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Singh P, Agrawal K, Patel RK, Patro PSS, Parida GK. Radioiodine Uptake at Suture Site Granuloma Mimicking Neck Node Metastasis on 131 I Whole-Body Iodine Scintigraphy. Clin Nucl Med 2024; 49:e301-e303. [PMID: 38598541 DOI: 10.1097/rlu.0000000000005215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
ABSTRACT Differentiated thyroid carcinoma constitutes over 90% of all thyroid cancers. The standard treatment approach involves total or near-total thyroidectomy with or without neck dissection followed by 131 I whole-body scintigraphy (WBS) to detect local or distant metastases. Radioiodine offers high sensitivity and specificity for detection of metastatic disease in well differentiated thyroid carcinoma. However, despite its high accuracy, 131 I WBS demonstrates false-positive results, mostly at inflammatory or infective site. These false-positive radioiodine accumulation can lead to misdiagnosis and unwarranted radioiodine treatment. This case presents localization of 131 I to the suture site granuloma leading to false-positive results on 131 I WBS.
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Affiliation(s)
| | | | - Ranjan Kumar Patel
- Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, India
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2
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Singh P, Parida GK, Singhal T, Gupta J, Agrawal K. Incidental Detection of Myocardial Ischemia on Whole-Body PET/CT in a Patient With Carcinoma Lung. Clin Nucl Med 2024; 49:e156-e157. [PMID: 38377353 DOI: 10.1097/rlu.0000000000005082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
ABSTRACT 18 F-FDG PET/CT being a whole-body technique can detect multiple other critical nononcological findings. Various cardiac disorders identified incidentally on 18 F-FDG have been reported to help in timely management and improve overall patient care. We hereby present one such case where 18 F-FDG PET/CT performed for a workup of carcinoma lung revealed abnormal myocardial FDG uptake in the anteroseptal and apical region, which raised suspicion of myocardial ischemia such as hot spot imaging. On coronary angiography, coronary artery disease was detected and subsequently managed.
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Affiliation(s)
| | | | | | - Jaydeep Gupta
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, India
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3
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Singhal T, Singh P, Parida GK, Agrawal K. Role of PSMA-targeted PET-CT in renal cell carcinoma: a systematic review and meta-analysis. Ann Nucl Med 2024; 38:176-187. [PMID: 38340144 DOI: 10.1007/s12149-024-01904-w] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
Fluoro-deoxy glucose positron emission tomography/computed tomography (PET/CT), the workhorse of nuclear medicine, has limited utility for renal cell carcinoma (RCC), particularly clear cell variant. Thus, various other tracers have been tried for evaluation of RCC. One of the most promising targets for radiotracers is prostate-specific membrane antigen (PSMA) expressed in abundance in carcinoma-associated neo-vasculature. Thus, we tried to review and analyse the role of PSMA-targeted PET/CT in evaluation of RCC. Databases like PubMed, EMBASE and SCOPUS were searched for original studies published on PSMA-targeted PET/CT in RCC till 30 September 2023. Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) checklist was used to assess the included studies. Pooled sensitivity and specificity were calculated and represented with 95% confidence intervals (95%CI). Heterogeneity in the studies was assessed by I-square index. Pooled sensitivity and specificity of PSMA-targeted PET/CT for detection of local disease estimates were 87.2% (95%CI: 77-94%) and 100% (95%CI: 92.9-100%), respectively. Pooled sensitivity and specificity for detection of local recurrent disease are 100% (95%CI: 71.5-100%) and 100% (95%CI: 89.4-100%), respectively. Pooled sensitivity and specificity for detection of metastatic disease are 92% (95%CI: 86.2-96%) and 96.9% (95%CI: 83.8-99.9%), respectively. Pooled sensitivity of PSMA-targeted PET/CT for detection of clear cell renal cell carcinoma (ccRCC) and non-ccRCC are 94.7% (95%CI: 88-98.3%) and 75% (95%CI: 35-96.8%), respectively. PSMA-targeted PET-CT demonstrated better diagnostic efficacy for the detection of recurrent RCC. Whilst for staging RCC, it had higher specificity but lower sensitivity. Thus, it can serve as a non-invasive adjuvant tool to conventional imaging in the evaluation of staging of RCC, particularly clear cell variant.
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Affiliation(s)
- Tejasvini Singhal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India.
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
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Singh P, Patro SS, Singhal T, Parida GK, Agrawal K. Uterine Metastasis Presenting as Abnormal Uterine Bleeding in a Case of Primary Breast Cancer Identified on 18F-FDG PET/CT. J Nucl Med Technol 2023; 51:333-334. [PMID: 37699642 DOI: 10.2967/jnmt.123.266221] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/18/2023] [Indexed: 09/14/2023] Open
Abstract
Metastases to the female genital tract are rare, especially from extragenital primaries. The most common extragenital sites associated with genital metastasis are the gastrointestinal tract (37.6%) followed by the breast (34.9%). It is crucial to differentiate primary from metastatic involvement of the uterus for appropriate patient management. We present one such case of endometrial metastasis in a patient who presented clinically with abnormal uterine bleeding and was diagnosed with primary breast cancer via 18F-FDG PET/CT.
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Affiliation(s)
- Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sai Sradha Patro
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Tejasvini Singhal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
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Yanamandra U, Reddy Gorla AK, Agrawal K, Mittal BR, Prakash G, Khadwal AR, Varma N, Varma S, Malhotra P. Prognostic significance of extramedullary disease (EMD) detected on pre-transplant 18F-FDG PET/CT in patients with multiple myeloma: Results of PIPET-M trial. Med J Armed Forces India 2023; 79:672-678. [PMID: 37981939 PMCID: PMC10654356 DOI: 10.1016/j.mjafi.2023.08.007] [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: 06/18/2023] [Accepted: 08/11/2023] [Indexed: 11/21/2023] Open
Abstract
Background It is difficult to prognosticate the post-Autologous Stem Cell Transplant (ASCT) responses in multiple myeloma (MM) with the currently available prognostication models. 18F-FDGPET/CT has numerous advantages to prognosticate the post-transplant responses by assessing extramedullary disease (EMD) in addition to the extent of active disease. We aimed at identifying the prognostic value of EMD in predicting progression-free survival (PFS) and overall survival (OS). Methods This is a single centre prospective study from western India during a study period of 2014-2022 (with a median follow-up of patients of 6 years). All ASCT patients underwent 18F-FDG-PET/CT as part of pre-transplant workup. The conditioning and treatment protocols were not modified based on PET/CT findings. EMD on PET/CT was correlated with pre-transplant biochemical markers and post-ASCT survival/ progression (as defined by revised IMWG criteria). Statistical analysis was done using SPSS ver. 20. Results Patients with pre-ASCT EMD had a hazard-ratio for post-transplant all-cause mortality of 5.46 (p-0.045). Pre-transplant β2M and LDH were significantly higher in patients with EMD (p-0.036). The 6-year median OS in patients with and without EMD were 57.1%, and 80.6% respectively. Kaplan-Meier analysis showed poorer OS in patients with EMD χ2 (1-0.496, p-0.481). There was no significant difference in clinical or biochemical EFS among patients with EMD. Conclusion EMD detected on 18F-FDG-PET/CT has a higher hazard for mortality and is significantly correlated with pre-transplant higher β2M and LDH levels. Thus, EMD by pre-transplant 18F-FDG-PET/CT has a significant prognostic role.
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Affiliation(s)
- Uday Yanamandra
- Professor, Department of Internal Medicine, Armed Forces Medical College, Pune, India
| | - Arun Kumar Reddy Gorla
- Junior Consultant, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Kanhaiyalal Agrawal
- Associate Professor (Nuclear Medicine), All India Institute of Medical Sciences, Bhubaneshwar, India
| | - Bhagwant Rai Mittal
- Professor (Nuclear Medicine), Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Gaurav Prakash
- Professor (Clinical Hematology & Medical Oncology), Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Alka Rani Khadwal
- Professor (Clinical Hematology & Medical Oncology), Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Neelam Varma
- Ex-Professor & Head (Hematology), Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Subhash Varma
- Ex-Dean, Ex-Professor & Head (Internal Medicine), Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Pankaj Malhotra
- Professor & Head (Clinical Hematology & Medical Oncology), Post Graduate Institute of Medical Education & Research, Chandigarh, India
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Bishnoi K, Parida GK, Patro PSS, Agrawal K, Singh P. Complex Regional Pain Syndrome-like Pattern in a Case of Pancoast Tumor. Indian J Nucl Med 2023; 38:384-386. [PMID: 38390551 PMCID: PMC10880852 DOI: 10.4103/ijnm.ijnm_38_23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/06/2023] [Accepted: 08/09/2023] [Indexed: 02/24/2024] Open
Abstract
We present the case of a 52-year-old male who was recently diagnosed case of a Pancoast tumor and presented to the pulmonary outpatient department with a complaint of pain in the shoulder and chest region which was burning type, associated with shoulder abduction weakness and poor hand grip. Subsequently, he was referred for a 99m-Tc bone scan for metastatic workup, which showed increased uptake in all the joints and long bones of the ipsilateral upper limb. This case highlights the importance of considering nontraumatic cause of pattern similar to complex regional pain syndrome.
