Background Lung cancer is the most common among all kinds of cancers. It still constitutes the leading cause of cancer-related deaths worldwide, even with major advancements in prevention and treatments available. More than 85% of the cases are of non-small cell lung cancer (NSCLC), while less than 15% are of small cell lung cancers (SCLCs). Patients and methods This is a prospective study of 20 patients confirmed histopathologically to have bronchogenic carcinoma, who came for assessment of therapeutic response. All patients underwent positron emission tomography/computed tomography (PET/CT) before and after therapy. Semiquantitative assessment was used to determine maximum standardized uptake value (SUVmax). Treatment response evaluation was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Results Comparison of the pre- and post-treatment SUVmax in the responder and non-responder groups revealed that the post-treatment SUV was significantly lower than the baseline SUV in the responder group (P = 0.008). The responder post-treatment SUV and ∆ SUV were significantly lower than the non-responder values (P = 0.014 and 0.0004 respectively). The optimum threshold values of post-treatment SUV and ∆ SUV threshold defined by the receiver operating characteristic (ROC) curve analysis were ≤ 8 and ≤ −48.3 respectively. The sensitivity, specificity, PPV, NPV, and AUC of post-treatment SUV for predicting tumor response were 100%, 66.67%, 66.7%, 100%, and 0.833 respectively. The sensitivity, specificity, PPV, NPV, and AUC of ∆ SUV for predicting tumor response were 100%, 91.67%, 88.9%, 100%, and 0.979% respectively. Conclusion PET/CT proved itself as useful, efficient, and reliable tool in follow-up of lung cancer patients as it gives an early and accurate metabolic response assessment before any CT changes, leading to early modification of therapy or confirmation of its efficiency.

Background Tetralogy of Fallot (TOF) is considered the most common form of cyanotic congenital heart diseases (CHD), accounting for about 10% of cases. It includes four main cardiac defects, in addition to various extra-cardiac anomalies. Aim This study aimed to evaluate cardiac and extra-cardiac vascular defects associated with TOF among Egyptian children, regarding frequency and types with assessment of multi-slice or multi-detector computed tomography (MDCT) role in their diagnosis. Definitely, full detection of these vascular anomalies has utmost importance when evaluating such patients particularly before surgical intervention. Methods This study included 60 pediatric patients diagnosed as TOF, who underwent MDCT examination in our institute during period of 6 months from (March to September 2020), to confirm their trans-thoracic echocardiography (TTE) findings and detect other vascular abnormalities which cannot be precisely detected with TTE before their surgical interventions. Results The incidence of different extra-cardiac vascular defects diagnosed by MDCT among our patients was 85% which was significantly higher than that detected by TTE (55%). Moreover, MDCT was superior to TTE assessment as regards its diagnostic accuracy (96.6% vs. 80%), sensitivity (98% vs. 76.9%), and specificity (88.9% vs. 85.7%), in addition to both positive and negative predictive values. The most common anomalies detected were affecting the pulmonary artery (80%), followed by aorto-pulmonary vessels (45%), then aortic artery (40%), coronary arteries (20%), and lastly vena cava connection (6.7%). Patients’ demographic characteristics and clinical presentations were also presented. Conclusion This study confirmed that many extra-cardiac vascular defects are commonly associating cardiac lesions in TOF and emphasizing the great value of MDCT in their diagnosis. Certainly, proper detection of these anomalies will help decision-making during preoperative evaluation, corrective interventions, and further management of these cases.

Background: Minimally invasive procedures; like ultrasound-guided percutaneous injection of foam sclerotherapy (USGFS) are being the keystone methods in managing lower limb varicose veins and its complications, being advantageable over the surgery as being minimally invasive with better postoperative comfort and immediate cosmetic effect and faster return to full socioeconomic activity. Varicose veins are common problem that affects the quality of life and have a significant cost burden on the health care system. Sclerotherapy (endovenous chemical ablation) destructs the endothelium to induce inflammation and fibrosis and then occlusion of the blood vessel lumen. Results: The study included 33 diseased limbs of females (64.7%) and 18 (35.3 %) limbs of males. Of the diseased limbs, 16 (31.3%) presented with disfigurement, 14 (27.4%) with pain, 11 (19.6%) with heaviness, 6 (11.7%) with edema, and 4 (7.8%) with non-healed venous ulcer. Twenty-six (50.9%) diseased limbs show competent saphenofemoral junction (SFJ) while 25 (49.1%) limbs showed SFJ reflux of variant degrees. All patients underwent direct ultrasound-guided foam sclerotherapy either as the primary therapy in 29 (56.9%) limbs or as a complementary therapy for residual perforators and varicosities after treatment with other methods of treatment like laser ablation and phlebograph in 22 (43.1%) limbs. Nine (17.6%) limbs treated with 2% polidocanol (Pol.) and 42 (82.3%) limbs with 3% Pol. In the 2nd session Doppler follow-up, 35 (68.6%) limbs showed complete occlusion while 13 (25.5%) limbs showed partial occlusion, while in the 3rd session Doppler follow-up, 3 (5.9%) limbs still show partial occlusion while 45 (88.2%) limbs showed complete occlusion and no recanalization. Forty (78.4%) limbs addressed marked symptomatic relief while 5 (9.8%) limbs moderate relief and 3 (5.9%) cases with mild relief and the other 3 (5.9%) cases missed follow-up. Twenty-five (49%) limbs had no complications while 23 (45%) limbs had different local complications ranging from pain, hyperpigmentation, and superficial thrombophlebitis. Also, we find a statistically significant correlation between the Pol. concentration injected and the symptomatic relief and Doppler US follow-up while there is a borderline correlation between the Pol. concentration injected and the detected complications. Conclusions: The preliminary results revealed ultrasound-guide foam sclerotherapy is an effective and safe treatment for lower limb varicose veins. The concentration of polidocanol injected could be correlated significantly with the symptoms improvement and borderline correlation to the complication rate.

