No abstract

Introduction: Carcinoma of the lung is one of the most common cancer in Bangladesh. Fluorine-18-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) plays an important role in staging and evaluating therapy response. Currently, limited data is available about the demography and characteristics of lung cancer patients in Bangladesh by 18F-FDG PET-CT scan. Objectives: To evaluate the demographic pattern and pattern of findings in lung cancer patients by 18F-FDG PET-CT scan in the National Institute of Nuclear Medicine and Allied Sciences (NINMAS), Dhaka. Materials and Methods: This retrospective study was conducted in the PET-CT division of NINMAS. A total of 53 patients out of 103 patients with lung cancer were enrolled who were referred to NINMAS from October 2020 to December 2021 for either baseline PET CT or for assessment of therapy response. Data were collected in a predesigned format from old documents and analyzed for demographic characteristics, histopathologic, morphologic and metabolic patterns as well as a comparison of the overall number of lung cancer patients with previous years. Results: Among the enrolled 53 lung cancer patients the majority (34%) are in the 6th to 7th decades with 56.6% male and 43.4 % female. Adenocarcinoma (62%) and squamous cell carcinoma (24%) were the most common lung cancer subtypes. The majority of patients (53%) came for a therapeutic response evaluation; among them, 32% had a good response following therapy, 25% with progressive disease and others had mixed response, partial response, and stable disease. Nine percent of the patients came for follow up and among them, recurrence is detected in 20%. Lung cancer patients who came for baseline study, (38%) were upstaged (80%) mainly with 20% remaining in the same stage. Conclusion: The demographic pattern of lung cancer patients observed in this study belonged to 6th & 7th decades having male predominance. Most of the patients were diagnosed with advanced stages of lung cancer. The use of 18FDG PET-CT is crucial for the staging and diagnosis of suspected lung cancer, as well as therapeutic response and follow-up. Bangladesh J. Nuclear Med. 25(1): 22-27, 2022

not available Bangladesh J. Nuclear Med. 21(1): 46-47, January 2018

Bilateral adrenal metastases at the time of initial diagnosis of non-small cell lung cancer is a rare phenomenon. In elderly patients with an extra-adrenal malignancy and other nodal metastases, it is difficult to diagnose the etiology of adrenal mass by invasive procedure. Fluorine-18 FDG PET-CT scan can be an effective alternative in this type of patient to characterize adrenal masses as metastatic using several metabolic and imaging parameters in a single setting. Here we present a rare case of synchronus bilateral adrenal metastatic masses found in an elderly gentleman with non-small cell lung cancer (NSCLC) diagnosed during his baseline evaluation by 18F- FDG PET-CT scan. Bangladesh J. Nuclear Med. 24(1&2): 51-56, 2021

Background: Cardiovascular disease (CVD) is an important cause of morbidity and mortality in Bangladesh. The coronary artery calcium (CAC) score is a readily and widely available tool for noninvasive diagnosis of atherosclerotic coronary artery disease (CAD). Aims: To evaluate the diagnostic efficacy of combined CAC score with Single Photon Emission Computed Tomography (SPECT) Myocardial Perfusion Imaging (MPI) for the diagnosis of CAD. Methods: This cross sectional study was carried out in the National Institute of Nuclear Medicine & Allied Sciences (NINMAS) during July 2017 to June 2018. A total of 33 participants with known or suspected cases of CAD were included in this study who underwent SPECT MPI and CAC imaging. Statistical analyses of the results were obtained by using Statistical Packages for Social Sciences (SPSS-22). Results: Nearly half (48.5 %) of the participants belonged to age 51-60 years. Was male predominant in this study, 93.9% and 6.1% ware female. Regarding MPI 69.7% participants had severely abnormal perfusion and 21.2% had normal perfusion. According to CAC score 33.3% participants had moderate calcification in coronary artery. Significant CAD was found in 81.82% participants in Coronary Angiogram (CAG) study. Combined SPECT MPI and CAC score diagnosed significant CAD in 90.9% patents. The performance test of CAC score showed 96.3% sensitivity, 33.3% specificity, 84.8%accuracy, 86.7% positive predictive value (PPV) and 66.7% negative predictive value (NPV) for diagnosis of significant CAD. The performance test of SPECT MPI has sensitivity of 85.2%, specificity 50%, accuracy 78.8% and PPV 88.5% and NPV 42.8%. The performance test of combined SPECT MPI and CAC score, has 96.3% sensitivity, 50% specificity, 87.8% accuracy, 89.6% PPV and NPV 75%. CAC score with a cut off value of 12.5 had best combination of sensitivity 93.9% and specificity 50% for identifying the CAD missed by SPECT MPI. Conclusion: The CAC score may offer incremental diagnostic information over SPECT MPI for identifying patients with significant CAD and negative MPI results. Bangladesh J. Nuclear Med. 23(1&2): 21-28, 2020

