Hybrid Imaging in Head and Neck Sarcoidosis

To determine the prevalence of head and neck sarcoidosis (HNS) and evaluate the role of hybrid molecular imaging in HNS. Between 2010 and 2018, 222 patients with chronic sarcoidosis and presence of prolonged symptoms of active disease were referred to FDG PET/CT. Active disease was found in 169 patients, and they were all screened for the presence of HNS. All patients underwent MDCT and assessment of the serum ACE level. Follow-up FDG PET/CT examination was done 19.84 ± 8.98 months after the baseline. HNS was present in 38 out of 169 patients. FDG uptake was present in: cervical lymph nodes (38/38), submandibular glands (2/38), cerebrum (2/38), and bone (1/38). The majority of patients had more than two locations of disease. After FDG PET/CT examination, therapy was changed in most patients. Fourteen patients returned to follow-up FDG PET/CT examination in order to assess the therapy response. PET/CT revealed active disease in 12 patients and complete remission in two patients. Follow-up ACE levels had no correlation with follow-up SUVmax level (ρ = −0.18, p = 0.77). FDG PET/CT can be useful in the detection of HNS and in the evaluation of the therapy response. It may replace the use of non-purposive mounds of insufficiently informative laboratory and radiological procedures

14 C-urea breath test in the detection of Helicobacter pylori infection

Helicobacter pylori infection is supposed to be one of the major causes of digestive and other diseases. Among a lot of invasive and non-invasive methods for its detection, none is ideal. The aim is an assessment of the Helicobacter pylori infection in the stomach using breath test and comparison to other diagnostic methods, as well as following up the effects of therapy. In 17 patients with digestive discomfort, breath test, rapid ure- ase test and histology were performed, while in 47 patients with proven HP infection the effect of therapy was followed up using breath test and clinical findings. Breath test was performed af- ter per oral administration of the capsule of 14 C urea (37 kBq). Findings of the breath and urease tests were in accordance in 14/ /17 patients (83%) while breath test and histology in 16/17 patients (94%). During follow-up of the therapeutic effects, breath test and clinical findings were in accordance in 43/47 patients (98%). Breath test can be useful in diagnosis but is a method of choice in following up the patients after therapy for H. pylori infection, because it is non-invasive, fast and precise

Evaluation of neuroendocrine tumors with 99mTc-EDDA/HYNIC TOC

BACKGROUND: This paper is the short review of our preliminary results obtained with 99mTc-EDDA/HYNIC-TOC. MATERIAL AND METHODS: The total of 495 patients with different neuroendocrine tumors were investigated during last few years. RESULTS: There have been 334 true positive (TP), 73 true negative (TN), 6 false positive (FP) and 82 false negative findings (FN). Diagnosis was made according to SPECT findings in 122 patients (25%). The mean T/NT ratio for TP cases was significantly higher (p < 0.01) on SPECT (3.12 ± 1.13) than on whole body scan (2.2 ± 0.75). According to our results, overall sensitivity of the method is 80%, specificity 92%, positive predictive value 98%, negative predictive value 47% and accuracy 82%. Fifteen TP patients underwent therapy with 90Y-DOTATATE. CONCLUSION: Scintigraphy of neuroendocrine tumors with 99mTc-Tektrotyd is a useful method for diagnosis, staging and follow up of the patients suspected to have neuroendocrine tumors. SPECT had important role in diagnosis. It is also helpful in the appropriate choice of the therapy, including the peptide receptor radionuclide therapy. In the absence of 68Ga-labeled peptides and PET/CT, the special emphasize should be given to application of SPECT/CT as well as to the radioguided surgery

The impact of socioeconomic factors on quality of life and functional impairment in patients treated for oropharyngeal carcinoma

