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1.
Rania Refaat Hesham Elghazaly 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1065-1071
Background
Metastatic adrenal disease can occur in a wide diversity of malignancies. Distinguishing benign from metastatic adrenal masses in oncologic patients is vital.Objective
To appraise the 18F-FDG PET/CT performance for distinguishing benign from metastatic adrenal masses.Material and methods
In the current prospective study, 21 patients with proven extra-adrenal primary malignancy, having adrenal masses?≥10?mm on the axial CT images of their PET/CT examinations, were enrolled. Positive PET findings for malignancy were considered if the mass showed FDG uptake equivalent to or more prominent than the FDG liver uptake. Alternatively, negative PET findings for malignancy were considered if the mass showed FDG uptake not as much of the FDG liver uptake. Afterward, the obtained results were correlated with serial imaging follow-up or histopathological diagnosis by surgery or percutaneous biopsy as the diagnostic standard of reference.Results
An overall number of 24 adrenal masses was diagnosed. Positive PET/CT results were found in 14 adrenal masses. All were finally considered to be metastases by serial imaging follow-up (n?=?8) and histopathological analysis by surgery (n?=?1) and percutaneous biopsy (n?=?5). Accordingly, no false positive result was obtained. Negative PET/CT results were observed in 10 adrenal masses, 9 of them were finally confirmed to be benign by serial imaging follow-up. The remaining mass was finally confirmed to be metastasis by percutaneous biopsy and hence, it represented the false negative result. 93% sensitivity, 100% specificity and 96% accuracy for identifying adrenal metastases were obtained.Conclusion
18F-FDG PET/CT is a precise, non invasive modality for distinguishing benign from metastatic adrenal masses in oncologic patients. 相似文献2.
Susan Adil Ali Maged Abd Elgalil Hamed 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):671-676
Purpose
to assess the efficacy of FDG PET/CT in detecting unexpected additional primary malignant neoplasms in patients being evaluated by PET/CT for known malignancies compared to conventional staging work-up (CSW).Patients and methods
Of 1889 patients referred for whole-body FDG PET/CT in the period from February 2015 to May 2016, only 273 were included in this prospective study. Patients included are those with histopathologicaly proven primary malignancy and sent for initial tumor staging before treatment within 1 month of CSW that was performed for the patients according to the site and cell type of the primary tumor. Histopathologic examination was performed for lesions indicating additional primary cancer detected by either PET/CT or CSW.Results
In 13 out of 273 patients included in the study (4.76%) only were proved to have additional primary cancer, the PPV of PET/CT for detecting an additional primary cancer was 56.5%. Also, it showed high sensitivity of 89.2%, which was significantly higher than 23% from the CSW (P < 0.005).Conclusion
PET/CT is more accurate than CSW for detecting additional primary cancer with a higher sensitivity and positive predictive value, which consequently affect further management. 相似文献3.
Ekhlas Abdelmonem Ibrahem Nasr Shaban 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1057-1063
Purpose
The aim of this study is to clarify the role of 18-F-FDG PET/CT over CT alone in the detection of primary, recurrent and metastatic disease in renal cancers patients.Patients and methods
In this study; 18-F-PET/CT scans were performed for 25 patients (19 males and 6 females) with renal cancer. A patient-based analysis was performed in a dedicated manner to pick up lesions on CT, PET and PET/CT fused images. Statistical analysis was calculated. A final diagnosis of disease extent was affirmed by clinical, radiologic workup and histopathological correlation.Results
PET/CT has 100% sensitivity, 93% specificity, 100% PPV, 91% NPV and 96% accuracy; compared to 100% sensitivity and 70% specificity, 83% PPV, 100% NPV and 88% accuracy for CT in diagnosis of primary, recurrent and metastatic disease in renal cancer.Conclusion
Incorporated 18-F FDG PET/CT is a very versatile and accurate imaging technique for renal cancers. It significantly improves the accuracy and predictive values over CT alone for detection of primary, recurrent and metastatic disease in renal cancer thus change the treatment decision. 相似文献4.
