Publications by authors named "Abdul Jalil Nordin"

17 Publications

  • Page 1 of 1

Metastatic Adenocarcinoma of Temporal Bone with Collet-Sicard Syndrome.

Iran J Otorhinolaryngol 2018 Nov;30(101):361-364

Department of Otorhinolaryngology, University Putra Malaysia (UPM), Selangor, Malaysia.

Introduction: Metastatic tumors of the temporal bone are extremely rare. Collet-Sicard syndrome is an uncommon condition characterized by unilateral palsy of the lower four cranial nerves. The clinical features of temporal bone metastasis are nonspecific and mimic infections such as chronic otitis media and mastoiditis.

Case Report: This report describes a rare case of metastatic adenocarcinoma of the temporal bone causing Collet-Sicard syndrome, presenting with hearing loss, headache and ipsilateral cranial nerve palsies. The patient was a 68-year old woman initially diagnosed with extensive mastoiditis and later confirmed as having metastatic adenocarcinoma of the temporal bone, based on histopathologic findings.

Conclusion: Clinical presentation of metastatic carcinoma of the temporal bone can be overshadowed by infective or inflammatory conditions. This case report is to emphasize the point that a high index of clinical suspicion is necessary for the early diagnosis of this aggressive disease which carries relatively poor prognosis. This report highlights that it is crucial to suspect malignant neoplasm in patients with hearing loss, headache and cranial nerve palsies.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6291818PMC
November 2018

Papillary Thyroid Carcinoma Presenting As a Cystic Neck Lesion: Case Series.

Iran J Otorhinolaryngol 2018 Jan;30(96):49-54

Department of Otorhinolaryngology, Faculty of Medicine & Health Sciences, University Putra Malaysia, Selangor, Malaysia.

Introduction: Papillary thyroid carcinoma (PTC) constitutes 75-85% of all thyroid cancers. PTC usually presents as a subtle, commonly slow-growing, painless thyroid mass or a solitary nodule in the neck. This presentation of a cystic neck lump, without the presence of a thyroid nodule, may imitate the course of a benign disease, thus delaying diagnosis and proper treatment.

Case Report: Three cases that had been initially presented as a cystic neck lesion in which a benign etiology was considered primarily were compiled in this study. PTC was only diagnosed after surgical excision of these cystic neck lesions in the first two cases, and after performing fine needle aspiration cytology (FNAC) and an 18fluorine-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET CT) scan in the latter case.

Conclusion: PTC can sometimes present as a cystic neck mass; a presentation which is usually related to a benign lesion. This case series emphasizes that patients who appear to have a solitary cystic neck mass must be treated with a high index of clinical suspicion. Although not a first-line imaging modality, 18F-FDG-PET can be extremely useful in assessing patients with a cystic neck lesion, where diagnosis is still uncertain after standard investigations such as ultrasonography and FNAC have been performed.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787655PMC
January 2018

Estimation of kidneys and urinary bladder doses based on the region of interest in fluorine-fluorodeoxyglucose positron emission tomography/computed tomography examination: a preliminary study.

Quant Imaging Med Surg 2017 Jun;7(3):310-317

Faculty of Health Sciences, Universiti Teknologi MARA Selangor, Selangor, Malaysia.

Background: Kidneys and urinary bladder are common physiologic uptake sites of 18fluorine-fluorodeoxyglucose (F-FDG) causing increased exposure of low energy ionizing radiation to these organs. Accurate measurement of organ dose is vital as F-FDG is directly exposed to the organs. Organ dose from F-FDG PET is calculated according to the injected 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 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 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 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 F-FDG and organs activity concentration of F-FDG based on drawn ROI with the application of recommended dose coefficients for 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.
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http://dx.doi.org/10.21037/qims.2017.05.03DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537126PMC
June 2017

Systematic Review on the Accuracy of Positron Emission Tomography/Computed Tomography and Positron Emission Tomography/Magnetic Resonance Imaging in the Management of Ovarian Cancer: Is Functional Information Really Needed?