Uvod/Cilj. Incidencija orofaringealnih karcinoma se povećavala tokom poslednje decenije, a epidemiologija promenila sa pojavom humanog papiloma virusa (HPV) kao bitnog faktora rizika od ovih karcinoma. Potrebno je ustanoviti bolje terapeutske izbore za specifične grupe bolesnika koji se leče od orofaringealnog karcinoma. Cilj ove studije bio je da se procene kvalitet života i funkcionalne performanse, kao i uticaj različitih demografskih faktora, stadijuma bolesti i tipa terapija na te parametre kod bolesnika sa orofaringealnim karcinomom kod kojih je postignuta uspešna lokoregionalna kontrola, godinu dana posle sprovedene terapije. Metode. Studija je uključila 87 bolesnika koji su odgovorili na upitnike o kvalitetu života i funkcionalnim performansama: European Organization for Research and Treatment of Cancer Quality-of Life-Questionnaire-C30 - EORTC QLQ-C30), European Organization for Research and Treatment of Cancer Quality of-Life Questionnaire-Head and Neck 35 (EORTC QLQ-H&N35) i Karnofsky Performance Scale (KPS), 12 do 14 meseci posle završenog onkološkog tretmana. Rezultati. Specifične grupe bolesnika značajno su se razlikovale u skorovima na upitnicima za kvalitet života posle lečenja. Faktori koji su bili povezani sa slabijim rezultatima su bili ženski pol, život bez partnera, nivo obrazovanja, zaposlenost i HPV status. Zaključak. Kliničari bi trebali da uzmu u obzir socioekonomske faktore i HPV status u planiranju postoperativnog oporavka kod bolesnika lečenih od orofaringealnog karcinoma. Pol bolesnika, nivo obrazovanja i zaposlenost su faktori koji nose određen nivo rizika koji je povezan sa nižim nivoom kvaliteta života kod ovih bolesnika.Backround/Aim. Considering the distinct increase in the incidence of oropharyngeal cancer over oral cavity cancers and changing epidemiology with human papilloma virus (HPV) infection emerging as an important risk factor, there is a need to establish better treatment choices in specific groups of patients with oropharyngeal cancer. The aim of this study was to assess the quality of life (QOL) and functional performance and the impact of different demographical data, stage of disease, and treatment type on these parameters in patients with oropharyngeal cancer with successfully achieved locoregional control a year after the treatment. Methods. Study included 87 patients who underwent QOL and functional impairment assessment 12 to 14 months after finished oncological treatment with the following questionnaires: the European Organization for Research and Treatment of Cancer Quality-of Life-Questionnaire-C30 (EORTC QLQ-C30), European Organization for Research and Treatment of Cancer Quality of-Life Questionnaire-Head and Neck 35 (EORTC QLQ-H&N35) and the Karnofsky Performance Scale (KPS). Results. Specific groups of patients had significantly different post-treatment QOL scores. The factors associated with the worse QOL scores were female gender, not being in a partnership, level of education and HPV status. Conclusion. Clinicians should consider socioeconomic factors and HPV status in planning the recovery after treatment of patients with oropharyngeal carcinoma. Gender, education level and employment are the variables that form a certain risk profiles associated with the lower QOL

Prediction of Cervical Lymph Node Metastasis in Clinically Node-Negative T1 and T2 Papillary Thyroid Carcinoma Using Supervised Machine Learning Approach

Papillary thyroid carcinoma (PTC) is generally considered an indolent cancer. However, patients with cervical lymph node metastasis (LNM) have a higher risk of local recurrence. This study evaluated and compared four machine learning (ML)-based classifiers to predict the presence of cervical LNM in clinically node-negative (cN0) T1 and T2 PTC patients. The algorithm was developed using clinicopathological data from 288 patients who underwent total thyroidectomy and prophylactic central neck dissection, with sentinel lymph node biopsy performed to identify lateral LNM. The final ML classifier was selected based on the highest specificity and the lowest degree of overfitting while maintaining a sensitivity of 95%. Among the models evaluated, the k-Nearest Neighbor (k-NN) classifier was found to be the best fit, with an area under the receiver operating characteristic curve of 0.72, and sensitivity, specificity, positive and negative predictive values, F1 and F2 scores of 98%, 27%, 56%, 93%, 72%, and 85%, respectively. A web application based on a sensitivity-optimized kNN classifier was also created to predict the potential of cervical LNM, allowing users to explore and potentially build upon the model. These findings suggest that ML can improve the prediction of LNM in cN0 T1 and T2 PTC patients, thereby aiding in individual treatment planning

FDG PET/CT in the detection of infections and inflammations

Detection of inflammation/infection still remains great clinical problem. That is why nuclear medicine procedures still play a significant role regarding this issue. There has been attempts for detection of infection/inflammation using 67Ga-citrate, 99mTc/111 In labeled white blood cells, 99mTc/111In labeled human immunoglobulin, 99mTc labeled antigranulocyte antibodies (whole or fragments), 99mTc labeled antibiotic, 99mTc nanocolloid as well as different other radiopharmaceuticals. However, there has not been discovered the ideal one. Recently, 18F-FDG PET begins to play a significant role