Browsing by Author "Saranovic, Dragana Sobic (57202567582)"

The aim of the study was evaluation of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography with computed tomography (PET/CT) in the detection of active disease in the patients with suspected recurrence of the medullary thyroid carcinoma (MTC). 18F-FDG PET/CT investigation was performed in 67 patients, investigated from 2010 to 2019. _ Follow up was performed from 6 to 116 months after surgery (median 16.5 months, x± SD = 29±28.9 months). Twenty five of 67 patients underwent 99mTc-dimercaptosuccinic acid (99mTc-DMSA) scintigraphy, 11 underwent somatostatin receptor scintigraphy (SRS) with 99mTc-HYNIC TOC while 11 123I-metaiodobenzylguanidine (MIBG) scintigraphy. From 67 patients, 35 (52.2%) had true positive 18F-FDG PET/CT findings (TP). Average maximal standardized uptake value (SUVmax) for all TP lesions was 5.01+3.6. In 25 (37.3%) patients findings were true negative (TN). Four (6%) patients had false positive (FP) findings while three (4.5%) were false negative (FN). Thus, sensitivity of the 18F-FDG PET/ CT was 92.11%, specificity 86.21%, positive predictive value 89.74%, negative predictive value 89.29% and accuracy 89.55%. In 27 patients (40%) 18F-FDG PET/CT finding influenced further management of the patient. 18F-FDG PET/CT has high accuracy in the detection of metastases/recurrences of MTC in patients after thyroidectomy as well as in evaluation and the appropriate choice of the therapy. © 2021 2021 Jelena Saponjski, Djuro Macut, Dragana Sobic Saranovic, Branislava Radovic, Vera Artiko, published by Sciendo.

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.

Gastrointestinal metastases from invasive lobular breast cancer are uncommon with the stomach and small intestines being the most common metastatic sites. Peritoneal and rectal metastases are very rare and only rarely occur as the frst manifestation of disease. We herein report the case of a 47-year-old woman who presented with abdominal carcinomatosis as a frst sign of invasive lobular breast carcinoma (ILC). Identifying the most important immunohistochemical markers for ILC: gross cystic disease fuid protein 15, estrogen and progesterone receptors enabled a correct diagnosis. After a six year disease-free period, relapse occurred with severe obstruction due to rectal metastasis from lob-ular breast carcinoma. Since there was no widespread metas-tatic disease, surgery with concomitant hormonal therapy was performed. copy; 2011 Korean Breast Cancer Society.

Gastrointestinal metastases from invasive lobular breast cancer are uncommon with the stomach and small intestines being the most common metastatic sites. Peritoneal and rectal metastases are very rare and only rarely occur as the frst manifestation of disease. We herein report the case of a 47-year-old woman who presented with abdominal carcinomatosis as a frst sign of invasive lobular breast carcinoma (ILC). Identifying the most important immunohistochemical markers for ILC: gross cystic disease fuid protein 15, estrogen and progesterone receptors enabled a correct diagnosis. After a six year disease-free period, relapse occurred with severe obstruction due to rectal metastasis from lob-ular breast carcinoma. Since there was no widespread metas-tatic disease, surgery with concomitant hormonal therapy was performed. copy; 2011 Korean Breast Cancer Society.