World J Nucl Med 2017 Jul-Sep;16(3):176-185

Department of Nuclear Medicine, Royal Liverpool and Broadgreen University Hospitals, NHS Trusts, Liverpool, UK.

Ovarian cancer (OC) often presents at an advanced stage with frequent relapses despite optimal treatment; thus, accurate staging and restaging are required for improving treatment outcomes and prognostication. Conventionally, staging of OC is performed using contrast-enhanced computed tomography (CT). Nevertheless, recent advances in the field of hybrid imaging have made positron emission tomography/CT (PET/CT) and PET/magnetic resonance imaging (PET/MRI) as emerging potential noninvasive imaging tools for improved management of OC. Several studies have championed the role of PET/CT for the detection of recurrence and prognostication of OC. We provide a systematic review and meta-analysis of the latest publications regarding the role of molecular imaging in the management of OC. We retrieved 57 original research articles with one article having overlap in both diagnosis and staging; 10 articles (734 patients) regarding the role of PET/CT in diagnosis of OC; 12 articles (604 patients) regarding staging of OC; 22 studies (1429 patients) for detection of recurrence; and 13 articles for prognostication and assessment of treatment response. We calculated pooled sensitivity and specificity of PET/CT performance in various aspects of imaging of OC. We also discussed the emerging role of PET/MRI in the management of OC. We aim to give the readers and objective overview on the role of molecular imaging in the management of OC.
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http://dx.doi.org/10.4103/wjnm.WJNM_31_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460299PMC
July 2017

Cerebral glucose hypometabolism in Tick-Borne Encephalitis, a pilot study in 10 Patients.

Int J Infect Dis 2016 Oct 11;51:73-77. Epub 2016 Jul 11.

Department of Neurology, Neurological Intensive Care Unit, Innsbruck Medical University, Innsbruck, Austria.

Background: Tick borne encephalitis (TBE) is an acute meningoencephalitis with or without myelitis caused by an RNA virus from the flavivirus family transmitted by Ixodes spp ticks. The neurotropic TBE virus infects preferentially large neurons in basal ganglia, anterior horns, medulla oblongata, Purkinje cells and thalamus. Brain metabolic changes related to radiologic and clinical findings have not been described so far.

Methods: Here we describe the clinical course of 10 consecutive TBE patients with outcome assessment at discharge and after 12 month using a modified Rankin Scale. Patients underwent cerebral MRI after confirmation of diagnosis and before discharge. F-FDG PET/CT scans were performed within day 5 to day 14 after TBE diagnosis. Extended analysis of coagulation parameters by thrombelastometry (ROTEM® InTEM, ExTEM, FibTEM) was performed every other day after confirmation of TBE diagnosis up to day 10 after hospital admission or discharge.

Results: All patients presented with a meningoencephalitic course of disease. Cerebral MRI scans showed unspecific findings at predilection areas in 3 patients. F-FDG PET/CT showed increased glucose utilization in one patient and decreased F-FDG uptake in seven patients. Changes in coagulation measured by standard parameters and thrombelastometry were not found in any of the patients.

Discussion: Glucose hypometabolism was present in 7 out of 10 TBE patients reflecting neuronal dysfunction in predilection areas of TBE virus infiltration responsible for development of clinical signs and symptoms.
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http://dx.doi.org/10.1016/j.ijid.2016.06.022DOI Listing
October 2016

PET/CT in nononcological lung diseases: current applications and future perspectives.

Eur Respir Rev 2016 Sep;25(141):247-58

Nuclear Medicine, ASST Grande Ospedale Metropolitano Niguarda, Dept of Advanced Diagnostic Therapeutic Technologies, Milan, Italy.

