Publications by authors named "Archi Agrawal"

Purpose: The clinico-radiological dilemma in post-treatment high-grade gliomas, between disease recurrence (TR) and treatment-related changes (TRC), still persists. FET (Fluoro-ethyl-tyrosine) PET has been extensively used as problem-solving modality for cases where MR imaging is inconclusive. We incorporated a systematic imaging and clinical follow-up algorithm in a multi-disciplinary clinic (MDC) setting to analyse our cohort of FET PET in post-treatment gliomas.

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Article Synopsis
  • - Extracranial metastasis from high-grade glial tumors is very rare, occurring in less than 1% of cases, with common sites being the leptomeninges, spinal cord, liver, lung, and skeleton.
  • - The rarity of these metastases is linked to the aggressive nature of glial tumors, leading to lower median survival rates for patients.
  • - The article presents two cases of extracranial metastases to cervical nodes and a postoperative site in the preauricular region, diagnosed using F18 Fluoro ethyl tyrosine PET-CT and confirmed by histopathology.
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Purpose: We proposed to administer Lu-177-DOTATATE in intra-arterial (IA) mode for higher first-pass localization to somatostatin receptors, higher residence time in liver metastases, and more radiation to tumor. This study aimed at assessing early hematological, renal and hepatotoxicity; and objective response to IA peptide receptor radionuclide therapy (PRRT).

Materials And Methods: Fourteen patients (4 females and 10 males) were prospectively assessed.

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Prostate-specific membrane antigen (PSMA) is a widely accepted and used tracer in staging and biochemical recurrences of prostate cancer. PSMA is extensively expressed in normal prostatic epithelial cells and prostate cancer cells, with some amount of expression also in nonprostatic cells. False-positive PSMA uptake in nonmalignant lesions creates ambiguity in disease detection.

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  • - PRRT, specifically using Lu-177 DOTATATE, shows promising results for treating refractory and recurrent meningiomas, a type of brain tumor with limited therapies.
  • - In a study of eight patients, the median time to progression post-PRRT was 8.9 months, with seven patients maintaining stable disease and only one showing progression after treatment.
  • - The intra-arterial (IA) delivery method provided better dose delivery compared to intravenous (IV) administration, making IA a recommended approach for such therapies.
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Aim: To evaluate relationship between metabolic PET metabolic parameters and size of the primary tumor, various histopathological subtypes of renal cell carcinoma (RCC) and Fuhrman grade of the tumors.

Material And Methods: Retrospective analysis of 93 biopsy-proven RCC patients who underwent pretreatment flourine 18 flourodeoxyglucose PET/computed tomography ( 18 F FDG PET/CT) was performed. Quantitative PET parameters, size of the primary tumor, histopathological subtypes and Fuhrman grades of the tumor were extracted.

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Objective: Interpreting complex post-treatment changes in head and neck cancer (HNC) is challenging with further added perplexity due to variable interobserver interpretation and hence evolved the NI-RADS lexicon. We evaluated the accuracy of NI-RADS in predicting disease status on 1st post-treatment follow-up CECT in a homogenous cohort of those who received only chemoradiation.

Methods: Retrospective analysis of imaging was done for LASHNC patients who received radical chemoradiation in an open-label, investigator-initiated, phase 3 randomized trial (2012-2018) randomly assigned to either radical radiotherapy with concurrent weekly cisplatin (CRT) or CRT with the same schedule plus weekly nimotuzumab (NCRT).

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Objective: Assessment of diagnostic accuracy of FDG-PET/CT in the detection of viable disease in post-chemotherapy seminomatous residual masses using visual interpretation, SUVmax, and T/L ratio.

Methods: This is a retrospective study assessing the post-chemotherapy seminomatous residual masses of size >3 cm. The PET/CT scan findings were interpreted visually for presence of residual disease which were validated from histopathology reports or imaging follow-up for a maximum of 3 years.

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Purpose: Modified and superficial inguinal lymph node dissection (MILD and SILD) are the 2 widely used templates for surgical staging of clinically node negative (cN0) penile cancer (PeCa); however, no previous reports have compared their outcomes. We compared these 2 surgical templates for oncological outcomes and complications.

Materials And Methods: We retrospectively reviewed records of cN0 PeCa patients who underwent MILD/SILD at our cancer care center from January 2013 to December 2019.

