Papers by Sellam Karunanithi
ABSTRACT Objectives: Few recent studies have highlighted the utility of 18F-DOPA imaging in carci... more ABSTRACT Objectives: Few recent studies have highlighted the utility of 18F-DOPA imaging in carcinoid tumors. 68Ga-DOTANOC PET/CT, however, has already been established in many countries for the evaluation of carcinoid tumors. Thus, a prospective trial was designed for a head-to-head comparison of 18F-DOPA PET/CT and 68Ga-DOTANOC PET/CT. Methods: Twenty eight patients with biopsy proven carcinoid tumors were prospectively enrolled and scheduled for 68Ga-DOTANOC and 18F-DOPA PET/CT. These patients were scanned for staging/restaging, detection of recurrence and for evaluation of response to therapy. Both the studies were conducted, in random orders, within three weeks time interval. The scans were reported independently by two experienced nuclear medicine physicians. The readers were blinded to the clinical and biochemical details. PET/CT results were correlated with conventional imaging, and when possible with histopathology. Results: The most common primary tumor site was the pancreas followed by the ileum. One primary site was localized to lung and one in lateral ventricle. The most common metastatic site was liver. Either on patient-basis (sensitivity- 96% vs 71%) or on lesion-basis (92 vs 63), 68Ga-DOTANOC scans picked up more disease compared to 18F-DOPA imaging. Conclusions: Overall, 68Ga-DOTANOC showed superior sensitivity in evaluation of primary carcinoid tumors as well as metastatic involvement of liver, lymph node and bone. Moreover, 68Ga-DOTANOC PET positivity indicates somatostatin receptor expression, thus guiding further management with octreotide and/or radiopeptide therapy
European Journal of Nuclear Medicine and Molecular Imaging, 2014
The objective of this study was to evaluate the role of (68)Ga-DOTATOC positron emission tomograp... more The objective of this study was to evaluate the role of (68)Ga-DOTATOC positron emission tomography (PET)/CT scan in patients with suspected pulmonary carcinoid tumour and to compare its results with (18)F-fluorodeoxyglucose (FDG) PET/CT scan. In this prospective study, 32 patients (age 34.22 ± 12.03 years; 53.1 % female) with clinical suspicion of bronchopulmonary carcinoid were evaluated with (68)Ga-DOTATOC PET/CT and (18)F-FDG PET/CT. The two imaging modalities were compared, considering the tissue diagnosis as the reference standard. Based on the reference standard 26 cases were carcinoid tumours [21 typical carcinoids (TC) and 5 atypical carcinoids (AC)] and 6 cases were non-carcinoid tumours. The sensitivity, specificity and accuracy of (68)Ga-DOTATOC PET/CT in the diagnosis of pulmonary carcinoid tumour were 96.15, 100 and 96.87 % respectively, whereas those of (18)F-FDG PET/CT were 78.26, 11.1 and 59.37 % respectively. The maximum standardised uptake value (SUV max) of TC on (68)Ga-DOTATOC PET/CT scan ranged from 3.58 to 55, while that of AC ranged from 1.1 to 32.5. (18)F-FDG PET/CT was true-positive in all cases of AC and false-negative in eight cases of TC (sensitivity for TC 61.9 % and for AC 100 %). (68)Ga-DOTATOC PET/CT is a useful imaging investigation for the evaluation of pulmonary carcinoids. (18)F-FDG PET/CT scan suffers from low sensitivity and specificity in differentiating the pulmonary carcinoids from other tumours.
