111 results on '"Padhy AK"'
Search Results
2. Haemodynamic Effects of Pericardial Closure after Cardiac Surgery
- Author
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KS, Saurabh, primary, Padhy, AK, additional, Kumar, Madhur, additional, Munjal, R, additional, and Gupta, A., additional
- Published
- 2020
- Full Text
- View/download PDF
3. Fluorine-18-fluorodeoxyglucose PET/CT for the evaluation of suspected recurrent uterine leiomyosarcomas.
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Kao YH, Saad U, Tan AE, Magsombol BM, and Padhy AK
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MEDICAL radiography ,MEDICAL imaging systems ,CANCER ,TOMOGRAPHY ,OPTICAL tomography ,PEDIATRIC tomography - Published
- 2011
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4. Diuresis renography in the evaluation of equivocal pelviureteric junction obstruction.
- Author
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Singh, SS, primary, Gupta, NP, additional, Padhy, AK, additional, and Singh, SM, additional
- Published
- 1985
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5. A report on the implementation aspects of the International Atomic Energy Agency's first doctoral coordinated research project, 'Management of liver cancer using radionuclide methods with special emphasis on trans-arterial radio-conjugate therapy and...
- Author
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Padhy AK and Dondi M
- Published
- 2008
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6. The Quantification of 123I-FP-CIT (DaTSCAN) Imaging: Statistical Differentiation between Parkinson's Disease and Essential Tremor
- Author
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Mihaljević, Ivan, Štefanić, Mario, Krstonošić, Branislav, Butković-Soldo, Silva, Štenc- Bradvica, Ivanka, and Padhy, AK
- Subjects
ioflupane ,I-123 ,Parkinson's disease ,essential tremor - Abstract
Aim: Qualitatively and semiquantitatively, 123I- FP-CIT brain SPECT was used to estimate the possibility of precise and early differentiation of Parkinson's disease (PD) from essential tremor (ET) for the purpose of an adequate and early treatment of patients with PD. Methods: 123I-FP- CIT binding, expressed as normalized specific to nonspecific (occipital cortex) uptake ratio, was investigated in 134 patients with clinically uncertain PD (58 male, 76 female, median 67, interquartile range 58-72 years). PD versus ET differentiation was based on visual interpretation and quantification of 123I-FP-CIT accumulation within regions of interest including the whole striatum, nucleus caudatus and putamen (3-4 h p.i., 128x128 matrix, 64x30 s, 360°, LEHR parallel collimator, FBP).Results: Reduced striatal dopamine transporter (DAT) density [0.85 (0.44- 1.3)] was detected in 64 PD patients. The 123I-FP- CIT SPECT images were normal in 70 patients with ET [median striatal uptake ratio 2.44 (1.78-3.1)]. DAT density was significantly reduced in PD patients when compared to the ET patients (for striatum, p=5.8x10-32 ; for putamen p=1.7x10-36, and caudate of advanced PD p=1.3x10-27). The 123I- FP-CIT uptake in PD patients was progressively reduced with disease stage in the striatum, putamen and caudate (all p
- Published
- 2010
7. Radioimmunotherapy with Zevalin in Patients with Non-Hodgkin's Lymphoma
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Huić, Dražen, Aurer, I, Žuvić, Marijan, Radman, I, Mitrović, Z, Ajduković, R, Sever-Prebilić, M, Ostojić-Kolonić, S, Škare-Librenjak, Lj, Labar, Boris, Dodig, Damir, and Padhy AK
- Subjects
radioimmunotherapy ,zevalin ,Non-Hodgkin's Lymphoma ,hemic and lymphatic diseases - Abstract
The aim of this prospective study was to asses the value of new radioimmunotherapy treatment with Zevalin (IgGl monoclonal antibody covalently bound to tiuxetan and labeled with Y-90) for adult patients with refractory or relapsed CD20+ follicular B-cell non- Hodgkin's lymphoma (NHL). This multicentric study included eight patients (median age 55 years, range 51 -59 years) from five hospitals in Croatia. The treatment involved a day 1 infusion of rituximab 250 mg /m2 ; a second infusion of rituximab on day 8, followed by "slow push" 10 minute infusion of Zevalin (median dose 1020 MBq ; range 820-1177 MBq). On follow-up 12 weeks after treatment response was achieved in six patients (75%). In three patients tumor mass was completely disappeared (complete response), and in other three patients tumor mass was significantly decreased (partial response). Hematological toxicity was observed in three patients and manifested with infections requiring hospitalization. One patient died because of extreme pancytopenia and Candida sepsis, in spite of support with granulocyte colony-stimulating factor. The median time to lowest blood counts was four weeks after Zevalin injection. Acute and non-hematological side-effects were not observed. Our preliminary results confirmed Zevalin as a very effective therapy for patients with refractory or relapsed CD20+ follicular B-cell NHL. One should be aware of hematologic toxicity ; therefore the close follow-up is required.
- Published
- 2007
8. Adjuvant Hysterectomy in Patients After Radiation for Locally Advanced Cervical Cancer: A Single-Center Prospective Longitudinal Study.
- Author
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Nanda S, Nayak B, Senapati SN, Padhy AK, Nayak M, Parija J, Mohapatra J, and Mahapatra M
- Abstract
Introduction: Residual or recurrent cervical cancer post-CCRT is a challenging clinical issue, even though there has been much effort in recent decades to increase patient survival after radiation. There is a paucity of literature regarding the role of hysterectomy in recurrent/residual disease after radiation in LACC patients. Such a procedure is controversial and not routinely performed because of difficulties in obtaining tumor-free margins and the high rate of associated morbidity., Aims and Objectives: Evaluate outcomes and morbidities in patients who had undergone hysterectomy for residual or recurrent disease after radiation in LACC patients., Material and Methods: This is a prospective observational study on radiotherapy-treated LACC patients (IIB-III) with residual disease or recurrent disease who have undergone adjuvant hysterectomy. This study has been conducted at AHPGIC, Cuttack, with a sample size of 30 patients., Results: 18/30 patients underwent extrafascial hysterectomy, and rest 12 patients had radical hysterectomy. No significant difference in complications, achieving tumor free margins or recurrences post adjuvant hysterectomy based on the radicality of surgery was observed. 5 cases of recurrences post-adjuvant hysterectomy were detected. Some of the factors which had significant association with recurrences post adjuvant hysterectomy were non squamous histology, no preoperative brachytherapy, deep stromal invasion and positive surgical margins. Median follow-up time was 14 months (12-27 months)., Conclusion: This study shows that adjuvant hysterectomy is feasible with good outcome and acceptable morbidity after chemoradiotherapy in cervical cancer patients " If selection of patients for adjuvant hysterectomy is appropriate.", Competing Interests: Conflict of interestNone declared., (© Federation of Obstetric & Gynecological Societies of India 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)
- Published
- 2024
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9. Colored wheat and derived products: key to global nutritional security.
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Padhy AK, Kaur P, Singh S, Kashyap L, and Sharma A
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- Plant Breeding, Antioxidants, Nutritional Status, Triticum, Malnutrition
- Abstract
Ensuring food and nutritional security of fast-growing population will pose a huge challenge in future. An estimated one-half population who does not go hungry, nonetheless suffers the debilitating effects of unhealthy diets. In view of the nutritional awareness, when the major wheat breeding programs have started shifting to quality, instead of quantity in wheat, the colored wheats give a novel twist of targeting the malnutrition by enhancing the antioxidants such as anthocyanin, carotenoids, flavonoids, polyphenols etc. Moreover, changing consumer demands have picked the trend to prefer a nutritionally balanced diet over the conventional high energy diets and thus, colored wheat has opened up a hidden avenue for providing additional value to the wheat-based products. Besides providing nutrition, these pigments have the potential to replace the synthetic dyes and food colorants prevalent in the market. The review summarizes the genetics and biochemistry of the pigments of colored wheat along with their product development, nutritional status and consumer preference. The review also sheds light on the environmental effect on color accumulation and the effect of increased colorants on other quality traits of wheat.
