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S Bakheet

Publications and source records attributed to S Bakheet.

14 recordsLinked to original sources
PubMed2001

Positron emission tomography for the evaluation of metastases in patients with carcinoma of the cervix: a retrospective review.

OBJECTIVES: The aim of this study was to assess the usefulness of 18-fluorodeoxyglucose positron emission tomography (PET) scanning for the evaluation of metastases (nodal and distant) in patients with carcinoma of the cervix. METHODS: A retrospective review was performed of 13 patients with carcinoma of the cervix who had a 18-fluorodeoxyglucose PET scan as part of their workup (10 during initial workup, 3 at time of relapse). Ten patients also underwent a fine needle aspiration (FNA) under imaging guidance for verification. RESULTS: All 10 patients with positive sites identified by PET scan who underwent an FNA were positive for cancer. In 3 situations PET identified sites where other imaging studies were negative. CONCLUSIONS: PET scanning is a useful imaging tool in the evaluation of patients with carcinoma of the cervix. This review supports other limited published data in this regard and suggests that further prospective studies are needed.

Adult↗
PubMed2001

123I isotope as a diagnostic agent in the follow-up of patients with differentiated thyroid cancer: comparison with post 131I therapy whole body scanning.

Radioactive iodine (131I) plays a major role in the diagnosis and management of differentiated thyroid cancer (DTC); however, data on the use of the 123I isotope in DTC are limited. We compared 238 diagnostic whole body scans performed 24 h after oral ingestion of 185-555 MBq 123I with their corresponding 131I posttherapy whole body scans obtained 4-5 d after 131I therapy. We studied scans in 3 clinical situations: with the first 131I therapy, with the second 131I therapy, and in cases of elevated Tg and negative diagnostic scan. One hundred and seventy-seven pairs were obtained with the first 131I therapy and showed complete concordance between pretreatment and posttreatment scans in 166 pairs (concordance rate, 93.8%). Six other posttreatment scans showed more foci in the thyroid bed than the pretreatment scans, but no evidence of uptake in new areas. Only 5 posttreatment scans showed foci in new locations: 3 in cervical lymph nodes (CLN), 1 in the lung, and 1 new bone metastasis in a patient with known skeletal metastases. With the second 131I therapy, 34 pairs were obtained and showed complete concordance in 28 pairs (concordance rate, 82.4%). Five discordant pairs showed additional foci in areas that were already positive on pretreatment scans. Only 1 posttreatment scan showed a new bone metastasis in a different site from the bone metastases that were seen on its corresponding pretreatment scan. Of 27 pairs of scans in patients with elevated Tg and negative pretreatment scans, 15 posttreatment scans remained negative, 6 posttreatment scans showed an uptake in the thyroid bed, and 3 other posttreatment scans showed lung uptake in patients whose computed tomography scans of the chest showed only bronchiectasis (in 2 patients) and lung scarring (in the third patient) without evidence of lung metastases. Three posttreatment scans showed definite uptake (in thyroid bed, thyroid bed and lung, and CLN) compared with their corresponding pretreatment scans, which were initially reported negative but were retrospectively thought to have had faint uptake. In 56 pretreatment scans, the 123I diagnostic activity was 185 MBq, and the results showed complete concordance in 54 pairs. Two posttreatment scans showed additional uptake: 1 in the bone and 1 in CLN. These data suggest that pretreatment scanning using 123I is highly comparable to 131I posttreatment scanning and that 123I is an excellent diagnostic agent in DTC.

Adolescent↗
PubMed1999

18Fluoro-2-deoxyglucose (18FDG) PET scan of the brain in type IV 3-methylglutaconic aciduria: clinical and MRI correlations.

The clinical, 18fluorodeoxyglucose positron emission tomography (18FDG PET) and the magnetic resonance imaging (MRI) brain scan characteristics of four patients diagnosed to have 3-methylglutaconic aciduria were reviewed retrospectively. The disease has a characteristic clinical pattern. The initial presentations were developmental delay, hypotonia, and severe failure to thrive. Later, progressive encephalopathy with rigidity and quadriparesis were observed, followed by severe dystonia and choreoathetosis. Finally, the patients became severely demented and bedridden. The 18FDG PET scans showed progressive disease, explaining the neurological status. It could be classified into three stages. Stage I: absent 18FDG uptake in the heads of the caudate, mild decreased thalamic and cerebellar metabolism. Stage II: absent uptake in the anterior half and posterior quarter of the putamina, mild-moderate decreased uptake in the cerebral cortex more prominently in the parieto-temporal lobes. Progressive decreased thalamic and cerebellar uptake. Stage III: absent uptake in the putamina and severe decreased cortical uptake consistent with brain atrophy and further decrease uptake in the cerebellum. The presence of both structural and functional changes in the brain, demonstrated by the combined use of MRI and 18FDG PET scan, with good clinical correlation, make the two techniques complementary in the imaging evaluation of 3-methylglutaconic aciduria.

Brain↗
PubMed1999

18Fluoro-2-deoxyglucose (18FDG) PET scan of the brain in propionic acidemia: clinical and MRI correlations.

