scholarly journals Focal Increased Radiopharmaceutical Uptake Differentiation Using Quantitative Indices

2021 ◽  
Author(s):  
V. Sivasubramaniyan ◽  
K. Venkataramaniah

Focal increased radiopharmaceutical uptake in a lesion results in focal Hot Spots in the scans. This can occur in benign infective or inflammatory disorders and cancerous diseases as well. Comparison between malignant and benign lesions is important. The Hot spots can be classified into benign and malignant lesions by Spatial Scintimetry or Temporal Scintimetry. Spatial Scintimetry compares the uptake in the region of interest with the adjacent tissue or the unaffected contralateral site. The quantitative indices are lesion/non lesion ratio, lesion/background activity and lesion to Bone ratio etc. The Temporal Scintimetry relies on the changes in the counts or uptake in the Hotspot lesion with reference to the dual point time of acquisition. The Hotspot in the bone scan can be classified using the quantitative index of retention ratio by Dr. V. Siva and Israel. In PET studies the focal hot spots can be differentiated into benign and malignant lesion using the dual phase PETCT evaluation using the Rong’s Retention ratio and Dr. V. Siva’s modified RRI values.

2018 ◽  
Vol 20 (1) ◽  
pp. 9
Author(s):  
Afroza Naznin ◽  
Sadia Sultana ◽  
Kamrun Nahar ◽  
Taslima Sifat ◽  
Pupree Mutsuddy

<p>Skeletal scintigraphy is a highly sensitive tool in the detection of metastatic disease from prostate cancer, but its specificity is relatively low. Various quantitative parameters have been introduced to improve the bone scan specificity. Scintimetric method based Dr. V. Siva’s retention ratio is one such parameter proposed to help in predicting malignant or metastatic nature of the skeletal hot spots in a bone scan non-invasively. This study was performed to evaluate the V. Siva’s ratio in a small sample of prostate cancer patients in Bangladeshi population. This prospective observational study was carried out at the National Institute of Nuclear Medicine and Allied Sciences (NINMAS) from July 2015 to June 2016. A total of 32 patients with diagnosed prostate cancer were enrolled. Each patient underwent two bone scans at 4 hours and 24 hours respectively after radiopharmaceutical injection. Focal hot spots reported by expert Nuclear Medicine specialists were identified in both scans and maximum counts were taken by drawing region of interest over the spots. Dr. V. Siva’s retention ratio was calculated by dividing the 4-hour count with 24-hour count. Finally statistical analysis was done. The mean V. Siva's ratio of metastatic group was 9.3 ± 2.2 (95% CI 8.5-10.1) and that of degenerative group was 8.2 ± 2.0 (95% CI 7.5-8.9). Statistically significant difference was observed between the two groups. So it can be said that V. Siva’s retention ratio might be useful as a quantitative parameter in adjunct to conventional bone scintigraphy for the skeletal survey of carcinoma prostate patients.</p><p>Bangladesh J. Nuclear Med. 20(1): 9-13, January 2017</p>


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10589-10589
Author(s):  
Joseph W. Kim ◽  
Maria Liza Lindenberg ◽  
William L. Dahut ◽  
James L. Gulley ◽  
Ravi A. Madan ◽  
...  

