Publications by authors named "Indraja Dev"

Fibroblast-activated protein (FAP) expression in glial cells is attributed to FAP-positive foci on tumor vessels and neoplastic cells. Preclinical and pilot studies have shown FAP expression in high-grade gliomas. We aimed at comparing PET imaging with FAP-inhibitor (FAPI-PET) with current standard, i.

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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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Programmed Death 1 (PD1) and Programmed Death Ligand (PDL1) play a crucial role in tumor microenvironment by helping cancer cells evade innate immunity. Numerous inhibitor anticancer drugs targeting this interplay have been used in clinical practice and many more are in preclinical stage. These drugs have shown promising results in achieving good response and long-term clinical benefit, is routinely performed to identify patients who may benefit.

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  • - 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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  • The study analyzes factors affecting progression-free survival (PFS) in patients with metastatic grade 1 gastroenteropancreatic neuroendocrine tumors (GEP-NET) from a database between January 2018 and December 2021.
  • Among 589 treated GEP-NET patients, 100 were grade 1 with metastasis, showing a median PFS of 54.5 months and a significant difference in overall survival rates based on liver disease burden.
  • The findings suggest that higher liver tumor burden correlates with poorer PFS and overall survival, indicating a need for more aggressive treatment strategies in these cases.
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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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PET/CT and radioisotope therapy are diagnostic and therapeutic arms of Nuclear Medicine, respectively. With the emergence of better technology, PET/CT has become an accessible modality. Diagnostic tracers exploring disease-specific targets has led the clinicians to look beyond FDG PET.

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  • * 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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Background: Re-irradiation (ReRT) is an effective treatment modality in appropriately selected patients with recurrent/progressive high-grade glioma (HGG). The literature is limited regarding recurrence patterns following ReRT, which was investigated in the current study.

Methods: Patients with available radiation (RT) contours, dosimetry, and imaging-based evidence of recurrence were included in the retrospective study.

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Introduction: Conventional magnetic resonance imaging (MRI) has limitations in differentiating tumor recurrence (TR) from radionecrosis (RN) in high-grade gliomas (HGG), which can present with morphologically similar appearances. Multiparametric advanced MR sequences and Positron Emission Tomography (PET) with amino acid tracers can aid in diagnosing tumor metabolism. The role of both modalities on an individual basis and combined performances were investigated in the current study.

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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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  • Imaging in prostate cancer is increasingly vital due to rising incidence rates and advancements in screening techniques.
  • The need for whole-body imaging is underscored by the development of personalized systemic therapies.
  • PSMA PET has become a favored method for diagnosing, staging, and assessing treatment responses because it effectively localizes to prostate tumor cells and maps disease extent.
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The incidence of congenital melanocytic nevi (CMNs) is 1% to 6% for small- to intermediate-size nevi to 1 in 500,000 for giant size nevi. Large and satellite CMNs are known to be associated with neurocutaneous melanosis and central nervous system malformations such as Dandy-Walker malformation, defects of the vertebra-skull, and intraspinal lipomas. We hereby present a case of CMN syndrome in an 18-year-old girl with leptomeningeal melanoma, evaluated with MRI, adequately staged, and screened with FDG PET.

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Giant cell tumors (GCTs) are benign bone lesions which are treated with curettage and bone grafting. Infrequently, GCTs show local site recurrences which are then treated with either surgical excision or radiation therapy. Radiation-induced sarcoma is rarely seen as a late complication of radiation therapy which needs to be differentiated from recurrent GCT.

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Introduction: The utility of positron emission tomography (PET) in detecting additional M1 patients over conventional staging modalities is not known in rectal cancer patients with enlarged lateral pelvic nodes.

Methods: Prospective, single center, single-arm interventional study of consecutive rectal cancer patients that had baseline lateral pelvic nodes on MRI (>10 mm) between February 2017 to December 2018. Such patients underwent PET after confirming non-metastatic status on CT of thorax and abdomen.

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  • A 66-year-old man with metastatic prostatic adenocarcinoma showed an unusual case of intense focal PSMA uptake in his lungs during a PSMA PET/CT scan.
  • Typically, PSMA uptake is linked to morphological changes in benign conditions, but this case had no accompanying CT findings.
  • The report highlights the rarity of PSMA uptake without identifiable changes on the CT component, emphasizing the need for careful evaluation in similar cases.
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  • Higher-grade glial neoplasms often require surgery, radiotherapy, and alkylating agents, but distinguishing between disease recurrence and treatment-related changes can be challenging after treatment.
  • This study analyzed 72 patients using FET PET imaging to establish a cutoff for differentiating true recurrence from post-treatment changes, finding a T/Wm ratio of 2.65 to be effective.
  • Results showed 57% had recurrent disease, while 43% displayed post-treatment changes, confirming that static FET PET is a valuable tool for assessing brain glioma conditions when MR imaging is inconclusive.
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Medulloblastomas, especially the sonic hedgehog subgroup, are treated aggressively with surgery and chemoradiotherapy, as they are associated with high local site recurrence rate and poor overall survival. Radiation-induced meningioma is the most common delayed complication of craniospinal irradiation. This needs to be differentiated from meningeal or ependymal metastases as the later need aggressive management.

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  • Carcinoma of breast with neuroendocrine differentiation is rare, particularly in men, and lacks extensive literature compared to more common male breast cancer types.
  • A case study is reported involving a 57-year-old man who experienced pituitary symptoms that were later identified as a metastatic lesion through specialized PET/CT imaging.
  • The imaging revealed a primary breast cancer exhibiting somatostatin expression and confirmed neuroendocrine differentiation through histopathological analysis.
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  • The study aimed to evaluate how metabolic parameters from 18F-FDG PET/CT scans can predict prognosis and correlate with molecular markers in patients with IDH-1 wild-type glioblastoma (GBM).
  • The analysis involved 129 patients with unclear MRI findings, identifying those who underwent surgery and were diagnosed with IDH-1 wild-type GBM, utilizing measures like SUVmax, metabolic tumor volume (MTV), and total lesion glycolysis (TLG).
  • Results indicated that higher T/w ratio, MTV, and TLG predicted significantly shorter overall survival, while SUVmax was not a strong predictor; age emerged as the most important independent prognostic factor in the multivariate analysis.
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High-grade gliomas, metastases, and primary central nervous system lymphoma (PCNSL) are common high-grade brain lesions, which may have overlapping features on magnetic resonance (MR) imaging. Our objective was to assess the utility of 18-fluoride-fluoro-ethyl-tyrosine positron emission tomography (FET-PET) in reliably differentiating between these lesions, by studying their metabolic characteristics. Patients with high-grade brain lesions suspicious for glioma, with overlapping features for metastases and PCNSL were referred for FET-PET by Neuroradiologists from Multidisciplinary Neuro-Oncology Joint Clinic.

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