Egyptian Society of Nuclear Medicine SpecialistsEgyptian Journal Nuclear Medicine1687-499420120200601Theranostics in Prostate Cancer.1810668310.21608/egyjnm.2020.106683ENZidan,L.Nuclear medicine Unit, Faculty of Medicine, Cairo University, Egypt.Journal Article20200809Metastatic castration resistant prostate cancer (mCRPC) is a highly mortal disease, requiring safe and effective therapeutic agents to improve the patient outcome. Prostate-specific membrane antigen (PSMA) is over expressed in many prostate cancer cells, and act as target for molecular imaging (MI) and radionuclide therapy (RNT). The introduction of Gallium-68 (68Ga) PSMA- PET/CT in 2012 has changed the management of prostate cancer. In addition to its importance in identifying PSMA expression for selection of patients suitable for PSMA RNT, PSMA- PET/CT showed superior diagnostic accuracy to combined CT and bone scan. Lutetium-177 (177Lu) PSMA-617 is the most investigated PSMA radio ligand for RNT in prostatecancer, it is a radiolabelled small molecule, binds with high affinity to PSMA, enabling beta-particles emissions with short tissue penetration depth (mean range of 0.7 mm and maximum range of 2.1 mm in soft tissue). Since 2014 multiple studies showed a highly impressive therapeutic efficacy and safety of 177Lu-PSMA RNT. The evidence achieved by these studies paved the way to ongoing randomized clinical trials, and currently this therapy is being applied and clinically accepted in many centers worldwide. The aim of this article is to share the practical aspect of PSMA Theranostics for prostate cancer, including patient selection, therapy protocol and follow-up.https://egyjnm.journals.ekb.eg/article_106683_fe2f3387adf1cc851ea1f35f17291f30.pdfEgyptian Society of Nuclear Medicine SpecialistsEgyptian Journal Nuclear Medicine1687-499420120200601Role of PET/CT in Differentiated Thyroid Carcinoma.91710668810.21608/egyjnm.2020.106688ENMaamoun,N.Nuclear medicine Unit, NCI, Egypt.Moustafa,H.Nuclear medicine Unit, Faculty of Medicine, Cairo University, Egypt.Journal Article20200809https://egyjnm.journals.ekb.eg/article_106688_dda7859f9fa059475880ecc28ad36e95.pdfEgyptian Society of Nuclear Medicine SpecialistsEgyptian Journal Nuclear Medicine1687-499420120200601How Hybrid PET/CT Improve Pitfalls and Artifacts in Malignant Lymphoma?648110672110.21608/egyjnm.2020.106721ENMoustafa,M.Nuclear Medicine Unit, NEMROCK Center, Cairo University, Egypt.NagyA.Nuclear Medicine Unit, Maadi Armed Forced Hospital, Egypt.Gammal,M.Nuclear Medicine Unit, Maadi Armed Forced Hospital, Egypt.Badawy,A.Nuclear Medicine Unit, NEMROCK Center, Cairo University, Egypt.Journal Article2020080918F-FDG PET/CT has become a standard procedure for the evaluation of lymphomas. An understanding of the role of FDG PET/CT in the management of lymphomas and knowledge of its limitations is mandatory for the optimal utilization of this technique. The present study aimed to assist accurate interpretation with proper diagnosis by exclusion of false positive or false negative causes of PET/CT studies. Material and Methods: This retrospective study included 105 adult patients with malignant lymphoma to diagnose possible pitfalls during study interpretation. All clinical and histopathological information were extracted from the patients’ clinical sheet. Results: The study included 105 patients (48patients with HD and 57 patients with NHL). The mean age of all patients was (46.78 ± 16.78) years.The majority of patients were males (61.9%); while (38.1%) were females. Total numbers of pitfalls detected were 373 sites. Physiological Pitfalls were detected in 71 sites, (36 sites had muscle uptake 12 sites had uterine-related uptake pitfalls, 12 sites had brown adipose tissue uptake and 5 sites had unilateral vocal cord uptake. Technical pitfalls were detected in 128 sites (50 sites had contrast-induced artifacts,41 sites had head movement, 36 sites had metallic artifact and one site showed truncation related pitfalls). Therapy related artifacts were detected in 156 sites (56 sites had gastric uptake. 