Publications by authors named "Arpita Sahu"

7 Publications

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Atypical imaging presentation of herpes simplex virus encephalitis in paediatric immunocompromised oncology patients.

J Med Imaging Radiat Oncol 2021 Sep 14. Epub 2021 Sep 14.

Tata Memorial Centre, Mumbai, India.

Introduction: We aim to assess the imaging manifestations of brain involvement in paediatric immunocompromised patients with haematological malignancies on chemotherapy presenting with encephalitis and positive HSV CSF PCR. We also aim to determine whether our findings are similar or different to those described in literature for paediatric patients in general.

Methods: A retrospective study was performed in paediatric ALL/lymphoma patients on chemotherapy, and cases with positive CSF HSV-PCR with at least one head MRI scan were included. On imaging, location(typical/atypical), post-contrast enhancement and haemorrhage/diffusivity/gliosis were evaluated.

Result: A total of 28 scans were included in study from 16 patients fulfilling inclusion criteria, 12 (75%) HSV-1 and 4 (25%) HSV-2. Of the 16 initial scans (CT n = 10, MRI n = 6), 11 were normal (CT = 7, MRI = 4). Fourteen patients had follow-up MRI, of which two had normal scans. On the abnormal initial scan (5/16), only 20% had typical medial temporal/inferomedial frontal/cingulate involvement. Most had frontal (80%), parietal (60%) and non-medial temporal (40%) lesions. Abnormal diffusivity/haemorrhage was absent in all, and postcontrast enhancement was seen in 20%. On follow-up, more patients (33%) had typical medial temporal/inferomedial frontal/cingulate involvement. Widespread atypical site involvement of frontoparietal (75%), thalamus (58%), non-medial temporal (50%), occipital/basal ganglia (33%) and cerebellum (8%) was noted. Most lesions were cortical (91%)/subcortical (75%) with few periventricular lesions (58%). Few showed abnormal diffusivity (16%), post-contrast parenchymal enhancement/haemorrhage (8%), post-contrast meningeal enhancement (25%) and gliosis (16%).

Conclusion: Immunocompromised paediatric patients with haematological malignancies have widespread atypical brain involvement in herpes simplex encephalitis with lack of diffusion restriction and post-contrast enhancement, likely due to haematogenous spread of HSV across the blood-brain barrier, lack of cellular immunity and limited inflammatory cytokine response.
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http://dx.doi.org/10.1111/1754-9485.13326DOI Listing
September 2021

Diagnosing the drug resistance signature in : a review from contemporary methods to novel approaches.

J Parasit Dis 2021 Sep 7;45(3):869-876. Epub 2021 Jan 7.

P.G. Department of Zoology, Berhampur University, Berhampur, 760007 Odisha India.

The genome sequence project of the human malaria parasite reveal variations in the parasite DNA sequence. Most of these variations are single nucleotide polymorphism (SNP). A high frequency of single nucleotide polymorphism (SNP) in the  population is usually a benchmark for anti-malarial resistance which allows parasites to be elusive to the chemotherapeutic agents, vaccine and vector control strategies, resulting in the leading cause of morbidity and mortality globally. The high density of drug resistance signature markers such as , and in the genome opens up a scope for the study of the genetic basis of this elusive parasite. The precise and prompt diagnosis of resistance strains of parasite plays vital role in malaria elimination program.This review probably shed light on contemporary SNP diagnostic tools used in molecular surveillance of drug resistance in terms of mechanism, reaction modalities, and development with their virtues and shortcomings.
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http://dx.doi.org/10.1007/s12639-020-01333-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8368610PMC
September 2021

Brain FET PET tumor-to-white mater ratio to differentiate recurrence from post-treatment changes in high-grade gliomas.

J Neuroimaging 2021 Nov 13;31(6):1211-1218. Epub 2021 Aug 13.

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.

Background And Purpose: Highergrade glial neoplasms undergo standard treatment with surgery, radiotherapy, and alkylating agents. There is often a clinical/neuroimaging dilemma in the post-treatment setting to differentiate disease recurrence from treatment-related changes. FET (fluoro-ethyl-tyrosine) PET has emerged as a molecular imaging modality for cases where MR imaging is inconclusive. This study aims to develop a cutoff on FET PET for differentiating true recurrence from post-treatment changes.

Methods: We retrospectively analyzed72 patientswith post-treatment grade 3 or 4 brain gliomas. Five to six mCi of F-FET was injected and static imaging of the brain was performed at 20 min. A tumor-to-white matter (T/Wm) ratio was used as semiquantitative parameter. A T/Wm cutoff of 2.5 was used for image interpretation. Imaging findings were confirmed by either histopathologic diagnosis in a multidisciplinary joint clinic or based on follow-up of clinical and neuroimaging findings.