ABSTRACT Objectives: To examine whether 99mTc-glucoheptonic acid (GHA) SPECT can differentiate ne... more ABSTRACT Objectives: To examine whether 99mTc-glucoheptonic acid (GHA) SPECT can differentiate newly enhancing lesions into recurrent tumor or treatment-induced changes (TIC)in patients with treated high-grade (WHO grade III/IV) gliomas. Methods: Thirty-two lesions in 31 patients satisfying the inclusion criterion, namely, presence of new enhancing lesion on contrast-enhanced MR within the irradiated field, were examined prospectively with GHA SPECT. Abnormal tracer uptake in the lesion as compared to the contralateral normal side was taken as criterion for tumor diagnosis. Using region of interest (ROI) analyses, two indices were obtained per lesion - sum index and maximal index representing respectively the total and maximal ROI counts normalized to the contralateral normal side. Composite gold standard consisted of histopathology (7), imaging (MR diffusion, perfusion and spectroscopy) (20) and clinical (5) follow-up. Results: Twenty-one lesions were due to tumor recurrence and 11 lesions were due to TIC. Abnormal tracer uptake was noted in all (21/21) lesions from the recurrent tumor group and in 82% (9/11) lesions from the TIC group. Although the sensitivity and negative predictive value for recurrent tumor were high (both 100%), the specificity (18%), positive predictive value (70%) and accuracy (72%) were suboptimal. Medians of both the sum index (7.1) and the maximal index (3) were higher in the recurrent tumor group than in the TIC group (3.9 and 2.3 respectively). However, the difference between two groups was not statistically significant (p<0.05) for either of the two indices. Conclusions: 99mTc-GHA SPECT has high sensitivity and negative predictive value for differentiation of recurrent tumor from treatment-induced changes. However, due to high occurrence of false-positive results, prospective differentiation between the two entities is not possible in most patients. Research Support: Partly supported by a grant from the Indian Council of Medical Research (ICMR)(No.3/2/2008/PG-thesis-MPD-13)
ABSTRACT Objectives: To examine whether 99mTc-glucoheptonic acid (GHA) SPECT can differentiate ne... more ABSTRACT Objectives: To examine whether 99mTc-glucoheptonic acid (GHA) SPECT can differentiate newly enhancing lesions into recurrent tumor or treatment-induced changes (TIC)in patients with treated high-grade (WHO grade III/IV) gliomas. Methods: Thirty-two lesions in 31 patients satisfying the inclusion criterion, namely, presence of new enhancing lesion on contrast-enhanced MR within the irradiated field, were examined prospectively with GHA SPECT. Abnormal tracer uptake in the lesion as compared to the contralateral normal side was taken as criterion for tumor diagnosis. Using region of interest (ROI) analyses, two indices were obtained per lesion - sum index and maximal index representing respectively the total and maximal ROI counts normalized to the contralateral normal side. Composite gold standard consisted of histopathology (7), imaging (MR diffusion, perfusion and spectroscopy) (20) and clinical (5) follow-up. Results: Twenty-one lesions were due to tumor recurrence and 11 lesions were due to TIC. Abnormal tracer uptake was noted in all (21/21) lesions from the recurrent tumor group and in 82% (9/11) lesions from the TIC group. Although the sensitivity and negative predictive value for recurrent tumor were high (both 100%), the specificity (18%), positive predictive value (70%) and accuracy (72%) were suboptimal. Medians of both the sum index (7.1) and the maximal index (3) were higher in the recurrent tumor group than in the TIC group (3.9 and 2.3 respectively). However, the difference between two groups was not statistically significant (p<0.05) for either of the two indices. Conclusions: 99mTc-GHA SPECT has high sensitivity and negative predictive value for differentiation of recurrent tumor from treatment-induced changes. However, due to high occurrence of false-positive results, prospective differentiation between the two entities is not possible in most patients. Research Support: Partly supported by a grant from the Indian Council of Medical Research (ICMR)(No.3/2/2008/PG-thesis-MPD-13)
ABSTRACT Objectives: The objective of this study was to evaluate the diagnostic performance of 68... more ABSTRACT Objectives: The objective of this study was to evaluate the diagnostic performance of 68Ga-DOTANOC PET/CT in patients with a clinically suspected or established diagnosis of Gastrinoma in whom the results of conventional imaging with computed tomography (CT) were either unrevealing or equivocal. Methods: 24 patients (14male, 10 female, mean age-45.9 yrs) were included in this retrospective analysis. Inclusion criteria were a clinical symptomatology suggestive of Gastrinoma, elevated serum Gastrin levels (median value-1261.5, range 239-9516) and negative (12 patients) or equivocal CT results (12 patients). Results: 68Ga-DOTANOC PET/CT turned positive in 17/24 patients. A detection rate of 41.7% was observed in patients who had no findings on CT (5/12). Of the remaining twelve patients who had doubtful lesions on CT imaging, 68Ga-DOTANOC PET/CT was considered abnormal in all patients, yielding a detection rate of 100%. Reference standard was established using a combination of histopathology (seven patients), follow-up imaging (five patients), and biochemical markers (12 patients).Most common site of primary tumor localization was duodenum followed by pancreas (Median SUVmax-35.75). Overall 20 individual tumors were discovered in 12 patients. Previously unidentified metastatic involvement of lymph nodes were seen in nine and liver metastases in four patients (Median SUVmax-28.5). Conclusions: 68Ga-DOTANOC seems a promising imaging modality in patients suspected to have Gastrinoma with negative or indeterminate CT results. It has the potential to become a front line non-invasive imaging investigation for diagnosis and staging of such patients
Pediatric Radiology, Oct 1, 2010
Pediatric nasopharyngeal carcinoma (NPC) is rare and usually poorly differentiated. We report a 1... more Pediatric nasopharyngeal carcinoma (NPC) is rare and usually poorly differentiated. We report a 14year-old boy with NPC with metastases to liver, spleen, lymph nodes and bone marrow. The liver metastases closely resembled benign cystic liver disease on imaging; however, they showed intense uptake similar to other metastatic sites on positron emission tomography (PET) scan. A liver biopsy could not be performed on the boy. The boy responded clinically to platinum-based chemotherapy, and all the baseline PET-positive lesions became negative. This case highlights the rarity of splenic and cystic liver metastases in pediatric NPC and demonstrates the potential use of PET/CT in diagnosis, staging and response assessment in metastatic pediatric NPC.