Avascular necrosis (AVN) may be defined as cellular death of bone components due to the lack of blood supply resulting in joint damage and loss of joint function. This condition may arise from a number of causes i.e. both traumatic and non-traumatic. Diagnosis of the disease at an early stage and deliberate management can prevent the unwanted complications like femoral head collapse and severe arthritis and may save the bone. Although diagnosis of AVN is primarily dependent on radiological investigations, the incremental value and vital role of 99mTc-methylene diphosphonate (99mTc-MDP) single-photon emission computed tomography (SPECT) over planar bone scintigraphy permits more accurate localization of lesions and provide pertinent information to recognize the disease at initial stage for better management. We present a case of unexplained low back pain in a young woman who was diagnosed as having avascular necrosis of both femoral heads by 99mTc-MDP bone scan incorporated with SPECT Bangladesh J. Nuclear Med. 23(1&2): 55-58, 2020

Incidental high fluorine-18 FDG (fluorodeoxyglucose) uptake in well-differentiated prostate cancer is rare. We reported the case of a 75-year-old man who underwent a whole-body FDG PET-CT (positron emission tomography with computed tomography) scan for post-operative evaluation of caecal cancer and demonstrated no evidence of recurrence. However, a focal hypermetabolic lesion was detected in the right lateral lobe of the prostate. The patient’s prostatic biopsy from the right lobe revealed well-differentiated adenocarcinoma with a Gleason score of six and a raised serum PSA level. Incidental, focally intense FDG uptake in the prostate gland should be considered for further investigations to confirm the presence of prostate cancer. Bangladesh J. Nuclear Med. 26(1): 51-53, 2023

Ewing's sarcoma (ES) is a bone-related tumor that typically affects young children and adolescents. Primary renal Ewing sarcoma (RES) is extremely rare. Sources of Ewing sarcoma in the kidney include invagination or migration of neural crest cells to the kidney. Here, a case of a young adult male with renal Ewing sarcoma is presented. A 28-year-old male presented with nausea, hematuria, and left flank pain for seven days with an unremarkable previous medical history. An ultrasound and CT scan revealed a massive lobulated mass in the upper and midsection of the left kidney. A radical nephrectomy was done. Histopathology and immunohistochemistry revealed Ewing’s sarcoma/primitive neuroectodermal tumor. The chest X-ray and chest CT scan were negative for metastasis. Initial staging was T2bNxM0. Before starting further treatment, the patient was advised to undergo a fluorine-18 FDG (fluorodeoxyglucose) positron emission tomography (F-18 FDG PET-CT) scan for the detection of occult metastases. A F-18 FDG PET-CT scan revealed peritoneal seeding, skeletal and abdominal lymph node metastases. A multimodality workup is essential for proper management of Ewing sarcoma of the kidney due to its rarity and unusual location. F-18 FDG PET-CT plays a critical role in the detection of occult metastases, staging, restaging, and treatment planning in patients with RES. Bangladesh J. Nuclear Med. 26(1): 54-57, 2023