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Abdlkadir AS, Al-Adhami D, Alsyouf B, Alhouwari R, Al-Rasheed U, Jaber O, Mohamad I, Al-Ibraheem A. Hepatic Superscan in Medullary Thyroid Carcinoma: A Rare Presentation in [ 18F]FDG PET/CT. Nucl Med Mol Imaging 2024; 58:147-149. [PMID: 38633289 PMCID: PMC11018564 DOI: 10.1007/s13139-023-00836-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 04/19/2024] Open
Affiliation(s)
- Ahmed Saad Abdlkadir
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, 11941 Amman Jordan
| | - Dhuha Al-Adhami
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, 11941 Amman Jordan
| | - Baraa Alsyouf
- Department of Radiology and Nuclear Medicine, Division of Nuclear Medicine, University of Jordan, Al-Jubeiha, 11942 Amman Jordan
| | - Raghad Alhouwari
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, 11941 Amman Jordan
| | - Ula Al-Rasheed
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, 11941 Amman Jordan
| | - Omar Jaber
- Department of Pathology, King Hussein Cancer Center (KHCC), Al-Jubeiha, 11941 Amman Jordan
| | - Issa Mohamad
- Department of Radiation Oncology, King Hussein Cancer Center (KHCC), Al-Jubeiha, 11941 Amman Jordan
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, 11941 Amman Jordan
- Schoold of Medicine, University of Jordan, Al-Jubeiha, 11942 Amman Jordan
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Mansour A, Obeidat S, Al-Adhami D, Abu Hejleh T, Al-Ibraheem A. Gallium-68-Labeled Fibroblast Activation Protein Inhibitor as an Alternative Radiotracer to Fluorine 18-Fluorodeoxyglucose: A Case Report of Rare Pulmonary Colloid Adenocarcinoma Diagnosed by PET/CT. Cureus 2024; 16:e56173. [PMID: 38618464 PMCID: PMC11015907 DOI: 10.7759/cureus.56173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 04/16/2024] Open
Abstract
Colloid pulmonary adenocarcinoma represents a seldom encountered neoplasm in clinical practice. The diagnostic process for this rare neoplasm is complicated by its infrequency and the limited understanding of its specific molecular imaging characteristics. We report a 65-year-old male who was diagnosed with pulmonary colloid mucinous cystadenocarcinoma. Fluorine 18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was conducted for initial evaluation. The scan showed mild 18F-FDG expression at the primary tumor site, and several non-18F-FDG-avid mediastinal and paraesophageal lymph nodes exhibited suspicious morphologic features. Owing to the ongoing atrial fibrillation, initial histopathological confirmation of the primary tumor mass carries a sense of risk, prompting the imperative for cardiological assessment before proceeding. Instead, Gallium-68-labeled fibroblast activation protein inhibitor (68Ga-FAPI) PET/CT was performed, expecting this to be more informative in terms of malignancy potential than 18F-FDG PET in colloid mucinous histology. A scan revealed moderate 68Ga-FAPI expression at the primary tumor site but unremarkable 68Ga-FAPI expression at the questionable lymph node. Subsequently, a biopsy from a mediastinal node (left para-aortic) lymph node via endobronchial ultrasound (EUS) showed benign findings. The patient was treated with concurrent chemoradiation. This case underscores the vital role that 68Ga-FAPI PET/CT can play in specific cases of rare cancers, especially when invasive testing for tissue biopsy is not feasible.
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Affiliation(s)
- Areen Mansour
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Shahed Obeidat
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Dhuha Al-Adhami
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Taher Abu Hejleh
- Department of Medicine, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
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Al-Ibraheem A, Ruzzeh S, Badarneh M, Al-Adhami D, Telfah A. Beyond CT: A Case Analysis of Serial [18F]FDG PET/CT for Assessment of Necrosis and Early Recurrence in Colorectal Liver Metastases. Cureus 2023; 15:e51393. [PMID: 38292976 PMCID: PMC10826454 DOI: 10.7759/cureus.51393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2023] [Indexed: 02/01/2024] Open
Abstract
Colorectal cancer is a common malignancy, with the liver being the most frequent site of metastases. [18F] Fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) has emerged as a valuable tool in detecting and evaluating liver metastases and extrahepatic disease. Herein, we present a case of a 76-year-old male with colorectal cancer associated with lung and liver metastases. The patient received 12 chemoimmunotherapy cycles and was then put on maintenance cetuximab; serial [18F]FDG PET/CT scans were utilized to evaluate treatment response. The patient exhibited a positive response to chemoimmunotherapy, with regression of rectal disease and resolution of pulmonary metastatic nodules. Serial [18F]FDG PET/CT scans unveiled three distinct necrotic patterns. The case report advocates that [18F]FDG PET/CT plays an important role in evaluating colorectal liver metastases (CRLM) response to treatment, identifying transient necrosis, early recurrence, and emphasizing the limitations of post-treatment CT scans in identifying early CRLM recurrence. Integrating functional imaging, particularly [18F]FDG PET/CT, promises for management monitoring and surveillance of CRLM patients.