Tamer W. Kassem 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):537-545
Objective
The aim of this study was to compare the diagnostic performance of positron emission tomography/computed tomography (PET/CT) scan and CT scan in follow up of proven gynecological malignancies omental deposits in first setting follow up after treatment.Patients and methods
60 female patients having proven omental deposits from gynecological malignancies underwent PET/CT examination following a preset protocol as baseline study. 34 cases of them had a second PET/CT examination following same protocol after 5–11 months considered as first setting follow up study aiming to assess therapeutic response.Results
Out of 34 cases 2 cases (6%) showed only newly developed lesions, 8 cases (23.5%) showed progression, 8 cases (23.5%) showed mixed response and 16 cases (47%) showed regression or complete resolution. In first setting follow up examination 18F-FDG PET/CT showed 31 TP, 2 TN and 1 FN cases while CT showed 29 TP, 2 TN, 2 FN and 1 FP cases. 18F-FDG PET/CT vs. CT revealed sensitivity, specificity and accuracy of 96.88% vs. 93.55%, 100% vs. 66.67% and 97.06% vs. 91.18% respectively.Conclusion
18F-FDG PET/CT is more accurate than CT in assessment of therapeutic response of proven gynecological malignancies omental deposits in first setting follow up. 相似文献5.
Ahmed Elsammak 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1073-1081
Objectives
To assess the clinical utility of PET-CT in assessment of thoracic involvement in lymphoma patients prior to, during and after finishing treatment and comparing it to contrast enhanced CT (CECT).Patients and methods
PET-CT was performed for 30 patients with lymphoma. Thoracic nodal and extranodal involvement was assessed and compared to contrast enhanced CT.Results
Comparison of CECT and PET-CT in staging and assessment of treatment response reveals significant statistical difference (P?=?.0001 & .04 respectively). CECT shows sensitivity?=?83.3% and specificity?=?75% in evaluation of patients after finishing chemotherapy.Conclusion
PET-CT plays an important role in staging, detection of response to treatment and restaging of lymphoma after finishing chemotherapy. 相似文献6.
Mohamed Houseni Amr Osama Dalia Ibrahim Mohamed Shahinda Salem 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):67-74
Purpose
To assess the value of contrast enhanced CT (ceCT) when added to positron emission tomography combined with the standard low-dose non-contrast CT (PET/CT) protocols for staging patients with malignant pleural mesothelioma (MPM).Methods
Retrospective analysis of 47 patients with pathologically proved MPM. All patients underwent PET/CT with low dose CT followed by ceCT. PET/CT and ce-CT were evaluated separately then in combination. All the results were validated either by histopathology and/or clinical-radiological follow-up. Staging was performed based on TNM system.Results
For T-stage, the sensitivities for PET/CT, ceCT and combined PET/CT-ceCT were 89.1%, 86.9%, and 97.5%, respectively, p = 0.04. Regarding nodal stage, the sensitivity, specificity and accuracy for PET/CT were 88.5%, 90.5%, and 89.4%; for ceCT 73.1%, 95.2% and 82.9%; and for PET/CT-ceCT 96.2%, 95.2% and 95.7%, respectively. PET/CT-ceCT significantly associated with the sensitivity, p = 0.05. Considering the metastatic disease, the sensitivity, specificity and accuracy for PET/CT were 81.3%, 96.8%, and 91.5%; for ceCT 56.3%, 90.3% and 78.7%; and for PET/CT-ceCT 93.8%, 96.8% and 95.7%, respectively. PET/CT-ceCT significantly improved the sensitivity (p = 0.03) and accuracy (p = 0.02). Furthermore, combined PET/CT-ceCT significantly identified patients not suitable for surgery.Conclusion
The addition of ceCT to PET/CT protocol has significantly contributed to the staging of MPM. 相似文献7.
Adel Ali Ramadan Mohamed Samir Shaaban Alaa Magdy El-Sayed 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1097-1104
Background
Urinary tract injuries occur in 3–10% of abdominal trauma. Early recognition and diagnosis of ruptured bladder is essential to lower this mortality rate. CT is the method of choice for the evaluation of patients with blunt or penetrating abdominal and/or pelvic trauma. Imaging in patients with suspected bladder injury with CT cystography may be performed using either an intravenous or retrograde technique.Aim of work
The aim was to evaluate the role of CT in diagnosing traumatic urinary bladder injuries.Materials and methods
The study was carried out on 32 patients with suspected traumatic urinary bladder injury. All patients were subjected to contrast-enhanced CT study and classified according to Sandler et al. classification of urinary bladder injuries.Results
All patients were classified according to the type of the encountered urinary bladder trauma. Type I injury was diagnosed in 3.1% of patients, type II in 18.8%, type III in 3.1%, type IVa in 12.5%, type IVb in 43.7% and type V in 18.8%. 21.8% of patients were managed conservatively, while 78.2% of patients underwent surgical repair.Conclusion
CECT well demonstrated traumatic urinary bladder injuries. 相似文献8.