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Affiliation(s)
- Komal Bishnoi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - P Sai Sradha Patro
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Singhal T, Singh P, Parida GK, Kumar P, Patro SSP, Agrawal K. Aberrant Radioactive Iodine Uptake in Simple Ovarian Cyst: A Rare Finding. Indian J Nucl Med 2023; 38:387-389. [PMID: 38390537 PMCID: PMC10880847 DOI: 10.4103/ijnm.ijnm_115_23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 02/24/2024] Open
Abstract
I-131 whole body scan and therapy play an important role in the follow-up of differentiated thyroid carcinoma patients for the detection of residual thyroid tissue and metastatic disease. However, various false-positive findings have been reported in the literature which can appear as metastases. Here, we present one such case, in which an I-131 posttherapy scan revealed false-positive radioactive iodine uptake which localized to a simple ovarian cyst.
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Affiliation(s)
- Tejasvini Singhal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pramit Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sai Sradha P Patro
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Singh P, Parida GK, Bishnoi K, Singhal T, Kumar P, Mishra SK, Agrawal K. Delayed Recurrence of Gall Bladder Cancer as Port-site Metastases with Occult Primary Detected on Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography: A Tale of Two Cases. Indian J Nucl Med 2023; 38:273-275. [PMID: 38046970 PMCID: PMC10693369 DOI: 10.4103/ijnm.ijnm_17_23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 12/05/2023] Open
Abstract
Laparoscopic cholecystectomy is a fairly common procedure and is currently considered the gold standard for cholecystectomy. However, the laparoscopic procedure in the presence of gall bladder cancer (GBC) is associated with the risk of port-site metastasis (PSM). Furthermore, in few cases, GBC remains occult even on postoperative histopathology and presents with PSM remotely. Here, we describe two such cases of GBC with occult primary who presented with PSM and also defined the role of fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography in the management of such cases.
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Affiliation(s)
- Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Komal Bishnoi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Tejasvini Singhal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pramit Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sourav Kumar Mishra
- Department of Medical Oncology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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9
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Singh P, Agrawal K, Tripathy SK, Patro SS, Velagada S. Emerging role of bone scintigraphy single-photon emission computed tomography/computed tomography in foot pain management. Nucl Med Commun 2023; 44:571-584. [PMID: 37114428 DOI: 10.1097/mnm.0000000000001698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Foot and ankle joints being weight-bearing joints are commonly subjected to wear and tear and are prone to traumatic and other pathologies. Most of these foot and ankle pathologies present with pain. The diagnosis of pathology and localization of pain generators is difficult owing to the complex anatomy of the foot and similar clinical presentation. This makes the management of foot pain clinically challenging. Conventional anatomical imaging modalities are commonly employed for evaluation of any anatomical defect; however, these modalities often fail to describe the functional significance of the anatomical lesions, especially in presence of multiple lesions which is common in ankle and foot; however, hybrid single-photon emission computed tomography/computed tomography (SPECT/CT) by virtue of its dual modalities, that is, highly sensitive functional imaging and highly specific anatomical imaging can serve as a problem-solving tool in patient management. This review attempts to describe the role of hybrid SPECT/CT in overcoming the limitation of conventional imaging and describes its potential application in the management of foot and ankle pain.
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Affiliation(s)
- Parneet Singh
- Nuclear Medicine, All India Institute of Medical Sciences, AIIMS, Bhubaneswar
| | - Kanhaiyalal Agrawal
- Nuclear Medicine, All India Institute of Medical Sciences, AIIMS, Bhubaneswar
| | - Sujit Kumar Tripathy
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha
| | - Sai Sradha Patro
- Nuclear Medicine, All India Institute of Medical Sciences, AIIMS, Bhubaneswar
| | - Sandeep Velagada
- Department of Orthopedics, S.L.N Medical College and Hospital, Koraput, India
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Singh P, Parida GK, Singhal T, Kumar P, Emerson R, Agrawal K. False-Positive Radioiodine Uptake in the Cervix in a Patient with Thyroid Cancer. Indian J Nucl Med 2023; 38:270-272. [PMID: 38046958 PMCID: PMC10693371 DOI: 10.4103/ijnm.ijnm_34_23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/30/2023] [Indexed: 12/05/2023] Open
Abstract
Radioactive iodine (RAI) accumulation is commonly used for the detection of metastatic disease posttotal thyroidectomy. However, false-positive results have been reported due to abnormal RAI accumulation in some benign pathologies apart from metastatic sites. Here, we present one such case where false-positive I-131 uptake in the pelvis which localized to the cervix and was attributed to menstruation.
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Affiliation(s)
- Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Tejasvini Singhal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pramit Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ralph Emerson
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Parida GK, Panda RA, Bishnoi K, Agrawal K. Efficacy and Safety of Actinium-225 Prostate-Specific Membrane Antigen Radioligand Therapy in Metastatic Prostate Cancer: A Systematic Review and Metanalysis. Med Princ Pract 2023; 32:178-191. [PMID: 37247612 PMCID: PMC10601660 DOI: 10.1159/000531246] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/22/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Actinium-225 (Ac-225) labelled PSMA RLT has been tested recently in metastatic castration-resistant prostate cancer (mCRPC), with encouraging results. Ac-225, being an alpha emitter, is expected to have higher efficacy and fewer side effects compared to the beta-emitters such as Lutetium-177. We have performed a meta-analysis to assess the therapeutic responses, survival effects, and significant side effects of Ac-225 PSMA RLT in patients with mCRPC. METHODOLOGY Systematic literature search was carried out from five electronic databases PubMed/MEDLINE, SCOPUS, EMBASE, Web of Science, and Cochrane Library until March 2021. Eight studies were found to be eligible for this metanalysis. RESULTS Eight studies with 226 patients were analyzed in this metanalysis. 81% (95% CI 73-89) patients had a decline in PSA levels. 60% of the patients showed more than 50% PSA decline. Two studies assessed survival effects of radioligand naïve patients compared to patients who had received Lu-PSMA therapy previously and the pooled HR for radioligand naïve patients is 0.22. The most common toxicity reported was xerostomia in 167 patients out of 226 patients (73.9%, 95% CI 67.6-79.5%); however, most of them were confined to grade I and II levels. Other reported side effects include hematologic toxicity and nephrotoxicity. CONCLUSION Ac-PSMA RLT is a safe and potentially effective treatment option for patients with mCRPC.
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Affiliation(s)
- Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Raj Abhisek Panda
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Komal Bishnoi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
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12
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Singhal T, Parida GK, Singh P, Kumar P, Emerson R, Agrawal K. Steroid-Induced Activated White Adipose Tissue Detected on 18F-FDG PET/CT. J Nucl Med Technol 2023:jnmt.122.265320. [PMID: 37192824 DOI: 10.2967/jnmt.122.265320] [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: 12/13/2022] [Revised: 02/07/2023] [Indexed: 05/18/2023] Open
Abstract
White adipose tissue (WAT) usually shows negligible 18F-FDG uptake due to negligible glucose utilization. However, corticosteroids alter the biodistribution of 18F-FDG and increase uptake in WAT. Here, we present a case of diffusely increased 18F-FDG uptake in WAT secondary to high-dose corticosteroid therapy for nephrotic syndrome.
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Affiliation(s)
- Tejasvini Singhal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Pramit Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Ralph Emerson
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
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13
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Singh P, Parida GK, Emerson R, Kumar P, Agrawal K. Small Chyle Leak Localized on Lymphoscintigraphy with Single-Photon Emission Computed Tomography-Computed Tomography. Indian J Nucl Med 2023; 38:188-190. [PMID: 37456199 PMCID: PMC10348508 DOI: 10.4103/ijnm.ijnm_160_22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/29/2022] [Accepted: 01/25/2023] [Indexed: 07/18/2023] Open
Abstract
Chylothorax refers to the accumulation of triglyceride-rich fluid (chyle) within the pleural space. We described a case of spontaneous chylothorax in an infant. Lymphoscintigraphy was performed with 99 m-Tc sulfur colloid which showed tracer accumulation into thoracic cavity, and single-photon emission computed tomography/CT (SPECT/CT) revealed leak in the thoracic duct at D8 vertebral level as the cause. We, thus, emphasize the role of lymphoscintigraphy with SPECT/CT in identification of cause and guiding the management of chylothorax, especially when surgical treatment is planned.
