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Fulltext Effective Dose Estimation of Patients Administered with 18F-FDG and Ga-68 DOTATATE in PET/CT Examination Associated with Gender and Weight

Kamal, I., Said, M. A., Bathumalai, J., Abdul Razak, H. R., Abdul Karim, M. K.

Physics and Technology in Medicine, 2020;1(1):15-21.
MyJurnal

The whole-body fluorodeoxyglucose F18 (18F-FDG) and gallium-68 (Ga-68 DOTATATE) are the most common radiopharmaceutical use in PET/CT imaging for cancer staging. Although radiopharmaceutical for PET/CT examination has been acknowledged for its safety and efficacy, the internal dosimetry and effective dose (ED) from the examinations are rarely discussed. Hence, this study aimed to evaluate radiation ED for whole-body radiopharmaceuticals PET/CT concerning patients’ gender and their weight. A total of 82 oncology patients (44 males and 38 females) were collected retrospectively from Institut Kanser Negara, Putrajaya. Data, such as 18F-FDG and Ga-68 DOTATATE activity and patient demography (weight, height, age), were recorded and analyzed. Effective doses from both internal and external exposure were calculated using the coefficient
provided by the International Commission on Radiological Protection (ICRP) report. The total ED of 18F-FDG for male patients was 20.2 ± 8.6 mSv and for female patients were 19.0 ± 8.2 mSv while total whole-body ED for Ga-68 DOTATATE for male patients was 18.5 ± 7.0 mSv and 17.0 ± 5.6 mSv for female patients. The ratio for ED between male and female were 1:1 for both examinations ranged from 12.0 – 23 mSv. From this study, it indicated that the ED of Ga-68 DOTATATE was far lower when compared to the ED of 18F-FDG by a factor of 0.7. Therefore, it is crucial to optimize the PET/CT protocol dose in order to uphold the dose as low as reasonably achievable (ALARA).
Fulltext Entrance Surface Dose Measurement and Lifetime Attribute Risk Analysis from Postero-anterior Chest X-ray Imaging via Direct and Indirect Measurement

Kamal, I., Salehhon, N., Hashim, S., Musa, Y., Abdul Karim, M. K.

Physics and Technology in Medicine, 2020;1(2):20-26.
MyJurnal

The aimed of this study is to estimate the entrance surface dose (ESD) of routine chest X-ray (CXR) examination and to compare the direct and indirect measurement. This study also extended to relate with the patients body thickness and established lifetime attributable risk (LAR) of the examinations. A total of 101 CXR examinations in posteroanterior (PA) projections were selected
as subjects and data, such as patient habitus and scanning acquisition parameters were recorded. The mean ESD value obtained from the TLD-100 and the software calculation was 0.31 mGy and 0.17 mGy, respectively. The percentage deviation obtained ranged from 25.5% to 61.3%. In comparison with the national diagnostic reference level (DRL), the mean values of ESD obtained from this study were lower by a factor of 3. Furthermore, it was observed that the mean absorbed dose of the adrenals, kidneys, lungs, oesophagus, and heart walls were lower as compared to the ESD value. The examinations were only associated with very low risk of cancer incidence and mortality. Hence, the results of this study suggested a need for standardisations of the personnel training to perform X-ray examinations according to ALARA principles.
Estimates of Average Glandular Dose with Auto-modes of X-ray Exposures in Digital Breast Tomosynthesis

Kamal I, Chelliah KK, Mustafa N

Sultan Qaboos Univ Med J, 2015 May;15(2):e292-6.
PMID: 26052465

The aim of this research was to examine the average glandular dose (AGD) of radiation among different breast compositions of glandular and adipose tissue with auto-modes of exposure factor selection in digital breast tomosynthesis.
Bibliometric Review of Optimization and Image Processing of Positron Emission Tomography (PET) Imaging System between 1981-2022

Murat H, Awang Kechik MM, Chew MT, Kamal I, Abdul Karim MK

Curr Med Imaging, 2024 Apr 09.
PMID: 38616750 DOI: 10.2174/0115734056282004240403042345

BACKGROUND: PET scan stands as a valuable diagnostic tool in nuclear medicine, enabling the observation of metabolic and physiological changes at a molecular level. However, PET scans have a number of drawbacks, such as poor spatial resolution, noisy images, scattered radiation, artifacts, and radiation exposure. These challenges demonstrate the need for optimization in image processing techniques.
OBJECTIVES: Our objective is to identify the evolving trends and impacts of publication in this field, as well as the most productive and influential countries, institutions, authors, themes, and articles.
METHODS: A bibliometric study was conducted using a comprehensive query string such as "positron emission tomography" AND "image processing" AND optimization to retrieve 1,783 publications from 1981 to 2022 found in the Scopus database related to this field of study.
RESULTS: The findings revealed that the most influential country, institution, and authors are from the USA, and the most prevalent theme is TOF PET image reconstruction.
CONCLUSION: The increasing trend in publication in the field of optimization of image processing in PET scans would address the challenges in PET scan by reducing radiation exposure, faster scanning speed, as well as enhancing lesion identification.
Systematic review and meta-analysis on the classification metrics of machine learning algorithm based radiomics in hepatocellular carcinoma diagnosis

Mohd Haniff NS, Ng KH, Kamal I, Mohd Zain N, Abdul Karim MK

Heliyon, 2024 Aug 30;10(16):e36313.
PMID: 39253167 DOI: 10.1016/j.heliyon.2024.e36313