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- 2024
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10. Combining high carotenoid, grain protein content and rust resistance in wheat for food and nutritional security.
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Padhy AK, Sharma A, Sharma H, Srivastava P, Singh S, Kaur P, Kaur J, Kaur S, Chhuneja P, and Bains NS
- Abstract
Globally, malnutrition has given birth to an alarming predicament, especially in developing countries, and has extensively shifted consumer preferences from conventional high-energy diets to a nutritionally balanced, cost-effective, sustainable, and healthy lifestyle. In keeping with this view and the mandate for developing high-yielding, disease-resistant biofortified staple food (wheat) for catering to the demand-driven market, the current research aimed at stacking together the enhanced grain protein content, carotenoid content, and disease resistance in an elite bread wheat background. The Y gene ( PsyE1 ) and the GpcB1 gene were used as novel sources for enhancing the grain carotenoid and protein content in the commercial elite bread wheat cultivar HD2967. The combination also led to the stacking of resistance against all three foliar rusts owing to linked resistance genes. A stepwise hybridization using Parent 1 (HD2967 + PsyE1/Lr19/Sr25 ) with Parent 2 (PBW550 + GpcB1/Yr36+ Yr15 ), coupled with a phenotypic-biochemical selection, narrowed down 2748 F
2 individuals to a subset of 649 F2 plants for molecular screening. The gene-specific markers PsyE1, PsyD1, Xucw108 , and Xbarc8 for the genes PsyE1, PsyD1, GpcB1, and Yr15, respectively, were employed for forward selection. Four bread wheat lines positive for all the desired genes with high carotenoid (>8ppm) and protein (>13%) content were raised to the F5 generation and will be evaluated for yield potential after bulking. These improved advanced breeding lines developed following multipronged efforts should prove a valuable and unique source for the development of cultivars with improved nutritional quality and rust resistance in wheat breeding programs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer MPJ declared a shared affiliation with the authors AKP to the handling editor at the time of review., (Copyright © 2023 Padhy, Sharma, Sharma, Srivastava, Singh, Kaur, Kaur, Kaur, Chhuneja and Bains.)- Published
- 2023
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11. Bread wheat with enhanced grain carotenoid content: a novel option for wheat biofortification.
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Padhy AK, Sharma A, Sharma H, Rajput R, Pandey A, Srivastava P, Kaur S, Kaur H, Singh S, Kashyap L, Mavi GS, Kaur J, Sohu VS, Chhuneja P, and Bains NS
- Abstract
Colored wheat has piqued the interest of breeders and consumers alike. The chromosomal segment from 7E of Thinopyrum ponticum , which carries a leaf rust resistant gene, Lr19 , has been rarely employed in wheat breeding operations due to its association with the Y gene, which gives a yellow tint to the flour. By prioritizing nutritional content over color preferences, consumer acceptance has undergone a paradigm change. Through marker-assisted backcross breeding, we introduced an alien segment harboring the Y ( PsyE1 ) gene into a high yielding commercial bread wheat (HD 2967) background to generate rust resistant carotenoid biofortified bread wheat. Agro-morphological characterization was also performed on a subset of developed 70 lines having enhanced grain carotene content. In the introgression lines, carotenoid profiling using HPLC analysis demonstrated a considerable increase in β-carotene levels (up to 12 ppm). Thus, the developed germplasm caters the threat to nutritional security and can be utilized to produce carotenoid fortified wheat., Supplementary Information: The online version contains supplementary material available at 10.1007/s11032-022-01338-0., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer Nature B.V. 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)
- Published
- 2022
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12. Oxidative Addition to the N-C Bond Vs Formation of the Zwitterionic Intermediate in Platinum(II)-Catalyzed Intramolecular Annulation of Alkynes to Form Indoles: Mechanistic Studies and Reaction Scope.
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Patra SR, Sangma SW, Padhy AK, and Bhunia S
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- Catalysis, Cyclization, Indoles chemistry, Oxidative Stress, Solvents, Alkynes chemistry, Platinum chemistry
- Abstract
In this study, Pt(II)-catalyzed intramolecular translocation annulation of ortho -alkynylamides to the formation of indoles is presented, where a proposed intermediacy of zwitterionic intermediate has been substantiated over the oxidative addition. We focused our attention on Pt(II)-catalyzed aminoacylation of alkynes both theoretically and experimentally using low boiling solvent where the formation of deacylation product was suppressed simultaneously. One-step intramolecular [1,3]-acyl migration from the zwitterionic intermediate is highly unlikely, which imparts a high energy barrier of +99.0 kcal mol
-1 . Another possible approach involving oxidative addition to the N-C bond, migratory insertion to alkyne, and subsequent reductive elimination is also explored through DFT studies to justify the reaction consequence. However, based on the computational studies, it is suggested that initial zwitterion formation is highly favored over oxidative addition. We suggest the formation of an acylium intermediate, which can further react with indol-3-ylplatinum species in an intramolecular manner, albeit within the same solvent cage to form 3-acyl indoles.- Published
- 2022
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13. Left sinus of Valsalva aneurysm rupturing into superior vena cava.
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Padhy AK, Sistla CV, and Gupta A
- Subjects
- Aortic Aneurysm diagnostic imaging, Aortic Rupture diagnostic imaging, Aortography methods, Computed Tomography Angiography, Female, Humans, Phlebography methods, Sinus of Valsalva diagnostic imaging, Treatment Outcome, Vascular Fistula diagnostic imaging, Vena Cava, Superior diagnostic imaging, Young Adult, Aortic Aneurysm surgery, Aortic Rupture surgery, Sinus of Valsalva surgery, Vascular Fistula surgery, Vena Cava, Superior surgery
- Published
- 2019
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14. Surgical challenge in situs inversus with dextrocardia and Lutembacher syndrome.
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Jenasamant SS, Jawarkar MV, Srivastava S, Padhy AK, and Geelani MA
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- Adult, Dextrocardia diagnostic imaging, Female, Heart Septal Defects, Atrial complications, Heart Septal Defects, Atrial diagnostic imaging, Heart Septal Defects, Atrial surgery, Humans, Lutembacher Syndrome diagnostic imaging, Mitral Valve Stenosis diagnostic imaging, Mitral Valve Stenosis etiology, Situs Inversus diagnostic imaging, Tomography, X-Ray Computed, Treatment Outcome, Dextrocardia complications, Heart Valve Prosthesis Implantation, Lutembacher Syndrome complications, Mitral Valve Annuloplasty, Mitral Valve Stenosis surgery, Situs Inversus complications
- Abstract
Situs inversus with dextrocardia and Lutembacher syndrome is a rare cardiac anomaly. It is associated with other complex cardiac anomalies and anatomical defects. A 30-year-old woman with this condition underwent mitral valve replacement and closure of a secundum atrial septal defect. We describe the surgical approach, position of the surgeon, and bicaval cannulation technique for this anatomical aberration.
- Published
- 2018
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15. Cor triatriatum sinistrum presenting in adulthood.
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Padhy AK, Jhajhria NS, and Gupta A
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- Adult, Echocardiography, Transesophageal, Humans, Male, Treatment Outcome, Cor Triatriatum diagnosis, Cor Triatriatum surgery
- Published
- 2016
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16. Spontaneous pneumomediastinum: A complication of swine flu.
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Padhy AK, Gupta A, Aiyer P, Jhajhria NS, Grover V, and Gupta VK
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- Adult, Antiviral Agents therapeutic use, Chest Tubes, Drainage instrumentation, Humans, Influenza A Virus, H1N1 Subtype drug effects, Influenza, Human complications, Influenza, Human diagnosis, Influenza, Human therapy, Male, Mediastinal Emphysema diagnosis, Mediastinal Emphysema therapy, Pleural Effusion virology, Pneumonia, Bacterial microbiology, Subcutaneous Emphysema virology, Tomography, X-Ray Computed, Treatment Outcome, Influenza A Virus, H1N1 Subtype isolation & purification, Influenza, Human virology, Mediastinal Emphysema virology
- Abstract
The occurrence of spontaneous pneumomediastinum in swine flu, or H1N1 influenza A infection, is a rare phenomenon and only few cases have been reported in children. We describe a case of spontaneous pneumomediastinum in adult infected with swine flu., (© The Author(s) 2015.)