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Affiliation(s)
- Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ralph Emerson
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pramit Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Emerson R, Singh P, Parida GK, Kumar P, Agrawal K. Recurrent Renal Cell Carcinoma Presenting as Port-Site Metastases, Detected on 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography. Indian J Nucl Med 2023; 38:174-176. [PMID: 37456184 PMCID: PMC10348512 DOI: 10.4103/ijnm.ijnm_168_22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/24/2022] [Indexed: 07/18/2023] Open
Abstract
The incidence of port-site metastases (PSMs) varies with the tumor type with adenocarcinoma having a high incidence. However, it is rarely seen in urological malignancies and more so in renal cell carcinoma (RCC). We hereby describe one such case of PSM after laparoscopic radical nephrectomy for RCC, which was detected on 18F-fluorodeoxyglucose positron emission tomography-computed tomography.
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Affiliation(s)
- Ralph Emerson
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pramit Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Singh P, Parida GK, Singhal T, Kumar P, Bishnoi K, Agrawal K. RARE CASE OF PHYLLODES TUMOUR OF BREAST WITH CARDIAC AND PANCREATIC METASTASES. FINDINGS ON FDG PET-CT. J Nucl Med Technol 2023:jnmt.122.265212. [PMID: 36750379 DOI: 10.2967/jnmt.122.265212] [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: 11/17/2022] [Accepted: 01/26/2023] [Indexed: 02/09/2023] Open
Abstract
Phyllodes tumors (PTs) represents a rare breast tumor arising from its stromal component rather than epithelium. Metastatic spread occurs hematogenous with lung, bone, brain and liver being the most common sites. We hereby present 18F-FDG PET-CT scan of one such case of phyllodes tumor showing cardiac and pancreatic metastases which is extremely rare occurrence.
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Affiliation(s)
- Parneet Singh
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Tejasvini Singhal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Pramit Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Komal Bishnoi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
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Bishnoi K, Emerson R, Parida GK, Acharya P, Padhi S, Agrawal K. Acute Myeloid Leukemia following Radioactive Iodine Therapy for Metastatic Follicular Carcinoma of the Thyroid. Indian J Nucl Med 2023; 38:56-58. [PMID: 37180180 PMCID: PMC10171747 DOI: 10.4103/ijnm.ijnm_133_22] [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: 07/29/2022] [Revised: 09/11/2022] [Accepted: 09/15/2022] [Indexed: 02/25/2023] Open
Abstract
Radioactive iodine (RAI) therapy is widely used and has an important role in the management of hyperthyroidism and thyroid malignancies. The development of acute or chronic leukemia is a very rare complication of RAI therapy. We report a case of metastatic Follicular thyroid cancer (FTC) who underwent total thyroidectomy followed by treatment with a cumulative dose of 1600 mCi of RAI (for 4 years) and by palliative radiotherapy for L4 spinal metastasis, later on, developed acute myeloid leukemia. Thus, all patients with thyroid carcinoma treated with RAI should undergo periodic hematological examinations irrespective of RAI dose.
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Affiliation(s)
- Komal Bishnoi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ralph Emerson
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Prapti Acharya
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Somanath Padhi
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Behera K, Sahu S, Agrawal K, Soren UK, Parida GK, Srinivasan A. Study of Correlation between Serum Osteoprotegerin, TNF-Alfa, and Biomarkers of Bone Metabolism in Patients with Treatment-Naive Graves' Disease-A Cross-Sectional Study. Indian J Endocrinol Metab 2023; 27:62-65. [PMID: 37215268 PMCID: PMC10198200 DOI: 10.4103/ijem.ijem_207_22] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 02/16/2023] [Accepted: 01/27/2023] [Indexed: 03/05/2023] Open
Abstract
Objectives Primary - a study of the correlation between serum osteoprotegerin (OPG), and biomarkers of bone metabolism in patients with treatment-naive Graves' disease (GD). Secondary - serum level of OPG, TNF-alfa, and biomarkers of bone metabolism in patients three months after treatment of GD with methimazole (MMI). Materials and Methods A total of thirty-five treatment-naive newly diagnosed GDs were recruited for the study, most of them female. All patients started with MMI for treatment and various blood parameters were measured at baseline and three months after treatment. Measurements: Serum calcium (Ca), phosphorus (P), bone-specific alkaline phosphatase (B-ALP), OPG, TNF-alfa, and urine deoxypyridinoline (U-DPD) along with serum-free T3 and T4, thyroid-stimulating hormone (TSH) and thyroid receptor antibody (TR-ab) were analysed at baseline and three months after MMI treatment. All the patients had euthyroid at three months of MMI treatment. Results Mean serum OPG (0.94 ± 1.39 vs. 0.63 ± 0.27 ng/ml; P = 0.262) level at baseline and after treatment with MMI did not show any significant change. Mean TSH level (0.207 ± 0.59 vs. 1.00 ± 1.95, P = 0.025) was significantly low at baseline than after treatment; FT4 (5.9 ± 5.22 v 1.77 ± 1.89 ng/dl; P < 0.001), FT3 (12.19 ± 6.91 vs. 4.99 ± 3.55 pg/ml; P < 0.001), and TNF-alfa values decreased significantly after treatment, however, PTH (58.09 ± 28.75 vs. 75.57 ± 41.50; P < 0.026) increased significantly after treatment. Discussion There is no correlation of OPG with thyroid hormone profile, TSH, thyroid receptor antibody (TR-ab), and bone metabolic parameters such as serum Ca, P, B-ALP, TNF-alfa, and U-DPD in our study. Mean TNF-alfa decreased significantly (393.43 ± 270.473 vs. 139.34 ± 101.264 pg/ml; P = 0.001) level after treatment with MMI. TNF-alfa was positively correlated with TR-ab (r = 0.374; P = 0.027) and B-ALP (r = 0.388; P = 0.021). Conclusion The bone turnover marker in GD seems to be mediated other than OPG. We observed an increase in circulating TNF-alfa in GD with a significant decrease after treatment. TNF-alfa could be a marker of GD activity as evidenced by a close positive correlation with TR-ab, a sensitive marker of GD autoimmunity. TNF-alfa could be a factor associated with bone turnover markers in GD despite its euthyroid state.
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Affiliation(s)
- Kishore Behera
- Endocrinology and Metabolism, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suchanda Sahu
- Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Uttam K. Soren
- Endocrinology and Metabolism, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Girish K. Parida
- Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Anand Srinivasan
- Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Bishnoi K, Parida GK, Emerson R, Agrawal K, Adhya AK. AN INCIDENTALLY DETECTED CASE OF ATYPICAL BRONCHIAL CARCINOID IN STRESS MYOCARDIAL PERFUSION SPECT/CT. J Nucl Med Technol 2022:jnmt.122.264507. [PMID: 36195445 DOI: 10.2967/jnmt.122.264507] [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: 06/10/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Myocardial perfusion imaging (MPI) is primarily done to look for stress induced perfusion defects in patients suspected of coronary artery disease. However, the rotating raw images can provide a significant information regarding surrounding structures. The lungs lie in close proximity to heart and any abnormality showing increased uptake can be seen on MPI. We report a case of 52-year-old man, with history of diabates for last 5 years, who presented to cardiac outpatient department (OPD) for occasional chest pain and dyspnea. Electrocardiogram (ECG) and echocardiography showed no significant abnormality. Patient was referred to nuclear medicine department for stress induced myocardial perfusion scintigraphy. The raw 99m-Tc sestamibi images were showing abnormal uptake in right lung hilar region which on subsequent investigations was diagnosed as a case of atypical bronchial carcinoid tumor.
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Affiliation(s)
- Komal Bishnoi
- All India Institute of Medical Sciences, Bhubaneswar, India
| | | | - Ralph Emerson
- All India Institute of Medical Sciences, Bhubaneswar, India
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19
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Bishnoi K, Parida GK, Emerson R, Agrawal K. "Ebstein's Anomaly" a Potential Cause of Misinterpretation on Myocardial Perfusion Imaging. Indian J Nucl Med 2022; 37:392-393. [PMID: 36817212 PMCID: PMC9930459 DOI: 10.4103/ijnm.ijnm_43_22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/06/2022] [Accepted: 05/19/2022] [Indexed: 12/03/2022] Open
Abstract
Ebstein's anomaly is a rare congenital heart disease. We present the case of a 47-year-old woman with history of Ebstein's anomaly who was referred to nuclear medicine department for a myocardial perfusion single-photon emission computed tomography (SPECT) imaging during pre-anesthetic check-up. Myocardial SPECT perfusion images with (99mTc)-Sestamibi demonstrated medium sizes fixed perfusion defect in the mid and proximal infero-septal wall adjacent inferior wall. This is a cause of potential misinterpretation on myocardial SPECT perfusion imaging as this perfusion defect was due to fibrosis rather than scarred myocardium.