The aim of this systematic review and meta-analysis is to evaluate the performance of classification metrics of machine learning-driven radiomics in diagnosing hepatocellular carcinoma (HCC). Following the PRISMA guidelines, a comprehensive search was conducted across three major scientific databases-PubMed, ScienceDirect, and Scopus-from 2018 to 2022. The search yielded a total of 436 articles pertinent to the application of machine learning and deep learning for HCC prediction. These studies collectively reflect the burgeoning interest and rapid advancements in employing artificial intelligence (AI)-driven radiomics for enhanced HCC diagnostic capabilities. After the screening process, 34 of these articles were chosen for the study. The area under curve (AUC), accuracy, specificity, and sensitivity of the proposed and basic models were assessed in each of the studies. Jamovi (version 1.1.9.0) was utilised to carry out a meta-analysis of 12 cohort studies to evaluate the classification accuracy rate. The risk of bias was estimated, and Logistic Regression was found to be the most suitable classifier for binary problems, with least absolute shrinkage and selection operator (LASSO) as the feature selector. The pooled proportion for HCC prediction classification was high for all performance metrics, with an AUC value of 0.86 (95 % CI: 0.83-0.88), accuracy of 0.83 (95 % CI: 0.78-0.88), sensitivity of 0.80 (95 % CI: 0.75-0.84) and specificity of 0.84 (95 % CI: 0.80-0.88). The performance of feature selectors, classifiers, and input features in detecting HCC and related factors was evaluated and it was observed that radiomics features extracted from medical images were adequate for AI to accurately distinguish the condition. HCC based radiomics has favourable predictive performance especially with addition of clinical features that may serve as tool that support clinical decision-making.
Fulltext A case series on safety and tolerability of human umbilical cord-derived mesenchymal stem cells on patients in Malaysia

Yusof B, Kamal I, Lee KM, Chai SK, Zuo XL, Ravichandran M, et al.

SAGE Open Med Case Rep, 2024;12:2050313X241249622.
PMID: 38694904 DOI: 10.1177/2050313X241249622

Umbilical cord-derived mesenchymal stem cells for regenerative therapy are a promising treatment option for chronic illnesses. Umbilical cord-derived mesenchymal stem cells offer several advantages over other sources, which makes them an attractive option in tissue repair and regeneration. This clinical study describes a 1-year follow-up on the safety and tolerance of umbilical cord-derived mesenchymal stem cell therapy on nine patients in Malaysia. Patients were assessed for adverse effects, and liver function tests were carried out on both pre- and post-treatments. Umbilical cord-derived mesenchymal stem cells' effectiveness and safety were assessed by follow-up evaluations. All nine patients responded positively towards umbilical cord-derived mesenchymal stem cell therapy, without any adverse effects. After umbilical cord-derived mesenchymal stem cell therapy, a significant improvement was observed in liver functioning test outcomes, as haematological parameters and tumour markers were stable. The present study concludes that umbilical cord-derived mesenchymal stem cell therapy is well tolerated by Malaysian patients; however, further clinical screening must be done over a large number of patients population.
Fulltext Mechanical and Imaging Properties of a Clinical-Grade Kidney Phantom Based on Polydimethylsiloxane and Elastomer

Kamal I, Razak HRA, Abdul Karim MK, Mashohor S, Liew JYC, Low YJ, et al.

Polymers (Basel), 2022 Jan 28;14(3).
PMID: 35160523 DOI: 10.3390/polym14030535

Medical imaging phantoms are considered critical in mimicking the properties of human tissue for calibration, training, surgical planning, and simulation purposes. Hence, the stability and accuracy of the imaging phantom play a significant role in diagnostic imaging. This study aimed to evaluate the influence of hydrogen silicone (HS) and water (H2O) on the compression strength, radiation attenuation properties, and computed tomography (CT) number of the blended Polydimethylsiloxane (PDMS) samples, and to verify the best material to simulate kidney tissue. Four samples with different compositions were studied, including samples S1, S2, S3, and S4, which consisted of PDMS 100%, HS/PDMS 20:80, H2O/PDMS 20:80, and HS/H2O/PDMS 20:40:40, respectively. The stability of the samples was assessed using compression testing, and the attenuation properties of sample S2 were evaluated. The effective atomic number of S2 showed a similar pattern to the human kidney tissue at 1.50 × 10-1 to 1 MeV. With the use of a 120 kVp X-ray beam, the CT number quantified for S2, as well measured 40 HU, and had the highest contrast-to-noise ratio (CNR) value. Therefore, the S2 sample formulation exhibited the potential to mimic the human kidney, as it has a similar dynamic and is higher in terms of stability as a medical phantom.
Fulltext Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines

Coccolini F, Improta M, Sartelli M, Rasa K, Sawyer R, Coimbra R, et al.

World J Emerg Surg, 2021 08 09;16(1):40.
PMID: 34372902 DOI: 10.1186/s13017-021-00380-1

Immunocompromised patients are a heterogeneous and diffuse category frequently presenting to the emergency department with acute surgical diseases. Diagnosis and treatment in immunocompromised patients are often complex and must be multidisciplinary. Misdiagnosis of an acute surgical disease may be followed by increased morbidity and mortality. Delayed diagnosis and treatment of surgical disease occur; these patients may seek medical assistance late because their symptoms are often ambiguous. Also, they develop unique surgical problems that do not affect the general population. Management of this population must be multidisciplinary.This paper presents the World Society of Emergency Surgery (WSES), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS) joined guidelines about the management of acute abdomen in immunocompromised patients.