10589 Background: We evaluated the clinical utility of 18F-sodium fluoride PET/CT bone scan (18F-NaF) in the detection of bone metastases in patients (pts) with prostate cancer in comparison with Technetium-99m MDP bone scan (TcBS). Methods: In a prospective study, from October 2010-December 2011, 30 prostate cancer pts (ages 51-79), 21 with known bone metastases and 9 without known bone metastases, had18F-NaF and a TcBS performed. Abnormal foci of uptake on both TcBS and 18F-NaFwere classified as benign, malignant or indeterminate. Benign lesions included uptake in the joints and linear uptake at the endplates of the vertebral bodies consistent with degenerative changes. Malignant uptake on 18F-NaF scans was confirmed by characteristic osteoblastic features on CT. All TcBS and 18F-NaF were reviewed by an experienced nuclear medicine physician. For the patient-based analysis, scan results were categorized as positive (POS) = any malignant lesion; indeterminate (IND) = not distinctly malignant or benign; negative (NEG) = benign lesions only. Results: In the lesion-based analysis, 21 of 30 (70%) pts had more malignant lesions identified on 18F-NaF than on TcBS. The mean number of additional malignant lesions per patient on 18F-NaF vs TcBS was 4. Eight of the 30 pts had same number of malignant lesions identified in both studies. One of 30 pts had one less malignant lesion identified on 18F-NaF than on TcBS. CT correlation by 18F-NaF PET/CT of this particular lesion did not confirm osteoblastic feature. Malignant lesion distribution on 18F-NaF included: spine (28%), thorax (26%), pelvis (24%), long bones (13%) and skull (10%). In the patient-based analysis, 24 pts (80%) were POS by 18F-NaF, of whom 14 pts were POS, 8 were IND, and 2 were NEG by corresponding TcBS; in the 4 pts with NEG 18F-NaF, zero were POS, 2 were IND and 2 were NEG by corresponding TcBS. Conclusions: 18F-NaF identified more malignant lesions than TcBS. 18F-NaF may also add useful information in the management of advanced prostate cancer pts with and without known bone metastases.


Author(s):  
Hind M. Alkatan ◽  
Khalid M. Alshomar ◽  
Hala A. Helmi ◽  
Wajda M. Alhothali ◽  
Abdulaziz M. Alshalan

Abstract Background Conjunctival lesions are common with a wide spectrum of benign, premalignant, and malignant lesions. Few histopathological studies have been conducted on conjunctival lesions with variable designs and results. Our aim in this study is to provide information on common conjunctival lesions seen in an ophthalmology tertiary care center in Saudi Arabia. Methods A retrospective, observational study of all consecutive conjunctival tissue specimens sent for histopathological assessment to the pathology department from 2015 to 2019 were analyzed. Clinical data were collected from medical records, and the histopathological slides were reviewed by a single pathologist. Results A total of 110 conjunctival specimens from 108 patients were included (mean age: 53 years, 67 males and 43 females). Bilateral involvement was mostly found in inflammatory lesions (40%). Most lesions were benign (91%), with a significantly longer duration of symptoms in malignant lesions (p = 0.036*). The clinical diagnosis matched the final histopathological diagnosis in 75.5% of the total specimens. The most frequent category of benign lesions was fibrodegenerative and proliferative lesions (53.6%), with a significantly higher prevalence among adult males (p < 0.001). Melanocytic lesions were more common in children (33.3%) than adults (9.8%), and the mean age of children was significantly lower (p = 0.013). The most frequent malignant lesion was ocular surface squamous neoplasia (50%), with equal prevalence among males and females. The overall outcome was favorable in 89.4% and unfavorable in 10.6%, mostly due to surgical complications, further progression of the lesion, or recurrence. Conclusion This study shows variability in the frequency of conjunctival lesions based on gender, age, geographical, racial, and environmental factors. There has been a shift in the gender-based prevalence of ocular squamous neoplasia over the last three decades, probably due to a change in lifestyle.


2013 ◽  
Vol 2013 ◽  
pp. 1-20 ◽  
Author(s):  
Luigi Grazioli ◽  
Lucio Olivetti ◽  
Giancarlo Mazza ◽  
Maria Pia Bondioni

Hepatocellular adenomas (HCAs) are currently categorized into distinct genetic and pathologic subtypes as follows: inflammatory hepatocellular adenoma, hepatocyte-nuclear-factor-1-alpha (HNF-1α-mutated) hepatocellular adenoma, andβ-catenin-mutated hepatocellular adenomas; the fourth, defined as unclassified subtype, encompasses HCAs without any genetic abnormalities. This classification has accepted management implications due to different risks of haemorrhage and malignant transformation of the four subtypes. Imaging guided biopsy and/or surgical resection very important in obtaining definitive characterization; nevertheless, MRI with intra-extravascular and hepatobiliary (dual phase) agents, is an important tool not only in differential subtypes definition but even in surveillance with early identification of complications and discovery of some signs of HCA malignant degeneration. Inflammation, abnormal rich vascularisation, peliotic areas, and abundant fatty infiltration are pathologic findings differently present in the HCA subtypes and they may be detected by multiparametric MRI approach. Lesion enlargement and heterogeneity of signal intensity and of contrast enhancement are signs to be considered in malignant transformation. The purpose of this paper is to present the state of the art of MRI in the diagnosis of HCA and subtype characterization, with particular regard to morphologic and functional information available with dual phase contrast agents, and to discuss differential diagnosis with the most common benign and malignant lesions mimicking HCAs.