- Published
- 2015
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17. Radioiodine Remnant Ablation: A Critical Review.
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Bal CS and Padhy AK
- Abstract
Radioiodine remnant ablation (RRA) is considered a safe and effective method for eliminating residual thyroid tissue, as well as microscopic disease if at all present in thyroid bed following thyroidectomy. The rationale of RRA is that in the absence of thyroid tissue, serum thyroglobulin (Tg) measurement can be used as an excellent tumor marker. Other considerations are like the presence of significant remnant thyroid tissue makes detection and treatment of nodal or distant metastases difficult. Rarely, microscopic disease in the thyroid bed if not ablated, in the future, could be a source of anaplastic transformation. On the other hand, microscopic tumor emboli in distant sites could be the cause of distant metastasis too. The ablation of remnant tissue would in all probability eliminate these theoretical risks. It may be noted that all these are unproven contentious issues except postablation serum Tg estimation that could be a good tumor marker for detecting early biochemical recurrence in long-term follow-up strategy. Radioactive iodine is administered as a form of "adjuvant therapy" for remnant ablation. There have been several reports with regard to the administered dose for remnant ablation. The first report of a prospective randomized clinical trial was published from India by a prospective randomized study conducted at the All India Institute of Medical Sciences, New Delhi in the year 1996. The study reported that increasing the empirical (131)I initial dose to more than 50 mCi results in plateauing of the dose-response curve and thus, conventional high-dose remnant ablation needs critical evaluation. Recently, two important studies were published: One from French group and the other from UK on a similar line. Interestingly, all three studies conducted in three different geographical regions of the world showed exactly similar conclusion. The new era of low-dose remnant ablation has taken a firm scientific footing across the continents.
- Published
- 2015
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18. Extraosseous uptake of technetium-99m methylene diphosphonate by an acute territorial cerebral infarct in a classical biodistribution pattern.
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Kannivelu A, Padhy AK, Srinivasan S, and Ali SZ
- Abstract
Technetium-99m methylene diphosphonate scintigraphy is usually performed to assess bone lesions, especially skeletal metastases in patients with a history of malignancy. However, it is important to recognize some specific conditions with a unique pattern of tracer uptake, especially in extraosseous locations as they are not related to primary neoplasm or metastases. Diagnosing such unusual presentation is essential as it significantly influences the clinical management. This case report describes an unusual presentation detected in a bone scan of an elderly female patient, who was a treated case of breast cancer and was referred for a bone scan to rule out bone metastases. Incidentally, a large acute territorial cerebral infarct was diagnosed, which was later confirmed by magnetic resonance imaging on diffusion-weighted images. Diagnosis of the typical presentation and timely management saved the patient life.
- Published
- 2013
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19. Incidental detection of clinically nondiagnosed inguinal hernia in (131)I whole-body scan.
- Author
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Kannivelu A, Magsombol B, and Padhy AK
- Subjects
- Humans, Iodine Radioisotopes, Male, Middle Aged, Radionuclide Imaging, Whole Body Imaging, Hernia, Inguinal diagnostic imaging, Incidental Findings
- Abstract
I whole-body bone scan was performed for an adult male patient after postradioactive iodine ablation of thyroid carcinoma. Besides the small thyroid remnants in the neck region, an incidental detection of left inguinal hernia was made in the scan, which was later confirmed by clinical examination. Despite the large size of the hernia, the patient was unaware of the condition. It can be concluded that, similar to other imaging procedures, incidental detection of unrelated clinical problems is possible in I scan also, and such early diagnosis prevents further complications that the patient may develop in the future.
- Published
- 2013
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20. Good bye general.
- Author
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Padhy AK
- Published
- 2013
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21. Potential requirement of positron emission tomography apparatuses in Asia and latin america including Mexico.
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Watanabe N, Padhy AK, Oku S, and Sasaki Y
- Abstract
The number of positron emission tomography (PET) machines has been increasing in regions of East-, Southeast-, and South-Asia as well as in Latin America including Mexico. This study was performed to assess the potential requirement of PET machines in 19 countries which already use PET in the aforementioned regions. Data on the number of PET machines and internationally available characteristics of the restrictive countries such as the land area, the total population, the gross national income (GNI), and the average life span of inhabitants were obtained from IAEA, UN, WB, and WHO. Correlation between the number of PET machines and the characteristics of each country was evaluated. The potentially required number of PET machines, which was obtained by adjusting the number of PET machines with statistically significant, correlative characteristics of each country, standardized on the state of Japan, were compared. The number of PET machines could be significantly correlated to the GNI of a country and the average life span of its inhabitants (P < 0.05). Based on Japan, most of the countries in the regions would require considerably more PET machines. With installation of the potentially required number of PET machines in each of the countries, the number of PET machine per 10(6) population would increase by 1.1- to 12-fold, in comparison with the current situation. With regards to the potentially required number of PET machines, most of the countries in these regions may require a considerable increase of PET machines. Nevertheless, some countries in the Asia seem to require outside assistance such as international support in order to introduce PET and enhance the efficacy of their health services.
- Published
- 2013
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22. Controversies about radioactive iodine-131 remnant ablation in low risk thyroid cancers: are we near a consensus?
- Author
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Zaman MU, Fatima N, Padhy AK, and Zaman U
- Subjects
- Humans, Neoplasm Recurrence, Local prevention & control, Randomized Controlled Trials as Topic, Risk, Iodine Isotopes administration & dosage, Iodine Isotopes adverse effects, Thyroid Neoplasms etiology
- Abstract
Well differentiated thyroid cancers (WDTC), including papillary (80%) and follicular (10%) types, are the most common endocrine cancers globally. Over the last few decades most the diagnosed cases have fallen into low risk categories. Radioactive iodine-131 (RAI) has an established role in reducing recurrence and improving the survival in high risk patients. In patients with primary tumor size <1 cm, RAI is not recommended by many thyroid societies. However, low risk WDTC has been an arena of major controversies, most importantly the role and dose of adjuvant RAI for remnant ablation to minimize chances of recurrence and improving survival. This review is an attempt to update readers about the previous and existing practice based on results of non- randomized trials and evolving trends fueled by recently published randomized studies.
- Published
- 2013
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23. Thyroid incidentalomas on fluorine-18-fluorodeoxyglucose positron emission tomography-computed tomography: incidence, malignancy risk, and comparison of standardized uptake values.
- Author
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Kao YH, Lim SS, Ong SC, and Padhy AK
- Subjects
- Female, Fluorodeoxyglucose F18, Humans, Incidental Findings, Male, Predictive Value of Tests, Retrospective Studies, Statistics, Nonparametric, Thyroid Neoplasms epidemiology, Multimodal Imaging, Positron-Emission Tomography, Radiopharmaceuticals, Thyroid Neoplasms diagnostic imaging, Tomography, X-Ray Computed
- Abstract
Introduction: To determine the incidence of fluorine-18-fluorodeoxyglucose (FDG) avid thyroid incidentalomas detected on positron emission tomography (PET) with integrated computed tomography (CT), and correlate the FDG-PET-CT findings to cytology., Methods: A total of 942 FDG-PET-CT reports were retrospectively reviewed. Patients with FDG-avid thyroid incidentalomas were further reviewed for correlative cytology., Results: The incidence of FDG-avid thyroid incidentalomas is 2.2%. Thyroid malignancies were identified in 3 of 6 patients who underwent cytologic correlation, with a positive predictive value of 50% (95% confidence interval, 14%-86%). The mean maximum standardized uptake values of benign and malignant FDG-avid thyroid incidentalomas were 5.6 and 6.6, respectively., Conclusion: A FDG-avid thyroid incidentaloma may predict underlying malignancy. Cytologic assessment should be considered for FDG-avid thyroid incidentalomas., (Copyright © 2012 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
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24. When was the Last Time You did Something for the First Time?
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Padhy AK
- Published
- 2012
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25. Unusual presentation of extraosseous metastases on bone scintigraphy.