54 sites had splenic & BM uptake and 30 patients had enhanced salivary uptake, while, 6 sites had diminished salivary uptake, 6 patients had thymic hyperplasia and 4 patients had early and late radiation effect). Benign pathological benign conditions were detected in18 sites (9 sites had incidental thyroid uptake and 8 patients had inflammatory lung uptake and one patient had bone fracture). Conclusion: PET/CT is a powerful imaging technique for characterizing pathological lymphomatous lesions with proper evaluation of physiological, technical and post therapy pitfalls or artifacts.https://egyjnm.journals.ekb.eg/article_106721_070b54f91f0c642688f3e8bd446099eb.pdfEgyptian Society of Nuclear Medicine SpecialistsEgyptian Journal Nuclear Medicine1687-499420120200601Prognostic Value of F-18 FDG PET/CT Volume-Based Metabolic Parameters in Patients with Cancer Esophagus.395210673010.21608/egyjnm.2020.106730ENDeif,D.Nuclear Medicine Unit, National Cancer Institute, Cairo University, Egypt.Moustafa,H.Nuclear Medicine & Clinical Oncology Department, Cairo University, Egypt.Fathy,H.Nuclear Medicine Unit, National Cancer Institute, Cairo University, Egypt.Abougabal,A.Radiotherapy department, National Cancer Institute, Cairo University, Egypt.Elazab,M.Radiology department, National Cancer Institute, Cairo University, Egypt.Elahmadawy, M.A.Nuclear Medicine Unit, National Cancer Institute, Cairo University, Egypt.Journal Article20200809Aim: To evaluate the prognostic value of the initial quantitative PET/CT parameters in terms of therapy response and survival in patients with esophageal carcinoma. Material &methods: This retrospective study includes thirty-two patients (17 males and 15 females). All patients had pathologically proven esophageal cancer. These Patients underwent whole body 18F-FDG PET/CT as a baseline staging method before Neoadjuvant therapy. Initial FDG PET/CT scans were retrieved and PET volumetric images were analysed for metabolic parameters including maximum SUV (SUV max), mean SUV (SUV mean), (SUV peak), MTV and TLG. Results: 53.1% of the enrolledpatients were males and 46.9%were female with the dominating pathological subtype was Squamous cell carcinoma in 20 patients (62.5%). Quantitative analyses of the metabolic parameters of the enrolled patients revealed SUV max with average value 16.13 +/- 8.71, SUV mean with average value 9.47+/- 5.2, SUV peak with average value 13.09 +/-7.1. MTV with average value 32.5+/-21.88 and TLG with average value 332.44+/- 318 and range between (34 and 1149). Survival analysis showed that initial SUV max, SUV mean, SUV Peak of oesophageal tumour were not correlated with OS. While MTV and TLG were correlated with OS with p value of 0.045 and 0.031 respectively. Conclusion: The initial PET/CT MTV and TLG metabolic parameters are prognostic parameter for response and survival ismore efficient than the other metabolic parameters in patients with esophageal cancer.https://egyjnm.journals.ekb.eg/article_106730_4aef97bdf8cb4a74730853b285dee1ac.pdfEgyptian Society of Nuclear Medicine SpecialistsEgyptian Journal Nuclear Medicine1687-499420120200601Does FDG PET/CT have Additional Diagnostic Accuracy of Surveillance in Detection of Early Relapse in Non- Hodgkin Lymphoma?183810673910.21608/egyjnm.2020.106739ENSerry,O.Nuclear Medicine, Faculty of Medicine, Cairo University, Egypt.Moustafa,H.Nuclear Medicine, Faculty of Medicine, Cairo University, Egypt.El-Ghamrawy,KOncology, Faculty of Medicine, Cairo University, Egypt.Tawakol,A.Nuclear Medicine, Faculty of Medicine, Cairo University, Egypt.Journal Article20200809Aim of the work: is to investigate the diagnostic accuracy of surveillance FDG PET/CT scans in early relapse detection in non-Hodgkin’s lymphoma patients coming in complete remission after their primary line of therapy. Material and Methods: This prospective study was conducted on 72 patients with NHL (37 males and 35 females) with median age of 52 years. All patients who