Relative value of ultrasound, computed tomography and positron emission tomography imaging in the clinically node-negative neck in oral cancer.

Aim: To determine the most accurate noninvasive imaging modality for occult metastasis in clinically node-negative necks in oral squamous cell carcinoma from a granulomatous disease endemic region.

Method: Prospective, observational study comparing ultrasound (US), contrast enhanced computed tomography (CECT) and positron emission tomography-computed tomography (PET-CT). Level wise assessment of neck nodes with each imaging modality was performed and compared with final histopathology.

Imaging spectrum of peritoneal carcinomatosis on FDG PET/CT.

Recognition of patterns has always been extremely important in cross-sectional imaging. Peritoneal involvement, both primary and as dissemination from abdominopelvic malignancies, is manifested in different forms, purely because of anatomical complexity. We studied series of peritoneal involvement by (18)F-fluorodeoxyglucose positron-emission tomography/computed tomography fusion imaging and derived patterns of tracer uptake on maximum intensity projection and cross-sectional fusion images.

PET reconstruction artifact can be minimized by using sinogram correction and filtered back-projection technique.

Filtered Back-Projection (FBP) has become an outdated image reconstruction technique in new-generation positron emission tomography (PET)/computed tomography (CT) scanners. Iterative reconstruction used in all new-generation PET scanners is a much improved reconstruction technique. Though a well-calibrated PET system can only be used for clinical imaging in few situations like ours, when compromised PET scanner with one PET module bypassed was used for PET acquisition, FBP with sinogram correction proved to be a better reconstruction technique to minimize streak artifact present in the image reconstructed by the iterative technique.

Extraskeletal osteosarcoma: An uncommon variant with rare metastatic sites detected with FDG PET/CT.

Extraskeletal osteosarcoma (ESOS) is a rare malignancy, which commonly presents with metastatic disease. Like their osteogenic counterparts, these tumors commonly metastasize to lungs and bones. We report the fluoro-deoxyglucose positron emission tomography findings in a case of ESOS presenting with a combination of rare metastatic sites such as brain, kidney and the bone marrow.

Response assessment in metronomic chemotherapy: RECIST or PERCIST?

Introduction: Metronomic chemotherapy (MC) is a novel therapeutic variation for resistant cancers, wherein chemotherapeutic drugs are administrated in low doses with no prolonged drug-free break. It lessens the level of toxicity, is better tolerated and enhances the quality of life. This retrospective analysis was undertaken to evaluate whether anatomical (computed tomography [CT]) or functional (positron emission tomography [PET]) imaging be used for response assessment in patients on MC.

Incremental value of 18F-FDG PET/CT in therapeutic decision-making of potentially curable esophageal adenocarcinoma.

Aims And Objectives: The aim of the study was to estimate the incremental value of fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) in aiding treatment decisions in a specific cohort of patients with lower esophageal and gastroesophageal junction adenocarcinoma who were considered for potentially curative treatment on the basis of conventional imaging.

Materials And Methods: The study included patients referred for a staging F-FDG PET/CT who were considered for potentially curative treatment (neoadjuvant therapy followed by surgery or definitive chemoradiotherapy) by a multidisciplinary tumor board. The proportion of patients with M1b disease (American Joint Committee on Cancer, 6th ed.

Report of two cases of fluorodeoxyglucose positron emission tomography/computed tomography appearance of hibernoma: A rare benign tumor.

False-positive findings are commonly seen in positron emission tomography computed tomography imaging. One of the most common false positive finding is uptake of fluorodeoxyglucose in brown adipose tissue. Herein, we report two cases with incidentally detected hibernomas-a brown fat containing tumor with metabolic activity.

Is it Time to Rejuvenate the Forceps?

The obstetric forceps was designed to assist extraction of the foetal head and thereby accomplish delivery of the foetus in the second stage of labour. More than 700 types of obstetric forceps have been described. An understanding of the anatomy of the birth canal and the foetal head is a prerequisite to becoming a skilled and safe user of forceps.

Identification of a unique cause of ring artifact seen in computed tomography trans-axial images.

Artifacts present in computed tomography (CT) image often degrade the image quality and ultimately, the diagnostic outcome. Ring artifact in trans-axial image is caused by either miscalibrated or defective detector element of detector row, which is often categorized as scanner based artifact. A ring artifact detected on trans-axial CT image of positron emission tomography/computed tomography (PET/CT), was caused by contamination of CT tube aperture by droplet of injectable contrast medium.

Stair-step artifact seen in coronal and sagittal reformatted images because of misalignment of computed tomography tube, in a positron emission tomography/computed tomography scanner.