Positron emission tomography (PET) combined with computed tomography (CT) is an established diagnostic modality that has become an essential imaging tool in oncological practice. However, thanks to its noninvasive nature and its capability to provide physiological information, the main applications of this technique have significantly expanded.(18)F-labelled fluorodeoxyglucose (FDG) is the most commonly used radiopharmaceutical for PET scanning and demonstrates metabolic activity in various tissues. Since activated inflammatory cells, like malignant cells, predominantly metabolise glucose as a source of energy and increase expression of glucose transporters when activated, FDG-PET/CT can be successfully used to detect and monitor a variety of lung diseases, such as infections and several inflammatory conditions.The added value of FDG-PET/CT as a molecular imaging technique relies on its capability to identify disease in very early stages, long before the appearance of structural changes detectable by conventional imaging. Furthermore, by detecting the active phase of infectious or inflammatory processes, disease progression and treatment efficacy can be monitored.This review will focus on the clinical use of FDG-PET/CT in nonmalignant pulmonary diseases.
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http://dx.doi.org/10.1183/16000617.0051-2016DOI Listing
September 2016

Increased regulatory T cells in acute lymphoblastic leukaemia patients.

Hematology 2016 May 24;21(4):206-12. Epub 2016 Feb 24.

a Department of Pathology, Faculty of Medicine and Health Sciences , Universiti Putra Malaysia , 43400 Serdang , Selangor , Malaysia.

Introduction: Regulation in adaptive immune response balances a fine line that prevents instigation of self-damage or fall into unresponsiveness permitting abnormal cell growth. Mechanisms that keep this balance in check include regulatory T cells (Tregs). Tregs consist of a small but heterogeneous population, which may be identified by the phenotype, CD3+CD4+CD25+CD127-. The role of Tregs in pathogenesis of cancers is thus far supported by evidence of increased Tregs in various cancers and may contribute to poorer prognosis. Tregs may also be important in acute leukaemias.

Objective: A review of the literature on Tregs in acute leukaemias was conducted and Tregs were determined in B-cell acute lymphoblastic leukaemias (ALLs).

Results: Studies on Tregs in B-cell ALL are few and controversial. We observed a significantly increased percentage of Tregs (mean±SD, 9.72 ± 3.79% vs. 7.05 ± 1.74%; P = 0.047) in the bone marrow/peripheral blood of ALL (n = 17) compared to peripheral blood of normal controls (n = 35). A positive trend between Tregs and age (R = 0.474, P = 0.055, n = 17) implicates this factor of poor prognosis in B-cell ALL.

Discussion: Tregs in cancer are particularly significant in immunotherapy. The manipulation of the immune system to treat cancer has for a long time ignored regulatory mechanisms inducible or in place. In lymphoma studies, tumour-specific mechanisms that are unlike conventional methods in the induction of Tregs have been hypothesized. In addition, tumour-infiltrating Tregs may present different profiles from peripheral blood pictures. Tregs will continue to be dissected to reveal its mysteries and their impact on clinical significance.
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http://dx.doi.org/10.1080/10245332.2015.1101965DOI Listing
May 2016

Impacts of biological and procedural factors on semiquantification uptake value of liver in fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging.

Quant Imaging Med Surg 2015 Oct;5(5):700-7

1 Faculty of Medicine and Health Sciences, 2 Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, Selangor, Malaysia ; 3 Department of Medical Imaging, Faculty of Health Sciences, Universiti Teknologi MARA Puncak Alam Campus, Selangor, Malaysia ; 4 Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.

Background: Increased metabolic activity of fluorodeoxyglucose (FDG) in tissue is not only resulting of pathological uptake, but due to physiological uptake as well. This study aimed to determine the impacts of biological and procedural factors on FDG uptake of liver in whole body positron emission tomography/computed tomography (PET/CT) imaging.