ABSTRACT Objectives: To evaluate response to therapy in patients with recurrent breast cancer wit... more ABSTRACT Objectives: To evaluate response to therapy in patients with recurrent breast cancer with metastasis using F18-FDG PET-CT. Methods: In this study 52 patients of recurrent/metastatic breast cancer were retrospectively analyzed. The age range was 26 to 74 years (mean age 52.27 years). All patients had baseline PET-CT scan with recurrent/metastatic disease. All patients underwent chemotherapy with/without radiotherapy and/or surgery. Follow-up PET-CT scan was done 4-6 weeks after last cycle of chemotherapy, radiotherapy, surgery. Pre-treatment PET-CT was compared with post treatment PET-CT to evaluate treatment response. Decrease in SUV of more than 50% was considered as significant response, decrease in SUV of more than 25% was considered as partial response. Increase in SUV of more than 25% or appearance of new lesion(s) was considered as progression. Results: Of 52 patients, 38 showed significant response, 4 showed stable disease and remaining 10 patients showed progression of disease. Most common metastases were to lymph nodes (31 patients). Out of five most common metastatic sites least common site of involvement was liver(8 patients). Lymph node metastasis, responded best where 18 out of 31 patients showed response. Least responsive were liver metastasis where 8 patients were positive before therapy and 9 patients were positive after therapy. Most common site for residual metastatic disease was bone(19 patients). Conclusions: F18-FDG PET-CT is a useful modality for evaluating response to treatment in metastatic/recurrent breast cancer. Lymph nodes metastases responded best while liver metastases responded poorly
Society of Nuclear Medicine Annual Meeting Abstracts, May 1, 2013
ABSTRACT Objectives: The purpose of the study was to compare the efficacies of contrast enhanced ... more ABSTRACT Objectives: The purpose of the study was to compare the efficacies of contrast enhanced MRI and 18F-FDOPA PET-CT in detection of recurrent gliomas. Methods: Prospective analytical study. Thirty five patients with histopathologically proven glioma with clinical suspicion of recurrence were evaluated using contrast enhanced MRI and 18F-FDOPA PET-CT. Combination of clinical follow up, repeat imaging and/or biopsy (when available) was taken as gold standard. Results: On the basis of gold standard 26 patients were positive and 9 patients were negative for recurrence. All patients were followed up for a period of at least 1 year. The sensitivity, specificity and accuracy of MRI were 92.3%, 44.4% and 80% respectively, whereas those of 18F-FDOPA PET-CT were 100%, 88.89% and 97.1% respectively. Results of MRI and 18F-FDOPA PET/CT were concordant in 74.3% (29/35) and discordant in 17.1% (6/35) of patients. On McNemar analysis the difference was not statistically significant (p=0.687). The difference was not significant neither for high grade tumor (p=0.5) nor for low grade tumors (p=1.0). MRI was false negative in 2 patients (Grade I-1; Grade II-1). There was no false negative report on FDOPA PET-CT. There were 5 false positive cases on MRI (GBM-1; Grade III-1; Grade II-3) but only one false positive case (Grade II -1) in FDOPA PET-CT. Between the specificity results of both imaging modalities the difference was statistically significant (p=0.0002). The difference was not significant for high grade tumor (p=0.0066) but was significant for low grade tumors (P=0.004). Conclusions: 18F-FDOPA PET-CT is highly sensitive and specific for detection of recurrence in glioma patients. It is superior to MRI in specificity and especially advantageous for low grade gliomas.