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Affiliation(s)
- Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
- School of Medicine, University of Jordan, Amman, JOR
| | - Saad Ruzzeh
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Mohannad Badarneh
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Dhuha Al-Adhami
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Ahmad Telfah
- Department of Medicine, King Hussein Cancer Center (KHCC), Amman, JOR
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Al-Ibraheem A, Abdlkadir AS, Shagera QA, Saraireh O, Al-Adhami D, Al-Rashdan R, Anwar F, Moghrabi S, Mohamad I, Muylle K, Estrada E, Paez D, Mansour A, Lopci E. The Diagnostic and Predictive Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Laryngeal Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:5461. [PMID: 38001720 PMCID: PMC10670341 DOI: 10.3390/cancers15225461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/11/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
This retrospective study examines the diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and neck magnetic resonance imaging (MRI) in detecting nodal metastasis for patients with laryngeal squamous cell carcinoma (LSCC) and assesses the predictive values of metabolic and structural features derived from 18F-FDG PET/CT. By involving 66 patients from 2014 to 2021, the sensitivity and specificity of both modalities were calculated. 18F-FDG PET/CT outperforms neck MRI for nodal disease detection, with 89% sensitivity, 65% specificity, and 77% accuracy for nodal metastasis (p = 0.03). On the other hand, neck MRI had 66% sensitivity, 62% specificity, and 64% accuracy. Approximately 11% of patients witnessed a change in their therapy intent when relying on 18F-FDG PET/CT nodal staging results. Analyzing the cohort for PET-derived metabolic and morphological parameters, a total of 167 lymph nodes (LN) were visualized. Parameters such as the LN maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and LN size were computed. Logistic regression and receiver operating characteristic (ROC) analyses were performed. Among the 167 identified cervical LNs, 111 were histopathologically confirmed as positive. ROC analysis revealed the highest area under the curve for LN MTV (0.89; p < 0.01), followed by LN size (0.87; p < 0.01). Both MTV and LN size independently predicted LN metastasis through multivariate analysis. In addition, LN MTV can reliably predict false-positive LNs in preoperative staging, offering a promising imaging-based approach for further exploration.
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Affiliation(s)
- Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
- School of Medicine, University of Jordan, Amman 11942, Jordan
| | - Ahmed Saad Abdlkadir
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
| | - Qaid Ahmed Shagera
- Nuclear Medicine Department, Institut Jules Bordet, Erasme Hospital, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Omar Saraireh
- Department of Surgical Oncology, King Hussein Cancer Center (KHCC), Amman 11941, Jordan;
| | - Dhuha Al-Adhami
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
| | - Rakan Al-Rashdan
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
| | - Farah Anwar
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
- Department of Nuclear Medicine, Warith International Cancer Institute, Karbala 56001, Iraq
| | - Serin Moghrabi
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
| | - Issa Mohamad
- Department of Radiation Oncology, King Hussein Cancer Center (KHCC), Amman 11941, Jordan;
| | - Kristoff Muylle
- Department of Nuclear Medicine, AZ Delta, 8800 Roeselare, Belgium;
| | - Enrique Estrada
- Nuclear Medicine and Diagnostic Imaging Section, Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), 6CM8+ Vienna, Austria; (E.E.); (D.P.)
| | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), 6CM8+ Vienna, Austria; (E.E.); (D.P.)
