Abstract. Ninety-eight Schistosoma mansoni-infected children from an endemic area in Sharkia Governorate, Egypt were evaluated by abdominal ultrasonography to determine liver and spleen sizes, grade of periportal fibrosis, ands splenic vein diameter. Circulating antigen levels were measured using a double sandwich ELISA in which the sensitivity was 91.8% and specificity was Ͼ 99%, with no evidence of cross-reactivity with other parasites. No significant relationship was observed between antigen level and clinical stages of the disease as assessed by physical examination (P Ͼ 0.05). When ultrasound was used to stage disease, the mean antigen level was significantly higher among hepatosplenic cases than intestinal cases (P Ͻ 0.05). No difference in mean antigen levels were found between the splenic and hepatic cases. Furthermore, a direct correlation (P Ͻ 0.01) was observed between antigen level and disease severity as monitored by ultrasonography. Antigen level showed a positive correlation with the degree of periportal fibrosis (P Ͻ 0.05). Moreover, a significant increase in the percent of children who were antigen positive (Ͼ 80 ng/ml) was found in those with more severe periportal fibrosis (P Ͻ 0.001). The findings suggest that ultrasonography along with measurement of circulating antigen levels predict morbidity in schistosomiasis mansoni.

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Background Breast cancer is considered the most common type of cancer and the second leading cause of cancer-related death among women. The prognostic factors including histological type, tumor nuclear grade, tumor size, and preoperative tumor-nodes-metastasis (TNM), hormone receptor and immunohistochemical molecular markers in the specimens, define the prognosis and survival rate. Early diagnosis and accurate follow-up of these patients affect the management. 18F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) has proved to be an effective and accurate imaging technique for a variety of diagnostic oncology tasks in breast cancer, lymph node staging, staging and restaging of recurrent and metastatic disease, and treatment follow up. Sufficient knowledge of the initial characteristics of breast tumors that may affect 18F-FDG uptake is essential for optimal use and interpretation of 18FFDG PET/CT imaging. Several pioneering studies have investigated the correlation between the affinity to 18F-FDG uptake and some of the histological and biological characteristics such as tumor type, grade, hormonal receptor status and HER2 status. Objective To correlate the relation of 18F-fluoro-2-deoxy-D-gIucose (18F-FDG) positron emission tomography/ computed tomography (PET/CT) uptake in breast cancer to histopathological and biological characteristics. Methods A prospective descriptive study over the course of 6 months from August 2019 till February 2020. It included twenty five patients with pathologically proven breast carcinoma referred to the Radiology department, Ain Shams University Hospitals/ Private centers for a preoperative 18FDG PET/CT scan. Results For the tumors in 25 women, the mean SUVmax was 4.75±2.55. Primary tumor 18FFDG uptake ratio was correlated with patients' age (P = 0.032), tumor size (P = 0.034), histological grade (P=O.OI 8), estrogen and progesterone negativity (P = 0.012), Her2/neu positivity (P = 0.012), high Ki-67 level (>10%) (P = 0.024), axillary lymph node involvement (P = 0.038) and distant metastasis (P = 0.039). High Ki-67 level (Pearson Correlation Coefficient= 0.457; 95% confidence interval; P = 0.037) and tumor size (Pearson Correlation Coefficient =0.458; 95% confidence interval, P = 0.021) were determining factors for high 18F-FDG uptake values. The histological type (P = 0.525) was not significantly correlated with 18F-FDG uptake. Conclusion FDG PET imaging was used to estimate tumor biologic behavior of breast cancer such as histopathologic grading, immunohistochemistry, axillary lymph node status and distant metastasis. SUVmax correlated with several of pathological prognostic factors may have potential for predicting the prognosis of breast cancer. 18F-FDG PET/CT could be a useful tool to pretherapeutically predict biological characteristics and baseline risk of breast cancer Increased 18FFDG uptake on PET/CT was correlated with a high Ki-67 proliferation index and larger tumor size. These results suggest a potential role of 18F-FDG PET/CT in identifying tumor aggressiveness.