Methods: Whole body fluorine-18 ((18)F) FDG PET/CT scans of 51 oncology patients have been reviewed. Maximum standardized uptake value (SUVmax) of lesion-free liver was quantified in each patient. Pearson correlation was performed to determine the association between the factors of age, body mass index (BMI), blood glucose level, FDG dose and incubation period and liver SUVmax. Multivariate regression analysis was established to determine the significant factors that best predicted the liver SUVmax. Then the subjects were dichotomised into four BMI groups. Analysis of variance (ANOVA) was established for mean difference of SUVmax of liver between those BMI groups.

Results: BMI and incubation period were significantly associated with liver SUVmax. These factors were accounted for 29.6% of the liver SUVmax variance. Statistically significant differences were observed in the mean SUVmax of liver among those BMI groups (P<0.05).

Conclusions: BMI and incubation period are significant factors affecting physiological FDG uptake of liver. It would be recommended to employ different cut-off value for physiological liver SUVmax as a reference standard for different BMI of patients in PET/CT interpretation and use a standard protocol for incubation period of patient to reduce variation in physiological FDG uptake of liver in PET/CT study.
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http://dx.doi.org/10.3978/j.issn.2223-4292.2015.05.02DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671971PMC
October 2015

Improving the (18)F-fluoromethylcholine ((18)F-FCH) radiochemical yield via optimising the azeotropic drying of non-carrier-added (18)F-fluorine.

J Labelled Comp Radiopharm 2015 Sep-Oct;58(11-12):458-9. Epub 2015 Sep 23.

Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, Serdang, Malaysia.

(18)F-Fluoromethylcholine ((18)F-FCH) has been suggested as one of the reputable imaging tracers for diagnosis of prostate tumour in PET/CT examination. Nevertheless, it has never been synthesised in Malaysia. We acknowledged the major problem with (18)F-FCH is due to its relatively low radiochemical yield at the end of synthesis (EOS). Therefore, this technical note presents improved (18)F-FCH radiochemical yields after carrying out optimisation on azeotropic drying of non-carrier-added (18)F-Fluorine.
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http://dx.doi.org/10.1002/jlcr.3347DOI Listing
August 2016

Optimising the Azeotropic Drying of 18F-Fluorine Wayto Improve the 18F-Fluorocholine Radiochemical Yield.

Curr Radiopharm 2016 ;9(2):121-7

Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia (UPM), Malaysia.

Background And Objective: 18F-Fluorocholine has been suggested as one of the reputable imaging tracers for diagnosis of prostate tumour in Positron Emission Tomography / Computed Tomography (PET/CT) modality. Nevertheless, it has never been synthesised in Malaysia. We acknowledged that the major problem with 18F-Fluorocholine is due to its relatively low radiochemical yield at the end of synthesis (EOS). Therefore, this article presents improved 18FFluorocholine radiochemical yields after carrying out optimisation on azeotropic drying of 18F-Fluorine.

Methods: In the previous study, the azeotropic drying of non-carrier-added (n.c.a) 18F-Fluorine in the reactor was conducted at atmospheric pressure (0 atm) and shorter duration time. In this study, however, the azeotropic drying of non-carried-added (n.c.a) 18FFluorine was made at a high vacuum pressure (- 0.65 to - 0.85 bar) with an additional time of 30 seconds. At the end of the synthesis, the mean radiochemical yield was statistically compared between the two azeotropic drying conditions so as to observe whether the improvement made was significant to the radiochemical yield.

Results: From the paired sample t-test analysis, the improvement done to the azeotropic drying of non-carrier-added (n.c.a) 18F-Fluorine was statistically significant (p < 0.05). With the improvement made, the 18F-Fluorcholine radiochemical yield was found to have increase by one fold.

Conclusion: Improved 18F-Fluorocholine radiochemical yields were obtained after the improvement had been done to the azeotropic drying of non-carrier-added (n.c.a) 18F-Fluorine. It was also observed that improvement made to the azeotropic drying of non-carrier-added (n.c.a) 18F-Fluorine did not affect the 18F-Fluorocholine quality control analysis.
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http://dx.doi.org/10.2174/1874471008666150804110923DOI Listing
February 2017

Increased regulatory T cells in acute lymphoblastic leukemia patients.

