Background: Accurate evaluation of ovarian carcinoma is utmost important for effective management. PET/CT is reported to be effective in evaluation of suspected recurrence of ovarian carcinoma. This study aims to assess the accuracy of PET/CT in evaluation of recurrent ovarian cancer among clinically suspected cases with rising tumor marker or suspicious clinic-radiological findings.
Patients and methods: This prospective cross-sectional study was conducted at Radiology department of Jinnah Postgraduate Medical Centre Karachi from 22nd April 2019 to 21st April 2020. Patients having age of 40 to 60 years and referred for PET scan with suspected recurrence of ovarian carcinoma were consecutively enrolled. Patients were suspected due to relevant history, clinical findings and initial imaging investigations with elevated CA-125 level. Results of 18FDG PET/CT scan was correlated with the raised tumor findings. The PET/CT scan showing abnormally elevated FDG take-up and higher SUV values than the background activity considered recurrence. Diagnostic accuracy of PET/CT was calculated taking raised tumor level as reference category.
Results: Of 65 patients, median age was 50 (43-56) years. The findings showed positive cases in 57 (87.7%) while negative in 8 (12.3%) patients, whereas the findings of tumor marker showed raised tumor marker in 61 (93.8%) patients. Diagnostic accuracy of PET/CT showed sensitivity, specificity, positive predicted value, negative predated value, and overall diagnostic accuracy as 93.44%, 100%, 100%, 50%, and 93.85% respectively.
Conclusion: A higher accuracy of PET/CT was observed in the diagnosis of recurrent ovarian cancer among clinically suspected cases, thus helping in devising an appropriate management plan by the treating physician.
Objective: To determine the outcome of Stereotactic Body Radiation Therapy (SBRT) and its prognostic factors among hepatocellular carcinoma (HCC) patients. Study Design: Descriptive study.
Objective: To evaluate the treatment response of CyberKnife stereotactic radiotherapy in patients with prostatic neoplastic lesions.Patients and methods: This prospective observational study was conducted at Radiology and Cyberknife Robotic Radiosurgery Department of Jinnah Post Graduate Medical Centre (JPMC), Karachi from 22nd June 2019 to 21st June 2020. Males with biopsy-proven prostatic adenocarcinoma with age 55 years or more having Gleason's score of 6 to 8, clinical stage of T1 to T2C, and prostate-specific antigen (PSA) of ≤30 ng/ml were consecutively enrolled. Detailed information regarding PSA concentration, Gleason score, T stage, risk group and ADT (Androgen Deprivation Therapy) usage were noted which were given to high risk patients only for 9 months. Drop in the PSA (biochemical marker) was assessed at baseline, at 3 months and 6 months follow-up.Results: The median age of the patients was 65 years. The overall median PSA level was 2.7 (0.86-7.3) ng/ml. Majority 49 (90.7%) patients presented with T2 N0 M0 TNM status while only 5 (9.3%) patients presented with T1 N0 M0 TNM status. There were 5 (9.3%) patients with high risk, 26 (48.1%) with intermediate risk, and 23 (42.6%) with low risk. ADT was received by 5 (9.3%) patients. The median PSA at baseline was 10.1 (6.9-18.1) ng/ml which significantly drops to 1.6 (0.8-3.6) ng/ml at 3rd months, and 0.4 (0.2-1.2) at 6th months (p-value <0.01).Conclusion: The findings showed an adequate treatment response of CyberKnife stereotactic radiotherapy of patients with prostatic neoplastic lesions.
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