No abstract

Background Uterine Artery Embolization (UAE) is a well-established treatment of symptomatic fibroids with clinical efficacy comparable with traditional surgical treatment. UAE is now commonly proposed as an organ preserving treatment to the population of younger women willing to conceive. It has been proven, in a large cohort of women wishing to conceive before embolization, that complete pregnancies can occur after UAE Objectives The study aims to assess the effect of uterine artery embolization using the different types of embolic microspheres in treatment of patients with uterine fibroid. Patients and Methods Type of Study: prospective study. Study Setting: At the radiology department of Ain Shams University hospitals and Ain Shams University Specialized Hospitals. Study Period: 6-12 months. Results High symptom severity score indicates severe symptoms and a high HRQOL score indicates a good quality of life. The mean UFS questionnaire baseline score was 70± 11.51 prior to embolization and became 45± 9.34 three months following embolization which indicates a good symptomatic response to the microspheres embolization. The mean QOL baseline score was 65± 8.58 prior to embolization and 81± 6.48 three months following embolization. Conclusion UAE using embolic microsphere is , an effective, minimally invasive procedure and easily one day procedure which showed competitive promising and well proved results when compared to other modalities outcomes in treating uterine fibroids such as conventional surgery. It deserves our attention to it's value and efficacy for the sake of the patient as a minimally invasive procedure providing better quality of life , using Embosphere and Embozene microspheres have the same symptomatic effect and volume reduction after three months follow up in compare with using Embosphere alone or with spherical polyvinyl alcohol particles.

No abstract

Background Osteoarthritis (OA) is a leading cause of chronic knee pain and disability with a reported prevalence of 25–30% of the population. Knee OA has traditionally been thought as a degenerative disease only related to chronic repetitive injury “wear and tear” mechanism, yet it is now considered as a much more complex disease of inflammatory nature induced by cytokines and inflammatory mediators through abnormal neo-vascularization (angiogenesis). The rational of geniculate artery embolization (GAE) is based on the hypothesis that suggesting a direct relationship between the abnormal angiogenesis and the chronic knee pain. As a novel treatment option based on occlusion of these abnormal neo-vessels via geniculate artery embolization, we postulated that such a mechanism will relieve pain and improve the quality of life. GAE has been previously approved as a safe and effective treatment in cases of post-knee arthroplasty hemarthrosis. Purpose To evaluate the feasibility, safety, and efficacy of geniculate artery embolization for OA-related knee pain. Materials and methods Sixteen patients with knee pain secondary to chronic OA refractory to conservative therapies for at least 6 months and not yet fit for total knee replacement were enrolled in a prospective single arm interventional study. GAE was performed using 150–300 μm microspheres. Patients were assessed and followed up using the visual analogue scale (VAS) for pain and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for the overall knee function at baseline and at 1 week, 1, 3, and 6 months post-embolization. Results A total 16 patients presented by knee pain secondary to chronic OA were enrolled. All of them showed a remarkable improvement in the VAS and WOMAC scores, with better clinical outcome after GAE. Pre- versus post-embolization ± MDs in VAS score from 8.38 ± 0.81 (baseline) to 2.88 ± 1.54 after 6 months (post-embolization) equivalent to 66.66% improvement. There was also a satisfactory improvement in the WOMAC scores, with ± MDs drop from 77.94 ± 10.62 (baseline) to 49.69 ± 15.43 (post-embolization) equivalent to 37.41% improvement. No severe or life-threatening complications were reported. Conclusions GAE holds promise as an effective minimally invasive procedure for the treatment of knee pain secondary to OA and could be introduced as a safe technique with no serious complications.

Background: Renal resistive index (RRI) was suggested as an indicator of renal atherosclerotic changes in hypertensive patients with possible prognostic role in treatment.Objectives: This study aimed to assess RRI in hypertensive subjects, its relation to other predictors of target organ damage and prognostic usefulness in management, specifically, with different antihypertensive drugs. Patients and methods:The study included 100 newly diagnosed hypertensive adult subjects, who underwent abdominal ultrasound with Doppler to assess RRI, which was correlated with their clinical parameters including estimated glomerular filtration rate (eGFR) and other subclinical atherosclerosis markers as carotid intima-media thickness (IMT) and aortic knob width (AKW) calculated from chest radiograph. Another 50 non hypertensive subjects were assessed for their RRI as a control group. In addition, some of hypertensive patients were followed up one year after starting treatment was done and effects of different antihypertensive agents on their RRI were compared. Results:The mean baseline RRI in hypertensive patients (0.71 ± 0.04) was significantly higher compared to control group (0.60 ± 0.02) and was positively significantly correlated with their clinical parameters (age, systolic, diastolic, pulse pressure and eGFR) and with their atherosclerotic parameters (IMT and AKW). In addition, ACE/ARBs treatment was associated with significant decrease of RRI compared to other drugs [beta blocker (BB) and calcium channel blocker (CCB)], indicating their more renal protective effect. Conclusion: Assessment of RRI in patients with primary hypertension not only reflecting intrarenal perfusion changes, but it indicates systemic atherosclerotic changes, so it can be useful as prognostic parameter in addition to its possible therapeutic implications.