The clinical data and the imaging findings of the positron emission tomography (PET) and the magnetic resonance imaging (MRI) studies in five patients, previously diagnosed to have propionic acidemia, were retrospectively reviewed. The patients were all normal at birth. The first clinical signs, typically hypotonia and failure to thrive, appeared during the first 2 years of life. With progression of the disease, the neurological findings consisted of variable degrees of dementia and extrapyramidal symptoms, notably dystonia, choreoathetosis and rigidity of variable degrees. Initial cerebral PET and MRI studies were normal. Follow-up MRI examinations showed progressive basal ganglia degeneration, with evidence of atrophy and signal abnormalities within the caudate nuclei and the putamina. The thalamic structures were normal. The PET studies demonstrated increased uptake in the basal ganglia and thalami, followed by decreased uptake in the basal ganglia at a later stage of the disease. The structural (MRI) and the functional (PET) studies of the brain were found to be complementary in the evaluation of propionic acidemia, and were in good correlation with the clinical findings.

Brain↗
PubMed1999

Positron emission tomography in breast cancer: a clinicopathological correlation of results.

We conducted a retrospective study to evaluate the sensitivity, specificity and accuracy of positron emission tomography (PET) scans in 109 patients with primary recurrent or metastatic breast cancer. All patients had a PET scan, X-ray or CT scan of the chest, an ultrasound or CT scan of the liver and a bone scan. Mammography was available for 86 patients. Correlation between the PET scan result and histological findings were made. The sensitivity, specificity and accuracy of the PET scan were calculated for both the primary tumour (T) and lymph nodes (N). In patients with metastasis (M) the accuracy of the PET scan was compared with other imaging modalities. Histological results of the site in question were available in only 105 patients. Information for the primary tumour was available for 93 patients and for nodes in 74. The PET scan was accurate in 89.2% for (T), with 3.2% false positive and 7.6% false negative. For (N) the PET scan was accurate in 90.5% with 9.5% false negative. In the 86 patients who underwent both mammography and PET scanning, the PET scan was more accurate in 89.5% versus 72% (p = 0.0003). In the 19 patients with metastasis, the PET scan was in agreement with other imaging modalities in 100% of cases. PET scanning is the only non-invasive imaging procedure that will detect tumours in the breast, lymph nodes, lung, liver, bone and bone marrow with high sensitivity, specificity and accuracy. It is a valuable tool in the management of patients in all stages of breast cancer for diagnosis, staging and following treatment response.

Adolescent↗
PubMed1998

Fluoro-2-deoxyglucose (18FDG) PET scan of the brain in glutaric aciduria type 1: clinical and MRI correlations.

The clinical, PET (positron emission tomography) and MRI (magnetic resonance imaging) findings of brain studies in eight patients, previously diagnosed to have glutaric aciduria type 1, were retrospectively reviewed. The neurological findings typically consisted of variable degrees of dementia and extrapyramidal symptoms (dystonia, choreoathetosis and rigidity). Both MRI and PET showed involvement of the putamina in all the patients. The PET scan demonstrated lesions in the head of the caudate nuclei in all of the patients. Brain atrophy, and in particular the characteristically-enlarged Sylvian fissures, was better demonstrated by MRI. On the other hand, the cerebral cortex and thalamic structures were found to be normal by MRI in all patients, whereas PET scan showed decreased uptake in the cerebral cortex in seven, and in the thalami in three patients. Correlation between imaging and clinical findings was found to be good when both PET scan and MRI findings of the brain were taken into consideration. Therefore, the functional (PET) and structural (MRI) studies of the brain were complementary in the imaging evaluation of glutaric aciduria type 1.

Brain↗
PubMed1998

Biotin-responsive basal ganglia disease: a novel entity.

We describe a novel, biotin-responsive basal ganglia disease in 10 patients. At onset, it appears as a subacute encephalopathy, with confusion, dysarthria and dysphagia with occasional supranuclear facial nerve palsy or external ophthalmoplegia, and progresses to severe cogwheel rigidity, dystonia and quadriparesis. These symptoms disappear within a few days if biotin (5-10 mg/kg/day) is administered, and there are no neurological sequelae. They reappear within 1 month if biotin is discontinued. Patients diagnosed late, or who have had repeated episodes, suffer from residual symptoms such as paraparesis, mild mental retardation or dystonia. The numerous biochemical studies of intermediary metabolism, like the autoimmune and toxicological studies, enzyme assays including biotinidase, carboxylase and lysosomal activities, and bacterial and viral studies were all normal. The aetiology may be related to a defect in the transporter of biotin across the blood-brain barrier. The only consistent radiological abnormality was central necrosis of the head of the caudate bilaterally and complete, or partial, involvement of the putamen on brain MRI. This was present during the initial acute encephalopathy and remained unchanged during follow-up of 3-10 years. Although its aetiology is unknown, it is important to recognize this disease, since its symptoms may be reversed and the progression of its clinical course prevented simply by providing biotin.

