Hepatobiliary radionuclide imaging is typically performed to detect cholecystitis. Infrequently, ... more Hepatobiliary radionuclide imaging is typically performed to detect cholecystitis. Infrequently, imaging reveals an obstructive pattern. Although delayed hepatobiliary imaging is commonly used to differentiate between intrahepatic (IH) and extrahepatic (EH) obstruction in the newborn; there is room to clarify the use of delayed imaging in the adult population. A retrospective review was performed of adult patients demonstrating a complete obstructive pattern on initial Tc-99m mebrofenin hepatobiliary imaging. Delayed imaging was divided into early delayed (ED) (<10 h) and late delayed (LD) (≥10 h) imaging. Two physicians qualified the presence of intestinal radiotracer (negative, low to high) on delayed images. Determination of EH or IH pathology was obtained from chart review. A total of 24 patients demonstrated an obstructive pattern using delayed Tc-99m mebrofenin hepatobiliary imaging, with delayed imaging ranging from 4 to 30 h. EH pathologies (choledocholithiasis, stricture, other) represented 63% of cases (n = 15), IH pathologies (cirrhosis, hepatitis, other) represented 33% cases (n = 8) and 1 case was indeterminate. 67% of EH cases showed intestinal activity on delayed imaging (67% on ED and 67% on LD imaging), whereas 63% of IH cases showed intestinal activity on delayed imaging (67% on ED imaging and 60% on LD imaging). The presence of intestinal activity on the both the early and delayed images did not differentiate between the IH and EH pathology groups. Subdividing the groups into ED imaging and LD imaging was also not predictive of determining location of obstructive pattern on the initial 1 h of imaging. This data suggests that delayed hepatobiliary scintigraphy has little or no role in determining the cause of obstructive pathology.
Two patients demonstrated an unusual pattern of intense bone and surrounding soft tissue hypermet... more Two patients demonstrated an unusual pattern of intense bone and surrounding soft tissue hypermetabolic uptake in the posterior pelvis on fluorodeoxyglucose positron emission tomography with computed tomography PET-CT scans. After further investigation, we found that both patients underwent uncomplicated autologous bone marrow harvesting several weeks before imaging. These two cases illustrate a distinctive PET-CT appearance following bone marrow harvesting that the radiologist needs to recognize to not confuse the findings with metastatic disease.
PURPOSE The aim of this study is to understand the patterns and imaging features of fluorodeoxygl... more PURPOSE The aim of this study is to understand the patterns and imaging features of fluorodeoxyglucose (FDG) positron emission tomography with computed tomography (PET-CT) in post cryoablation lung cancer patients in order differentiate benign from malignant findings. METHOD AND MATERIALS We identified 24 patients with 26 lesions treated by percutaneous cryoablation for primary non-small cell lung cancer. Two patients had metachronous lesions with different ablation dates. Two experienced nuclear radiologists blindly reviewed baseline images and follow up FDG PET-CT scans for up to 36 months with discrepancy determined by consensus. Seventeen lesions had baseline PET-CT while 9 had CT only. Follow up PET-CT studies were obtained at 6, 12, 18, 24, and 36 months with variability due to adherence to protocol. RESULTS Average patient age was 74.2 yrs. Average maximum standard uptake value (SUV) for baseline PET was 4.8±0.44. Average CT area of initial tumor was 2.17±0.30 cm2. Twenty pat...
To assess the therapeutic potential of methotrexate (MTX) and 5-[1251]liodo-2&amp;amp;amp;amp... more To assess the therapeutic potential of methotrexate (MTX) and 5-[1251]liodo-2&amp;amp;amp;amp;amp;amp;#39;-deoxyuridine (125IdUrd) administered sequentially in rats bearing advanced (ten-day-old) intrathecal (i.t.) TE671 human rhabdomyosarcoma tumours. Nude rats were injected with TE671 cells through an i.t. placed catheter. Ten days later, the animals were injected i.t. over a 12-day period with (i) saline daily, (ii) MTX every other day, (iii) 125IdUrd every other day, or (iv) MTX and 125IdUrd on alternating days. Onset of paralysis was determined as a function of time, and the medians for onset (M), percentage of cells killed (% kill), and log cell kill were calculated. The data show that (i) injection of MTX leads to a moderate delay in the onset of paralysis (M(MTX) = 29 d versus Msaline = 20 d), (ii) administration of 125IdUrd is more effective (M(IdUrd) = 36 d), and (iii) sequential administration of MTX- 125IdUrd further increases the therapeutic efficacy of 125IdUrd (M(MTX)-IdUrd = 47 d). Intrathecal injection of MTX-(125)IdUrd is efficacious in the therapy of advanced intrathecal tumours.