Hematology 2015 Oct 29;20(9):523-9. Epub 2015 Jun 29.

Introduction: Regulation in adaptive immune response balances a fine line that prevents instigation of self-damage or fall into unresponsiveness permitting abnormal cell growth. Mechanisms that keep this balance in check include regulatory T cells (Tregs). Tregs consist of a small but heterogeneous population which may be identified by the phenotype, CD3+CD4+CD25+CD127-. Role of Tregs in pathogenesis of cancers is thus far supported by evidence of increased Tregs in various cancers and may contribute to poorer prognosis. Tregs may also be important in acute leukemias.

Objective: A review of the literature on Tregs in acute leukemias was conducted and Tregs were determined in B-cell acute lymphoblastic leukemias (ALLs).

Results: Studies on Tregs in B-cell ALL are few and controversial. We observed a significantly increased percentage of Tregs (mean ± SD, 9.72 ± 3.79% vs. 7.05 ± 1.74%; P = 0.047) in the bone marrow/peripheral blood of ALL (n = 17) compared to peripheral blood of normal controls (n = 35). A positive trend between Tregs and age (R = 0.474, P = 0.055, n = 17) implicates this factor of poor prognosis in B-cell ALL.

Discussion: Tregs in cancer are particularly significant in immunotherapy. The manipulation of the immune system to treat cancer has for a long time ignored regulatory mechanisms inducible or in place. In lymphoma studies tumor-specific mechanisms that are unlike conventional methods in the induction of Tregs have been hypothesized. In addition, tumor-infiltrating Tregs may present different profiles from peripheral blood pictures. Tregs will continue to be dissected to reveal their mysteries and their impact on clinical significance.
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http://dx.doi.org/10.1179/1607845415Y.0000000025DOI Listing
October 2015

Convenient and Efficient Method for Quality Control Analysis of 18F-Fluorocholine: For a Small Scale GMP-based Radiopharmaceuticals Laboratory Set-up.

Curr Radiopharm 2016 ;9(2):128-36

Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, Serdang 43400, Malaysia.

Background And Objective: Prostate cancer continues to be the most prevalent cancer in men in Malaysia. As time progresses, the prospect of PET imaging modality in diagnosis of prostate cancer is promising, with on-going improvement on novel tracers. Among all tracers, 18F-Fluorocholine is reported to be a reputable tracer and reliable diagnostic technique for prostate imaging. Nonetheless, only 18F-Fluorodeoxyglucose (18F-FDG) is available and used in most oncology cases in Malaysia. With a small scale GMP-based radiopharmaceuticals laboratory set-up, initial efforts have been taken to put Malaysia on 18F-Fluorocholine map. This article presents a convenient, efficient and reliable method for quality control analysis of 18F-Fluorocholine. Besides, the aim of this research work is to assist local GMP radiopharmaceuticals laboratories and local authority in Malaysia for quality control analysis of 18F-Fluorocholine guideline.

Methods: In this study, prior to synthesis, quality control analysis method for 18F-Fluorocholine was developed and validated, by adapting the equipment set-up used in 18F-Fluorodeoxyglucose (18FFDG) routine production. Quality control on the 18F-Fluorocholine was performed by means of pH, radionuclidic identity, radio-high performance liquid chromatography equipped with ultraviolet, radio- thin layer chromatography, gas chromatography and filter integrity test.

