Publications by authors named "N Tagiling"

5 Publications

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Combined Techniques of Non-invasive Tc-Besilesomab/Tc-Sulfur Colloid with Hybrid SPECT/CT Imaging in Characterising Cellulitis from Symptomatic Perimegaprosthetic Infection: A Case Report.

Malays Orthop J 2020 Nov;14(3):188-193

Department of Nuclear Medicine, Radiotherapy and Oncology, Universiti Sains Malaysia, Kubang Kerian, Malaysia.

Megaprosthesis is used to restore the form and function of massive skeletal defects, but it is accompanied by risks of failure, mainly due to perimegaprosthetic infection (PMI). In practice, the diagnosis of infected megaprosthesis among patients with a high index of clinical suspicion, elevated serological markers, and multiple negative or inconclusive imaging can be very challenging and poses a diagnostic conundrum to many orthopaedic surgeons. We present the case of a symptomatic 26-year-old female with large B-cell lymphoma who developed cellulitis with suspected complication of PMI 15 months post-implantation. The combination of advanced nuclear medicine imaging strategies, i.e., Tc-besilesomab/Tc-sulfur colloid scintigraphy with hybrid single-photon emission computed tomography/computed tomography (SPECT/CT) scanning helps to characterise and delineate both infections. Invasive procedures such as joint aspiration and biopsy were avoided, and the patient was successfully treated with antibiotics. Hence, we report a case where advanced imaging modalities were decisive in the investigation of PMI.
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http://dx.doi.org/10.5704/MOJ.2011.032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752015PMC
November 2020

Tc-sodium phytate is a valid alternative to the gold-standard Tc-sulfur colloid in the measurement of gastric emptying among healthy multi-ethnic Asian population: results of a randomized cross-over trial.

BMC Gastroenterol 2020 Aug 31;20(1):293. Epub 2020 Aug 31.

Hospital USM, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia.

Background: It is unclear if the Tc-sodium phytate (Tc-SP) is as reliable as the gold-standard Tc-sulfur colloid (Tc-SC) for gastric emptying scintigraphy (GES). This study is aimed to compare the emptying rates of both radiotracers in a prospective, randomized cross-over trial and to determine the normative data of a healthy multi-ethnic Asian population.

Methods: Out of the 44 healthy individuals screened, 31 (14 females; mean age: 28.4 ± 7.0 years) were enrolled and underwent GES using the standardized egg-white meal. All participants were randomly assigned to either Tc-SP or Tc-SC on the first GES session before crossed over to the other formulation after 2 weeks.

Results: Both kits achieved the radiochemical purities of > 95%. The median rate (95th upper normative limit) of gastric emptying, reported as total gastric meal retention between Tc-SP and Tc-SC, was found to be comparable at all measured time points: 0.5 h [85.0% (96.6%) vs. 82.0% (94.0%)], 1 h [70.0% (86.4%) vs. 65.0% (86.6%)], 2 h [31.0% (55.8%) vs. 25.0% (64.4%)], 3 h [7.0% (26.3%) vs. 5.0% (29.9%)], and 4 h [3.0% (10.3%) vs. 2.0% (9.9%)]; P > 0.05. In addition, both radiotracers correlated well (Kendall's Tau (τ) coefficient = 0.498, P < 0.001) and presented with a good agreement at the 4th-hour time frame based on the Bland-Altman plot analysis.

Conclusions: Tc-SP is a valid radiotracer alternative to Tc-SC for routine GES examination. The normative values for both radiotracers have also been determined for the healthy multi-ethnic Asian population.

Trial Registration: This trial was registered retrospectively in the Thai Clinical Trials Registry on May 23rd, 2020 (Identifier: TCTR20200526004; http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=6296 ).
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http://dx.doi.org/10.1186/s12876-020-01426-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457507PMC
August 2020

Standardized Uptake Value from Semiquantitative Bone Single-Photon Emission Computed Tomography/Computed Tomography in Normal Thoracic and Lumbar Vertebrae of Breast Cancer Patients.

Asian Spine J 2020 Oct 30;14(5):629-638. Epub 2020 Mar 30.

Department of Nuclear Medicine, School of Medical Sciences, Universiti Sains Malaysia (Health Campus), Kubang Kerian, Malaysia.

Study Design: Retrospective study.

Purpose: This study aims to semiquantitatively evaluate the standardized uptake value (SUV) of 99mTc-methylene diphosphonate (MDP) radionuclide tracer in the normal vertebrae of breast cancer patients using an integrated single-photon emission computed tomography (SPECT)/computed tomography (CT) scanner.

Overview Of Literature: Molecular imaging techniques using gamma cameras and stand-alone SPECT have traditionally been utilized to evaluate metastatic bone diseases. However, these methods lack quantitative analysis capabilities, impeding accurate uptake characterization.