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Xie W, Padhy AK, and Wong WY
- Subjects
- Bone Neoplasms diagnostic imaging, Female, Humans, Knee diagnostic imaging, Radionuclide Imaging, Technetium Tc 99m Medronate, Tomography, X-Ray Computed, Young Adult, Bone Neoplasms secondary, Bone and Bones diagnostic imaging
- Abstract
Osteosarcoma metastases frequently occur in the lungs or the skeleton. Bone scans play an important role in disease staging by identifying other skip areas of skeletal involvement as well as extraosseous metastases. We report a case of aggressive osteosarcoma, with bone metastases and extraosseous areas of involvement in the lungs, distant lymph nodes, and peritoneal and subcutaneous metastasis seen in a preoperative Tc-99m methylene diphosphonate bone scan. These findings were confirmed with histology and correlative cross-sectional imaging.
- Published
- 2012
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26. "Crossed renal ectopia".
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Lu SJ, Lim CY, and Padhy AK
- Subjects
- Aged, Diagnosis, Differential, Humans, Kidney diagnostic imaging, Liposarcoma diagnosis, Liposarcoma surgery, Male, Radiography, Radioisotope Renography, Retroperitoneal Neoplasms diagnosis, Retroperitoneal Neoplasms surgery, Kidney abnormalities
- Published
- 2012
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27. The density factor: the enigma of dense breast.
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Padhy AK, Kok TY, and Ng D
- Published
- 2012
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28. The Conundrum of PET/MR.
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Kannivelu A, Kok TY, and Padhy AK
- Published
- 2012
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29. Umbilical metastatic deposit from recurrent cholangiocarcinoma: F18-FDG PET-CT findings.
- Author
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Tan ML and Padhy AK
- Subjects
- Aged, Cholangiocarcinoma diagnosis, Cholangiocarcinoma diagnostic imaging, Contrast Media pharmacology, Female, Humans, Neoplasm Metastasis, Prognosis, Recurrence, Soft Tissue Neoplasms diagnosis, Soft Tissue Neoplasms diagnostic imaging, Umbilicus, Cholangiocarcinoma pathology, Fluorodeoxyglucose F18 pharmacology, Positron-Emission Tomography methods, Soft Tissue Neoplasms pathology, Tomography, X-Ray Computed methods
- Abstract
A 69-year-old woman was diagnosed with stage IIIA advanced Type IV Klatskin cholangiocarcinoma, which was treated with radical choledochectomy, extended right hepatectomy and left hepaticojejunostomy. About six months after surgery, she presented with painless jaundice. A 2-18F-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography (F18-FDG PET-CT) was performed, which detected an FDG-avid umbilical metastatic nodule. We describe the F18-FDG PET-CT features of umbilical metastatic nodule in recurrent cholangiocarcinoma. It is sometimes difficult to detect the lesions when they present with non-specific soft tissue thickening on routine CT imaging. F18-FDG PET-CT would probably render these lesions easier to detect and interpret.
- Published
- 2011
30. Dosimetric considerations in radioimmunotherapy and systemic radionuclide therapies: a review.
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Loke KS, Padhy AK, Ng DC, Goh AS, and Divgi C
- Abstract
Radiopharmaceutical therapy, once touted as the "magic bullet" in radiation oncology, is increasingly being used in the treatment of a variety of malignancies; albeit in later disease stages. With ever-increasing public and medical awareness of radiation effects, radiation dosimetry is becoming more important. Dosimetry allows administration of the maximum tolerated radiation dose to the tumor/organ to be treated but limiting radiation to critical organs. Traditional tumor dosimetry involved acquiring pretherapy planar scans and plasma estimates with a diagnostic dose of intended radiopharmaceuticals. New advancements in single photon emission computed tomography and positron emission tomography systems allow semi-quantitative measurements of radiation dosimetry thus allowing treatments tailored to each individual patient.
- Published
- 2011
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31. Welcome to saigon.
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Padhy AK
- Published
- 2011
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32. Pancreatic metastasis detected by F-18 FDG PET/CT in a patient with breast cancer.
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Lam WW, Loke KS, Loi HY, and Padhy AK
- Subjects
- Adult, Female, Humans, Pancreatic Neoplasms pathology, Pancreatic Neoplasms physiopathology, Breast Neoplasms pathology, Fluorodeoxyglucose F18, Pancreatic Neoplasms diagnosis, Pancreatic Neoplasms secondary, Positron-Emission Tomography, Tomography, X-Ray Computed
- Abstract
Pancreatic involvement by metastasis from other primaries is rare and accounts for approximately 2% to 4% of pancreatic tumors. In this article, we describe FDG-avid pancreatic involvement in a patient with diagnosis of breast cancer. We conclude that FDG PET can be a convenient noninvasive method of early detection of recurrence and in monitoring metastatic disease during follow-up in such patients. A positive FDG PET warrants histopathologic correlation for appropriate treatment.
- Published
- 2011
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33. Butterfly lesion of the corpus callosum: an unusual case of extramedullary myeloid sarcoma (granulocytic sarcoma).
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Kei PL, Kok TY, Linn YC, and Padhy AK
- Subjects
- Corpus Callosum diagnostic imaging, Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Positron-Emission Tomography, Sarcoma, Myeloid diagnostic imaging, Tomography, X-Ray Computed, Corpus Callosum pathology, Sarcoma, Myeloid diagnosis, Sarcoma, Myeloid pathology
- Published
- 2011
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34. Differentiating suspected nasopharyngeal infection from carcinoma using dual-tracer and multiple time-point technetium-99m sestamibi and white blood cell SPECT/CT imaging.
- Author
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Tan AE, Thang SP, and Padhy AK
- Subjects
- Aged, Diagnosis, Differential, Humans, Male, Radiography, Radiopharmaceuticals, Leukocytes diagnostic imaging, Nasopharyngeal Neoplasms diagnostic imaging, Nasopharyngitis diagnostic imaging, Technetium Tc 99m Sestamibi, Tomography, Emission-Computed methods, Tomography, Emission-Computed, Single-Photon methods
- Abstract
The role of molecular and functional imaging lies in its capability to more accurately define and characterize pathologies, with a host of varied radiotracers and techniques being available to the clinician for use. We present a case in which dual-tracer and multiple time-point single photon emission computed tomography/computed tomography imaging using technetium-99m sestamibi and white blood cell radiotracers was used to characterize an indeterminate base of skull lesion.
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- 2011
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35. [18F] FDG PET/CT in patients with fever of unknown origin: a local experience.
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Kei PL, Kok TY, Padhy AK, Ng DC, and Goh AS
- Subjects
- Aged, Databases, Factual, Female, Humans, Male, Middle Aged, Retrospective Studies, Fever of Unknown Origin diagnostic imaging, Fluorodeoxyglucose F18, Positron-Emission Tomography, Tomography, X-Ray Computed
- Abstract
Objective: 2-deoxy-2-[¹⁸F]fluoro-D-glucose positron emission tomography/computed tomography ([¹⁸F] FDG PET/CT) has become an established imaging tool in oncology and is now emerging in the field of infectious disease. The aim of this study is to assess the value of fluorine [¹⁸F] FDG PET/CT in the investigation of patients with fever of unknown origin (FUO)., Methods: [¹⁸F] FDG PET/CT scans and clinical data of 12 patients were reviewed. These patients met the revised definition criteria of FUO (febrile illness of greater than 3 weeks duration, temperature greater than 38.3°C and no diagnosis after at least 3 days of in-patient investigation or 2 weeks of outpatient investigation). A retrospective analysis of our local database was performed and evaluated for the diagnostic contribution of [¹⁸F] FDG PET/CT scans., Results: An infective cause of the FUO was found in four (33.3%) patients, a neoplasm in two (16.7%) patients, non-infectious inflammatory disease or autoimmune in one (8.3%) patient. A definitive causative agent could not be found in five (41.7%) patients despite extensive investigations.In all, five (41.6%) patients had a PET/CT scan that was abnormal and was deemed 'helpful' as part of the investigation that pointed to the final diagnosis. Two (16.7%) patients had abnormal scans, which were deemed 'not-helpful' for the final diagnosis., Conclusion: [¹⁸F] FDG PET/CT can be helpful in some patients with FUO. This study adds value to the limited data published so far on this subject.