Hala Yehia Yousef Haitham A. Dawood Nesreen Mohey 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):927-930
Aim of the work
To evaluate the role of diffusion weighted imaging (DWI) in the planning for CT guided biopsy of lung and mediastinal lesions.Subjects and methods
This cross sectional study included 23 patients with mean age was 42.7?years came with clinical and imaging suspicion of chest malignancy, referred for CT guided transthoracic biopsy. DWI and apparent diffusion coefficient (ADC) were evaluated for all patients to choose the area of maximum restriction.Results
The study showed that with DWI guidance; all the biopsy specimens were diagnostic and provide adequate material for analysis.Conclusion
DWI and measurement of ADC value has a very helpful role in the pre-procedural planning of transthoracic biopsies. 相似文献9.
Mohamed Fouad Sherif 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):202-208
Aim
To clarify the role of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG) PET/CT in evaluating of bronchioalveolar carcinoma (BAC) recurrence and its ability to differentiate recurrent pure BAC type from recurrent adenocarcinoma containing BAC.Methods
A prospective study included 24 PET/CT scans (22 patients with known BAC; 14 male; 8 female; age range 49:75 Y.). 15 PET/CT scans performed for suspicious of recurrence and 9 scans for post treatment restating.Results
Among 15 cases with suspicious of recurrence; upstaging detected in 9 cases and downstaging in 1 case. In 9 cases underwent PET/CT scans for restaging after treatment; upstaging in one patient. Sensitivity?=?100%, Specificity?=?83.3%, PPV?=?94.1%, NPV?=?100% and accuracy?=?95.4%. Statistically significant difference was found between FDG uptake in recurrent BAC and primary BAC (P?<?0.0001) and between FDG uptake of recurrent pure BAC type and adenocarcinoma containing BAC (P?<?0.0001).Conclusion
In patients with known BAC, PET/CT proved high accuracy in detection of recurrence lesion sites and higher staging accuracy. [18F]FDG PET/CT scan was able to differentiate between recurrent adenocarcinoma containing BAC and recurrent pure BAC type. 相似文献10.
Mennatallah Hatem Shalaby Shady Samir Ahmed Deif 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):639-643
Objective
To compare the accuracy of 2D and 3D CT measurements of femoral anteversion angle, in pediatric patients with developmental hip dysplasia.Materials and methods
Twenty patients (20 hips) with unilateral non syndromic DDH were studies. CT scans were performed using a 16 slice CT scanner to measure the femoral anteversion angle (FAVA) using 2D & 3D techniques. Findings were correlated with the intra operative measurements.Results
There was a significant difference between 2D & 3D methods. Results of clinical assessment were comparable to results of 3D CT assessment which range from 30 to 50° with a mean of 37.5°. Mean percent difference between 3D and intra operative measurement of FAVA was significantly lower than the corresponding value between 2D and intraoperative measurement of FAVA.Conclusion
3D is more accurate than 2D in measuring the degree of FAVA in DDH patients. It is easily applied and rapid and doesn't require sophisticated software. 相似文献11.
Mennatallah Hatem Shalaby Sherin M. Sharara Mohammed H. Abdelbary 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):645-652
Background
The ankle is frequently injured in trauma, overuse syndrome and inflammatory processes. Different imaging modalities assess the ankle, including plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography (US).Purpose
Our objective is to assess the role of high resolution US as a valuable tool in the depiction of causes of ankle joint pain.Patients and methods
The study included 28 patients presented with ankle pain ranging in age from 17 to 60 years. They were examined by US and findings were correlated with MRI.Results
US was capable to detect various lesions (synovitis, arthritis, plantar fasciitis, tendon and ligamentous lesions). It had a sensitivity of 95.4%, a specificity of 83.3% and an overall accuracy of 92.8%. US had a limited value in detection of avascular necrosis (AVN), bone marrow oedema and fractures.Conclusion
US can be used as a first step diagnostic tool in cases of ankle pain. MRI should be spared to cases with negative or equivocal US findings. 相似文献12.
Aya S. Al-Rawy Mohammad al-Shatouri Mohammed El Tabbakh Azza A. Gad 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):877-884
Objectives
To create a systematic approach using computed tomography (CT) and magnetic resonance imaging (MRI) findings to facilitate identifying the etiology of hearing loss, evaluating the anatomy for surgery, and predicting complications.Methods
Twenty nine pediatric patients with congenital or acquired sensory-neural hearing loss (SNHL) requiring cochlear implant (CI) were included. They underwent combined CT, 3D DRIVE MRI axial plane and axial T2WIs for the whole brain. The inner ear, cochlear nerve development, temporal bone anatomy, operative window, normal variants and causes of central hearing loss were assessed.Results
CT showed that 100% of the patients are suitable for CI while MRI showed that 96.5% of studied patients are suitable. The examined ears were categorized into 4 groups according the candidacy for operation; 86.2% were suitable for CI, 5.1% were suitable for CI but with expected poor response, 1.7% of examined ears were suitable for CI with modification of surgical procedure and 6.8% were not suitable for CI.Conclusion
In Suez Canal area, the combined CT/MRI approach categorized the majority of patients with SNHL (96.6%) as good candidates for CI. 相似文献13.
