a case of post-radiotherapy ureteric-arterial-enteric fistula presenting as massive rectal and vaginal bleeding diagnosed prior to autopsy on PMCTA. The role of PMCTA in the diagnosis of such a UAF has not previously been reported in the literature.
    Matched MeSH terms: Whole Body Imaging
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