- Published
- 2010
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36. Intensely hypermetabolic extra-axial brainstem tumor in Erdheim-Chester disease.
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Tan IB, Padhy AK, Thng CH, Osmany S, Magsombol B, Ho YH, Tham CK, Quek R, Tao M, and Lim ST
- Subjects
- Brain Stem Neoplasms diagnostic imaging, Brain Stem Neoplasms metabolism, Erdheim-Chester Disease diagnostic imaging, Erdheim-Chester Disease metabolism, Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Positron-Emission Tomography, Tomography, X-Ray Computed, Brain Stem Neoplasms complications, Erdheim-Chester Disease complications
- Abstract
Erdheim-Chester disease is a rare non-Langerhans cell histiocytosis characterized by progressive histiocytic proliferation with multiorgan involvement, typically of the kidney, skin, brain, and lung, and less frequently, the heart and retro-orbital tissue. Fluorine-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) plays an important role in the management of this disease. It has been reported that FDG PET imaging allows accurate evaluation of the extent of the disease at baseline, as well as assessment of response to any specific therapy. In this case, a 57-year-old Chinese man presented with functional decline and a urinary tract infection. He had a prior history of xanthogranulomas of bilateral canthal masses. On imaging, he was found to have left hydronephrosis, diffuse urothelial thickening, increased density of the perinephric fat, mural thickening of the descending aorta and soft tissue masses along the posterior wall of the right atrium extending into the region of the interatrial septum and involving the right atrioventricular groove. Histopathology revealed retroperitoneal fibrosis. An IV contrast-enhanced FDG PET scan showed increased activity in a previously unidentified brain stem mass and the shafts of bilateral femora. Varying levels of FDG uptake were seen in the other lesions.
- Published
- 2009
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37. International Atomic Energy Agency-sponsored multination study of intra-arterial rhenium-188-labeled lipiodol in the treatment of inoperable hepatocellular carcinoma: results with special emphasis on prognostic value of dosimetric study.
- Author
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Bernal P, Raoul JL, Stare J, Sereegotov E, Sundram FX, Kumar A, Jeong JM, Pusuwan P, Divgi C, Zanzonico P, Vidmar G, Buscombe J, Chau TT, Saw MM, Chen S, Ogbac R, Dondi M, and Padhy AK
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Injections, Intra-Arterial, International Agencies, Male, Middle Aged, Nuclear Energy, Prognosis, Radioisotopes therapeutic use, Radiotherapy Planning, Computer-Assisted, Rhenium therapeutic use, Carcinoma, Hepatocellular radiotherapy, Iodized Oil administration & dosage, Liver Neoplasms radiotherapy, Radioisotopes administration & dosage, Rhenium administration & dosage
- Abstract
A multicenter study was sponsored by the International Atomic Energy Agency (IAEA) to assess the safety and efficacy of transarterial rhenium-188 ((188)Re) HDD lipiodol (radioconjugate to lipiodol using an HDD kit) in the treatment of unresectable hepatocellular carcinoma. During 5 years, 185 patients received at least 1 treatment of radioconjugate, and 51 were retreated. The level of radioconjugate administered was based on radiation-absorbed dose to critical normal organs, calculated after a "scout" dose of radioconjugate. The total injected activity, including the scout dose during the first treatment, ranged from 21 to 364 mCi (mean, 108 mCi/4 GBq). Immediate and late side-effects were minimal. Tumor size could be evaluated in 88 patients. Among these patients, the objective response rate was 25%; stable disease was observed in 53% and tumor progression in 22%. With a median follow-up of 455 days, the estimated 12- and 24-month overall survival was 46% and 23%. This multicenter study shows that (188)Re lipiodol is a safe and cost-effective method to treat primary hepatocellular carcinoma via the transarterial route and requires further evaluation by treatment of greater numbers of patients.
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- 2008
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38. Detection of thyroid metastases from nasopharyngeal carcinoma with F-18 FDG PET/CT.
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Osmany S, Padhy AK, and Ng DC
- Subjects
- Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Radiopharmaceuticals, Thyroid Neoplasms secondary, Tomography, Emission-Computed, Tomography, X-Ray Computed, Nasopharyngeal Neoplasms pathology, Thyroid Neoplasms diagnostic imaging
- Published
- 2008
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39. Thematic planning: the role of the International Atomic Energy Agency in promoting education, medical research, and technology transfer among nuclear medicine communities of developing countries.
- Author
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Padhy AK and Dondi M
- Subjects
- Developing Countries, Education, Graduate, Research, Technology Transfer, International Agencies, Nuclear Energy, Nuclear Medicine education
- Abstract
One of the major mechanisms of implementing the International Atomic Energy Agency's (IAEA) programs in nuclear medicine has been through coordinated research projects (CRPs). In recent years, the IAEA has initiated a new type of CRP, called Doctoral CRP, in an attempt to further improve the effectiveness of its programs. The structure of the Doctoral CRP has been built on the structure of the existing CRP concept, but with a broader "thematic" approach. The word "thematic" indicates that these CRPs should both have a fairly broad scope and be designed so that their outcome, in terms of practical applications, might readily fit into the selected nuclear applications that are offered to Member States under the IAEA's mechanism for thematic planning. The Nuclear Medicine Section of IAEA's Division of Human Health initiated the first Doctoral CRP of IAEA in the year 2000, entitled, "Management of Liver Cancer Using Radionuclide Methods with Special Emphasis on Trans-Arterial Radio-conjugate Therapy and Internal Dosimetry." Since then, the CRP has accomplished several milestones, including development of a new therapeutic radiopharmaceutical ((188)Re lipiodol) and successfully carrying out Phase I and Phase II clinical trials on patients using the new therapeutic radiopharmaceutical.
- Published
- 2008
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40. Role of Tc-99m DMSA (V) scanning and serum calcitonin monitoring in the management of medullary thyroid carcinoma.
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Howe TC, Padhy AK, Loke K, Magsombol B, Ng D, and Goh A
- Subjects
- Adult, Aged, Carcinoma, Medullary pathology, Disease-Free Survival, Female, Humans, Male, Medical Oncology methods, Middle Aged, Thyroid Neoplasms pathology, Thyroidectomy, Treatment Outcome, Calcitonin analysis, Carcinoma, Medullary diagnosis, Radiopharmaceuticals pharmacology, Technetium Tc 99m Dimercaptosuccinic Acid pharmacology, Thyroid Neoplasms diagnosis
- Abstract
Introduction: Medullary thyroid carcinoma (MTC) is a rare disease. Serum calcitonin levels and Tc-99m DMSA (V) scans are used in the follow-up of these patients after surgical resection. We present our experience in the follow-up of these patients at a tertiary institution., Methods: A retrospective review of the medical records was performed. Patients with histologically-proven MTC, and who had serum calcitonin assays and DMSA (V) scans in their postoperative follow-up, were included., Results: There were 17 patients with 56 DMSA (V) scans. Four out of seven patients with elevated preoperative calcitonin measurements had calcitonin normalisation within six months of surgery, and have remained disease-free. Two patients had persistently elevated calcitonin levels after six months, which predated positive DMSA (V) scans. Results of DMSA (V) scans and serum calcitonin levels were concordant in 38 of 48 instances (79.2 percent) and discordant in 10 of 48 instances (20.8 percent). Sensitivity of DMSA (V) scans for detecting recurrence was 71.4 percent. There were no false-positive scans., Conclusion: Serum calcitonin level is a sensitive and specific indicator of disease recurrence in postoperative follow-up of patients with MTC. Early (within six months) normalisation of calcitonin levels postsurgery may predict subsequent disease-free status. Discordant results between serum calcitonin levels and DMSA (V) scans may be due to undetectable lesions and follow-up scans or alternative radionuclide imaging may be required.