2015 ◽  
Vol 49 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Jan Jamsek ◽  
Ivana Zagar ◽  
Simona Gaberscek ◽  
Marko Grmek

AbstractBackground. Incidental18F-FDG uptake in the thyroid on PET-CT examinations represents a diagnostic challenge. The maximal standardized uptake value (SUVmax) is one possible parameter that can help in distinguishing between benign and malignant thyroid PET lesions.Patients and methods. We retrospectively evaluated18F-FDG PET-CT examinations of 5,911 patients performed at two different medical centres from 2010 to 2011. If pathologically increased activity was accidentally detected in the thyroid, the SUVmaxof the thyroid lesion was calculated. Patients with incidental18F-FDG uptake in the thyroid were instructed to visit a thyroidologist, who performed further investigation including fine needle aspiration cytology (FNAC) if needed. Lesions deemed suspicious after FNAC were referred for surgery.Results. Incidental18F-FDG uptake in the thyroid was found in 3.89% ― in 230 out of 5,911 patients investigated on PET-CT. Malignant thyroid lesions (represented with focal thyroid uptake) were detected in 10 of 66 patients (in 15.2%). In the first medical centre the SUVmaxof 36 benign lesions was 5.6 ± 2.8 compared to 15.8 ± 9.2 of 5 malignant lesions (p < 0.001). In the second centre the SUVmaxof 20 benign lesions was 3.7 ± 2.2 compared to 5.1 ± 2.3 of 5 malignant lesions (p = 0.217). All 29 further investigated diffuse thyroid lesions were benign.Conclusions. Incidental18F-FDG uptake in the thyroid was found in 3.89% of patients who had a PET-CT examination. Only focal thyroid uptake represented a malignant lesion in our study ― in 15.2% of all focal thyroid lesions. SUVmaxshould only serve as one of several parameters that alert the clinician on the possibility of thyroid malignancy.


2017 ◽  
Vol 2017 ◽  
pp. 1-10
Author(s):  
Freja Lærke Sand ◽  
Simon Francis Thomsen

Correct and rapid diagnosis of skin tumours often requires biopsy and histopathological examination to differentiate benign lesions such as seborrhoeic keratoses or melanocytic naevi from premalignant and malignant lesions such as malignant melanoma. Particularly, to the untrained eye, any benign skin tumour—pigmented or nonpigmented—is easily mistaken for a malignant lesion. Qualified clinical evaluation is paramount in order to reduce the frequency of unwarranted skin biopsies. Herein, the most common benign, premalignant, and malignant vulvar skin tumours are reviewed.


1978 ◽  
Vol 3 (9) ◽  
pp. 351-354 ◽  
Author(s):  
LYNNE BLEI ◽  
ROQUE A. CANO ◽  
A ERIC JONES ◽  
GERALD S. JOHNSTON
Keyword(s):  

2020 ◽  
Vol 5 (2) ◽  
pp. 63-70
Author(s):  
Thinley Dorji ◽  
Hari Prasad Pokhrel ◽  
Tshokey Tshokey

Background: The case burden of cervical cancer has been increasing globally especially in developing countries without proper health system. Cervical cancer can be eliminated with timely vaccination and screening program as it usually takes years for pre-malignant lesions to develop into malignant lesion. Bhutan has committed to eliminate cervical cancer. Thus, it is important to understand the factors associated with abnormal Pap test findings. Methodology: A retrospective study was conducted using the Pap smear data for the year 2018. It was extracted from the records maintained in the cytology unit of Samtse General Hospital. Result: The abnormal slide rate in this study was 2.5%. The majority of women seeking Pap smear services were women in reproductive age group and housewife by occupation. There were significant differences between age groups and marital status among normal in the Pap test results. Conclusion: The slide abnormality of Pap smear in Samtse District is low. The abnormality is more common among married and older women. Therefore, additional screening efforts needs to be put into this group to detect pre-malignant lesions.


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