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PET is considered to be the most sensitive and specific modality for the detection of recurrent colorectal cancer. This study is to assess the role of F18-FDG PET/CT in post-operative assessment in a patient with colorectal cancer with elevated CEA level to rule out local recurrence and/or metastasis and hence guiding the clinician to the proper management strategy. This study was performed on 45 patients who underwent surgical resection of the colon and/or rectal cancer; they were referred for PET/CT assessment at least 3 months after surgical resection. F18-FDG PET/CT sensitivity and specificity in detecting the recurrence and/or metastasis were 96.9 % and 83.3%, respectively. The positive predictive value was 94.2% while the negative predictive value was 90%. For post-operative detection of loco-regional recurrence and metastasis in patients with colorectal cancer and elevated CEA level, 18F-FDG PET/CT can be considered as an efficient diagnostic imaging tool due to its high sensitivity and specificity which extensively affect further management.

The purpose of this study is to assess the role of 18 fluorodeoxyglucose positron emission tomography/computed tomography (.sup.18FDG PET-CT) in the follow-up of patients with lymphoma after finishing therapy. This study included 42 lymphomas (25 non-Hodgkin's lymphoma and 17 Hodgkin's lymphoma); patients ranging in age from 18 to 70 years were examined by .sup.18FDG PET-CT after therapy and analyzed retrospectively. Confirmatory biopsy was mandatory in cases of suspected disease recurrence and follow-up in cases of complete metabolic response. Positron emission tomography/computed tomography in assessment of lymphoma treatment response reveals significant statistical significance (P < 0.05). It shows 100% sensitivity, 92.8% specificity, and 95.2% accuracy in the prediction of response. Positron emission tomography/computed tomography plays an important role in detection of response to treatment of lymphoma after finishing therapy.

Our aim to assess the significance of new multi-parametric MRI techniques as intra-voxel incoherent motion (IVIM), T2* perfusion, T1 permeability and susceptibility-weighted images (SWI) in differentiating from recurrent tumor from post treatment changes. Forty-five patients were enrolled in the current study, 25 patients with recurrence and 20 with radiation necrosis. As regard the IVIM parameters, the perfusion fraction (f) and the pseudodiffusion (D*) component shows significant difference between radiation changes and recurrent tumor (P value = 0.01). The Ktrans showed significant difference between radiation changes and recurrent tumor (P value = 0.001). The proportion of dark signal intensity on susceptibility-weighted imaging (proSWI) showed significant difference between radiation changes and recurrent tumor (P value = 0.0001), while the diffusion component (D) showed no significant difference between radiation changes and recurrent tumor (P value = 0.282). Multi-parametric new techniques as intra-voxel incoherent motion, susceptibility weighted images and post-contrast perfusion studies allow early and accurate differentiation of recurrent tumor from post radiation changes and thus improving the patients overall clinical outcome.

Tongue cancer is regarded as a major concern due to abundant vascular and lymphatic supply of the tongue that promote nodal metastases. The depth of invasion of the primary tumor has been demonstrated to be a prognostic factor for high-risk tumors, with the potential to inform treatment decisions and predict a favorable outcome and disease prognosis. Our study aimed to review and emphasize the accuracy of MRI in loco-regional staging of tongue carcinoma as regards depth of invasion (DOI), which is an important predictor of lymph node (LN) dissemination. A total of 30 patients with tongue squamous cell carcinoma were enrolled in this prospective study. Biopsy and conventional MRI in combination with diffusion weighted imaging and contrast enhanced MRI were performed as pre-operative local and nodal disease staging. The extent of the primary tumor (T) and metastasis to regional lymph nodes (N) were initially evaluated by MR imaging. Almost perfect agreement (k = 0.83) was noted for T staging between MRI and histopathological staging assessments. Also, almost perfect agreement was revealed for N stage between MRI and histopathological assessments (k = 0.89). The relation between DWI MRI and histopathology measured values for the mucosal epithelium depth of invasion of tongue squamous cell carcinoma was r = 0.818 (P < 0.001). The cutoff values for the DWI MRI-measured DOI and pathological DOI that indicated nodal metastasis were 7.5 mm and 8.7 mm, respectively. MRI with DWI and CE-MRI is the imaging modality of choice for evaluation of tongue cancer as a strong positive correlation between MRI and histopathology measured values for the mucosal epithelium depth of invasion of tongue squamous cell carcinoma. It accurately estimates cervical nodal metastasis before surgery.