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Affiliation(s)
- Komal Bishnoi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ralph Emerson
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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20
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Bishnoi K, Parida GK, Thavnani R, Patro PSS, Agrawal K. An Unusual Case of Glioblastoma Multiforme, Presenting as Skeletal Superscan. Indian J Nucl Med 2022; 37:268-270. [PMID: 36686309 PMCID: PMC9855241 DOI: 10.4103/ijnm.ijnm_209_21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/02/2022] [Accepted: 03/16/2022] [Indexed: 11/05/2022] Open
Abstract
Extracranial metastases of glioblastoma multiforme (GBM) are very rare. The estimated incidence is <2%. We report a case of a 49-year-old woman, who was a known case of GBM in the left temporo-occipital lobe. She was operated and had received radiotherapy and adjuvant chemotherapy for the same. Subsequently, the patient underwent bone scan. On 99 m-Tc methylene diphosphonate (MDP) bone scan, homogenously increased tracer uptake was noted in the axial and appendicular skeletal system, suggesting metastatic skeletal superscan.
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Affiliation(s)
- Komal Bishnoi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rachit Thavnani
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - P Sai Sradha Patro
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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21
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Gnanasegaran G, Agrawal K, Wan S. 18F-Fluorodeoxyglucose-PET-Computerized Tomography and non-Fluorodeoxyglucose PET-Computerized Tomography in Hepatobiliary and Pancreatic Malignancies. PET Clin 2022; 17:369-388. [PMID: 35717098 DOI: 10.1016/j.cpet.2022.03.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Molecular imaging with PET-computerized tomography (PET-CT) plays an important role in oncology. There is current and evolving evidence supporting the use of fluorodeoxyglucose (FDG) and non-FDG tracers in assessment patients with hepatobiliary and pancreatic cancers in various clinical scenarios. In this chapter, we discuss the advantages and limitations of FDG and non-FDG PET-CT in the management of patients with hepatobiliary and pancreatic cancers.
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Affiliation(s)
| | | | - Simon Wan
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
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22
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Mishra BR, Agrawal K, Biswas T, Mohapatra D, Nath S, Maiti R. Comparison of Acute Followed by Maintenance ECT vs Clozapine on Psychopathology and Regional Cerebral Blood Flow in Treatment-Resistant Schizophrenia: A Randomized Controlled Trial. Schizophr Bull 2022; 48:814-825. [PMID: 35556138 PMCID: PMC9212098 DOI: 10.1093/schbul/sbac027] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS In treatment-resistant schizophrenia (TRS), Clozapine is only approved treatment with undesirable side-effects, warranting better alternatives. Our hypothesis is acute followed by maintenance Electroconvulsive Therapy (M-ECT) will be comparable in efficacy and safety to Clozapine in TRS. STUDY DESIGN In this open-label trial, 60 TRS patients were randomized equally to M-ECT (following an acute-course) or Clozapine. Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Schizophrenia Scale (CGI-SCH), Montreal Cognitive Assessment (MoCA), and Global assessment of functioning (GAF) were measured and compared within and between the groups at baseline, 6 weeks, 12 weeks, and 24 weeks. SPECT-CT brain was done at baseline and 24 weeks to compare the changes in regional cerebral perfusion between the groups and correlate with the changes in the outcome-measures. STUDY RESULTS The PANSS-T scores changes from baseline over the observation-points were significant in both M-ECT and clozapine groups (P < .001), with comparatively better reduction with M-ECT (P < .001). Similar trends were observed in PANSS subscales, CGI-SCH and GAF in both groups, with significantly better improvement with M-ECT over the study-period. After 24 weeks, there was significantly better perfusion with M-ECT in bilateral prefrontal and temporal cortices (P < .05). With M-ECT, a positive correlation was found between changes in PANSS-P scores and left-lateral Temporal cortical perfusion (r = .465, P = .017). CONCLUSIONS Acute followed by M-ECT was more effective than clozapine over 6 months in reducing the positive and negative symptoms, general psychopathology, illness-severity, and improving the global functionality in TRS [clinicaltrials.gov: NCT03807882].
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Affiliation(s)
- Biswa Ranjan Mishra
- To whom correspondence should be addressed; Academic Block, Department of Psychiatry, AIIMS, Sijua, Patrapada, PO Dumduma, Bhubaneswar 751019, Odisha, India; tel: +91-9438884220, fax: 0674-2476002, e-mail:
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Tathagata Biswas
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Debadatta Mohapatra
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Santanu Nath
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, India
| | - Rituparna Maiti
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
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23
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Tripathy S, Varghese P, Sethy SS, Agrawal K. Safe surgical hip dislocation for acetabular osteoid osteoma excision. BMJ Case Rep 2022; 15:e246025. [PMID: 35228220 PMCID: PMC8886369 DOI: 10.1136/bcr-2021-246025] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2021] [Indexed: 02/05/2023] Open
Abstract
Excision of acetabular osteoid osteoma is technically difficult. We report osteoid osteoma of the quadrilateral plate in a 9-year-old girl who presented to us with persistent nocturnal pain, limp and restricted hip joint movement. The child was investigated with CT scan, MRI and triple-phase bone scan. The 0.7 cm nidus was located in the central portion of the cancellous bone in the quadrilateral plate, 1.94 cm inferior to the triradiate cartilage. The child was operated on through the safe surgical dislocation of the left hip. The location of the lesion was gauged from the preoperative CT scan measurement data and intraoperative fluoroscopic aid. The nidus with a sclerotic rim was burred down completely. Postoperative X-ray and CT scan revealed complete excision of the tumour, and the patient was pain-free. At 18 months follow-up, the patient is completely asymptomatic and walking normally.
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Affiliation(s)
- Sujit Tripathy
- Department of Orthopaedics, AIIMS, Bhubaneswar, Odisha, India
| | | | | | - Kanhaiyalal Agrawal
- Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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24
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Patro PS, Agrawal K, Parida GK, Parida DK. Uptake of bone seeking radiotracer in the metastatic lymph node from testicular tumour. BMJ Case Rep 2022; 15:e245002. [PMID: 35039343 PMCID: PMC8767994 DOI: 10.1136/bcr-2021-245002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- P Saisradha Patro
- Department of Nuclear Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
| | - Dilip Kumar Parida
- Department of Radiotherapy, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
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25
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Patro PSS, Patra S, Kumar R, Agrawal K, Parida GK. Assessment of Treatment Response by Bone SPECT-CT in a Case of Dermatomyositis with Calcinosis Cutis. Indian J Nucl Med 2022; 37:71-73. [PMID: 35478689 PMCID: PMC9037864 DOI: 10.4103/ijnm.ijnm_106_21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/04/2021] [Accepted: 09/14/2021] [Indexed: 11/25/2022] Open
Abstract
Calcinosis of soft tissue is a rare but known complication of dermatomyositis (DM), mostly associated with juvenile DM and rare in adult DM. Bone scan with Tc-99m Methylene diphosphonate is useful in disease mapping and has high sensitivity to know the extent of calcinosis. However, there is scanty literature available on the utility of bone scan in treatment response evaluation in DM. Rituximab has been found useful in adult DM with calcinosis unresponsive to conventional treatment. We describe an interesting case showing partial response to rituximab on bone scan with single-photon emission tomography-computed tomography.
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Affiliation(s)
- P. Sai Sradha Patro
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Subhabrata Patra
- Department of General Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Rajesh Kumar
- Department of General Medicine, All India Institute of Medical Sciences, Deogarh, Jharkhand, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India,Address for correspondence: Dr. Kanhaiyalal Agrawal, Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India. E-mail:
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
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Agrawal K, Patro PSS, Meher BR, Gnanasegaran G. Prevalence of Marine-Lenhart syndrome on 99mTc-thyroid scintigraphy and response to radioiodine: A single institutional retrospective study. World J Nucl Med 2021; 20:369-373. [PMID: 35018152 PMCID: PMC8686752 DOI: 10.4103/wjnm.wjnm_130_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/14/2021] [Accepted: 01/26/2021] [Indexed: 11/30/2022] Open
Abstract
Marine-Lenhart Syndrome is a rare entity, described as Graves’ disease with coexisting functioning thyroid nodules. It is often diagnosed on thyroid scintigraphy as a cold nodule with surrounding extranodular hyperactivity initially and postradioiodine ablation, they regain function on the follow-up thyroid scintigraphy due to endogenous thyroid-stimulating hormone (TSH) stimulation. We retrospectively reviewed all thyroid scintigraphy database performed between January 2018 and March 2020 in our institute. We searched patients with Graves’ disease with the following criteria to suggest Marine-Lenhart Syndrome: (a) initial thyroid scintigraphy showing features of Graves’ disease with coexistent poorly functioning nodules (b) There is normalization of uptake within the nodule on thyroid scan after radioiodine ablation suggestive of endogenous TSH stimulation (this also indirectly proves nodules are TSH dependent), (c) nodule(s) is/are benign on fine-needle aspiration cytology. Four patients (1.46%) were confirmed as Marine-Lenhart Syndrome as per the criteria. Three patients were female, and one was male. The eye signs were present in two of four patients. Two patients had two hypofunctioning nodules, whereas the remaining two had a single nodule and required re-ablation with radioiodine. Marine-Lenhart Syndrome requires special attention as these patients are relatively radioiodine resistant, require higher activity for iodine-131; however, it is curable with radioiodine treatment.