Society of Nuclear Medicine Annual Meeting Abstracts, May 1, 2013
ABSTRACT Objectives: The purpose of the study was to compare the efficacies of contrast enhanced ... more ABSTRACT Objectives: The purpose of the study was to compare the efficacies of contrast enhanced MRI and 18F-FDOPA PET-CT in detection of recurrent gliomas. Methods: Prospective analytical study. Thirty five patients with histopathologically proven glioma with clinical suspicion of recurrence were evaluated using contrast enhanced MRI and 18F-FDOPA PET-CT. Combination of clinical follow up, repeat imaging and/or biopsy (when available) was taken as gold standard. Results: On the basis of gold standard 26 patients were positive and 9 patients were negative for recurrence. All patients were followed up for a period of at least 1 year. The sensitivity, specificity and accuracy of MRI were 92.3%, 44.4% and 80% respectively, whereas those of 18F-FDOPA PET-CT were 100%, 88.89% and 97.1% respectively. Results of MRI and 18F-FDOPA PET/CT were concordant in 74.3% (29/35) and discordant in 17.1% (6/35) of patients. On McNemar analysis the difference was not statistically significant (p=0.687). The difference was not significant neither for high grade tumor (p=0.5) nor for low grade tumors (p=1.0). MRI was false negative in 2 patients (Grade I-1; Grade II-1). There was no false negative report on FDOPA PET-CT. There were 5 false positive cases on MRI (GBM-1; Grade III-1; Grade II-3) but only one false positive case (Grade II -1) in FDOPA PET-CT. Between the specificity results of both imaging modalities the difference was statistically significant (p=0.0002). The difference was not significant for high grade tumor (p=0.0066) but was significant for low grade tumors (P=0.004). Conclusions: 18F-FDOPA PET-CT is highly sensitive and specific for detection of recurrence in glioma patients. It is superior to MRI in specificity and especially advantageous for low grade gliomas.
Nuclear Medicine Communications, Sep 1, 2011
OBJECTIVE: The correct diagnosis of tumor thrombosis and its differentiation from benign thrombus... more OBJECTIVE: The correct diagnosis of tumor thrombosis and its differentiation from benign thrombus can change patient management and prevent unnecessary anticoagulation treatment. This study was aimed at evaluating the role of fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in the diagnosis of tumor thrombosis, and its differentiation from benign thromboembolism.METHODS: We conducted a retrospective review of FDG PET-CT scans of patients who underwent the study for staging/restaging of a known malignancy and had FDG-avid thrombosis. Maximum standardized uptake value (SUV max) of the thrombus, SUV max of tumor (if any), and SUV max of mediastinal blood pool were calculated. PET-CT results were confirmed with clinical follow-up, structural imaging, and histopathology when available.RESULTS: A total of 24 patients (15 male and nine female) with a mean age of 43.8 years (range: 3-72 years; median: 47.5 years) were evaluated. On the basis of structural imaging and clinical follow-up, 10 patients had benign and 14 patients had tumor thrombosis. On FDG PET-CT, uptake in the thrombus was linear in 18 patients and focal in six patients. The most common site of thrombosis was the inferior vena cava. The mean SUV max was 3.2 (range: 2.3-4.6; median: 3.3) in the benign thrombosis group and was 6.0 (range: 2.3-13.8; median: 3.3) in the tumor thrombosis group. The difference in SUV max was significant (P=0.013). On receiver operating characteristic analysis, a cut-off SUV max of 3.63 (sensitivity: 71.4% and specificity: 90%) was obtained to differentiate tumor thrombus from benign thromboembolism. In six patients, FDG PET-CT detected occult vascular thrombosis.CONCLUSION: FDG PET-CT can detect active tumor thrombosis and is helpful in differentiating it from benign thrombus.