Adolescent↗
PubMed1996

Papillary thyroid cancer in Saudi Arabia. Clinical, pathologic, and management characteristics.

During a 3-year period, 233 patients with papillary thyroid cancer were seen at King Faisal Specialist Hospital (KFSH) (79% were female; 94% were national subjects). Pathology revealed 88% pure papillary carcinoma and 12% mixed papillary and follicular carcinoma, 7% microfocus, 18% well encapsulated, 24% capsular invasion, and 51% soft tissue invasion. Thirty percent of patients who had initial surgery not done at KFSH compared with 93% of patients who had initial surgery done at KFSH had an I-123 24-hour uptake < 5%. One hundred seventeen patients required completion thyroidectomy at KFSH for significant residual thyroid tissue, 56% of those had residual papillary carcinoma. The amenability of papillary thyroid cancer for cure necessitates the optimization of management at the national level. In Saudi Arabia, papillary thyroid cancer presented in an advanced stage, especially in males as manifested by the large primary tumor size, advance pathologic staging, and distant metastases at the time of presentation. Findings at second surgery, showed significant residual disease.

Adult↗
PubMed1996

Radioiodine breast uptake in nonbreastfeeding women: clinical and scintigraphic characteristics.

UNLABELLED: We studied the scintigraphic and associated clinical characteristics of radioiodine breast uptake in nonbreastfeeding thyroid cancer patients undergoing routine whole-body radioiodine scanning. METHODS: We performed a retrospective review of the radioiodine scans and medical records of 30 prospectively collected cases. RESULTS: Twenty-three nonpregnant patients had discontinued breastfeeding for a mean of 11.4 mo. Three postmenopausal and four single nulliparous patients had radioiodine breast uptake on one or more occasions. This represented about 6% of all female patients who had radioiodine scans over a 3-yr period. Four patterns of uptake, full, focal, crescentic and irregular, were observed. Breast uptake mimicked lung metastasis in nine patients. Expressible galactorrhea and moderately elevated prolactin levels were present in 48% and 24%, respectively, of patients examined. In 14 patients followed for an average of 11.4 mo, there were no consistent changes in the pattern or intensity of breast uptake. In 18 patients who had both 123I diagnostic and 131I postablation scans within a few days, breast uptake was present on both scans in 75%. In four patients, breast uptake was present, despite the 4%-9% radioiodine uptake by the thyroid; in one patient, iodinated contrast material blocked the uptake of the thyroid gland but not of the breast. CONCLUSION: Although the mechanisms of radioiodine breast uptake remain unclear, breast uptake should be suspected in all female patients with radioiodine uptake in the chest area, even in the absence of a history of breastfeeding.

Adult↗
PubMed1995

Congenital bilobar emphysema.

Two cases of congenital bilobar emphysema are presented, both of which caused neonatal respiratory embarrassment. Plain radiography and lung scintigraphy revealed bilobar involvement in one child prior to surgery, while the bilobar involvement in the other child was found during a follow-up study.

Female↗
PubMed1993

False-positive thyroid cancer metastasis on whole-body radioiodine scanning due to retained radioactivity in the oesophagus.

In patients with differentiated thyroid cancer, radioiodine uptake in the mediastinal area most often indicates thyroid cancer metastasis. We review 15 radioiodine whole-body scans showing 19 mediastinal artefacts that mimicked lymph node or spinal metastasis. The artefacts disappeared on delayed images after eating and drinking (17) or on studies repeated within 1 week (2), suggesting their oesophageal origin. No patient had clinical oesophageal or gastric disease. Only two artefacts were linear; 12 were focal and five were diffuse. Twelve artefacts were better seen on anterior views (nine in the upper, two in the middle and one in the lower mediastinal area), whereas seven were better seen on posterior views (two in the upper, two in the middle, and three in the lower mediastinal area). The 15 scans were identified from about 1000 scans performed over 24 months in our centre. We conclude that the transient presence of radioiodine in an apparently normal oesophagus may not uncommonly mimic mediastinal lymph node or spinal metastases from thyroid cancer and that its scintigraphic presentation is variable.

Adult↗
PubMed1993

Spurious lung metastases on radioiodine thyroid and whole body imaging.

In patients with differentiated thyroid cancer, radioiodine uptake in the area of the lung usually denotes metastasis; however, it could represent an uptake by unrelated pulmonary disease or by the breasts, or external contamination. In this study, 22 foci that simulated lung metastasis on 11 thyroid and whole body scans were proven not to be metastasis by reimaging after cleaning (15 foci), or were strongly suspected to be due to external contamination because of the features of other images (7 foci). All foci were noted only on anterior views of the chest. Of the 22 foci, 19 were focal, two were smeared, and one was lobar. Foci were multiple in 7 scans, unilateral in 10 scans, and were associated with other artifacts in 4 scans. Caution should be used in interpreting apparent pulmonary radioiodine uptake as lung metastasis; reimaging after cleaning the skin and changing garment should be obtained when the uptake is confined to anterior views of the chest and/or when its pattern is atypical.

Adult↗