Methods: A total of 30 randomly selected female breast cancer patients were enrolled in this study. The SUV mean (SUVmean) and SUV maximum (SUVmax) values for 286 normal vertebrae at the thoracic and lumbar levels were calculated based on the patients' body weight (BW), body surface area (BSA), and lean body mass (LBM). Additionally, 106 degenerative joint disease (DJD) lesions of the spine were also characterized, and both their BW SUVmean and SUVmax values were obtained. A receiver operating characteristic (ROC) curve analysis was then performed to determine the cutoff value of SUV for differentiating DJD from normal vertebrae.

Results: The mean±standard deviations for the SUVmean and SUVmax in the normal vertebrae displayed a relatively wide variability: 3.92±0.27 and 6.51±0.72 for BW, 1.05±0.07 and 1.75±0.17 for BSA, and 2.70±0.19 and 4.50±0.44 for LBM, respectively. Generally, the SUVmean had a lower coefficient of variation than the SUVmax. For DJD, the mean±standard deviation for the BW SUVmean and SUVmax was 5.26±3.24 and 7.50±4.34, respectively. Based on the ROC curve, no optimal cutoff value was found to differentiate DJD from normal vertebrae.

Conclusions: In this study, the SUV of 99mTc-MDP was successfully determined using SPECT/CT. This research provides an approach that could potentially aid in the clinical quantification of radionuclide uptake in normal vertebrae for the management of breast cancer patients.
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http://dx.doi.org/10.31616/asj.2019.0308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595810PMC
October 2020

Radiosensitization Effects by Bismuth Oxide Nanoparticles in Combination with Cisplatin for High Dose Rate Brachytherapy.

Int J Nanomedicine 2019 18;14:9941-9954. Epub 2019 Dec 18.

School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Purpose: The aim of this study was to investigate the potential of the synergetic triple therapeutic combination encompassing bismuth oxide nanoparticles (BiONPs), cisplatin (Cis), and high dose rate (HDR) brachytherapy with Ir-192 source in breast cancer and normal fibroblast cell line.

Methods: In vitro models of breast cancer cell lines (MCF-7, MDA-MB-231) and normal fibroblast cell line (NIH/3T3) were employed. Cellular localization and cytotoxicity studies were conducted prior to inspection on the radiosensitization effects and generation of reactive oxygen species (ROS) on three proposed radiosensitizers: BiONPs, Cis, and BiONPs-Cis combination (BC). The optimal, non-cytotoxic concentration of BiONPs (0.5 mM) and the 25% inhibitory concentration of Cis (1.30 µM) were applied. The radiosensitization effects were evaluated by using a 0.38 MeV Iridium-192 HDR brachytherapy source over a prescribed dose range of 0 Gy to 4 Gy.

Results: The cellular localization of BiONPs was visualized by light microscopy and accumulation of the BiONPs within the vicinity of the nuclear membrane was observed. Quantification of the sensitization enhancement ratio extrapolated from the survival curves indicates radiosensitization effects for MCF-7 and MDA-MB-231 when treated with BiONPs, Cis, and BC. However, NIH/3T3 cells exhibited contradictive behavior as it only reacted towards the BC combination. Nonetheless, the MCF-7 cell line loaded with BC shows the highest SER of 4.29. ROS production analysis, on the other hand, shows that Cis and BC radiosensitizers generated the highest free radicals in comparison to BiONPs alone.

Conclusion: A BiONPs-Cis combination was unveiled as a novel approach that offers promising radiosensitization enhancement that will increase the efficiency of tumor control while preserving the normal tissue at a reduced dose. This data is the first precedent to prove the synergetic implication of BiONPs, Cis, and HDR brachytherapy that will be beneficial for future chemoradiotherapy strategies in cancer care.
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http://dx.doi.org/10.2147/IJN.S228919DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927229PMC
April 2020

Effect of scanning parameters on dose-response of radiochromic films irradiated with photon and electron beams.

Heliyon 2018 Oct 17;4(10):e00864. Epub 2018 Oct 17.

Medical Radiation Programme, School of Health Sciences, Universiti Sains Malaysia (Health Campus), Kelantan, Malaysia.

Proper dosimetry settings are crucial in radiotherapy to ensure accurate radiation dose delivery. This work evaluated scanning parameters as affecting factors in reading the dose-response of EBT2 and EBT3 radiochromic films (RCFs) irradiated with clinical photon and electron beams. The RCFs were digitised using Epson Expression 10000XL flatbed scanner and image analyses of net optical density () were conducted using five scanning parameters i.e. film type, resolution, image bit depth, colour to grayscale transformation and image inversion. The results showed that increasing spatial resolution and deepening colour depth did not improve film sensitivity, while grayscale scanning caused sensitivity reduction below than that detected in the Red-channel. It is also evident that invert and colour negative film type selection negated values, hence unsuitable for scanning RCFs. In conclusion, choosing appropriate scanning parameters are important to maintain preciseness and reproducibility in films dosimetry.
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http://dx.doi.org/10.1016/j.heliyon.2018.e00864DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6197593PMC
October 2018