Results: Post-synthesis; the pH of 18F-Fluorocholine was 6.42 ± 0.04, with half-life of 109.5 minutes (n = 12). The radiochemical purity was consistently higher than 99%, both in radio-high performance liquid chromatography equipped with ultraviolet (r-HPLC; SCX column, 0.25 M NaH2PO4: acetonitrile) and radio-thin layer chromatography method (r-TLC). The calculated relative retention time (RRT) in r-HPLC was 1.02, whereas the retention factor (Rf) in r-TLC was 0.64. Potential impurities from 18F-Fluorocholine synthesis such as ethanol, acetonitrile, dimethylethanolamine and dibromomethane were determined in gas chromatography. Using our parameters, (capillary column: DB-200, 30 m x 0.53 mm x 1 um) and oven temperature of 35°C (isothermal), all compounds were well resolved and eluted within 3 minutes. Level of ethanol and acetonitrile in 18F-Fluorocholine were detected below threshold limit; less than 5 mg/ml and 0.41 mg/ml respectively. Meanwhile, dimethylethanolamine and dibromomethane were undetectable.

Conclusion: A convenient, efficient and reliable quality control analysis work-up procedure for 18FFluorocholine has been established and validated to comply all the release criteria. The convenient method of quality control analysis may provide a guideline to local GMP radiopharmaceutical laboratories to start producing 18F-Fluorocholine as a tracer for prostate cancer imaging.
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http://dx.doi.org/10.2174/1874471008666150527091956DOI Listing
February 2017

Association of Cholesteryl Ester Transfer Protein and Endothelial Nitric Oxide Synthase Gene Polymorphisms With Coronary Artery Disease in the Multi-Ethnic Malaysian Population.

Clin Appl Thromb Hemost 2016 Sep 9;22(6):581-8. Epub 2015 Feb 9.

Department of Biomedical Science, Faculty of Medicine and Health Science, University Putra Malaysia, Selangor, Malaysia Centre for Diagnostic Nuclear Imaging, University Putra Malaysia, Selangor, Malaysia

Genetic variants of cholesteryl ester transfer protein (CETP) and endothelial nitric oxide synthase (eNOS) influence high-density lipoprotein cholesterol (HDL-C) metabolism and nitric oxide (NO) synthesis, respectively, and might increase the risk of coronary artery disease (CAD). This study is to investigate the relationship between genetic polymorphisms and the risk of CAD and to evaluate their potential interactions. A total of 237 patients with CAD and 101 controls were genotyped. The association of the polymorphism with the risk of CAD varied among the ethnic groups. Moreover, the concomitant presence of both CETP B1 and eNOS 4a alleles significantly increased the risk of CAD in the Malay group (OR = 33.8, P < .001) and the Indian group (OR = 10.9, P = .031) but not in the Chinese group. This study has identified a novel ethnic-specific gene-gene interaction and suggested that the combination of CETP B1 allele and eNOS 4a allele significantly increases the risk of CAD in Malays and Indians.
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http://dx.doi.org/10.1177/1076029615571628DOI Listing
September 2016

Imaging characteristics of extrapulmonary tuberculosis lesions on dual time point imaging (DTPI) of FDG PET/CT.

J Med Imaging Radiat Oncol 2011 Dec;55(6):556-62

Discipline of Medical Radiations, School of Medical Sciences, Bundoora West Campus, RMIT University, Victoria, Australia.

Introduction: This study aimed to evaluate the diagnostic value of dual time point imaging (DTPI) of 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT (PET/CT) for detecting the infective lesions in patients with extrapulmonary tuberculosis (EPTB).

Methods: Eleven patients were consecutively recruited and evaluated. After the intravenous injection of 369 ± 153 MBq of FDG, all patients underwent FDG PET/CT imaging at two different time points: early scan at 57 ± 23 min and delayed scan at 136 ± 42 min. The maximum standardized uptake values (SUVmax) were recorded for both time points (early scan: SUVmax1 and delayed scan: SUVmax2).

Results: In total, 30 lesions were detected. The SUVmax2 in 22 of the lesions in confirmed EPTB patients were significantly higher than the SUVmax1 (7.9 ± 3.2 vs. 6.8 ± 2.5; P = 0.001). The SUVmax for another eight non-EPTB lesions also showed a significant increasing pattern of change (6.2 ± 2.6 vs. 6.5 ± 2.8; P = 0.044). However, there was insignificant difference between the mean percentage difference of SUVmax (%ΔSUVmax) of EPTB and non-EPTB lesions (P = 0.06).

