The incidence of ureteric calculus as a cause for severe abdominal pain in children is mounting, especiallyin the tropical country. The course of illness may be non-specific but a swift detection via non-invasiveimaging modalities singly or in combination may avert unnecessary radiation hazard and futile surgery ina young child. In this paper, we discussed a case of an 11 year-old boy who was presented with a suddenonset of the right side severe abdominal colic whose a bedside ultrasound was positive for hydronephrosisfor which localisation of stone was further confirmed via a low dose limited intravenous urography (IVU).It is important to note that data available on the value of a combined ultrasound and the limited IVU inan emergency setting when urolithiais is being suspected in children with abdominal pain are particularlyscarce. Hence, this case documented the potential value of a combined ultrasound and a limited IVUstudy as a unique combined armamentarium used in a suspected childhood urolithiasis in the tropics.
The purpose of this article is to demonstrate the appearance of active TB lymphadenitis using multimodality imaging apparatus. Multi-modality diagnostic imaging tools, including chest radiograph, Ultrasound (US), Computed Tomographic Scan (CT), Magnetic Resonance Imaging (MRI), and integrated 18F-FDG Positron Emission Tomography/CT examination, were performed to demonstrate TB lymphadenitis in the neck and superior mediastinum of a 26 year old female patient. There was widening of superior mediastinum on chest radiograph. Meanwhile, the ultrasound carried out detected superficial cystic lesions in the cervical region. The MRI found multiple gadolinium enhanced cervical and mediastinal lymphadenophaties. Contrast enhanced CT found heterogeneous enhancing lymphadenopathies in the same anatomical region. FDG PET/CT demonstrated a high metabolic activity in all lesions, as demonstrated by conventional imaging
modalities. Mycobacterium tuberculosis was isolated from 1ml aspirate using US guidance. Post treatment FDG PET CT scan demonstrated a complete metabolic remission of active lesions FDG PET CT can be used to demonstrate metabolic activity of active TB lesions in addition to guide clinicians in treating TB lesions.
Introduction: Specific mutations in the epidermal growth factor receptor (EGFR) characterize a subgroup of nonsmall
cell lung cancer (NSCLC) patients that may be highly responsive to receptor inhibitor therapy. 18F-FDG PET/CT
scans can map the glucose metabolism and treatment response of NSCLC. Therefore, we aimed to assess the pattern
of metabolic response and outcome of inoperable NSCLC treated with epidermal growth factor receptor (EGFR)
inhibitors, using 18F-FDG PET/CT scan. Methods: A retrospective study of inoperable NSCLC patients on EGFR
inhibitor treatment that were referred for wholebody18F-FDG PET/CT scans was conducted based on cases scanned
from January 2011 to June 2014. Comparison was made among serial attenuation-corrected fused PET/CT images for
all study patients throughout the course of their treatment. Comparison based on PERCIST criteria was categorized
into 4 levels ie. complete response (CMR), partial response (PMR), stable disease (SMD), progressive metabolic
disease (PMD). Results: Overall, there were 5 patients identified, mean age: 57.4 years old +/- 2.9 years; The median
survival time from initiation of EGFR inhibitor treatment to death was 17 months. Two patients showed initial partial
metabolic response (PMR), two had progressive metabolic disease (PMD) and one had complete metabolic response
(CMR) after the initiation of treatment. The patient with initial CMR had relapse and PMD 5 months later. Majority of
patients eventually succumbed to their illness. Conclusions: Wholebody18F-FDG PET/CT is able to assess metabolic
treatment response of NSCLC towards EGFR inhibitor treatment.
This study sought to prospectively evaluate the influence of contrasted fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDGPET/CT) in the staging of and impact on the management plan for treatment in patients with nasopharyngeal carcinoma (NPC). A total of 14 histologically proven NPC patients (mean age: 44.64±4.01years) were included in the study. These patients underwent contrasted Computed Tomography (CT) as well as 18F-FDGPET/CT imaging. Staging was based on the 7th edition of the American Joint Committee on Cancer Tumor Node Metastases (AJCCTNM) recommendations.The oncologist was asked to prospectively assign a treatment plan for all patients being evaluated by CT and 18F-FDGPET/CT. The treatment plans were compared with the incremental information supplied by the FDG-PET/CT. The maximum standardised uptake value (SUVmax) and the widest dimension of the primary tumour, cervical lymph nodes size and the distant metastatic lesions were quantified on the co-registered PET/CT images by two experienced nuclear radiologists. The contrasted 18F-FDGPET/CT changed the management intent in nine patients (64.7%). A univariate analysis showed that there were significant correlations between SUVmax and the size of the metastatic
lymph nodes (R2 =0.0761, p
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.