- Published
- 2008
41. Intra-arterial rhenium-188 lipiodol in the treatment of inoperable hepatocellular carcinoma: results of an IAEA-sponsored multination study.
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Bernal P, Raoul JL, Vidmar G, Sereegotov E, Sundram FX, Kumar A, Jeong JM, Pusuwan P, Divgi C, Zanzonico P, Stare J, Buscombe J, Minh CT, Saw MM, Chen S, Ogbac R, and Padhy AK
- Subjects
- Adult, Aged, Aged, 80 and over, Bilirubin blood, Biomarkers blood, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular pathology, Female, Humans, Injections, Intra-Arterial, Iodized Oil adverse effects, Liver Cirrhosis complications, Liver Cirrhosis mortality, Liver Neoplasms mortality, Liver Neoplasms pathology, Male, Maximum Tolerated Dose, Middle Aged, Radioisotopes adverse effects, Regression Analysis, Remission Induction, Rhenium adverse effects, Statistics, Nonparametric, Carcinoma, Hepatocellular radiotherapy, Iodized Oil administration & dosage, Liver Neoplasms radiotherapy, Radioisotopes administration & dosage, Rhenium administration & dosage
- Abstract
Purpose: Intra-arterial injections (IAI) of 131I-lipiodol is effective in treating hepatocellular carcinoma patients, but is expensive and requires a 7-day hospitalization in a radioprotection room. 188Re is inexpensive, requires no patient isolation, and can be used with lipiodol., Methods and Materials: This International Atomic Energy Agency-sponsored phase II trial aimed to assess the safety and the efficacy of a radioconjugate 188Re + lipiodol (188Re-Lip) in a large cohort of hepatocellular carcinoma patients from developing countries. A scout dose is used to determine the maximal tolerated dose (lungs <12 Gy, normal liver <30 Gy, bone marrow <1.5 Gy) and then the delivery of the calculated activity. Efficacy was assessed using response evaluation criteria in solid tumor (RECIST) and alpha-feto-protein (alpha FP) levels and severe adverse events were graded using the Common Toxicity Criteria of the National Cancer Institute scale v2.0., Results: The trial included 185 patients from eight countries. The procedure was feasible in all participating centers. One treatment was given to 134 patients; 42, 8, and 1 received two, three, and four injections, respectively. The injected activity during the first treatment was 100 mCi. Tolerance was excellent. We observed three complete responses and 19 partial responses (22% of evaluable patients, 95% confidence interval 16-35%); 1- and 2-year survivals were 46% and 23%. Some factors affected survival: country of origin, existence of a cirrhosis, Cancer of the Liver Italian Program score, tumor dose, absence of progression, and posttreatment decrease in alpha FP level., Conclusions: IAI of 188Re-Lip in developing countries is feasible, safe, cost-effective, and deserves a phase III trial.
- Published
- 2007
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42. Planar Tc99m--sestamibi scintimammography should be considered cautiously in the axillary evaluation of breast cancer protocols: results of an international multicenter trial.
- Author
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Massardo T, Alonso O, Llamas-Ollier A, Kabasakal L, Ravishankar U, Morales R, Delgado L, and Padhy AK
- Abstract
Background: Lymph node status is the most important prognostic indicator in breast cancer in recently diagnosed primary lesion. As a part of an interregional protocol using scintimammography with Tc99m compounds, the value of planar Tc99m sestamibi scanning for axillary lymph node evaluation is presented. Since there is a wide range of reported values, a standardized protocol of planar imaging was performed., Methods: One hundred and forty-nine female patients were included prospectively from different regions. Their mean age was 55.1 +/- 11.9 years. Histological report was obtained from 2.987 excised lymph nodes from 150 axillas. An early planar chest image was obtained at 10 min in all patients and a delayed one in 95 patients, all images performed with 740-925 MBq dose of Tc99m sestamibi. Blind lecture of all axillary regions was interpreted by 2 independent observers considering any well defined focal area of increased uptake as an involved axilla. Diagnostic values, 95% confidence intervals [CI] and also likelihood ratios (LR) were calculated., Results: Node histology demonstrated tumor involvement in 546 out of 2987 lymph nodes. Sestamibi was positive in 30 axillas (25 true-positive) and negative in 120 (only 55 true-negative). The sensitivity corresponded to 27.8% [CI = 18.9-38.2] and specificity to 91.7% [81.6-97.2]. The positive and negative LR were 3.33 and 0.79, respectively. There was no difference between early and delayed images. Sensitivity was higher in patients with palpable lesions., Conclusion: This work confirmed that non tomographic Tc99m sestamibi scintimammography had a very low detection rate for axillary lymph node involvement and it should not be applied for clinical assessment of breast cancer.
- Published
- 2005
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43. Relationship between acute pyelonephritis, renal scarring, and vesicoureteral reflux. Results of a coordinated research project.
- Author
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Orellana P, Baquedano P, Rangarajan V, Zhao JH, Eng ND, Fettich J, Chaiwatanarat T, Sonmezoglu K, Kumar D, Park YH, Samuel AM, Sixt R, Bhatnagar V, and Padhy AK
- Subjects
- Acute Disease, Adolescent, Child, Child, Preschool, Cicatrix etiology, Demography, Female, Humans, Incidence, Infant, Male, Prospective Studies, Renal Insufficiency etiology, Pyelonephritis etiology, Renal Insufficiency epidemiology, Urinary Tract Infections complications, Vesico-Ureteral Reflux complications
- Abstract
Acute pyelonephritis (APN) may produce permanent renal damage (PRD), which can subsequently lead to diverse complications. We prospectively evaluated 147 females and 122 males (mean age 3.5 years) with APN in order to analyze the relationship between the presence of PRD, at the time of cortical renal scintigraphy, and age, gender, episodes of urinary tract infection (UTI), and presence of vesicoureteral reflux (VUR). There were 152 children studied after the first proven UTI. VUR was present in 150 children. PRD was observed in 170 children. There were no significant differences between boys and girls. PRD was found in 36.4% of children younger than 1 year and in 70.1% of those older than 1 year ( P<0.0001). Of children with VUR, 72% had PRD compared with 52% of children without VUR ( P<0.0001). Of children with a first episode of UTI, 55.9% developed PRD as did 72.6% of those with recurrent UTI ( P=0.004). Our results showed that PRD in children with APN is important, especially in the presence of VUR, recurrent UTI, and older age.
- Published
- 2004
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44. Preliminary results of transarterial rhenium-188 HDD lipiodol in the treatment of inoperable primary hepatocellular carcinoma.