achieved the first complete remission were scheduled for PET/CT scans every 6 months for the first 2 years. Deauville criteria, SUV max and TLG of all lesions during end of primary line of treatment (if present) and at the time of relapse were measured. Results: 56.9% of patients were classified as stage IV. During follow up 30 patients were in complete remission (41.7%), whereas 37 patients had relapse (51.4%), and 5 patients had indeterminate relapse (6.9%). In our study 26 patients of the relapsed group (70.3%) complained of clinical symptoms suspicious for relapsing disease, while only 11 patients (29.7%) did not show clinical manifestations suspicious for relapse before undergoing the follow up PET/CT scan with significant difference (P˂0.001). 21 patients of the relapsed group (56.8%) were proved positive by follow up PET/CT as progressive disease, 9 patients (24.3%) was proved by biopsy. 3 patients (8.1%) have undergone conventional imaging CT or MRI with suspicious disease before referral for PET/CT. Only four patients (10.8%) showed regressive course after second line of chemotherapy within close follow up PET/CT. Deauville score at the time of relapse showed 11 patients were presenting with Deauville 4 (29.7%) and the remaining 26 patients showed Deauville 5 score (70.3%). Diagnostic accuracy of using surveillance PET/CT for early relapse detection in reference to other diagnostic methods showed sensitivity 97.3%, specificity 85.7%, positive predictive value 87.8%, negative predictive value 96.7% and accuracy 91.6%. Conclusion: Routine surveillance imaging with PET/CT with NHL in CR is valuable in detection of early relapse in symptomatic patients. Metabolic PET/CT parameters including SUV max and TLG are available additive parameters during follow up.https://egyjnm.journals.ekb.eg/article_106739_9dcec7ed539e6afea9dcabc9010f3deb.pdfEgyptian Society of Nuclear Medicine SpecialistsEgyptian Journal Nuclear Medicine1687-499420120200601Assessment of Organ Doses for Patients undergoing 99mTc-MIBI Myocardial Perfusion Imaging.829310674710.21608/egyjnm.2020.106747ENSoli, I.AMedical Physics Department, School of Nuclear and Allied Sciences, University of Ghana.+Université Abdou Moumouni, Institute des Radio-Isotopes, Département de Médecine Nucléaire, BP 10727-Niamey, Niger.Moussa,I.Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, P.O. Box LG 80, Accra, Ghana.Ali, D.A.Université Abdou Moumouni, Institute des Radio-Isotopes, Département de Médecine Nucléaire, BP 10727-Niamey, Niger.Kyere,AKMedical Physics Department, School of Nuclear and Allied Sciences, University of Ghana, Ghana.Hasford,FMedical Physics Department, School of Nuclear and Allied Sciences, University of Ghana.+Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, P.O. Box LG 80, Accra, Ghana.Journal Article20200809Radiation absorbed doses associated with myocardial perfusion imaging (MPI) using 99mTc-MIBI has been determined at the Radioisotopes Institute of the Abdou Moumouni University. Thirty patients undergoing MPI were scanned and image quantification was done using Mediso Inter View XP® software. The average administrated activities of 99mTc-Sestamibi were 370 MBq (10 mCi) in stress condition and 1110 MBq (30 mCi) in rest condition with one day protocol. The radionuclide activities in the heart, liver, kidneys and urinary bladder were determined using the conjugate view method. The uptake of 99mTc-MIBI in the heart, liver and kidneys were respectively about 2.17% ±0.64, 6.53% ±1.47 and 5% ±0.52, 10 minutes after injection. The cumulative activities for the heart, liver, kidneys and urinary bladder were respectively 21.97 MBq.h, 63.11 MBq.h, 36.61 MBq.h, 79.48 MBq.h for the stress and 68.23 MBq.h, 239.79 MBq.h, 101.69 MBq.h and 223.1 MBq.hin the rest conditions. The organs absorbed doses in this study were 3.06 mGy for kidneys, 0.75 mGy for liver, 0.75 mGy for the heart, and 20.46mGy for bladder.https://egyjnm.journals.ekb.eg/article_106747_d0bca9154944048a0d77d83282ecde42.pdf