R.A. Elshafey N. Daabes S. Galal 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):1076-1082
Aim
Assessment of the clinical benefit of [18F]-FDG PET/CT examinations in restaging of patients with non Hodgkin lymphoma (NHL) in Egypt.Patients, methods
This study was performed on 45 patients with NHL. PET-CT and CECT were analyzed after end of chemotherapy regimen, using 12?months follow-up as standard of reference.Results
Follow-up of patients with NHL after 12?months of treatment revealed significant differences between staging by CT versus PET/CT (P?=?0.0001). Disease was upstaged by PET/CT in 36% (mostly in stages I and II) and downstaged in only 2% of patients. Agreement between PET-CT & CECT were usually in stage III and IV. Evaluation showed a sensitivity of 77% for CT alone, 95% for FDG-PET-CT.Conclusion
FDG PET-CT significantly improved sensitivity and specificity in restaging of NHL and therefore should be used routinely in follow up of patients with lymphoma. 相似文献14.
Mennatallah Hatem Shalaby Khaled A. Ali Shehata 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):791-798
Background
Ninety percent of hepatic cancers are hepatocellular carcinomas (HCC) which have an unfavorable prognosis. HCC is a hypervascular tumor supplied mainly by the hepatic artery. It has a higher blood supply than the surrounding hepatic tissue due to neovascularization. Computed tomography with perfusion imaging (CTP) is a non invasive tool which quantifies the blood flow parameters of HCC and compares it to the surrounding tissue.Purpose
To prove that CTP is a valuable diagnostic tool in diagnosis of HCC and posttherapeutic assessment.Patients and methods
One hundred and twenty-six HCC patients with 150 focal lesions are enrolled this study. Perfusion parameters are quantified and results are compared to those of triphasic CT.Results
CTP detected 141 lesions with 94% sensitivity and 40% specificity with elevated arterial perfusion (AP) and perfusion index (PI) with low portal flow (PF). It missed 5 lesions because of their hypovascularity and 4 lesions following radiofrequency ablation (RFA) and trans arterial chemo embolization (TACE).Conclusion
CTP is a safe and specific imaging tool for diagnosis and assessment of therapeutic interventional procedures in HCC. 相似文献15.
Youssriah Yahia Sabri Marian Fayek Farid Kolta Mostafa Ahmed Khairy 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):569-580
Background
Diffusion-weighted imaging is a fundamental tool integrated in MR protocols useful in differentiating benign from malignant mediastinal masses, assessing mediastinal lymphadenopathy and investigating central bronchogenic carcinoma. This method is an excellent alternative to CT or PET/CT in the investigation of mediastinal masses. Current applications of diffusion MRI in malignancies include monitoring the treatment response and detecting recurrent cancer.Aim of the work
This study aims to assess the value of using MRI diffusion in differentiating benign and malignant mediastinal masses, differentiating central masses from post obstructive collapse and differentiating lymphoma versus sarcoidosis.Patients and methods
This study included 30 patients; 16 males and 14 females in the period from June 2013 to July 2014. The mean age was 49.3 ± 16.85 (range: 22–82 years).Cases were referred for MRI assessment and were approved by the ethical committee in our department.The complaints varied between dyspnea, chest pain, cough, hemoptysis, fatigue and loss of weight. A superconducting 1.5 T MRI machine with a four-channel body phased-array coil was used for the examination. Biopsy and histopathological assessment was done after that.Results
MRI examination with diffusion imaging was able to differentiate between benign and malignant mediastinal and hilar lesion confirmed by the biopsy and histopathology.Conclusion
MRI with diffusion weighted images can detect and stage lung cancer, differentiate benign from malignant mediastinal masses and differentiate lymphoma from sarcoidosis in mediastinal/hilar lymphadenopathy. 相似文献16.
Nesreen Mohey Tamir A. Hassan 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(1):1-6
Perianal fistula is a common disorder with high tendency to recur in spite of satisfactory surgery. Pelvic MRI is the preferable imaging modality for recognition and assessment of perianal fistulas.