- Author
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Sundram F, Chau TC, Onkhuudai P, Bernal P, and Padhy AK
- Subjects
- Adult, Aged, Colombia epidemiology, Feeding and Eating Disorders etiology, Female, Fever etiology, Humans, Iodized Oil adverse effects, Male, Middle Aged, Mongolia epidemiology, Pilot Projects, Radiopharmaceuticals adverse effects, Radiopharmaceuticals therapeutic use, Rhenium adverse effects, Singapore epidemiology, Survival Analysis, Treatment Outcome, Vietnam epidemiology, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular radiotherapy, Infusions, Intra-Arterial methods, Iodized Oil administration & dosage, Liver Neoplasms mortality, Liver Neoplasms radiotherapy, Rhenium administration & dosage
- Abstract
A multicentre study was sponsored by the International Atomic Energy Agency (Vienna) to assess the safety and efficacy of trans-arterial rhenium-188 HDD conjugated lipiodol (radioconjugate) in the treatment of patients with inoperable hepatocellular carcinoma (HCC). The radioconjugate was prepared by using an HDD (4-hexadecyl 1-2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol) kit developed in Korea, and lipiodol. Over a period of 18 months, 70 patients received at least one treatment of radioconjugate. Some patients were re-treated if there was no evidence of disease progression. The level of radioconjugate administered was based on radiation-absorbed dose to critical normal organs, calculated following a "scout" dose of radioconjugate. The organs at greatest risk for radiation toxicity are the normal liver, the lung and the bone marrow. An Excel spreadsheet was used to determine maximum tolerated activity (MTA), defined as the amount of radioactivity calculated to deliver no more than 12 Gy to lungs, or 30 Gy to liver, or 1.5 Gy to bone marrow. These doses have been found to be safe in multiple trials using external beam therapy, but this has not been confirmed for systemically administered radiopharmaceuticals. Patients were followed for at least 12 weeks after therapy, until recovery from all toxicity. The clinical parameters evaluated included toxicity, response as determined by contrast-enhanced computed tomography, palliation of symptoms, overall survival, performance status (Karnofsky) and hepatic function (Child's classification). Liver function tests, serum alpha-fetoprotein (AFP) levels and complete blood counts were done at each follow-up visit. In the majority of patients, the scout dose studies indicated the radiation absorbed dose to normal liver to be the limiting factor to the treatment dose, while in a few patients dose to lung was the limiting factor. Radiation dose to bone marrow was negligible and was thus not a factor for the MTA calculations. Side-effects were minimal and usually presented as loss of appetite, right hypochondrial discomfort and low-grade fever, even at high levels of administered radioactivity. The symptoms resolved with simple supportive therapy within 3 days of onset. Liver function tests at 24 and 72 h showed no significant changes and complete blood counts at 1 week, 4 weeks and 12 weeks showed no changes (no bone marrow suppression). Sixteen patients were treated in the dose escalation phase of the study, when the activities administered started at 1.8 GBq (50 mCi) and rose to 7.7 GBq (206 mCi). In the efficacy phase of the study a further 54 patients were treated. Both groups of patients are included in this paper. The treatment activity of 188Re-lipiodol administered transarterially ranged from 1.8 to 9.8 GBq (50-265 mCi), with a mean activity of 4.6 GBq (124 mCi). Survival at 3 months was 90%, and at 6 months, 60%; 19% survived for 1 year. Mean survival after treatment in the total treated group of 70 patients was 9.5 months, with a range of 1-18 months. The results of this multicentre study show that 188Re-lipiodol is a safe and cost-effective method to treat primary HCC via the transarterial route. In terms of efficacy, it is potentially a new therapeutic approach for further evaluation by treatment of larger numbers of patients.
- Published
- 2004
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45. Scintigraphic patterns of lymphocele in post-renal transplant.
- Author
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Kumar R, Bharathi Dasan J, Choudhury S, Guleria S, Padhy AK, and Malhotra A
- Subjects
- Humans, Kidney Diseases surgery, Predictive Value of Tests, Radioisotope Renography, Radiopharmaceuticals, Retrospective Studies, Kidney Diseases diagnostic imaging, Kidney Transplantation adverse effects, Lymphocele diagnostic imaging, Lymphocele etiology, Technetium Tc 99m Pentetate
- Abstract
Lymphocele is a common cause of fluid collection in post-renal transplant patients. Most of these patients are routinely followed up with 99mTc diethylenetriaminepentaacetate renal dynamic scintigraphy. The present study retrospectively reviews the range of findings with renal dynamic scintigraphy in documented lymphoceles. A lymphocele was diagnosed when there was a pelvic collection on ultrasonography with a similar biochemical composition to plasma. Four types of scintigraphy patterns were noted in lymphocele in a total of 13 patients. In nine patients there was an initial photopenic area, which progressively filled up with tracer activity equal to that of the background level in delayed images. In two other patients, the activity in the initial photopenic area exceeded the background activity in delayed images. A persistently photopenic area was seen in early and delayed images in the two remaining patients. In addition, a rim of increased tracer activity was noted surrounding the photopenic area in four patients in the early images. In conclusion, an initial photopenic area (with or without a surrounding rim of increased tracer activity), which fills up with tracer in delayed images seems to be the most common pattern seen in lymphoceles in scintigraphic studies of renal transplants. The presence of a rim sign may add confidence to the reporting of a collection as a lymphocele.
- Published
- 2003
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46. Effect of inhalation of salbutamol, beclomethasone dipropionate & ipratropium bromide on mucociliary clearance in some patients with chronic stable bronchial asthma.
- Author
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Guleria R, Singh TR, Sinha S, Padhy AK, Gupta K, and Pande JN
- Subjects
- Administration, Inhalation, Adult, Albuterol therapeutic use, Anti-Asthmatic Agents therapeutic use, Asthma drug therapy, Beclomethasone therapeutic use, Bronchodilator Agents therapeutic use, Humans, Ipratropium therapeutic use, Middle Aged, Placebos, Radionuclide Imaging, Albuterol pharmacology, Anti-Asthmatic Agents pharmacology, Asthma physiopathology, Beclomethasone pharmacology, Bronchodilator Agents pharmacology, Ipratropium pharmacology, Mucociliary Clearance drug effects
- Abstract
Background & Objectives: Asthma is now regarded as an inflammatory disease and bronchial inflammation may disrupt mucociliary function. Inhaled drugs may act by improving mucociliary function. The aim of the study was to investigate the effect of salbutamol, ipratropium bromide and beclomethasone on mucociliary clearance in patients with chronic stable asthma and to compare the efficacy of these drugs on mucociliary clearance., Methods: Ten patients with chronic stable asthma were enrolled in the study, but two patients did not complete the study. Patients with bronchial asthma were chosen on clinical grounds. (99m)Tc phytate radioaerosol generated through a nebulizer, was given to each patient on four days. After each administration the radioactivity over the thorax was constantly measured in sequential frame mode for 120 min. Radioactivity in the thorax was also measured after 24 h. A base-line pulmonary function test with reversibility was obtained. Salbutamol, ipratropium bromide, beclomethasone dipropionate and placebo inhalation were given randomly to each patient on four days., Results: The mean age of patients (n = 8) was 36 +/- 9.3 yr and mean duration of symptoms was 5 +/- 6.6 yr. There was no visual impression that mucociliary clearance was enhanced with any of the drugs. The time activity curves did not show any visually recognisable change in slope. In only one patient the curve tended to show a steeper slope with ipratropium inhalation. In the rest of the patients the curves showed no difference at all with medication when compared with placebo. All the quantitative indices analyzed by two-way ANOVA at the end of one and two hours were comparable for the three test drugs and placebo. None of the three test drugs demonstrated statistically significant mucociliary clearance effect compared with placebo. However, the temporal difference in airways clearance efficiency (ACE) was significant with beclomethasone and ipratropium bromide., Interpretation & Conclusion: Inhalation of any of the three drugs tested did not produce any immediate improvement in mucociliary clearance as compared to placebo in patients with stable bronchial asthma suggesting the need for further studies using higher doses of drugs for longer duration in a large sample.
- Published
- 2003
47. Imaging bacterial infection with (99m)Tc-ciprofloxacin (Infecton).
- Author
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Britton KE, Wareham DW, Das SS, Solanki KK, Amaral H, Bhatnagar A, Katamihardja AH, Malamitsi J, Moustafa HM, Soroa VE, Sundram FX, and Padhy AK
- Subjects
- Abscess diagnostic imaging, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Endocarditis, Bacterial diagnostic imaging, Female, Humans, Infant, Male, Middle Aged, Osteomyelitis diagnostic imaging, Prosthesis-Related Infections diagnostic imaging, Radionuclide Imaging, Radiopharmaceuticals, Soft Tissue Infections diagnostic imaging, Tuberculosis diagnostic imaging, Bacterial Infections diagnostic imaging, Ciprofloxacin analogs & derivatives, Organotechnetium Compounds
- Abstract
Aims: The diagnosis of deep seated bacterial infections, such as intra-abdominal abscesses, endocarditis, and osteomyelitis, can be difficult and delayed, thereby compromising effective treatment. This study assessed the efficacy of a new radioimaging agent, Tc-99m ciprofloxacin (Infecton), in accurately detecting sites of bacterial infection., Methods: Eight hundred and seventy nine patients with suspected bacterial infection underwent Infecton imaging and microbiological evaluation. The sensitivity and specificity of Infecton in detecting sites of bacterial infection were determined with respect to Centres of Disease Control, World Health Organisation, and Dukes's criteria., Results: Five hundred and seventy four positive and 295 negative images were produced. These included 528 true positives, 46 false positives, 205 true negatives and 90 false negatives, giving an overall sensitivity of 85.4% and a specificity of 81.7% for detecting infective foci. Sensitivity was higher (87.6%) in microbiologically confirmed infections., Conclusions: Infecton is a sensitive technique, which aids in the earlier detection and treatment of a wide variety of deep seated bacterial infections. The ability to localise infective foci accurately is also important for surgical intervention, such as drainage of abscesses. In addition, serial imaging with Infecton might be useful in monitoring clinical response and optimising the duration of antimicrobial treatment.