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Article Synopsis
  • * These tumors vary in aggressiveness, ranging from well-differentiated (usually less aggressive) to aggressive neuroendocrine carcinoma, requiring different treatment approaches.
  • * A unique case of a well-differentiated NET was detected through a PET/CT scan done for another reason and later confirmed through additional imaging and biopsy methods.
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Objectives: Advanced Hodgkin Lymphoma has a higher probability of relapse and recurrence. Classical clinicopathological parameters including the International Prognostic Score (IPS) have not been reliable in predicting prognosis or tailoring treatment. Since FDG PET/CT is the standard of care in staging Hodgkin Lymphoma, this study attempted to evaluate the clinical utility of baseline metabolic tumor parameters in a cohort of advanced Hodgkin lymphoma (stage III and IV).

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Epithelioid angiosarcoma is a rare subtype of angiosarcoma, with metastases occurring in more than 50% of cases and the lung is the most organ which is involved. Whole-body fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has demonstrated its clinical utility in the early detection of metastases in angiosarcoma. It is helpful to differentiate between benign lesions with low FDG uptake as compared to malignancies with high FDG avidity.

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Primary ovarian lymphoma is a rare malignancy with <1% incidence. Plasmablastic lymphoma usually associated with immunocompromised diseases such as HIV rarely involves the ovary; only two case studies are reported in the literature - plasmablastic lymphomatous involvement of an ovarian teratoma and another of plasmablastic variant of B-cell lymphoma involving bilateral ovaries. There are reported case series of synchronous presentation of carcinomas usually including lung, stomach, and colon and nonaggressive lymphomas.

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Fibrolamellar hepatocellular carcinoma (HCC) is a variant of HCC. It is a malignant tumor, but its imaging features often overlap focal nodular hyperplasia, which is a benign entity. FDG PET/CT is also not much help in these cases because both lesions do not concentrate FDG.

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Objective: The objective was to assess the roles of 68Ga-PSMA PET/CT and 18F-NaF PET/CT in evaluation of skeletal metastatic lesions in prostate cancer.

Methods: Two hundred consecutive prostate cancer patients who had undergone 68Ga-PSMA PET/CT and 18F-NaF PET/CT at baseline evaluation (n = 80) and following suspected recurrence or disease progression (restaging) (n = 120) were analyzed retrospectively.

Results: PSMA and NAF scans were positive for skeletal metastatic lesions in 67% (134 patients) and negative in 33% (66 patients).

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Sporadic cerebellar hemangioblastomas are rare with majority of these tumors presenting as a part of von Hippel-Lindau syndrome. We demonstrate an unusual case of a symptomatic sporadic cerebellar hemangioblastoma mimicking a meningioma on MRI and 68 Ga-DOTANOC PET imaging.

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The main modality of management of paratesticular mesothelioma remains orchiectomy while the use of adjuvant chemotherapy has not yet been explored. We aim to analyse the outcome of the multimodal management protocol in testicular mesothelioma We conducted a retrospective analysis of patients registered and treated for testicular mesothelioma between 2009 and 2019 in an oncology tertiary care hospital. Patients presenting with nodal, metastatic disease were treated with adjuvant, palliative chemotherapy respectively and their response to treatment was periodically monitored.

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Objectives: This study aimed to see the impact of FDG PET/CT with somatostatin receptor PET (SSTR PET) in directing the treatment plan in lower-grade well-differentiated neuroendocrine tumors (NETs) with Ki67 index ≤5%.

Methods: Sixty-three NET cases with Ki67 index ≤5% with both FDG PET and SSTR PET ( 68 Ga-DOTANOC PET) were included for this retrospective observational study. FDG PET findings were classified into positive, weakly positive, and negative based on a visual scale.

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Article Synopsis
  • The study aimed to evaluate how well F-18 FDG PET/CT can detect recurrent adenocarcinoma of the gallbladder and its potential effects on survival rates post-recurrence.
  • A total of 117 PET/CT studies were analyzed, revealing a sensitivity of 98.8% and an accuracy of 93.1%, indicating that PET/CT outperformed traditional tumor markers in diagnosing recurrence.
  • Results showed that patients with isolated abdominal wall and loco-regional recurrences had significantly better survival rates (median survivals of 39 and 25 months) compared to those with distant metastasis (12 months).
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