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  1. Fathinul Fikri A, Lau W
    Biomed Imaging Interv J, 2010 10 01;6(4):e37.
    PMID: 21611073 DOI: 10.2349/biij.6.4.e37
    An incidental finding of an intense focus of (18)F-Fluorodeoxyglucose (FDG) pulmonary uptake on positron emission tomography (PET) without detectable lesions on computed tomography (CT) is highly suggestive of FDG microembolus. Its microscopic nature means it is undetectable on CT. It is an artefact attributable to (18)F-FDG-tracer contamination at the injection site. This paper reports a case of a 61 year-old lady with a past history of breast carcinoma, in whom follow-up PET/CT images demonstrated an incidental intense FDG pulmonary abnormality. A follow-up PET/CT seven months later demonstrated complete resolution of the abnormality.
  2. Fathinul Fikri A, Lau W
    Biomed Imaging Interv J, 2010 10 01;6(4):e34.
    PMID: 21611070 DOI: 10.2349/biij.6.4.e34
    The significance of a subcentimetre (18)F-FDG PET/CT pulmonary abnormality in a patient with known extrapulmonary primary malignancy can have a major impact on the clinical management of the patient. The clinician's reliance on the semi-quantitative and qualitative PET/CT analysis of the abnormality has, at times, led to untoward diagnostic problems, given the limited spatial resolution of PET for a small volume lesion performed as part of the standard PET/CT study. This paper highlights a case each of an FDG-positive and an FDG-negative focal pulmonary abnormality in a combined PET/CT study of patients with known extrapulmonary malignancy. © 2010 Biomedical Imaging and Intervention Journal. All rights reserved.
  3. 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).
  4. Mustapha FA, Bashah FAA, Yassin IM, Fathinul Fikri AS, Nordin AJ, Abdul Razak HR
    Quant Imaging Med Surg, 2017 Jun;7(3):310-317.
    PMID: 28811997 DOI: 10.21037/qims.2017.05.03
    BACKGROUND: Kidneys and urinary bladder are common physiologic uptake sites of 18fluorine-fluorodeoxyglucose ((18)F-FDG) causing increased exposure of low energy ionizing radiation to these organs. Accurate measurement of organ dose is vital as (18)F-FDG is directly exposed to the organs. Organ dose from (18)F-FDG PET is calculated according to the injected (18)F-FDG activity with the application of dose coefficients established by International Commission on Radiological Protection (ICRP). But this dose calculation technique is not directly measured from these organs; rather it is calculated based on total injected activity of radiotracer prior to scanning. This study estimated the (18)F-FDG dose to the kidneys and urinary bladder in whole body positron emission tomography/computed tomography (PET/CT) examination by comparing dose from total injected activity of (18)F-FDG (calculated dose) and dose from organs activity based on the region of interest (ROI) (measured dose).

    METHODS: Nine subjects were injected intravenously with the mean (18)F-FDG dose of 292.42 MBq prior to whole body PET/CT scanning. Kidneys and urinary bladder doses were estimated by using two approaches which are the total injected activity of (18)F-FDG and organs activity concentration of (18)F-FDG based on drawn ROI with the application of recommended dose coefficients for (18)F-FDG described in the ICRP 80 and ICRP 106.

    RESULTS: The mean percentage difference between calculated dose and measured dose ranged from 98.95% to 99.29% for the kidneys based on ICRP 80 and 98.96% to 99.32% based on ICRP 106. Whilst, the mean percentage difference between calculated dose and measured dose was 97.08% and 97.27% for urinary bladder based on ICRP 80 while 96.99% and 97.28% based on ICRP 106. Whereas, the range of mean percentage difference between calculated and measured organ doses derived from ICRP 106 and ICRP 80 for kidney doses were from 17.00% to 40.00% and for urinary bladder dose was 18.46% to 18.75%.

    CONCLUSIONS: There is a significant difference between calculated dose and measured dose. The use of organ activity estimation based on drawn ROI and the latest version of ICRP 106 dose coefficient should be explored deeper to obtain accurate radiation dose to patients.

  5. Nisha SN, Fathinul Fikri AS, Aida AR, Salasiah M, Hamed S, Rohit T, et al.
    Med J Malaysia, 2020 01;75(1):62-67.
    PMID: 32008023
    OBJECTIVE: To identify regions of the brain affected during cognitive working memory during tasks to assess attention, planning and decision making among military aviation personnel who have chronic intermittent exposure to high altitude environment.

    METHOD: A case-control study was conducted in the Universiti Putra Malaysia among eight military personnel, four of whom had chronic intermittent exposure to high altitude training. They were divided into two groups, chronic intermittent exposure group (CE) (n=4) and a control group (n=4). They underwent a task-based functional magnetic resonance imaging (fMRI) that utilised spatial working memory task to objectively evaluate the neural activation in response to the Tower of London paradigm. Each correct answer was given a score of one and the maximum achievable score was 100%.

    RESULTS: A consecutive dichotomised group of CE (4/8) and control (4/8) of age-matched military aviation personnel with a mean age of 37.23±5.52 years; showed significant activation in the right middle frontal gyrus (MFG). This in turn was positively correlated with response accuracy. A significant difference in the response accuracy was noted among both the groups at p<0.05.

    CONCLUSION: At the minimum results of power analysis of this preliminary fMRI study, our group of aviation personnel who had chronic intermittent exposure to hypobaric hypoxic environment, did not have any significant decrease in cognitive function namely attention, decision-making and problem solving compared to controls during a working memory task.

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