The aim of this study is to investigate whether quantitative DW metrics can provide additive value to the reliable categorization of lesions within existing PI-RADSv2 guidelines. Fifty-eight patients with clinically suspicious prostate cancer who underwent PR examination, PSA serum levels, sextant TRUS-guided biopsies, and bi-parametric MR imaging were included in the study. Sixty-six lesions were detected by histopathological analysis of surgical specimens. The mean ADC values were significantly lower in tumor than non-tumor tissue. The mean ADC value inversely correlated with Gleason score of tumors with a significant p value < 0.001.Conversely, a positive relationship was found between the ADC ratio (ADC of benign prostatic tissue to prostate cancer) and the pathologic Gleason score with a significant elevation of the ADC ratio along with an increase of the pathologic Gleason score (p 7) was high (AUC for ADC and ADC ratio, 0.946 and 0.897; p = 0.014 and 0.039, respectively). The ADC cut-off value for GS [greater than or equal to] 7 was 0.8620 with sensitivity and specificity 97 and 94%. The cutoff ADC ratio for predicting (GS > 7) was 1.42 and for GS [less than or equal to] 6 was > 1.320 with sensitivity and specificity 97 and 92%. By applying this ADC ratio cut-off value the sensitivity and specificity of reader 1 for correct categorization of PIRADSv2 DW > 4 increased from 90 and 68% to 95 and 90% and that of reader 2 increased from 94 and 88% to 97 and 92%, respectively. Estimation of DW metrics (ADC and ADC ratio between benign prostatic tissue and prostate cancer) allow the non-invasive assessment of biological aggressiveness of prostate cancer and allow reliable application of the PIRADSv2 scoring to determine clinically significant cancer (DW score > 4) which may contribute in planning initial treatment strategies.

BackgroundOvarian cancer is one of the leading causes of death in females worldwide. Early diagnosis and accurate staging are mandatory for proper management. Anatomic imaging and serum cancer antigen 125 (CA 125) measurement have been widely used for follow up of treated ovarian cancer patients to detect residual or recurrent neoplasia. The aim of this study was to assess the value of whole-body positron emission tomography/computed tomography using 18F-Fluorodeoxyglucose (18F-FDG PET/CT) in follow up of ovarian cancer patients presented with elevated CA 125 serum level.ResultsThe current study was performed over a period of 2 years between March 2019 and March 2022. Seventy-six patients were included with history of treated ovarian cancer (underwent either surgical resection and/or received radio/chemotherapy) but were subsequently presented rising tumor marker CA-125 serum level (more than 35 U/ml). All patients underwent a 18F-FDG PET/CT scanning on whole body. The FDG-PET results were correlated with histological findings, radiological or tumor marker/clinical follow-up. The patients with inconsistent findings were followed up with U/S, post contrast pelviabdominal CT, MRI or PET/CT 3–6 months later. The 18FDG PET/CT scan was positive in 62 patients, and it was negative in 14 patients. Specificity, sensitivity, negative predictive value, as well as positive predictive value and diagnostic accuracy of integrated PET/CT, were found to be 92.3%, 96.3%, 96.1%, 85.7% and 98.4%, respectively.Conclusions18F-FDG PET/CT is a valuable imaging tool for assessment of ovarian cancer patients presented with elevated CA-125 tumor marker serum level.