The aim of this study was to understand the imaging features of fluorine-18 fluorodeoxyglucose (F... more The aim of this study was to understand the imaging features of fluorine-18 fluorodeoxyglucose (F-FDG) PET-computed tomography (CT) in postcryoablation lung cancer patients that could help predict recurrence. We identified 28 patients with 30 lesions treated by means of percutaneous cryoablation for stage I non-small-cell lung cancer. Two experienced nuclear radiologists blindly reviewed baseline images and follow-up F-FDG PET-CT scans for a minimum of 24 months, with discrepancy in interpretation resolved by consensus. Nineteen lesions had undergone baseline PET-CT studies, whereas 11 lesions had undergone only baseline CT studies. Follow-up PET-CT studies were analyzed for up to 24 months, whereas the recurrence-free survival analysis was performed for 36 months. The average maximum standardized uptake value (SUVmax) at baseline (n=19) was 5.2±3.9 and the average CT area at baseline was 2.2±1.6 cm. Only the CT area was significantly different between recurring and nonrecurring lesions at baseline (P=0.0028). The Kaplan-Meier survival analysis showed that dichotomizing lesions around 2 cm on CT did not result in a statistically significant survival difference (hazard ratio=1.42, 95% confidence interval: 0.63-2.21). The average SUVmax at first follow-up was 1.9±1.8 for 27 lesions, whereas the average SUVmax of recurrent lesions was 2.2±2.2 and that of nonrecurrent lesions was 1.5±0.3 (P=0.17). Six lesions had SUVmax more than or equal to 2.5 within 24 months, all of which recurred in the ablation zone. F-FDG PET-CT is a valuable tool for determining treatment response and for distinguishing benign from malignant lesions after cryoablation. The CT area was most predictive of future recurrence at baseline, whereas SUVmax more than or equal to 2.5 was most predictive of future recurrence at first follow-up.
Inflammatory breast cancer is a rare and aggressive form of breast cancer typically presenting wi... more Inflammatory breast cancer is a rare and aggressive form of breast cancer typically presenting with skin changes instead of a breast lump. Hybrid PET/MR imaging provides the anatomic detail and metabolic assessment to characterize the cancer and localize a biopsy target site as well as evaluate for axillary nodal spread and distant metastases.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2005
UNLABELLED This study assesses targeting of lung metastases in mice with the radioiodinated thymi... more UNLABELLED This study assesses targeting of lung metastases in mice with the radioiodinated thymidine analog 5-[(123)I/(125)I]iodo-2'-deoxyuridine ((123)I-IUdR/(125)I-IUdR), formulated with varying amounts of tributyltin precursor and injected intravenously. METHODS Six- to 8-wk-old C57BL/6 mice were injected intravenously with B16F10 melanoma cells. Two weeks later, when lung tumors were established, the animals were injected intravenously with (125)I-IUdR synthesized using 1, 35, 100, 150, 200, or 250 microg 5-tributylstannyl-2'-deoxyuridine (SnUdR) in the presence of an oxidant. Nontumor-bearing mice were also injected with these formulations and served as control animals. Twenty-four hours later, the animals were killed, and the radioactivity associated with the lungs and other tissues was measured in a gamma-counter. The percentage injected dose per gram tissue (%ID/g) and tumor-to-nontumor ratios (T/NT ratios) were calculated. Phosphor imaging was done on lungs from tu...
Inflammatory breast cancer is a rare and aggressive form of breast cancer typically presenting wi... more Inflammatory breast cancer is a rare and aggressive form of breast cancer typically presenting with skin changes instead of a breast lump. Hybrid PET/MR imaging provides the anatomic detail and metabolic assessment to characterize the cancer and localize a biopsy target site as well as evaluate for axillary nodal spread and distant metastases.