Nuclear Medicine Communications, Sep 1, 2011
OBJECTIVE: The correct diagnosis of tumor thrombosis and its differentiation from benign thrombus... more OBJECTIVE: The correct diagnosis of tumor thrombosis and its differentiation from benign thrombus can change patient management and prevent unnecessary anticoagulation treatment. This study was aimed at evaluating the role of fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in the diagnosis of tumor thrombosis, and its differentiation from benign thromboembolism.METHODS: We conducted a retrospective review of FDG PET-CT scans of patients who underwent the study for staging/restaging of a known malignancy and had FDG-avid thrombosis. Maximum standardized uptake value (SUV max) of the thrombus, SUV max of tumor (if any), and SUV max of mediastinal blood pool were calculated. PET-CT results were confirmed with clinical follow-up, structural imaging, and histopathology when available.RESULTS: A total of 24 patients (15 male and nine female) with a mean age of 43.8 years (range: 3-72 years; median: 47.5 years) were evaluated. On the basis of structural imaging and clinical follow-up, 10 patients had benign and 14 patients had tumor thrombosis. On FDG PET-CT, uptake in the thrombus was linear in 18 patients and focal in six patients. The most common site of thrombosis was the inferior vena cava. The mean SUV max was 3.2 (range: 2.3-4.6; median: 3.3) in the benign thrombosis group and was 6.0 (range: 2.3-13.8; median: 3.3) in the tumor thrombosis group. The difference in SUV max was significant (P=0.013). On receiver operating characteristic analysis, a cut-off SUV max of 3.63 (sensitivity: 71.4% and specificity: 90%) was obtained to differentiate tumor thrombus from benign thromboembolism. In six patients, FDG PET-CT detected occult vascular thrombosis.CONCLUSION: FDG PET-CT can detect active tumor thrombosis and is helpful in differentiating it from benign thrombus.
Society of Nuclear Medicine Annual Meeting Abstracts, 2012
ABSTRACT Objectives: The objective of the present study was to evaluate the role of 68Ga-labelled... more ABSTRACT Objectives: The objective of the present study was to evaluate the role of 68Ga-labelled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI3-Octreotide (Ga68-DOTANOC) positron emission tomography computed tomography (PET-CT) for detection and staging of pancreatic neuroendocrine tumors (NETs). Methods: 37 patients (Age: 47±13.3 years; male/female: 20/17) with clinically suspected and/or histopathologically proven pancreatic NET underwent Ga68-DOTANOC PET-CT imaging for staging (n=8) and /or localisation of primary lesion (n=29). All patients also underwent contrast enhanced CT (CECT). SUVmax of primary and metastatic lesions were measured. Results were verified with histopathology for primary tumor and with clinical follow up/MRI and /or biopsy for metastatic disease. Results of Ga68-DOTANOC PET-CT were compared to CECT. Results: Ga68-DOTANOC PET-CT correctly localised primary in all 37 and CECT in 28 patients. Ga68-DOTANOC PET-CT demonstrated 39 primary pancreatic tumors (head-16, body-17, and tail-6). The mean SUVmax of primary tumors was 21.5±22.7. The accuracy of Ga68-DOTANOC PET-CT detecting primary tumor was 100% and that of CECT was 70.2%.Ga68-DOTANOC PET-CT demonstrated metastases in 25 patients and CECT in 15. Liver and lymph nodes were commonest site of metastases on PET-CT. The mean SUVmax of metastasis was 17.6±11.6. The sensitivity, specificity and accuracy for detection metastatic disease were 96%, 100%, 97% for Ga68-DOTANOC PET-CT and 58%, 100%, and 70% for CECT. On McNemar analysis Ga68-DOTANOC PET-CT was superior to CECT for detecting both primary tumor (p=0.003) and metastatic disease (p=0.006). Conclusions: Ga68-DOTANOC PET-CT is a very useful imaging modality for diagnosing and staging pancreatic NET. It is superior to CECT for this purpose
Society of Nuclear Medicine Annual Meeting Abstracts, 2012
ABSTRACT Objectives: The objective of the present study was to evaluate the role of 68Ga-labelled... more ABSTRACT Objectives: The objective of the present study was to evaluate the role of 68Ga-labelled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI3-Octreotide (Ga68-DOTANOC) positron emission tomography computed tomography (PET-CT) for detection and staging of pancreatic neuroendocrine tumors (NETs). Methods: 37 patients (Age: 47±13.3 years; male/female: 20/17) with clinically suspected and/or histopathologically proven pancreatic NET underwent Ga68-DOTANOC PET-CT imaging for staging (n=8) and /or localisation of primary lesion (n=29). All patients also underwent contrast enhanced CT (CECT). SUVmax of primary and metastatic lesions were measured. Results were verified with histopathology for primary tumor and with clinical follow up/MRI and /or biopsy for metastatic disease. Results