Aim of the work
To evaluate the effectiveness of MRI in grading of primary perianal fistula and verification of its associated findings in correlation with surgical outcome.Subjects and methods
This prospective study included 30 patients with age range 14–44 years. Preoperative MR grading was correlated with surgical outcome.Results
The sensitivity, specificity, PPV, NPV and weighted Kappa of MR grading in correlation with surgery was 95.8%, 83.3%, 95.8%, 83.3% and 0.79 respectively with P value = 0.000Conclusion
MRI is a valuable modality for grading of primary perianal fistula and its complications. Accurate pre-operative grading may reduce the surgical complications and possibility of recurrence. 相似文献17.
Haney Heneidy Waled Yosef Sheirin Badr 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):779-783
Objective
The aim of this study was to assess the ability of CT to predict the pathological nature of pancreatic cystic lesions if it is benign, malignant or premalignant.Methods
This is a retrospective study from the database of our hospital EMR (electronic medical records) for pancreatic lesions from patients who proven to be of pathological cystic nature. The diagnosis and characterization of pancreatic cysts were done by multislice 32 CT examination. We reviewed the data from the radiology, surgery and pathology departments from the period of November 2012 until January 2015. We compared between operative and pathological data and findings of MDCT using chi square test.Results
We reviewed the data from the radiology, surgery and pathology departments from the period of November 2012 until January 2015. The study was done on 66 patients. Our results showed that CT features for benign cystic lesions are lobulated shape and a thin wall (≤1?mm) while the round or oval shape or a complex cystic shape with tubular cyst and a thick wall (>1?mm) are more frequently seen in pancreatic premalignant and malignant macrocytic lesions.Conclusion
CT with thin section images allows adequate morphological characterization of macrocytic pancreatic masses that could predict its pathological nature if benign or malignant. 相似文献18.
Mohamed M. Radwan Khaled M. Moghazi Nevine M.F. ElDeeb Mohamed E. Ibrahim Mohamed A. Sharaan Doaa M. Emara 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):771-778
Introduction
Cystic pancreatic lesions are currently discovered at higher rate, hence adequate characterization of these lesions by the radiologist is important in guiding management.Aim of the work
Was to identify the role of MRI in characterization of cystic pancreatic lesions.Patients and methods
Thirty patients with suspected cystic lesions of the pancreas were examined by MRI using 1.5?T machines including conventional MRI sequences, dynamic contrast enhanced imaging, DWI and IP/OP sequence.Results
The study included 30 patients (12 males and 18 females) with their age ranging from 16 to 88?years (mean age 55?years), MRI analysis of the cyst contents and communication with ductal system were used to characterize different cyst types, among these patients we found serous cystadenoma in five patients, mucinous cystadenoma in seven patients, mucinous cystadenocarcinoma in one patient, branch type Intraductal papillary mucinous neoplasms (IPMN) in seven patients, Mixed IPMN in two patients. Cystic neuroendocrine tumors (CNET) in three patients. Solid cystic pancreatic neoplasm (SPN) in two patients. Pseudocyst in one patient and walled off necrosis (WON) in two patients. Pathological assessment of the lesions was done whenever indicated.Conclusions
MRI with its superior soft tissue resolution is of value in characterization of different cystic pancreatic lesions helping to reach the correct diagnosis. 相似文献19.
Mohamed I. Yousef Medhat M. Refaat Mohamed H. Faheem 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):817-824
Aim
To evaluate accuracy of DWI in evaluating HCC response to DEB TACE and compare the results with DCE MRI.Material and methods
42 patients with 59 lesions underwent precontrast abdominal MRI, DWI, ADC map with ADC value measurement and DCE MRI. The qualitative DWI and ADC values were correlated to the DCE MR findings.Results
Comparing the qualitative DWI findings to DCE MRI, showed sensitivity of 83.9%, specificity of 64.3%, positive predictive value of 72.2%, and negative predictive value of 78.3% and overall accuracy of 74.5%. The measured ADC values showed significant difference (P value <0.05) between the ADC values measured in the active tumoral areas and necrotic areas with no significant difference between areas of active tumoral enhancement in the different groups. ROC analysis for ADC values showed area under curve 0.7 and maximum combined sensitivity and specificity of 79% and 69.6% respectively at cutoff ADC value of 1.395?mm2/sec.Conclusion
DWI is useful highly sensitive technique in evaluation of HCC response to DEB TACE, yet it has low specificity related to high number of false positive results preventing using it solely. Also, DWIs is a reliable method in differentiation between active tumor residue/recurrence and benign perilesional enhancement. 相似文献20.
Tamer W. Kassem 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):621-626