BackgroundFluorine-18 fluorodeoxyglucose positron emission tomography combined with multi-detector helical computed tomography (18F-FDG PET/CT) has emerged as one of the most important one of diagnostic and prognostic tools for lymphoma management. 18F-FDG PET/CT is well-regarded for evaluating bone marrow infiltration (BMI) and assessing disease burden in non-Hodgkin’s lymphoma patients. Therefore, this study was done to compare findings detected by 18F-FDG PET/CT with findings by bone marrow biopsy (BMB) regarding bone marrow infiltration (BMI) in patients had large B-cell lymphoma (LBCL).ResultsA cross-sectional study including 78 newly diagnosed cases of lymphoma who were referred for initial staging at first by BMB then underwent 18F-FDG PET/CT scan. Although 30 (38.5%) patients had bone marrow infiltration was detected by 18F-FDG PET/CT scan. However, 20 (25.6%) patients were detected by bone marrow biopsy. Both methods were concordant for BMI detection in 62 (79.5%) patients out of 78 cases with a Kappa value of 0.583 (p < 0.001), indicating moderate agreement. Both of them revealed concordant negative results (57.69%), while concordant positive results (21.79%). The discordant result (16.67%) was BMB-negative but 18F-FDG PET/CT-positive. 18F-FDG PET/CT, had higher sensitivity and higher negative predictive value (85.0% and 93.8%), compared to BMB, which had (56.7% and 77.6%), respectively. While BMB had higher specificity and positive predictive value (93.8% and 85.0%) compared to 18F-FDG PET/CT (77.6% and 56.7%) respectively. The diagnostic accuracy was 79.5% for both two diagnostic methods.Conclusion18F-FDG PET/CT diagnostic imaging is more sensitive modality than bone marrow biopsy to detect bone marrow infiltration in patients with LBCL.

Positron emission tomography-computed tomography (PET/CT) is considered a powerful modality in the follow-up of hepatocellular carcinoma (HCC) patients. In this study, PET/CT was done in an evaluation of patients with unexplained rising alpha fetoprotein (AFP) post hepatocellular carcinoma (HCC) interventional management in 40 patients (16 females and 24 males); their age ranged from 25 to 82 years, had undergone interventional management for HCC and underwent PET/CT follow-up within an 8-month duration from their intervention. Whole-body PET/CT was performed after injection of (18)-FDG, and the results were read in a masked manner by two specialists, and diagnostic performance was assessed from the results of consensus masked reading. All the results were evaluated with the Barcelona criteria and biopsy correlation. During the follow-up PET/CT, 24 patients had complete response and 8 patients showed focal residual while the rest 8 patients showed newly developed lesions. PET/CT is an excellent method for the evaluation of HCC patients with equivocal results after interventional management.

Ovarian cancer is one of the leading causes of death in females worldwide. Early diagnosis and accurate staging are mandatory for proper management. Anatomic imaging and serum cancer antigen 125 (CA 125) measurement have been widely used for follow up of treated ovarian cancer patients to detect residual or recurrent neoplasia. The aim of this study was to assess the value of whole-body positron emission tomography/computed tomography using .sup.18F-Fluorodeoxyglucose (.sup.18F-FDG PET/CT) in follow up of ovarian cancer patients presented with elevated CA 125 serum level. The current study was performed over a period of 2 years between March 2019 and March 2022. Seventy-six patients were included with history of treated ovarian cancer (underwent either surgical resection and/or received radio/chemotherapy) but were subsequently presented rising tumor marker CA-125 serum level (more than 35 U/ml). All patients underwent a .sup.18F-FDG PET/CT scanning on whole body. The FDG-PET results were correlated with histological findings, radiological or tumor marker/clinical follow-up. The patients with inconsistent findings were followed up with U/S, post contrast pelviabdominal CT, MRI or PET/CT 3-6 months later. The .sup.18FDG PET/CT scan was positive in 62 patients, and it was negative in 14 patients. Specificity, sensitivity, negative predictive value, as well as positive predictive value and diagnostic accuracy of integrated PET/CT, were found to be 92.3%, 96.3%, 96.1%, 85.7% and 98.4%, respectively. .sup.18F-FDG PET/CT is a valuable imaging tool for assessment of ovarian cancer patients presented with elevated CA-125 tumor marker serum level.