of Ga68-DOTANOC PET-CT were compared to CECT. Results: Ga68-DOTANOC PET-CT correctly localised primary in all 37 and CECT in 28 patients. Ga68-DOTANOC PET-CT demonstrated 39 primary pancreatic tumors (head-16, body-17, and tail-6). The mean SUVmax of primary tumors was 21.5±22.7. The accuracy of Ga68-DOTANOC PET-CT detecting primary tumor was 100% and that of CECT was 70.2%.Ga68-DOTANOC PET-CT demonstrated metastases in 25 patients and CECT in 15. Liver and lymph nodes were commonest site of metastases on PET-CT. The mean SUVmax of metastasis was 17.6±11.6. The sensitivity, specificity and accuracy for detection metastatic disease were 96%, 100%, 97% for Ga68-DOTANOC PET-CT and 58%, 100%, and 70% for CECT. On McNemar analysis Ga68-DOTANOC PET-CT was superior to CECT for detecting both primary tumor (p=0.003) and metastatic disease (p=0.006). Conclusions: Ga68-DOTANOC PET-CT is a very useful imaging modality for diagnosing and staging pancreatic NET. It is superior to CECT for this purpose
Nuclear Medicine and Molecular Imaging, 2015
Nuclear Medicine and Molecular Imaging, 2015
Indian Journal of Nuclear Medicine, 2015
We present the case of a 35-year-old man with calcinosis, Raynaud&amp... more We present the case of a 35-year-old man with calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly and telangiectasia variant scleroderma who presented with dysphagia, Raynaud's phenomenon and calf pain. (99m)Tc-methylene diphosphonate bone scintigraphy was performed to identify the extent of the calcification. It revealed extensive dystrophic calcification in the left thigh and bilateral legs which was involving the muscles and was well-delineated on single photon emission computed tomography/computed tomography. Calcinosis in scleroderma usually involves the skin but can be found in deeper periarticular tissues. Myopathy is associated with a poor prognosis.
![Research paper thumbnail of [Role of 18F-FDG PET/CT in diagnosis and staging of nasopharyngeal carcinoma]](https://attachments.academia-assets.com/42824257/thumbnails/1.jpg)
Ai zheng = Aizheng = Chinese journal of cancer, 2008
Because (18)F-FDG PET/CT can display cancer lesion morphology, size and the relatinship of the ca... more Because (18)F-FDG PET/CT can display cancer lesion morphology, size and the relatinship of the cancer lesion to adjacent tissues, it is used in the diagnosis and classification of nasopharyngeal carcinoma (NPC). This study was to explore the application value of (18)F-FDG PET/CT in TNM staging by comparing the performance of MRI and PET/CT together with pathological results for some small lymph nodes. Sixty-eight pathologically proven NPC patients were selected from Sep.2005 to Mar. 2007 in Sun Yat-sen University Cancer Center. All cases underwent both MRI and (18)F-FDG PET/CT examinations. PET/CT two-dimensional (2D) data were collected. Automatic dose tracking scanning and contrast-enhanced CT scanning were performed. (18)F-FDG was intravenously administrated at a dose of 3.7-5.5 MBq/kg. MRI T1W, T2W and T1W Gd-DTPA enhanced images were obtained. Neck lymph nodes of 10 NPC patients were pathologically examined. Nasopharyneal lesions of all 68 cases were all clearly displayed by bo...
Clinical Nuclear Medicine, 2015
We report a 15-year-old case of tuberous sclerosis complex or Bourneville&amp... more We report a 15-year-old case of tuberous sclerosis complex or Bourneville's disease with history of generalized tonic-clonic seizure for last 2 years and was currently on antiepileptic medication. He also had a history of left nephrectomy for renal cell carcinoma clear cell type. The patient had multiple adenoma sebaceum over the nasolabial region, ash leaf spots over the lower limbs, a Shagreen patch over the back, and multiple calcified tubers in the subependymal region. He was then referred for the skeletal scintigraphy to look for skeletal lesions, which revealed involvement of bilateral humeri, tibiae, and iliac bones accurately characterized on SPECT/CT.
Clinical Nuclear Medicine, 2015
We report a 15-year-old case of tuberous sclerosis complex or Bourneville&amp... more We report a 15-year-old case of tuberous sclerosis complex or Bourneville's disease with history of generalized tonic-clonic seizure for last 2 years and was currently on antiepileptic medication. He also had a history of left nephrectomy for renal cell carcinoma clear cell type. The patient had multiple adenoma sebaceum over the nasolabial region, ash leaf spots over the lower limbs, a Shagreen patch over the back, and multiple calcified tubers in the subependymal region. He was then referred for the skeletal scintigraphy to look for skeletal lesions, which revealed involvement of bilateral humeri, tibiae, and iliac bones accurately characterized on SPECT/CT.
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Papers by Sellam Karunanithi