Results: Forty-one of 72 patients (57%) showed recurrent disease on FET PET. Thirty-five of them were confirmed to have tumor recurrence; six patients showed post-treatment changes. Thirty-one of 72 patients (43%) showed post-treatment changes on FET PET; 27 were confirmed as post-treatment change and four patients had tumor recurrence on subsequent MR imaging. An optimum T/Wm cutoff of 2.65 was derived based on receiver operating characteristic analysis with a sensitivity of 80% and specificity of 87.5%.

Conclusion: Static FET PET can be used as problem-solving imaging modality with a T/Wm cutoff of 2.65 to differentiate late recurrence from post-treatment changes in grade 3 or 4 brain gliomas with equivocal MR features.
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http://dx.doi.org/10.1111/jon.12914DOI Listing
November 2021

A Pictorial Review on Reversible Splenial Lesions.

Indian J Radiol Imaging 2021 Jan 17;31(1):3-9. Epub 2021 Apr 17.

Department of Radiodiagnosis and Imaging, King Edward Memorial Hospital and Seth GS Medical College, Mumbai, Maharashtra, India.

Splenium of corpus callosum can be involved in a variety of pathologies causing reversible or irreversible damage. Magnetic resonance imaging (MRI) is a useful investigation to evaluate the same. In spite of the differing etiologies implicated, MRI findings can be quite common. We review the reversible causes of diffusion restriction involving the splenium of corpus callosum and highlight the etiopathologic mechanisms implicated in these pathologies. We further discuss these pathologies in entirety with relevant clinical and laboratory findings helping make definitive diagnosis and guiding appropriate management.
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http://dx.doi.org/10.1055/s-0041-1729127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299498PMC
January 2021

Clinical approach to re-irradiation for recurrent diffuse intrinsic pontine glioma.

Jpn J Clin Oncol 2021 Apr;51(5):762-768

Department of Radiation Oncology, Tata Memorial Centre (TMH/ACTREC), Mumbai, India.

Background: We present our institutional approach for re-irradiation in diffuse intrinsic pontine glioma and their outcomes.

Methods: Consecutive patients of recurrent diffuse intrinsic pontine glioma treated with re-irradiation (January 2015-September 2019) were reviewed retrospectively to describe the clinical-response-based approach followed for the dose and volume decision. Outcomes were defined with clinical and steroid response criteria and survival endpoints included progression-free survival and overall survival as cumulative(c) overall survival and re-irradiation overall survival (re-irradiation starting to death). The Kaplan-Meier method and log-rank test were used for survival analysis.

Results: Twenty-patient cohort with a median (m) age of 7.5 years, m-progression-free survival of 8.4 months and m-Lansky performance score of 50 received re-irradiation of which 17 (85%) were called clinical responders. The median re-irradiation-overall survival with 39.6-41.4, 43.2 and 45 Gy were 5.8, 7 and 5.3 months, respectively. One-month post-re-irradiation steroid independent status was a significant predictor of better survival outcomes (overall survival, P≤0.004). No ≥ grade 3 toxicities were noticed. Two patients succumbed to intra-tumoral hemorrhage.

Conclusions: Higher doses of re-irradiation based on a clinical-response-based approach show improvement in survival and steroid dependence rates with acceptable toxicity. Steroid independent status at 1-month post-re-irradiation predicts better outcomes. Prospective studies may validate this with quality of life data.
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http://dx.doi.org/10.1093/jjco/hyab006DOI Listing
April 2021

MR Imaging in Neurocritical Care.

Indian J Crit Care Med 2019 Jun;23(Suppl 2):S104-S114

Department of Radiodiagnosis, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

Patra A, Janu A, Sahu A. MR Imaging in Neurocritical Care. Indian J Crit Care Med 2019;23(Suppl 2):S104-S114.
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http://dx.doi.org/10.5005/jp-journals-10071-23186DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707490PMC
June 2019

A rare case of chemotherapy induced reversible cerebral vasoconstriction syndrome in a patient of acute lymphocytic leukemia.

J Cancer Res Ther 2015 Oct-Dec;11(4):1012-4

Department of Radiodiagnosis and Imaging, King Edward Memorial Hospital and Seth GS Medical College, Mumbai, Maharashtra, India.

Neurotoxic reactions of chemotherapy occur frequently and are often dose limiting side effects of chemotherapy. It is important to differentiate these various nonneoplastic effects from metastases, or sometimes even from each other, since the therapeutic approach differs accordingly. To arrive at a definitive and comprehensive diagnosis, the radiologist should integrate imaging findings, clinical signs, and laboratory results together. Here we present a unique case of chemotherapy induced reversible cerebral vasoconstriction syndrome in a 13-year-old patient of acute lymphoblastic leukemia.
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http://dx.doi.org/10.4103/0973-1482.168993DOI Listing
November 2016
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