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Affiliation(s)
- Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - P Sai Sradha Patro
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bikash Ranjan Meher
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Agrawal K, Swaroop S, Patro PSS, Tripathy SK, Naik S, Velagada S. Comparison of bone SPECT/CT and MRI in detection of pain generator in ankle and foot pain: a retrospective diagnostic study. Nucl Med Commun 2021; 42:1085-1096. [PMID: 34075007 DOI: 10.1097/mnm.0000000000001443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To study the sensitivity and specificity of MRI and bone SPECT-CT in detecting the pain generator in ankle and foot pain with diagnostic dilemma. METHODS Retrospectively data of patients with ankle or foot pain who underwent both MRI and Bone SPECT-CT were analyzed. The lesions and probable pain generator sites were reported as per MRI and bone SPECT-CT findings. These lesions were correlated clinically, managed accordingly and followed up. The patients who had significant improvement in response to the treatment provided were considered to have been diagnosed accurately. The foot and ankle disability index (FADI) was used to evaluate the patient's pre- and postintervention condition. RESULTS The study included 37 patients retrospectively (18 women and 19 men). The lesions were classified into soft tissue lesions (ligaments/tendons), joint lesions (arthritis) and bony lesions (fractures/osteomyelitis/osteochondral lesions). Overall, MRI had sensitivity, specificity, positive predictive value and negative predictive value of 82, 31, 74 and 42%, respectively, and SPECT-CT had sensitivity, specificity, positive predictive value and negative predictive value of 84, 60, 84 and 60%, respectively. The mean FADI score pretreatment for all patients was 61.5 (SD = 13.8) and posttreatment 88.4 (SD = 13.01) showing significant improvement in the score (P < 0.05), suggesting that the final diagnosis of these patients was accurate. Overall, management change due to bone SPECT-CT over MRI was seen in 26% of patients. CONCLUSION Bone SPECT-CT has incremental value over MRI in the diagnosis of pain generator in foot and ankle pain. The overall specificity of bone SPECT-CT is higher than MRI in detection of pain generators. Bone SPECT-CT performed better than MRI in detection of culprit pathology in the bone, whereas MRI is better in soft tissue lesions. ADVANCES IN KNOWLEDGE There are only a few published literature with direct comparison of bone SPECT-CT scintigraphy and MRI in detection of foot and ankle pain generator. This study directly compares diagnostic utility of bone SPECT-CT scintigraphy and MRI in foot and ankle pain. In the present study, the bone SPECT-CT performed better than MRI in detection of culprit pathology in the bone, whereas MRI is better in soft tissue lesions.
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Affiliation(s)
- Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar
| | - Shakti Swaroop
- Department of Orthopedics, Institute of Medical Sciences & SUM Hospital
| | - P Sai Sradha Patro
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar
| | | | - Suprava Naik
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Goswami RK, Agrawal K, Shah MP, Verma P. Bioremediation of heavy metals from wastewater: a current perspective on microalgae-based future. Lett Appl Microbiol 2021; 75:701-717. [PMID: 34562022 DOI: 10.1111/lam.13564] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 07/21/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/30/2022]
Abstract
Heavy metals-containing drinking water and wastewater are posing a severe threat to the environment, and living beings on land, air and water. Different conventional, advanced nanomaterials-based and biological method has been employed for the treatment of heavy metals. Among the biological methods, microalgae are an important group of micro-organisms that have numerous environmental applications and can remediate heavy metals from wastewater. Also, it has numerous advantages over conventional remediation processes. Microalgae cells can uptake the heavy metal via different physiological and biological methods and are utilized as a nutrient source to regulate its metabolic process for the production of biomass. Furthermore, the enhancement in heavy metal removal efficiency can be improved using different strategies such as immobilization of algal cells, development of algal consortia and designing of microalgae-based nanocomposite materials. Also, it can significantly contribute towards environmental sustainability and future. Thus, the review provides a critical overview of heavy metals and their existence along with their negative effects on humans. This review provides insight on recent advanced nanomaterial approaches for the removal of heavy metals, overviews of microalgae-based heavy metal uptake mechanisms and their potential for the amputation of different heavy metals. Furthermore, the special focus is on recent strategies that enhance heavy metal removal efficiency and contribute towards sustainability for the development of a microalgae-based future.
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Affiliation(s)
- R K Goswami
- Bioprocess and Bioenergy Laboratory, Department of Microbiology, Central University of Rajasthan, Ajmer, Rajasthan, India
| | - K Agrawal
- Bioprocess and Bioenergy Laboratory, Department of Microbiology, Central University of Rajasthan, Ajmer, Rajasthan, India
| | - M P Shah
- Industrial Waste Water Research, Division of Applied and Environmental Microbiology, Environment Technology Ltd, Ankleshwar, Gujarat, India
| | - P Verma
- Bioprocess and Bioenergy Laboratory, Department of Microbiology, Central University of Rajasthan, Ajmer, Rajasthan, India
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Meher BR, Agrawal K, Gnanasegaran G. Review of Adverse Reactions Associated with the Use of Common Diagnostic Radiopharmaceuticals. Indian J Nucl Med 2021; 36:163-167. [PMID: 34385787 PMCID: PMC8320829 DOI: 10.4103/ijnm.ijnm_219_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/24/2022] Open
Abstract
Radiopharmaceuticals are used in the diagnosis and management of various diseases. There are several reports of adverse reactions related to the use of radiopharmaceuticals, though it is not as common as conventional drugs. Adverse reactions related to radiopharmaceuticals have been not widely reported and documented. In this review, we have tried to summarize the adverse reactions associated with some of the commonly used radiopharmaceuticals.
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Affiliation(s)
- Bikash Ranjan Meher
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Gopinath Gnanasegaran
- Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, England
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Parida GK, Panda RA, Agrawal K. Impact of fluorine-18-fluorodeoxyglucose PET/computed tomography in staging of patients with gallbladder cancer: a systematic review and meta-analysis. Nucl Med Commun 2021; 42:846-854. [PMID: 33741859 DOI: 10.1097/mnm.0000000000001405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Fluorine-18-fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT) has proven its efficacy in various malignancies; however, currently it is not used routinely for the management of gallbladder carcinoma (GBCa). So, we tried to review and analyze the impact of FDG PET/CT in the staging workup of gallbladder carcinoma. METHODS Databases like PubMed, SCOPUS, and EMBASE were searched for published original studies on F-18 FDG PET/CT in staging workup gallbladder carcinoma till December 2020. The included studies were assessed using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) checklist. A random-effect model was used for calculating pooled estimates of sensitivity and specificity. They were demonstrated in Forest plots. I2 statistic was used to assess heterogeneity in the studies. RESULTS There is a paucity of literature with respect to the role of FDG PET/CT in GBCa. With the available data, the pooled sensitivity and specificity of 18F-FDG PET/CT for detection of local disease estimates of 96% [95% confidence interval (CI), 90-99%] and 91% (95% CI, 77-98%), respectively. Pooled sensitivity and specificity for detection of metastatic disease are 95% (95% CI, 88-98%) and 97% (95% CI, 90-100%), respectively. For nodal disease, these values are 75% (95% CI, 53-90%) and 91% (95% CI, 77-98%), respectively. Besides this, FDG PET/CT findings have changed the management in significant proportion of patients. CONCLUSION With the limited data available currently, we found that 18F-FDG PET/CT is a quite accurate noninvasive tool in staging the workup of GBCa. However, further large multicentre trials are necessary for the generation of stronger evidence in this regard.
