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العنوان
Value of PET/CT Scanning in Detection of Osseous and Marrow Metastatic Lesions in Cancer Patients /
المؤلف
Abdelfadil, Mostafa Abdelwahab Hussein.
هيئة الاعداد
باحث / مصطفى عبدالوهاب حسين عبدالفضيل
مشرف / شيرين محمد إبراهيم شرارة
مشرف / هبة يسرى النجار
مشرف / شيرين محمد إبراهيم شرارة
تاريخ النشر
2022.
عدد الصفحات
144p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
الأشعة والطب النووي والتصوير
تاريخ الإجازة
1/1/2022
مكان الإجازة
جامعة عين شمس - كلية الطب - الأشعة التشخيصية والتداخلية
الفهرس
Only 14 pages are availabe for public view

from 144

from 144

Abstract

SUMMARY
M
etastatic bone disease remains the commonest bone lesion affecting human being, with presentations in almost all types of cancers. Bone metastases occur in half of patients with cancer, the commonest pattern of bone metastasis is in the vertebral region (Macedo et al., 2017), with unknown primary in 10% of patients (Argentiero et al., 2019).
Metastasis of malignant neoplasms to bone is common with metastases being far more prevalent than primary bone malignancies (Cuccurullo et al., 2013). The bone is the third most common site for metastasis, exceeded only by the lungs and liver (Cuccurullo et al., 2013).
The vertebrae, pelvis, ribs and the ends of long bones are the preferred sites for metastatic process because of their high red marrow content (Saha et al., 2013). Within the spine, the most common site for metastases is in the lumbar region, less frequently in the thoracic spine, and rarely in the cervical spine (52%, 36% and 12% respectively).
The MBD lesions are classified into lytic (lucent) or sclerotic (dense) metastasis, although features often coincide. This depends on the balance between osteoclastic activity (causing bone resorption), osteoblastic activity (causing bone deposition), as well as reactive bony changes (necrosis, fibrosis, or response to therapies) (Isaac et al., 2020).
F18-FDG-PET/CT is a sensitive molecular imaging modality capable of diagnosing bone marrow metastases by means of increased FDG uptake in growing metastatic cancer cells (Evangelista et al., 2012).
Early bone marrow affection is not always associated with radiographic abnormality (Kamby et al., 1987). F18- FDG-PET/CT is therefore highly sensitive in detecting these early bone marrow metastases (Evangelista et al., 2012). On the other hand, CT is not able to detect early BM metastasis (CT occult lesions) even when utilizing the optimal CT window width and level (Lewanski et al., 2017).
Our results showed that PET CT was higher in sensitivity, accuracy, PPV and NPV than the conventional CT study and set an optimal cut off value for FDG uptake to detect marrow lesions of > 6.5 with the estimated P-value (0.000) which was highly significant.