The liver is the most frequent site of hematogenous metastatic spread from many cancers including... more The liver is the most frequent site of hematogenous metastatic spread from many cancers including breast malignancy. Liver metastases from breast cancer are associated with a poor prognosis and are easily diagnosed with FDG PET/MR imaging.
Invasive ductal carcinoma is the most common type of breast cancer, making up to nearly 70–80% of... more Invasive ductal carcinoma is the most common type of breast cancer, making up to nearly 70–80% of all breast cancer diagnoses. PET/MR imaging is useful for staging and restaging of locally advanced cancer, chest wall involvement, axillary or internal mammary lymph node metastases, or distant metastases.
This study assesses targeting of lung metastases in mice with the radioiodinated thymidine analog... more This study assesses targeting of lung metastases in mice with the radioiodinated thymidine analog 5-[ 123 I/ 125 I]iodo-2-deoxyuridine ( 123 I-IUdR/ 125 I-IUdR), formulated with varying amounts of tributyltin precursor and injected intravenously. Methods: Six- to 8-wk-old C57BL/6 mice were injected intravenously with B16F10 melanoma cells. Two weeks later, when lung tumors were established, the animals were injected intravenously with 125 I-IUdR synthesized using 1, 35, 100, 150, 200, or 250 g 5-tributylstannyl-2-deoxyuridine (SnUdR) in the presence of an oxidant. Nontumor-bearing mice were also injected with these formulations and served as control animals. Twentyfour hours later, the animals were killed, and the radioactivity associated with the lungs and other tissues was measured in a -counter. The percentage injected dose per gram tissue (%ID/g) and tumor-to-nontumor ratios (T/NT ratios) were calculated. Phosphor imaging was done on lungs from tumor-bearing and nontumor-bearing...
Internal mammary lymph node metastasis from breast cancer is important to detect as it upstages t... more Internal mammary lymph node metastasis from breast cancer is important to detect as it upstages the patient and requires adjustment of the radiotherapy field. PET/MR imaging can help determine if there is malignant lymph node involvement through the combination of morphological MRI characteristics and determination of metabolic activity.
Hepatobiliary radionuclide imaging is typically performed to detect cholecystitis. Infrequently, ... more Hepatobiliary radionuclide imaging is typically performed to detect cholecystitis. Infrequently, imaging reveals an obstructive pattern. Although delayed hepatobiliary imaging is commonly used to differentiate between intrahepatic (IH) and extrahepatic (EH) obstruction in the newborn; there is room to clarify the use of delayed imaging in the adult population. A retrospective review was performed of adult patients demonstrating a complete obstructive pattern on initial Tc-99m mebrofenin hepatobiliary imaging. Delayed imaging was divided into early delayed (ED) (<10 h) and late delayed (LD) (≥10 h) imaging. Two physicians qualified the presence of intestinal radiotracer (negative, low to high) on delayed images. Determination of EH or IH pathology was obtained from chart review. A total of 24 patients demonstrated an obstructive pattern using delayed Tc-99m mebrofenin hepatobiliary imaging, with delayed imaging ranging from 4 to 30 h. EH pathologies (choledocholithiasis, stricture, other) represented 63% of cases (n = 15), IH pathologies (cirrhosis, hepatitis, other) represented 33% cases (n = 8) and 1 case was indeterminate. 67% of EH cases showed intestinal activity on delayed imaging (67% on ED and 67% on LD imaging), whereas 63% of IH cases showed intestinal activity on delayed imaging (67% on ED imaging and 60% on LD imaging). The presence of intestinal activity on the both the early and delayed images did not differentiate between the IH and EH pathology groups. Subdividing the groups into ED imaging and LD imaging was also not predictive of determining location of obstructive pattern on the initial 1 h of imaging. This data suggests that delayed hepatobiliary scintigraphy has little or no role in determining the cause of obstructive pathology.
Two patients demonstrated an unusual pattern of intense bone and surrounding soft tissue hypermet... more Two patients demonstrated an unusual pattern of intense bone and surrounding soft tissue hypermetabolic uptake in the posterior pelvis on fluorodeoxyglucose positron emission tomography with computed tomography PET-CT scans. After further investigation, we found that both patients underwent uncomplicated autologous bone marrow harvesting several weeks before imaging. These two cases illustrate a distinctive PET-CT appearance following bone marrow harvesting that the radiologist needs to recognize to not confuse the findings with metastatic disease.