Background Vertebral collapse is a common problem due to benign conditions (trauma, infection, osteoporosis) or malignant process. And although the spine is the most common site of bone metastases (39% of bony metastases in patients with primary neoplasms) benign vertebral fractures due to osteopenia occur in one third of cancer patients, making it essential to determine whether the cause of vertebral collapse is benign or malignant. Aim of the Work To establish the role of DWI in differentiating benign from pathologic vertebral fractures using ADC values in comparison with histopathology report /laboratory evaluation and clinical follow-up. Patients and Methods A cross sectional study is approved by the ethics review board of Ain Shams University Hospital (Al Demerdash). All patients provided informed consent for the MR imaging examinations and for inclusion of their data in this analysis. From April 2020 to october 2020, 25 cases with previous imaging with vertebral compression underwent conventional MRI study on the affected region. Diffusion weighted imaging and ADC was added. Results We performed DWI using maximum b-values 600, and quantitative analysis, named apparent diffusion coefficient (ADC). We correlated the ADC number to histopathology, laboratory finding and clinical follow up. In our study there was significant difference (p < 0.04) between DWI of the benign and malignant groups. Also the ADC value showed significant difference <0.001. The mean ADCs of benign VCFs were higher significantly than those of pathological fractures. Conclusion DWI with ADC value was helpful when added to conventional MRI to differentiate benign from pathological (malignant) vertebral compression. It should be a routine sequence in patients with vertebral compression fractures for accurate diagnosis and successful management also can decrease no of biopsies.

Aim of work The aim of the study is to show the feasibility of diffusion weighted (DWI) MRI with calculation of the apparent diffusion coefficient in characterization of hepatic focal lesions as well as differentiating benign from malignant lesions in cirrhotic patients. Patients and Methods The study included 35 patients (25 males and 10 females) by cross sectional study and convenient sampling at the Demerdash hospital, inclusion criteria: patients diagnosed by hepatic focal lesions on top of post-viral induced cirrhosis, detected by ultrasound, triphasic CT or dynamic MRI imaging. All patients to be included in the study underwent characterization of hepatic focal lesions to differentiate benign from malignant lesions using a combination of characteristic imaging criteria, including contrast enhancement patterns on MRI. Sequences used were T2 weighted imaging, T2 Spectral Attenuated Inversion Recovery (SPAIR), and diffusion weighted imaging sequences with estimation of the ADC map and calculation of the ADC values. Results Our study was carried on a total of 35 patients including 25 males and 10 female patients having a mean age of 59 ± 10.2 years (58.1 ± 11 and 61.2 ± 8 years for the male and female patients respectively). DWI and ADC showed statistically significant difference among the benign and malignant focal lesions in terms of their diffusion restriction criteria ( P < 0.0001), with a sensitivity, specificity, positive and negative predictive values of 100% (95% CI = 89.5 – 100%), 92.3% (95% CI = 79.6 – 97.3%), 91.6% (95% CI = 78.1 – 97.1%) and 100% (95% CI = 90.3 – 100%), as well as a likelihood ratio of 13. On comparing the ADC values of the focal lesions for the benign and malignant focal lesions, the malignant lesions showed statistically significant lower means as compared to the benign lesions (malignant = 1.08 ± 0.28 x 10-3 mm2/s, benign =2.0 ± 0 x 10-3 mm2/s, P < 0.0001). ROC curve analysis of the ADC values of the benign and malignant focal lesions was highly significant (P < 0.0001), with an area under curve of 0.9745 (97.45% overall accuracy), giving an ADC cut-off value of (< 0.98 x 10-3 mm2/s) for malignant lesions with 97.2% sensitivity (95% CI = 85.83% - 99.86%), 97.2% specificity (95% CI = 85.83% - 99.86%) and a likelihood ratio of 35. Summary and conclusion DWI MRI and the calculation of the ADC are great non invasive possible tools to detect and characterize hepatic focal lesions as well as to differentiate benign from malignant lesions in cirrhotic patients especially in patients with renal impairment and allergy to contrast media also to avoid unnecessary biopsies.