Reconstruction artifacts often affect the image quality. An unusual wavy imaging pattern was seen on computed tomography (CT) part of positron emission tomography/CT, on sagittal and coronal images. This pattern was corrected on realignment of CT tube.

Broncho-esophageal fistula leading to lung abscess: A life-threatening emergency detected on FDG PET/CT in a case of carcinoma of middle third esophagus.

Sinister undesirable pathologies often accompany malignancies. Though the entire emphasis is on cancer management, these benign conditions are more life-threatening than the primary malignancy itself. We report an interesting imaging finding of broncho-esophageal fistula leading to lung abscess on (18)F- fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) in large middle esophageal cancer, which due to early detection, was promptly managed.

Exploiting biospectroscopy as a novel screening tool for cervical cancer: towards a framework to validate its accuracy in a routine clinical setting.

Biospectroscopy is an emerging field that harnesses the platform of physical sciences with computational analysis in order to shed novel insights on biological questions. An area where this approach seems to have potential is in screening or diagnostic clinical settings, where there is an urgent need for new approaches to objectively interrogate large numbers of samples in an objective fashion with acceptable levels of sensitivity and specificity. This review outlines the benefits of biospectroscopy in screening for precancer lesions of the cervix due to its ability to separate different grades of dysplasia.

Hepatic metastasis disguised as fat spared area in the background of fatty liver: Detection on FDG PET/CT.

Area of fat sparing in fatty liver is known to pose a diagnostic challenge in an oncological setting, especially in cancers with higher propensity for liver metastases. We report an unusual appearance of hepatic metastases in a fat spared area, on both computed tomography (CT) and positron emission tomography (PET), in a combined 18 fluorine-fluorodeoxyglucose (18 F-FDG) PET/CT study done in metastatic adenocarcinoma of colon.

Stage IV lung cancer: Is cure possible?

Reporting a case, 53 years old male with stage IV Nonsamall cell lung cancer in view of cytologically proven malignant pleural effusion. Usually the management of stage IV lung cancer is with palliative intent where the patient receives palliative chemotherapy along with palliative radiotherapy and surgery if required. Most of the data on curative management of oligometastatic non-small cell lung cancer includes patient with adrenal metastasis and some reports with brain metastasis.

Four rare extranodal sites seen on FDG PET/CT in a single patient of disseminated lymphoma.

Extranodal disease refers to lymphomatous infiltration of anatomic sites other than lymph nodes. With the advent of FDG PET/CT for staging, rare sites of extranodal disease have been documented. We report a case of Non- Hodgkin's lymphoma with four rare extranodal sites, namely adrenal, peripheral nerves, pancreas and prostate, in the same patient, detected on FDG PET/CT imaging.

Extensive tumor thrombus of hepatocellular carcinoma in the entire portal venous system detected on fluorodeoxyglucose positron emission tomography computed tomography.

Detection of thrombus is usually an incidental finding on fluorodeoxyglucose positron emission tomography/computed tomography studies. Nevertheless this is an important finding in terms of disease prognostication and in planning the treatment strategy. We herein report a case of a 50-years-old male, a diagnosed case of hepatocellular carcinoma with extensive hypermetabolic thrombus involving the entire portal venous system.

Autoimmune pancreatitis: An incidental detection on FDG PET/CT with response to steroid therapy.

Autoimmune pancreatitis (AIP) is most often incidentally detected, with the diagnosis being based on radiological characteristics. A steroid regimen for 6 weeks is the standard line of treatment for AIP. In our case, AIP was incidentally suspected on fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) performed for staging a malignancy, and a follow-up PET/CT study after steroid treatment, showed complete metabolic and morphological response; thus confirming the imaging diagnosis of AIP.

Duplicated gall bladder detected on 99m Tc HIDA hepatobiliary scintigraphy: A report of two cases.

Gall bladder (GB) duplication is a rare condition often found incidentally; most of these detected on screening Ultrasonography (USG) for abdominal colic. Nuclear hepatobiliary scan, popularly known as hepatobiliary iminodiacetic acid (HIDA) scan, with its biliary kinetics, is highly specific for picking up abnormalities related to biliary tract and GB. We report two cases of duplication of GB visualized on HIDA scan.

Incidentally detected grade 3 cystocele on FDG PET/CT in a case of suspected malignancy.

Unexpected findings are seen on FDG PET/CT outside the primary site of abnormality. Such incidental findings are common in the genitourinary tract due to normal urinary excretion of FDG. We report a case of incidentally detected grade 3 cystocele in a patient who underwent FDG PET/CT study for a suspected lung malignancy.