Background: A large proportion of the huge global burden of extrapulmonary tuberculosis (EPTB) cases are treated empirically without accurate definition of disease sites and extent of multi-organ disease involvement. Positron emission tomography (PET) imaging using 2-deoxy-2-(fluorine-18) fluoro-Dglucose (18F-FDG) in tuberculosis could be a useful imaging technique for localising disease sites and extent of disease. Methods: We conducted a study of HIV-negative adult patients with a new clinical diagnosis of EPTB across eight centres located in six countries: India, Pakistan, Thailand, South Africa, Serbia and Bangladesh, to assess the extent of disease and common sites involved at first presentation. 18F-FDG PET/ computed tomography (CT) scans were performed within 2 weeks of presentation. Findings: 358 patients with EPTB (189 females; 169 males) were recruited over 45 months, with an age range of 18–83 years (females median 30 years; males median 38 years). 350 (98%) out of 358 patients (183 female, 167 male) had positive scans. 118 (33.7%) out of 350 had a single extrapulmonary site and 232 (66.3%) out of 350 had more than one site (organ) affected. Lymph nodes, skeleton, pleura and brain were common sites. 100 (28%) out of 358 EPTB patients had 18F-FDG PET/CT-positive sites in the lung. 110 patients were 18F-FDG PET/CT-positive in more body sites than were noted clinically at first presentation and 160 patients had the same number of positive body sites. Interpretation: 18F-FDG PET/CT scan has potential for further elucidating the spectrum of disease, pathogenesis of EPTB and monitoring the effects of treatment on active lesions over time, and requires longitudinal cohort studies, twinned with biopsy and molecular studies. Copyright © ERS 2020

Purpose: Radioactive iodine therapy (RAIT) is important when treating patients who have been diagnosed with differentiated thyroid carcinoma and have gone through initial surgery. However, deciding whether a patient should undergo such therapy as well as the proper iodine dose is a complex task, especially for those with a lack of experience. Therein, this paper aimed to develop and compare classifier systems to aid inexperienced physicians in decision making on radioactive iodine therapy for thyroid cancer patients. Methods: The study cohort consisted of 210 thyroid cancer patients who had undergone a total thyroidectomy. We developed and evaluated the performance of three machine learning (ML) algorithms that suggest whether these patients should undergo RAIT and propose an administrable I-131 dose. These algorithms were Artificial Neural Network (ANN), Naïve Bayes Classifier (NB) and Group Method of Data Handling (GMDH). The kappa coefficient was used to measure agreement of classifiers with gold standard decision made by an experienced physician. Results: Our results indicate that the ANN performs better than NB and GMDH in terms of accuracy (95.71%). On the basis of the Kappa coefficient, ANN was also the best 0.96 (0.91-1.00). Additionally, kappa coefficient increased to 0.93 (0.86-1.00) by comparing young physicians' decisions on thyroid cancer therapy before and after using ANN as a decision making tool. Conclusion: Our results suggest that developed classifiers are able to imitate the real decisions of medical expert. Furthermore, classifiers may be utilized to educate inexperienced medical professionals, especially in the absence of strict guidelines' recommendations. © 2021 Zerbinis Publications. All rights reserved.

Purpose: Radioactive iodine therapy (RAIT) is important when treating patients who have been diagnosed with differentiated thyroid carcinoma and have gone through initial surgery. However, deciding whether a patient should undergo such therapy as well as the proper iodine dose is a complex task, especially for those with a lack of experience. Therein, this paper aimed to develop and compare classifier systems to aid inexperienced physicians in decision making on radioactive iodine therapy for thyroid cancer patients. Methods: The study cohort consisted of 210 thyroid cancer patients who had undergone a total thyroidectomy. We developed and evaluated the performance of three machine learning (ML) algorithms that suggest whether these patients should undergo RAIT and propose an administrable I-131 dose. These algorithms were Artificial Neural Network (ANN), Naïve Bayes Classifier (NB) and Group Method of Data Handling (GMDH). The kappa coefficient was used to measure agreement of classifiers with gold standard decision made by an experienced physician. Results: Our results indicate that the ANN performs better than NB and GMDH in terms of accuracy (95.71%). On the basis of the Kappa coefficient, ANN was also the best 0.96 (0.91-1.00). Additionally, kappa coefficient increased to 0.93 (0.86-1.00) by comparing young physicians' decisions on thyroid cancer therapy before and after using ANN as a decision making tool. Conclusion: Our results suggest that developed classifiers are able to imitate the real decisions of medical expert. Furthermore, classifiers may be utilized to educate inexperienced medical professionals, especially in the absence of strict guidelines' recommendations. © 2021 Zerbinis Publications. All rights reserved.