- Published
- 2002
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48. Diagnostic value of 99mTc-methylene diphosphonate and 99mTc-pentavalent DMSA compared with 99mTc-sestamibi for palpable breast lesions.
- Author
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Massardo T, Alonso O, Kabasakal L, Llamas-Olier A, Shankar UR, Zhu H, Delgado L, González P, Mut F, and Padhy AK
- Subjects
- Axilla, Female, Humans, Lymph Nodes diagnostic imaging, Lymphatic Metastasis, Middle Aged, Prospective Studies, Radionuclide Imaging, Sensitivity and Specificity, Breast Neoplasms diagnostic imaging, Radiopharmaceuticals, Technetium Tc 99m Dimercaptosuccinic Acid, Technetium Tc 99m Medronate, Technetium Tc 99m Sestamibi
- Abstract
Unlabelled: Different radiopharmaceuticals have been used to detect breast cancer. Among them, sestamibi has been extensively studied and has come to have a well-recognized role in the evaluation of palpable breast lesions. The goal of this study was to compare the diagnostic value of 99mTc-labeled compounds, such as methylene diphosphonate (MDP) and pentavalent dimercaptosuccinic acid (DMSA-V), with sestamibi for palpable breast lesions, in the scope of a multicenter trial sponsored by the International Atomic Energy Agency., Methods: Patients from 7 countries were included: 47 women (mean age, 54 +/- 13 y) examined with MDP and sestamibi and 111 women (mean age, 55 +/- 12 y) examined with DMSA-V and sestamibi. Cancer was diagnosed in 41 of 49 lesions from the MDP group and in 78 of 113 lesions from the DMSA-V group. Axillary lymph node involvement was observed in 18 of 30 patients from the first group and in 27 of 53 patients from the second group. Prone scintimammography was performed using a dose of 740 MBq of each tracer, and diagnostic values were calculated from a masked interpretation of scans., Results: In the first group, the sensitivity for sestamibi and MDP studies was 82.9% and 65.9%, respectively, with a specificity of 87.5% and 50%, respectively. In the second group, the sensitivity for sestamibi and DMSA-V studies was 87.2% and 65.4%, respectively, with a specificity of 77.1% and 74.3%, respectively. Regarding axillary involvement, the sensitivity was 33.3% for sestamibi in both groups, whereas the values for MDP and DMSA-V were 16.7% and 7.4%, respectively. In contrast, the specificity for sestamibi was 83.3% and 92.3% for the first and second groups, respectively, and the specificity for MDP and DMSA-V was 91.7% and 100%, respectively., Conclusion: Sestamibi is the most adequate alternative among the mentioned 99mTc-labeled radiopharmaceuticals for the evaluation of palpable breast lesions.
- Published
- 2002
49. Is (99m)Tc-sestamibi scintimammography complementary to conventional mammography for detecting breast cancer in patients with palpable masses?
- Author
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Alonso O, Massardo T, Delgado LB, Horvath J, Kabasakal L, Llamas-Olier A, Maunda KK, Morales R, Padhy AK, and Shankar UR
- Subjects
- Adult, Aged, Aged, 80 and over, Breast Neoplasms pathology, Female, Humans, Middle Aged, Prospective Studies, Radionuclide Imaging, Breast Neoplasms diagnostic imaging, Mammography, Radiopharmaceuticals, Technetium Tc 99m Sestamibi
- Abstract
Unlabelled: The aim of this trial was to evaluate in developing countries from different regions the diagnostic performance of (99m)Tc-sestamibi scintimammography (SM) in palpable breast lesions and to verify the clinical usefulness of a joint evaluation with mammography and SM., Methods: From 10 countries, a total of 238 patients with palpable breast masses (n = 245) were included in this prospective multicenter trial. Prone SM was performed 10 min and 60-90 min (157 patients) after injection using an isotime acquisition of 10 min. Mammography was assessed by the same dedicated imaging radiologist according to breast imaging reporting and data system (BI-RADS) categories for malignancy and breast density. Masked SM findings and mammography findings were checked for a correlation with histopathology findings for excisional biopsy samples. Diagnostic values for breast cancer detection were calculated per lesion., Results: Histopathology revealed 189 cancerous lesions and 56 benign lesions. The sensitivity and specificity of SM were 0.83 and 0.77, respectively. SM diagnostic values did not depend on the incidence of breast cancer in the country of origin or on the timing of imaging (early vs. delayed scans). On mammography, the technique yielded a sensitivity and specificity of 0.85 and 0.66, with 27 mammograms classified as BI-RADS category 1, 33 as category 2, 5 as category 3, 56 as category 4, and 124 as category 5. Thirty-seven lesions were considered to show increased radiologic density. No significant difference was found in SM diagnostic values among different BI-RADS categories or between the groups with low and high breast density. A sensitivity of 96% was calculated when SM and mammography results were combined, with 75% of all false-negative mammography findings classified as true-positive results by SM., Conclusion: SM complements mammography in patients with palpable masses and negative mammography findings.
- Published
- 2001
50. Clinical features of differentiated thyroid carcinoma in children and adolescents from a sub-Himalayan iodine-deficient endemic zone.
- Author
-
Bal CS, Padhy AK, and Kumar A
- Subjects
- Adenocarcinoma, Follicular pathology, Adenocarcinoma, Follicular radiotherapy, Adenocarcinoma, Follicular surgery, Adolescent, Adult, Age Distribution, Bone Neoplasms epidemiology, Bone Neoplasms secondary, Carcinoma, Papillary pathology, Carcinoma, Papillary radiotherapy, Carcinoma, Papillary surgery, Child, Child, Preschool, Female, Follow-Up Studies, Humans, India epidemiology, Lung Neoplasms epidemiology, Lung Neoplasms secondary, Lymphatic Metastasis, Male, Neoplasm, Residual surgery, Retrospective Studies, Thyroid Neoplasms pathology, Thyroid Neoplasms surgery, Time Factors, Adenocarcinoma, Follicular epidemiology, Carcinoma, Papillary epidemiology, Iodine deficiency, Iodine Radioisotopes therapeutic use, Thyroid Neoplasms epidemiology, Thyroid Neoplasms radiotherapy
- Abstract
Northern India is an identified sub-Himalayan iodine-deficient endemic zone. We retrospectively analysed the case files of children with differentiated thyroid carcinoma from this endemic zone and attempted to define the disease in terms of its presentation, clinical course and outcome of radioiodine therapy. Between 1967 and June 2000, 1135 patients with thyroid cancer were treated in our centre and 80 (7%) were less than 20 years of age. There were 45 females and 35 males. Histologically, 85% of patients had papillary carcinoma and the rest follicular carcinoma. Cervical lymph node involvement was seen in 66% of patients, and distant metastasis, mainly pulmonary, in 29%. In children less than 10 years of age, 75% of patients had distant metastasis at the time of presentation. The post-surgery 48 h radioiodine neck uptake was 12.2+/-9.6%. Ninety-six per cent of the residual thyroid, 90% of nodal metastases and 57% of pulmonary metastases were ablated. Although nine patients had nodal recurrence between surgery and radioiodine treatment, no recurrence was observed thereafter, and three disease-related deaths (all in children less than 10 years of age) were seen in the mean follow-up of 6 years. We conclude that, except for the relatively higher incidence of follicular thyroid cancer and the higher mortality in the less than 10 year age group, the course and outcome of differentiated thyroid carcinoma in children from iodine-deficient areas is no different from that in children in iodine-sufficient areas.
- Published
- 2001
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