Browsing by Author "Petrovic, Milorad (55989504900)"

Objective: To prospectively study whether in patients with resected primary colorectal cancer fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) examination could diagnose the stage, specify treatment procedure and be prognostic. Subjects and methods: This prospective study included 75 patients with resected primary colorectal adenocarcinoma referred for 18F-FDG PET/CT to the National PET Center, at the Clinical Center of Serbia, Belgrade, from January 2010 to May 2013. Findings of 18F-FDG PET/CT were compared to findings of subsequent histopathological examinations or with results of clinical and imaging follow-up. Patients were followed after PET/CT examination for a mean follow-up time of 16.7±5.9 months. Results: In the detection of recurrent disease 18FFDG PET/CT showed overall sensitivity, specificity, PPV, NPV and accuracy of 96.6%, 82.4%, 94.9%, 87.5% and 93.3%, respectively. In the detection of stages I and II sensitivity, specificity and accuracy of 18F-FDG PET/CT were: 88%, 96.6% and 94.7%, respectively, and in the detection of stages III and IV sensitivity, specificity and accuracy were 94.9%, 87.5% and 93.3%, respectively. These findings prevented or changed intended surgical treatment in 12/32 cases. Univariate and multivariate Cox proportional regression analyses revealed that metastatic recurrence (stages III and IV) was the only and independent prognostic factor of disease progression during follow-up (P=0.012 and P=0.023, respectively). Although, survival seemed better in patients with local recurrence compared to metastatic recurrent disease, this difference did not reach significance (Log-rank test; P=0.324). In addition, progression-free survival time was significantly longer in patients in whom 18F-FDG PET/CT scan led to treatment changes (Log-rank test; P=0.037). Conclusion: 18F-FDG PET/CT was sensitive and accurate for the detection and staging of local and metastatic recurrent colorectal carcinoma, with higher specificity in the detection of local recurrences. The 18F-FDG PET/CT scan induced treatment changes in 30/75 patients, including 12/32 patients in which surgical treatment was previously planned, and progression free survival time was significantly longer in these patients.

Objective: Proposed methods for treating early glottic carcinoma are cordectomy through laryngofissure, laser cordectomy, and radiotherapy. The aim of the study was to conduct comprehensive study to evaluate oncological and functional results of different treatment modalities for Tis and T1 glottic carcinoma, identify prognostic factors for the outcome of treatment and decide where we stand in applying worldwide standards of early glottic carcinoma treatment. Methods: Prospective study was conducted on 221 patients treated with Tis and T1 glottic carcinoma from 1998 to 2003 (72 patients were treated endoscopically with CO2 laser, 75 patients with cordectomy through laryngofissure and 74 with radiotherapy), with follow-up period from 38 to 107 months. Important demographic and clinical variables were analyzed. Voice quality after the treatment was assessed using multidimensional voice analysis. Results: Comparing oncological results of three modalities of treatment, there were no significant differences. Functional results of treatment were better after laser cordectomy and primary radiotherapy than following the open cordectomy. Five-year survival rate was almost identical in all three groups of patients, and important prognostic factors for survival were age and histological grade of the tumor. Conclusion: Considering that the choice of treatment in our country is also greatly influenced by other paramedical factors, such as distance from treatment facility, reliability of follow-up, significant time delay of radiotherapy because of small number of radiology centers and strong patients' surgeon and treatment preference, we consider endoscopic laser surgery highly efficient and preferred choice of treatment for early glottic carcinoma. © 2012 Elsevier Ireland Ltd.

Background/Aims: The aim of this investigation was to evaluate the role of detection of late mesh infection following incisional hernia repair with radiolabeled antigranulocyte antibodies. Methodology: Mesh infection diagnoses were set up with clinical examination and laboratory analysis and confirmed by ultrasonography (US), computerized tomography (CT), scintigraphy with 99mTc-antigranulocyte antibodies and microbiological examination. Results: Of the 17 patients investigated, 6 had a late mesh infection, and 11 had both mesh infection and recurrent incisional hernia. Clear clinical signs of late mesh infection were present in 13 patients. Four remaining patients had non-specific discomfort and recurrent incisional hernia without clinical manifestation of mesh infection ("silent infection"). US was positive in 12/17 patients, CT in 13/17 patients, while scintigraphy with antigranulocyte antibodies in 17/17 patients. Therefore, sensitivity of US was 71%, of CT 76% and of scintigraphy 100%. In four patients late mesh infection was confirmed exclusively by 99mTc-antigranulocyte antibody scintigraphy, while US and CT did not indicate the infection. Conclusions: According to the present results, scintigraphy with 99mTc antigranulocyte antibodies is a useful method for the detection of "silent" abdominal wall infections after surgery, which is very important for prompt and appropriate therapy. © H.G.E. Update Medical Publishing S.A.

Objective: Assessment of the first febrile urinary tract infection (UTI) in children has been the subject of debate for many years. Diagnosis of acute pyelonephritis (APN) is usually based on clinical and biological data. The clinical usefulness of early Tc-99m DMSA scintigraphy remains controversial, although it may influence the type and duration of treatment. The aim of this study was to assess the role of initial cortical scintigraphy in the detection of early renal parenchymal damage in children highly suspected of having APN and to compare the scintigraphic findings with selected clinical/laboratory parameters and ultrasonography. Methods: A prospective study was conducted in 34 infants and young children (18 boys, 16 girls), aged 1.5-36 months (mean 9.8 ± 8.7 months), hospitalized with a first episode of clinically suspected APN. Within the first 5 days after admission, Tc-99m DMSA renal scintigraphy, ultrasonography (US), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell count (WBC) and urine analyses were performed. Results: DMSA scintigraphy showed changes consistent with APN in 27/34 (79%) patients, with a mean age of 10.9 months, including 12 males (44%) and 15 (56%) females. Out of 9 febrile children with negative urine culture and supportive evidence of UTI, scintigraphy showed parenchymal involvement in 8 children (24% in the whole group, 30% in scintigraphically documented APN). There were no statistically significant correlations between the frequency or size of the initial scintigraphic abnormalities and age, sex, body temperature, CRP levels or ESR. A CRP level of >54 mg/L and a WBC of >13,300/mm3 had sensitivities of 56 and 59% and specificities of 86 and 71%, respectively. US showed changes consistent with APN in 7/34 (21%) in the whole group and in 7/27 (26%) patients with positive cortical scan (p < 0.05). Conclusion: Initial DMSA renal scintigraphy is a sensitive method for the early diagnosis of APN in young children and is useful in the assessment of the severity of kidney injury even in patients with negative urine culture. Clinical, biological and ultrasound parameters do not identify children with renal damage. Normal DMSA study, excluding parenchymal involvement and late sequelae, could minimize the use of scintigraphy in the follow-up and reduce the redundancy of cystography. © 2010 The Japanese Society of Nuclear Medicine.