| | - Asem Mansour
- Department of Diagnostic Radiology, King Hussein Cancer Center (KHCC), Amman 11941, Jordan
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS, Humanitas Clinical and Research Hospital, Via Manzoni56, 20089 Milan, Italy;
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Al-Shammaa M, Abdlkadir A, Al-Adhami D, Jawad A, Al-Ibraheem A. Thyroid Carcinoma Arising From Struma Ovarii at Adolescence: A Challenging Case With Favorable Outcome. Cureus 2023; 15:e47163. [PMID: 38021785 PMCID: PMC10652026 DOI: 10.7759/cureus.47163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Malignant struma ovarii (MSO) is a rare and aggressive ovarian tumor that mostly affects adults but can occur in adolescents. Prompt recognition, accurate diagnosis, and multidisciplinary management are essential for favorable outcomes. Herein, we report the youngest case of an 11-year-old girl with a large MSO. First, conventional imaging revealed a large left ovarian mass, leading to a left oophorectomy. Subsequently, histopathological examination confirmed papillary thyroid carcinoma within MSO. Thyroid and fertility-preserving surgery were chosen after multidisciplinary consultation. Despite challenges, the patient had a positive outcome with no recurrence after 36 months. Therefore, the adoption of less invasive surgical approaches and vigilant follow-up can achieve remission, but more research is needed to further enhance our understanding of the disease's risk stratification and optimal treatment strategies.
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Affiliation(s)
- Mohamed Al-Shammaa
- Nuclear Medicine, Baghdad Radiotherapy and Nuclear Medicine Hospital, Baghdad, IRQ
| | - Ahmed Abdlkadir
- Nuclear Medicine and Positron Emission Tomography/Computed Tomography, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Dhuha Al-Adhami
- Nuclear Medicine and Positron Emission Tomography/Computed Tomography, King Hussein Cancer Center (KHCC), Amman, JOR
| | - Ali Jawad
- Rheumatology, Royal London Hospital, London, GBR
| | - Akram Al-Ibraheem
- Nuclear Medicine and Positron Emission Tomography/Computed Tomography, King Hussein Cancer Center (KHCC), Amman, JOR
- Medicine, University of Jordan, Amman, JOR
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Al-Ibraheem A, Abdlkadir AS, Al-Adhami D, Hejleh TA, Mansour A, Mohamad I, Juweid ME, Al-Rasheed U, Al-Hajaj N, Laban DA, Estrada-Lobato E, Saraireh O. The Prognostic and Diagnostic Value of [ 18F]FDG PET/CT in Untreated Laryngeal Carcinoma. J Clin Med 2023; 12:jcm12103514. [PMID: 37240619 DOI: 10.3390/jcm12103514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/06/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
This study aims to determine the diagnostic accuracy of staging PET/CT and neck MRI in patients with laryngeal carcinoma and to assess the value of PET/CT in predicting progression-free survival (PFS) and overall survival (OS). Sixty-eight patients who had both modalities performed before treatment between 2014 and 2021 were included in this study. The sensitivity and specificity of PET/CT and MRI were evaluated. PET/CT had 93.8% sensitivity, 58.3% specificity, and 75% accuracy for nodal metastasis, whereas MRI had 68.8%, 61.1%, and 64.7% accuracy, respectively. At a median follow-up of 51 months, 23 patients had developed disease progression and 17 patients had died. Univariate-survival analysis revealed all utilized PET parameters as significant prognostic factors for OS and PFS (p-value < 0.03 each). In multivariate analysis, metabolic-tumor volume (MTV) and total lesion glycolysis (TLG) predicted better PFS (p-value < 0.05 each). In conclusion, PET/CT improves the accuracy of nodal staging in laryngeal carcinoma over neck MRI and adds to the prognostication of survival outcomes through the use of several PET metrics.
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Affiliation(s)
- Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
- Department of Radiology and Nuclear Medicine, Division of Nuclear Medicine, University of Jordan, Amman 11942, Jordan
| | - Ahmed Saad Abdlkadir
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Dhuha Al-Adhami
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Taher Abu Hejleh
- Department of Medical Oncology, King Hussein Cancer Center, Amman 11941, Jordan
| | - Asem Mansour
- Department of Diagnostic Radiology, King Hussein Cancer Center, Amman 11941, Jordan
| | - Issa Mohamad
- Department of Radiation Oncology, King Hussein Cancer Center, Amman 11941, Jordan
| | - Malik E Juweid
- Department of Radiology and Nuclear Medicine, Division of Nuclear Medicine, University of Jordan, Amman 11942, Jordan
| | - Ula Al-Rasheed
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Nabeela Al-Hajaj
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman 11941, Jordan
| | - Dima Abu Laban
- Department of Diagnostic Radiology, King Hussein Cancer Center, Amman 11941, Jordan
| | - Enrique Estrada-Lobato
- Nuclear Medicine and Diagnostic Section, Division of Human Health, International Atomic Energy Agency, 1220 Vienna, Austria
| | - Omar Saraireh
- Department of Surgical Oncology, King Hussein Cancer Center, Amman 11941, Jordan
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