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Affiliation(s)
- Girish Kumar Parida
- Department of Nuclear Medicine, All India of Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Agrawal K, Padhy BM, Meher BR, Mohanty RR. Diagnostic utility of Ga-68 DOTA-SSTR and F-18 FDG PET/CT in the detection of culprit tumours causing osteomalacia: a systematic review and meta-analysis. Nucl Med Commun 2021; 42:646-655. [PMID: 33625187 DOI: 10.1097/mnm.0000000000001379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Tumour-induced osteomalacia (TIO) or oncogenic osteomalacia is a rare variant of paraneoplastic syndrome secondary to a small benign phosphaturic mesenchymal tumour that secretes phosphaturic substances. Complete tumour excision is often curative. However, the localization of these offending tumours has always remained a challenge because of their small size, slow-growing nature, and presence in atypical locations. We performed a systemic review and meta-analysis on the sensitivity and specificity of F-18 FDG PET/CT and Ga-68 DOTA-SSTR PET/CT to detect tumours causing osteomalacia. METHODS Pub Med, SCOPUS, the Cochrane Library and Web of Science were searched for articles on F-18 FDG and Ga-68 DOTA-SSTR PET/CT in the detection of culprit tumours in TIO till September 2020. Both retrospective and prospective studies having three or more patients were included. The methodological quality of included studies was assessed using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies-2 checklist. A random-effect model was used for the statistical pooling of sensitivity and specificity. Pooled data were presented with 95% confidence intervals (95% CI) and displayed using Forest plots. Heterogeneity was expressed using the I2 statistic. RESULTS The pooled sensitivity of Ga-68 DOTA-SSTR PET/CT in detecting the culprit tumour derived from all included studies is 86% (95% CI: 79-91%). There is moderate statistical heterogeneity among the included studies (I2 = 72.7%). The pooled sensitivity of F-18 FDG PET/CT in detecting the offending tumour derived from all included studies is 73% (95% CI: 61-84%) with moderate statistical heterogeneity among the included studies (I2 = 45.4%). CONCLUSION In the detection of offending tumours in TIO, Ga-68 DOTA-SSTR PET/CT has better sensitivity than F-18 FDG PET/CT and should be used as first-line imaging modality due to very high sensitivity.
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Affiliation(s)
| | | | | | - Rashmi Ranjan Mohanty
- Department of General Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Meher BR, Padhy BM, Das S, Mohanty RR, Agrawal K. Effectiveness of Convalescent Plasma Therapy in the Treatment of Moderate to Severe COVID 19 Patients: A Systematic Review and Meta-Analysis. J Assoc Physicians India 2020; 68:35-43. [PMID: 33247641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
UNLABELLED Though Convalescent plasma therapy (CPT) is being used for management of COVID-19, the evidence is still equivocal. So, we carried out this study to evaluate the currently available data to provide evidence about CPT in COVD-19 patients. RCTs and observational studies with sample size with more than 5 were included in the analysis. Out of 196 studies, 12 studies were selected for systematic review and meta-analysis was carried out for 6 studies having a control arm. For dichotomous values, risk ratio (RR) and 95% confidence interval was expressed. MAIN OUTCOMES All-cause mortality, clinical improvement by day 7 and viral detection by day 7 were the defined outcome measures before starting of data extraction. RESULT For 6 studies (2 RCTs and 4 observational studies) with 474 patients, the overall pooled RR for all-cause mortality was 0.61 (95%CI: 0.37 to 0.99. P= 0.04). Only RCTs and only observational studies for all-cause mortality showed pooled RR of 0.60 (95% CI: 0.33 to 1.10, P=0.10) and 0.48 (95% CI: 0.17 to 1.36, P= 0.17) respectively. There was risk of bias in the studies due to randomization process and confounding. Sensitivity analysis was carried out only for observational studies. The overall pooled RR for clinical improvement by day 7 and viral detection by day 7 were 1.12 (95%CI: 0.96 to 1.31, P=0.16) and 0.19 (95%CI: 0.09 to 0.60, P < 0.0001). CONCLUSION AND RELEVANCE Though the review suggests modest utility of CPT in reducing all-cause mortality, improving clinical outcome, and early viral clearance, it should be interpreted cautiously.
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Affiliation(s)
- Bikash Ranjan Meher
- Associate Professor, Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha
| | - Biswa Mohan Padhy
- Additional Professor, Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha
| | - Smita Das
- Assistant Professor, Department of Pharmacology, IMS and SUM Hospital, Bhubaneswar, Odisha
| | - Rashmi Ranjan Mohanty
- Additional Professor, Department of Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha
| | - Kanhaiyalal Agrawal
- Associate Professor, Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha
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Abstract
A 35-year-old female presented with right-sided gluteal pain and difficulty in walking 10 years after surgical symphysiotomy. Radiograph of the pelvis and bilateral hip joints showed osteoarthritis of the right sacroiliac joint with pubic diastasis of 1.5 cm. She was operated with pubis symphysis reduction and fixation using two orthogonal plates with one iliosacral screw. Postoperative period was uneventful. She was able to walk independently after three months of fixation. Follow-up at 18 months showed complete relief of symptoms with maintenance of reduction and no hardware breakage. The Lindahl score was 78, indicating an excellent outcome.
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Affiliation(s)
- Sujit K Tripathy
- Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Sudeep K Samanta
- Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Paulson Varghese
- Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Saurav N Nanda
- Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
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Tripathy SK, Swaroop S, Velagada S, Priyadarshini D, Das RR, Satpathy AK, Agrawal K. Response to Zoledronic Acid Infusion in Children With Fibrous Dysplasia. Front Pediatr 2020; 8:582316. [PMID: 33330278 PMCID: PMC7732464 DOI: 10.3389/fped.2020.582316] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 10/02/2020] [Indexed: 02/05/2023] Open
Abstract
Objective: This retrospective study evaluated the outcome and safety of long-term treatment with zoledronic acid, in both polyostotic and mono-ostotic fibrous dysplasia (FD) of children. Methods: The case records of children and adolescents with symptomatic FD who received zoledronic acid (0.1 mg/kg IV infusion over 1 h) and have completed at least 2 years follow-up were analyzed. The relevant details were recorded in a predesigned chart. Clinical assessment [pain assessment by visual analog scale (VAS) and incidence of new fracture], radiological changes (cortical thickening, ossification, and decrease in the diameter of the osteolytic lesions) and biochemical parameters [alkaline phosphatase (ALP)] were used to evaluate the improvement. Results: The mean age of presentation was 9.1 years, with four males and six females. All patients had symptomatic FD in the lower limb with complaints of pain, tenderness, swelling, or deformity. Four children had associated pathological fracture. The radiological evaluation with bone scan revealed polyostotic involvement in eight patients and mono-ostotic involvement in two patients. Three patients had associated systemic features like café-au-lait spots or precocious puberty. The fracture united within 3 months and the radiological improvement was evident in the form of filling of the osteolytic defect. The pain score in six patients showed significant improvement (VAS < 3). The ALP level decreased to 544.12 ± 47.35 IU/L from an initial value of 895.75 ± 79.64 IU/L (p = 0.04) at 12 months. One patient had symptomatic hypocalcaemia after zoledronic acid infusion. Conclusion: The clinical and radiological response of zoledronic acid treatment in FD of children is promising. Further randomized control trials with a larger sample size are required to establish this drug as a first-line medical treatment in FD.
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Vats K, Agrawal K, Sharma R, Sarma HD, Satpati D, Dash A. Preparation and clinical translation of 99mTc-PSMA-11 for SPECT imaging of prostate cancer. Medchemcomm 2019; 10:2111-2117. [PMID: 32190233 DOI: 10.1039/c9md00401g] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 10/15/2019] [Indexed: 01/07/2023]
Abstract
This study explores the feasibility of radiolabeling the HBED-CC-PSMA (PSMA-11) ligand with Tc-99m for SPECT imaging of prostate cancer patients. 68Ga-HBED-CC-PSMA (PSMA-11) is used clinically for PET/CT imaging of prostate cancer (PCa) patients. However, a PET/CT facility may not be affordable and/or accessible to remotely located health centers. Thus, economic considerations require development of a SPECT-based tracer to provide low cost effective health care to the entire global population. Hence, radiochemical parameters were varied and optimized to obtain the maximum radiochemical yield of 99mTc-PSMA-11. 99mTc-PSMA-11 could be prepared in 60 ± 5% radiochemical yield and >98% radiochemical purity with a specific activity of 15 ± 5 GBq μmol-1. The radiotracer exhibited high stability in vitro in human serum after 24 h. A cell uptake of 15.2 ± 1.2% was observed for 99mTc-PSMA-11 in PSMA-positive prostate carcinoma LNCaP cells. Rapid clearance from blood, liver, intestine, lungs and other major organs was observed during normal biodistribution studies. The radiotracer, 99mTc-PSMA-11, exhibited physiological distribution in salivary and lacrimal glands similar to that of 68Ga-PSMA-11 in mice and successfully identified primary tumors as well as metastatic lesions in human patients. This study thus highlights successful radiolabeling of HBED-CC-PSMA with Tc-99m and the potential of 99mTc-PSMA-11 as a SPECT imaging agent for PCa.
