Background Lung cancer is the most common among all kinds of cancers. It still constitutes the leading cause of cancer-related deaths worldwide, even with major advancements in prevention and treatments available. More than 85% of the cases are of non-small cell lung cancer (NSCLC), while less than 15% are of small cell lung cancers (SCLCs). Patients and methods This is a prospective study of 20 patients confirmed histopathologically to have bronchogenic carcinoma, who came for assessment of therapeutic response. All patients underwent positron emission tomography/computed tomography (PET/CT) before and after therapy. Semiquantitative assessment was used to determine maximum standardized uptake value (SUVmax). Treatment response evaluation was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Results Comparison of the pre- and post-treatment SUVmax in the responder and non-responder groups revealed that the post-treatment SUV was significantly lower than the baseline SUV in the responder group (P = 0.008). The responder post-treatment SUV and ∆ SUV were significantly lower than the non-responder values (P = 0.014 and 0.0004 respectively). The optimum threshold values of post-treatment SUV and ∆ SUV threshold defined by the receiver operating characteristic (ROC) curve analysis were ≤ 8 and ≤ −48.3 respectively. The sensitivity, specificity, PPV, NPV, and AUC of post-treatment SUV for predicting tumor response were 100%, 66.67%, 66.7%, 100%, and 0.833 respectively. The sensitivity, specificity, PPV, NPV, and AUC of ∆ SUV for predicting tumor response were 100%, 91.67%, 88.9%, 100%, and 0.979% respectively. Conclusion PET/CT proved itself as useful, efficient, and reliable tool in follow-up of lung cancer patients as it gives an early and accurate metabolic response assessment before any CT changes, leading to early modification of therapy or confirmation of its efficiency.
Background Lymphoid neoplasms are broadly divided into Hodgkin disease (HD) and non-Hodgkin’s lymphoma (NHL). Non-Hodgkin lymphoma accounts for about 5% of all cases of cancer with greater predilection to disseminate to extra-nodal sites. Extranodal lymphoma describes that there is neoplastic proliferation at sites other than the expected native lymph nodes or lymphoid tissue. Lymphomas that initially appear to have the bulk of the disease at extranodal sites are described as primary extranodal lymphoma and categorized as Stage I or II. In secondary extranodal lymphoma, there is secondary involvement of the extranodal sites from primary nodal disease, which is categorized as Stage III or IV. Aim and Objectives To assess the added value of hybrid Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the evaluation of extranodal involvement in patients with non-Hodgkin lymphoma in comparison to contrast-enhanced CT (CECT). Patients and Methods All patients had Non-Hodgkin lymphoma, proved by histopathological and immunophenotyping examinations. They underwent CECT and F-18 FDG PET–CT studies. Results This study included 76 patients with pathologically confirmed lymphoma who underwent PET/CT study. The patients' ages ranged between 20 and 78 years old (mean age 51 ± 14.7 years). This study included 51 males and 21 females. Diffuse large B-cell lymphoma subtype had the highest prevalence 53% (40/76), whereas mucosa-associated lymphoid tissue lymphoma was the least prevalent 4%. The Spleen was the most common site as it was involved in 20 patients followed by bone and bone marrow 15 patients, lung 13, Liver 9, Nasopharynx 4, Muscular and Cutaneous Nodules 4 patients each, CNS, Adrenal, Renal and Pleural Affection 3 patients each, Tonsillar, stomach, Pancreas and Prostate 2 patients each, and finally only one patient had salivary gland, thyroid, breast, and testicular involvement. The overall sensitivity, specificity, PPV, NPV, and accuracy of PET/CT and CECT are 97%, 20%, 94.5%, 33.3%, 91, 6 % and 87.3%, 60 %, 93.9%, 10% and 87.5%, respectively. Conclusion Combined PET/CT using 18F-FDG is the best oncologic imaging modality at present time with indispensable role and valuable application in monitoring and management of the extranodal lymphoma. It can detect metabolically active lesions without CT structural changes and identify a viable tumor in normal size lymph nodes. PET/CT is more effective than CECT in evaluating extranodal Lymphomatous infiltration, especially in spleen, bone, and bone marrow.
Background Cesarean delivery is increasing worldwide in the last few years, unnecessary CS is a growing problem affecting both developed as well as developing countries. There is no benefits either to mother or neonate when the procedure is not medically indicated. The ideal rate of CS is considered between 10%-15%, beyond which there is no benefits for either mother or fetus. However recent studies showed a much higher rate of CS. WHO proposes that health care facilities use the Robson's 10 group classification system to monitor their CS rates. This classification helps to understand the internal structure of the CS rates at each health facilities, the indications in each group and formulate strategies to reduce these rates. Objectives the aim is to describe the frequency of CS delivery in Ain Shams University Maternity Hospital by Robson classification. And to describe maternal and neonatal outcomes. Methods The study was a descriptive cross sectional study conducted at labor ward of Ain Shams University Maternity Hospital (a tertiary care center). All women delivered by CS during a period of six months were recruited and classified into 10-Robson's groups. The overall CS rate were calculated, and also the contribution of each groups to the overall CS rate. Results The highest contribution to the overall CS was by group five 38.98%, followed by group ten 34.20%. While group 9 was lowest frequency 0.50% of overall CS rates. Conclusion s: The use of Robson’s classification system allows to monitor the CS rates which helps to identify the main contributors for the increasing CS rates, also helps to identify the target groups that may benefit from implementations of interventions for reducing CS rates. Women with previous CS were an important determinant of overall CS rates, reducing primary CS rates, counselling for VBAC, encouraging versions when available, could reduce the CS rates.
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