PURPOSE The aim of this study is to understand the patterns and imaging features of fluorodeoxygl... more PURPOSE The aim of this study is to understand the patterns and imaging features of fluorodeoxyglucose (FDG) positron emission tomography with computed tomography (PET-CT) in post cryoablation lung cancer patients in order differentiate benign from malignant findings. METHOD AND MATERIALS We identified 24 patients with 26 lesions treated by percutaneous cryoablation for primary non-small cell lung cancer. Two patients had metachronous lesions with different ablation dates. Two experienced nuclear radiologists blindly reviewed baseline images and follow up FDG PET-CT scans for up to 36 months with discrepancy determined by consensus. Seventeen lesions had baseline PET-CT while 9 had CT only. Follow up PET-CT studies were obtained at 6, 12, 18, 24, and 36 months with variability due to adherence to protocol. RESULTS Average patient age was 74.2 yrs. Average maximum standard uptake value (SUV) for baseline PET was 4.8±0.44. Average CT area of initial tumor was 2.17±0.30 cm2. Twenty pat...
To assess the therapeutic potential of methotrexate (MTX) and 5-[1251]liodo-2&amp;amp;amp;amp... more To assess the therapeutic potential of methotrexate (MTX) and 5-[1251]liodo-2&amp;amp;amp;amp;amp;amp;#39;-deoxyuridine (125IdUrd) administered sequentially in rats bearing advanced (ten-day-old) intrathecal (i.t.) TE671 human rhabdomyosarcoma tumours. Nude rats were injected with TE671 cells through an i.t. placed catheter. Ten days later, the animals were injected i.t. over a 12-day period with (i) saline daily, (ii) MTX every other day, (iii) 125IdUrd every other day, or (iv) MTX and 125IdUrd on alternating days. Onset of paralysis was determined as a function of time, and the medians for onset (M), percentage of cells killed (% kill), and log cell kill were calculated. The data show that (i) injection of MTX leads to a moderate delay in the onset of paralysis (M(MTX) = 29 d versus Msaline = 20 d), (ii) administration of 125IdUrd is more effective (M(IdUrd) = 36 d), and (iii) sequential administration of MTX- 125IdUrd further increases the therapeutic efficacy of 125IdUrd (M(MTX)-IdUrd = 47 d). Intrathecal injection of MTX-(125)IdUrd is efficacious in the therapy of advanced intrathecal tumours.
The aim of this study was to understand the imaging features of fluorine-18 fluorodeoxyglucose (F... more The aim of this study was to understand the imaging features of fluorine-18 fluorodeoxyglucose (F-FDG) PET-computed tomography (CT) in postcryoablation lung cancer patients that could help predict recurrence. We identified 28 patients with 30 lesions treated by means of percutaneous cryoablation for stage I non-small-cell lung cancer. Two experienced nuclear radiologists blindly reviewed baseline images and follow-up F-FDG PET-CT scans for a minimum of 24 months, with discrepancy in interpretation resolved by consensus. Nineteen lesions had undergone baseline PET-CT studies, whereas 11 lesions had undergone only baseline CT studies. Follow-up PET-CT studies were analyzed for up to 24 months, whereas the recurrence-free survival analysis was performed for 36 months. The average maximum standardized uptake value (SUVmax) at baseline (n=19) was 5.2±3.9 and the average CT area at baseline was 2.2±1.6 cm. Only the CT area was significantly different between recurring and nonrecurring lesions at baseline (P=0.0028). The Kaplan-Meier survival analysis showed that dichotomizing lesions around 2 cm on CT did not result in a statistically significant survival difference (hazard ratio=1.42, 95% confidence interval: 0.63-2.21). The average SUVmax at first follow-up was 1.9±1.8 for 27 lesions, whereas the average SUVmax of recurrent lesions was 2.2±2.2 and that of nonrecurrent lesions was 1.5±0.3 (P=0.17). Six lesions had SUVmax more than or equal to 2.5 within 24 months, all of which recurred in the ablation zone. F-FDG PET-CT is a valuable tool for determining treatment response and for distinguishing benign from malignant lesions after cryoablation. The CT area was most predictive of future recurrence at baseline, whereas SUVmax more than or equal to 2.5 was most predictive of future recurrence at first follow-up.