Conclusion: Our study demonstrates that early whole body PET/CT imaging may be sufficient for the detection of the EPTB lesions and DTPI of PET/CT may also not be a useful technique in differentiating between EPTB and non-EPTB lesions. However, our findings are based on a limited number of patients, and therefore, further investigations in larger series of patients are warranted.
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http://dx.doi.org/10.1111/j.1754-9485.2011.02309.xDOI Listing
December 2011

Quantifying the effects of iodine contrast media on standardised uptake values of FDG PET/CT images: an anthropomorphic phantom study.

Australas Phys Eng Sci Med 2011 Sep 23;34(3):367-74. Epub 2011 Jul 23.

Discipline of Medical Radiations, School of Medical Sciences, Bundoora West Campus, RMIT University, VIC 3083, Australia.

This study aimed to quantify the amount of change in Standardised Uptake Values (SUVs) of PET/CT images by simulating the set-up as closely as possible to the actual patient scanning. The experiments were conducted using an anthropomorphic phantom, which contained an amount of radioactivity in the form of Fluorodeoxyglucose (FDG) in a primary plastic test tube and one litre saline bags, including the insertion of bony structures and another two test tubes containing different concentrations of iodine contrast media. Standard scanning protocols were employed for the PET/CT image acquisition. The highest absolute differences in the SUVmax and SUVmean values of the saline bags were found to be about 0.2 and 0.4, respectively. The primary test tube showed the largest change of 1.5 in both SUVs; SUV max and SUVmean. However, none of these changes were found to be statistically significant. The clinical literature also contains no evidence to suggest that the changes of this magnitude would change the final diagnosis. Based on these preliminary data, we propose that iodine contrast media can be used during the CT scan of PET/CT imaging, without significantly affecting the diagnostic quality of this integrated imaging modality.
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http://dx.doi.org/10.1007/s13246-011-0088-yDOI Listing
September 2011

Segmentation of extrapulmonary tuberculosis infection using modified automatic seeded region growing.

Biol Proced Online 2009 Jul 14;11:241-52. Epub 2009 Jul 14.

In the image segmentation process of positron emission tomography combined with computed tomography (PET/CT) imaging, previous works used information in CT only for segmenting the image without utilizing the information that can be provided by PET. This paper proposes to utilize the hot spot values in PET to guide the segmentation in CT, in automatic image segmentation using seeded region growing (SRG) technique. This automatic segmentation routine can be used as part of automatic diagnostic tools. In addition to the original initial seed selection using hot spot values in PET, this paper also introduces a new SRG growing criterion, the sliding windows. Fourteen images of patients having extrapulmonary tuberculosis have been examined using the above-mentioned method. To evaluate the performance of the modified SRG, three fidelity criteria are measured: percentage of under-segmentation area, percentage of over-segmentation area, and average time consumption. In terms of the under-segmentation percentage, SRG with average of the region growing criterion shows the least error percentage (51.85%). Meanwhile, SRG with local averaging and variance yielded the best results (2.67%) for the over-segmentation percentage. In terms of the time complexity, the modified SRG with local averaging and variance growing criterion shows the best performance with 5.273 s average execution time. The results indicate that the proposed methods yield fairly good performance in terms of the over- and under-segmentation area. The results also demonstrated that the hot spot values in PET can be used to guide the automatic segmentation in CT image.
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http://dx.doi.org/10.1007/s12575-009-9013-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055983PMC
July 2009

Disseminated tuberculosis infection: a 'super' 18F-FDG PET/CT appearance.

Eur J Nucl Med Mol Imaging 2009 May 19;36(5):882. Epub 2009 Mar 19.

Faculty Medicine and Health Sciences, University Putra Malaysia, Serdang 43400, Malaysia.

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http://dx.doi.org/10.1007/s00259-009-1107-zDOI Listing
May 2009