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Affiliation(s)
- Kusum Vats
- Radiopharmaceuticals Division , India . ; ; Tel: +91 22 25590748
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine , All India Institute of Medical Sciences , Bhubaneswar-751019 , India
| | - Rohit Sharma
- Radiopharmaceuticals Division , India . ; ; Tel: +91 22 25590748.,Homi Bhabha National Institute , Anushaktinagar , Mumbai-400094 , India
| | - Haladhar Dev Sarma
- Radiation Biology and Health Science Division , Bhabha Atomic Research Centre , Mumbai-400085 , India
| | - Drishty Satpati
- Radiopharmaceuticals Division , India . ; ; Tel: +91 22 25590748.,Homi Bhabha National Institute , Anushaktinagar , Mumbai-400094 , India
| | - Ashutosh Dash
- Radiopharmaceuticals Division , India . ; ; Tel: +91 22 25590748.,Homi Bhabha National Institute , Anushaktinagar , Mumbai-400094 , India
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Agrawal K, Surya N, Someshwar H. Short term health care costs associated with acute ischemic stroke in Mumbai, India. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Someshwar H, Agrawal K, Surya N. Effect of a brief awareness lecture on knowledge, attitude and perception of epilepsy amongst school children of Mumbai, Maharashtra. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Agrawal K, Sradha Patro PS, Behera KK. Graves' Disease in Eutopic Thyroid with Ectopic Mediastinal Thyroid Tissue: Role of Single Photon Emission Computed Tomography-Computed Tomography. Indian J Nucl Med 2019; 34:230-232. [PMID: 31293306 PMCID: PMC6593940 DOI: 10.4103/ijnm.ijnm_64_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ectopic thyroid is a rare embryological aberration due to defective migration. Most patients with ectopic thyroid tissue have absent thyroid gland in normal anatomical position and present with hypothyroidism. We present a patient with Graves' disease in the eutopic thyroid with ectopic thyroid tissue in the mediastinum and usefulness of single-photon emission computed tomography-computed tomography.
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Affiliation(s)
- Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - P Sai Sradha Patro
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kishore Kumar Behera
- Department of Endocrinology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Abstract
Osteoid osteoma (OO) of distal fibula is extremely rare, and only few cases are reported in the literature. We report a case of OO of distal fibula and its surgical management at our tertiary care hospital.
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Affiliation(s)
- Saurav Narayan Nanda
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
- Address for correspondence: Dr. Kanhaiyalal Agrawal, Department of Nuclear Medicine, All India Institute of Medical Sciences, SIJUA, Bhubaneswar - 751 019, Odisha, India. E-mail:
| | - Sandeep Velagada
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar Odisha, India
| | - Sujit Kumar Tripathy
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar Odisha, India
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Agrawal K, Patro PSS, Preetam C. Tc-99m HYNIC-TOC scintigraphy in dedifferentiated thyroid cancer. BMJ Case Rep 2019; 12:12/4/e227910. [PMID: 30940668 DOI: 10.1136/bcr-2018-227910] [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] [Indexed: 11/03/2022] Open
Abstract
There is literature evidence showing utility of somatostatin receptor (SSTR) positron emission tomography-CT (PET-CT) imaging in differentiated thyroid cancer with Thyroglobulin Elevated and Negative Iodine Scan (TENIS). These patients are less benefited with I-131 therapy and surgery remains only curable option if disease could be localised. If surgery is not feasible, other therapeutic options are not promising. However, if these patients show strongly positive SSTR imaging, then possibility of peptide receptor radionuclide therapy may be explored. As SSTR PET-CT imaging is expensive and not widely available, Technetium-99m (Tc-99m) hydrazinonicotinyl-Tyr3-octreotide (HYNIC-TOC), which is a Single photon emission computed tomography (SPECT) tracer, can be used. We are documenting a case of raised serum thyroglobulin antibody and negative I-131 whole body scan with disease recurrence localised on Tc-99m HYNIC-TOC scan.
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Affiliation(s)
- Kanhaiyalal Agrawal
- Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - P Sai Sradha Patro
- Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - C Preetam
- ENT, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Abstract
Pancytopenia due to thyrotoxicosis is a rare but serious complication. In this report, we describe a rare case of Graves’ disease confirmed on thyroid scintigraphy presented with coexisting pancytopenia and liver dysfunction. There was complete recovery of blood counts and hepatic enzyme level to normal after antithyroid treatment and radioiodine ablation.
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Affiliation(s)
- Kishore Kumar Behera
- Department of Endocrinology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Amit Kumar Adhya
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Affiliation(s)
- Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bikash Ranjan Meher
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Biswa Mohan Padhy
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Agrawal K, Mohanty R, Meher B. Thyroid scintigraphy in fever of unknown origin. Indian J Nucl Med 2019; 34:307-308. [PMID: 31579229 PMCID: PMC6771206 DOI: 10.4103/ijnm.ijnm_111_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Thyroiditis is a very rare cause of fever of unknown origin (FUO). Thyroiditis presenting as only fever and weight loss is very rare. We present a case of FUO, which was later on confirmed as thyroiditis on thyroid scintigraphy.
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Mittra I, Pal K, Pancholi N, Shaikh A, Rane B, Tidke P, Kirolikar S, Khare NK, Agrawal K, Nagare H, Nair NK. Prevention of chemotherapy toxicity by agents that neutralize or degrade cell-free chromatin. Ann Oncol 2018; 28:2119-2127. [PMID: 28911066 DOI: 10.1093/annonc/mdx318] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Toxicity associated with chemotherapy is a major therapeutic challenge and is caused by chemotherapy-induced DNA damage and inflammation. We have recently reported that cell-free chromatin (cfCh) fragments released from dying cells can readily enter into healthy cells of the body to integrate into their genomes and induce DNA double-strand breaks, apoptosis and inflammation in them. We hypothesized that much of the toxicity of chemotherapy might be due to release of large quantities of cfCh from dying cells that could trigger an exaggerated DNA damage, apoptotic and inflammatory response in healthy cells over and above that caused by the drugs themselves. Methods We tested this hypothesis by administering cfCh neutralizing/degrading agents namely, anti-histone antibody complexed nanoparticles, DNase I and a novel DNA degrading agent-Resveratrol-Cu concurrently with five different chemotherapeutic agents to examine if chemotherapy-induced toxicity could be minimized. Results We observed (i) significant reduction in chemotherapy-induced surge of cfCh in blood; (ii) significant reduction in chemotherapy-induced surge of inflammatory cytokines CRP, IL-6, IFNγ and TNFα in blood; (iii) abolition of chemotherapy-induced tissue DNA damage (γH2AX), apoptosis (active caspase-3) and inflammation (NFκB and IL-6) in multiple organs and peripheral blood mononuclear cells; (iv) prevention of prolonged neutropenia following a single injection of adriamycin and (v) significant reduction in death following a lethal dose of adriamycin. Conclusion Our results suggest that toxicity of chemotherapy is caused to a large extent by cfCh released from dying cells and can be prevented by concurrent treatment with cfCh neutralizing/degrading agents.
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Affiliation(s)
- I Mittra
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
| | - K Pal
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
| | - N Pancholi
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
| | - A Shaikh
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
| | - B Rane
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
| | - P Tidke
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
| | - S Kirolikar
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
| | - N K Khare
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
| | - K Agrawal
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
| | - H Nagare
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
| | - N K Nair
- Translational Research Laboratory, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Sector 22, Utsav Chowk - CISF Road, Kharghar, Navi Mumbai, Raigad, Maharashtra 410210, India
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Abstract
BACKGROUND Protease activity of Per a 10 favours Th2 responses by differential regulation of IL-12p70 and IL-23 cytokine subunits. This study aimed to elucidate the underlying mechanism of differential regulation of IL-12p70 and IL-23. METHODS PAR-2 activation was blocked in murine model by administering SAM11 before each sensitization. CD11c+ p-STAT3+ cells were measured in lungs by flow cytometry. BMDCs were pretreated with SAM11 or isotype control or stattic and stimulated with Per a 10. p-STAT3 levels were measured using Western blot. Transcript levels of IL-12p35, IL-12/23p40 and IL-23p19 were measured using RT-PCR. Cytokine levels were analysed using ELISA. RESULTS Protease activity of Per a 10 increased p-STAT3 levels in mouse lungs, which was reduced upon PAR-2 blockage. Percentage of p-STAT3+ CD11c+ cells was higher in Per a 10-administered mice and was reduced upon PAR-2 blockage. IL-12p35 and IL-12p70 levels were higher, and IL-23p19 and IL-23 levels were lower in both SAM11-treated mice and BMDCs indicating a role of PAR-2-mediated signalling. IL-4, TSLP, IL-17A, EPO activity, total cell count and specific IgE and IgG1 levels were lower in SAM11-administered mice. Inhibiting STAT3 activation via stattic also leads to lower levels of IL-23p19 and IL-23 and higher levels of IL-12p35. CONCLUSIONS Per a 10 leads to PAR-2 activation on BMDCs resulting in downstream activation of STAT3 to regulate the balance between IL-12/IL-23 subunits causing a cytokine milieu rich in IL-23 to favour Th2 polarization.