Inflammatory breast cancer is a rare and aggressive form of breast cancer typically presenting wi... more Inflammatory breast cancer is a rare and aggressive form of breast cancer typically presenting with skin changes instead of a breast lump. Hybrid PET/MR imaging provides the anatomic detail and metabolic assessment to characterize the cancer and localize a biopsy target site as well as evaluate for axillary nodal spread and distant metastases.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2005
UNLABELLED This study assesses targeting of lung metastases in mice with the radioiodinated thymi... more UNLABELLED This study assesses targeting of lung metastases in mice with the radioiodinated thymidine analog 5-[(123)I/(125)I]iodo-2'-deoxyuridine ((123)I-IUdR/(125)I-IUdR), formulated with varying amounts of tributyltin precursor and injected intravenously. METHODS Six- to 8-wk-old C57BL/6 mice were injected intravenously with B16F10 melanoma cells. Two weeks later, when lung tumors were established, the animals were injected intravenously with (125)I-IUdR synthesized using 1, 35, 100, 150, 200, or 250 microg 5-tributylstannyl-2'-deoxyuridine (SnUdR) in the presence of an oxidant. Nontumor-bearing mice were also injected with these formulations and served as control animals. Twenty-four hours later, the animals were killed, and the radioactivity associated with the lungs and other tissues was measured in a gamma-counter. The percentage injected dose per gram tissue (%ID/g) and tumor-to-nontumor ratios (T/NT ratios) were calculated. Phosphor imaging was done on lungs from tu...
Inflammatory breast cancer is a rare and aggressive form of breast cancer typically presenting wi... more Inflammatory breast cancer is a rare and aggressive form of breast cancer typically presenting with skin changes instead of a breast lump. Hybrid PET/MR imaging provides the anatomic detail and metabolic assessment to characterize the cancer and localize a biopsy target site as well as evaluate for axillary nodal spread and distant metastases.
The liver is the most frequent site of hematogenous metastatic spread from many cancers including... more The liver is the most frequent site of hematogenous metastatic spread from many cancers including breast malignancy. Liver metastases from breast cancer are associated with a poor prognosis and are easily diagnosed with FDG PET/MR imaging.
Invasive ductal carcinoma is the most common type of breast cancer, making up to nearly 70–80% of... more Invasive ductal carcinoma is the most common type of breast cancer, making up to nearly 70–80% of all breast cancer diagnoses. PET/MR imaging is useful for staging and restaging of locally advanced cancer, chest wall involvement, axillary or internal mammary lymph node metastases, or distant metastases.
This study assesses targeting of lung metastases in mice with the radioiodinated thymidine analog... more This study assesses targeting of lung metastases in mice with the radioiodinated thymidine analog 5-[ 123 I/ 125 I]iodo-2-deoxyuridine ( 123 I-IUdR/ 125 I-IUdR), formulated with varying amounts of tributyltin precursor and injected intravenously. Methods: Six- to 8-wk-old C57BL/6 mice were injected intravenously with B16F10 melanoma cells. Two weeks later, when lung tumors were established, the animals were injected intravenously with 125 I-IUdR synthesized using 1, 35, 100, 150, 200, or 250 g 5-tributylstannyl-2-deoxyuridine (SnUdR) in the presence of an oxidant. Nontumor-bearing mice were also injected with these formulations and served as control animals. Twentyfour hours later, the animals were killed, and the radioactivity associated with the lungs and other tissues was measured in a -counter. The percentage injected dose per gram tissue (%ID/g) and tumor-to-nontumor ratios (T/NT ratios) were calculated. Phosphor imaging was done on lungs from tumor-bearing and nontumor-bearing...
Internal mammary lymph node metastasis from breast cancer is important to detect as it upstages t... more Internal mammary lymph node metastasis from breast cancer is important to detect as it upstages the patient and requires adjustment of the radiotherapy field. PET/MR imaging can help determine if there is malignant lymph node involvement through the combination of morphological MRI characteristics and determination of metabolic activity.
Uploads
Papers by Elham Safaie