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Affiliation(s)
- K. Agrawal
- Allergy and Immunology section; CSIR-Institute of Genomics and Integrative Biology; New Delhi India
- Academy of Scientific and Innovative Research (AcSIR); CSIR-IGIB Campus; New Delhi India
| | - N. Arora
- Allergy and Immunology section; CSIR-Institute of Genomics and Integrative Biology; New Delhi India
- Academy of Scientific and Innovative Research (AcSIR); CSIR-IGIB Campus; New Delhi India
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Agrawal K, Gainder S, Dhaliwal LK, Suri V. Ovulation Induction Using Clomiphene Citrate Using Stair - Step Regimen versus Traditional Regimen in Polycystic Ovary Syndrome Women - A Randomized Control Trial. J Hum Reprod Sci 2018; 10:261-264. [PMID: 29430152 PMCID: PMC5799929 DOI: 10.4103/jhrs.jhrs_15_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To determine the efficacy of the stair-step protocol (SSP) using clomiphene citrate (CC) in patients with polycystic ovary syndrome (PCOS) and compare it with traditional regimen. Design: This was randomized control trial. Setting: Infertility Clinic. Patient(s): Sixty infertile PCOS women. Intervention(s): Patients were randomized into the study (SSP – 30 patients) and control group (traditional protocol – 30 patients). In the SSP, patients were treated with CC 50 mg/day for 5 days and in nonresponsive patients, the dosage was increased to 100 mg/day for 5 days in the same cycle. Maximum dose of 150 mg was given until the dominant follicle was generated. In control group, the dose increment in nonovulatory cases was done in subsequent cycle. Ultrasonography follow-up was done to detect ovulation. Main Outcome Measure(s): Ovulation rate and duration of treatment. Results: Ovulation (66.7% vs. 50% respectively) and pregnancy rates (26.7% vs. 15.7%) were similar between the stair step and the control group. The duration of treatment was significantly shorter in stair step compared to traditional protocol (17.23 vs. 53 days). CC 100 mg was the most effective dose for ovulation in either group. There were no significant differences in the systemic side effect. Conclusions: By using SSP, effective treatment is provided in significantly shorter time period without any detrimental effect on the ovulation and pregnancy rates.
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Affiliation(s)
- K Agrawal
- Department of Obstetrics and Gynecology, PGIMER, Chandigarh, India
| | - Shalini Gainder
- Department of Obstetrics and Gynecology, PGIMER, Chandigarh, India
| | | | - Vanita Suri
- Department of Obstetrics and Gynecology, PGIMER, Chandigarh, India
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Chen PM, Nguyen DT, Ho JP, Pirastehfar M, Narula R, Rapp K, Agrawal K, Huisa B, Modir R, Meyer D, Hemmen T, Kidwell C, Meyer BC. Factors Influencing Acute Stroke Thrombolytic Treatments in Hispanics In the San Diego Region. Austin J Cerebrovasc Dis Stroke 2018; 5:1074. [PMID: 30148213 PMCID: PMC6103626] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Since the introduction of recombinant tissue plasminogen activator (rt-PA) for acute ischemic stroke, rt-PA rate and number of stroke centers have increased. Despite this, studies have shown racial and ethnic disparities in stroke care especially in Black and Hispanic populations. What factors are related to the administration of rt-PA within the Hispanic population has to date been unclear. METHODS We performed a retrospective review of IRB approved, prospectively collected data from the UC San Diego Stroke Registry from 7/2004-7/2016. Patients were included based on the primary diagnosis of Transient Ischemic Attack or Ischemic Stroke. Hispanic vs non-Hispanic patients were compared to assess for overall rt-PA treatment rates and process of care intervals. For the Hispanic cohort itself, demographics and NIHSS scores were assessed to determine why some Hispanics received rt-PA while others were not. RESULTS Overall, 1489 patients (300 Hispanic vs. 1189 non-Hispanic) were included. Comparing Hispanics to non-Hispanics, there was no difference in rt-PA rate (35.3% vs. 33.1%; p=0.49). In rt-PA treated patients, "onset to arrival" interval was higher in Hispanics (1.03 vs. 0.88 hours; p=0.04), while the "arrival to treatment" interval was not different (1.13 vs. 1.02 hours; p=0.07). When looking at Hispanic patients only, there was no difference in baseline characteristics except for initial NIHSS in treated vs. non-treated patients (13.27 vs. 7.24; p<.001). CONCLUSION Our analyses sought to determine the factors important to administration of rt-PA to Hispanic patients. These findings highlight the need for strategies to improve recognition and presentation pathways for Hispanics.
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Affiliation(s)
- P M Chen
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - D T Nguyen
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - J P Ho
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - M Pirastehfar
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - R Narula
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - K Rapp
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - K Agrawal
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - B Huisa
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - R Modir
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - D Meyer
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - T Hemmen
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
| | - C Kidwell
- Department of Neurology, University of Arizona, USA
| | - B C Meyer
- Department of Neurosciences, Stroke Center, University of California, San Diego, USA
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Affiliation(s)
- Bikash Ranjan Meher
- Department of Pharmacology, All India Institute of Medical Sciences, Sijua, Bhubaneswar, Odisha, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Sijua, Bhubaneswar, Odisha, India
| | - Biswa Mohan Padhy
- Department of Pharmacology, All India Institute of Medical Sciences, Sijua, Bhubaneswar, Odisha, India
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Agrawal K, Tripathy SK, Sen RK, Santhosh S, Bhattacharya A. Nuclear medicine imaging in osteonecrosis of hip: Old and current concepts. World J Orthop 2017; 8:747-753. [PMID: 29094004 PMCID: PMC5656489 DOI: 10.5312/wjo.v8.i10.747] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 08/02/2017] [Accepted: 08/16/2017] [Indexed: 02/06/2023] Open
Abstract
Osteonecrosis (ON) is caused by inadequate blood supply leading to bone death, which results in the collapse of the architectural bony structure. Femoral head is the most common site involved in ON. Magnetic resonance imaging (MRI) is a commonly used imaging modality to detect early ON. When MRI is inconclusive, bone scan is helpful in detecting ON during early phase of the disease. As newer nuclear medicine equipment, like single photon emission computed tomography/computed tomography (CT) and positron emission tomography/CT, are emerging in medical science, we review the role of these imaging modalities in ON of femoral head.
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Affiliation(s)
- Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Sujit Kumar Tripathy
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Ramesh Kumar Sen
- Department of Orthopedics, Fortis Hospital, Mohali, Chandigarh 160162, India
| | - S Santhosh
- Institute of Nuclear Imaging and Molecular Medicine, Tamilnadu Government Multi Super Specialty Hospital, Anna Salai, Chennai, Tamilnadu 600002, India
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Kashyap R, Agrawal K, Singh H, Mittal BR. Disease- and Treatment-related Complication on F-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Oncology Practice: A Pictorial Review. Indian J Nucl Med 2017; 32:304-315. [PMID: 29142347 PMCID: PMC5672751 DOI: 10.4103/ijnm.ijnm_78_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
F-18-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is routinely performed in oncology patients for various indications including staging, restaging, recurrence detection, and treatment response evaluation. Many disease- and treatment-related complications can be incidentally detected on PET/CT, which may be due to the complication of radiotherapy, chemotherapy, intervention, or primary tumor itself. Some of these complications could be life threatening and need urgent intervention. Therefore, these incidental findings should be recognized on PET/CT and immediately informed to the treating physicians if required urgent intervention.
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Affiliation(s)
- Raghava Kashyap
- Department of Nuclear Medicine and Positron Emission Tomography, Mahatma Gandhi Cancer Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Harmandeep Singh
- Department of Nuclear Medicine and Positron Emission Tomography, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhagwant Rai Mittal
- Department of Nuclear Medicine and Positron Emission Tomography, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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