Rajeev Kumar*, Yasmin Nasir, Arunav Kumar and Rajesh Kumar Singh
Acinic cell carcinoma of parotid gland is defined by parotid neoplasm with at least some serous acinous differentiation. It is one of the rare malignancies of parotid (3–11% of adult parotid neoplasm) with very unpredictable clinical behavior in nature. Close differentials are warthins tumor, oncocytoma, clear cell and mucoepidermoid carcinomas. Surgery is the standard of care in this case. A 22-year-old male patient developed a swelling over the left parotid region in 2018, which gradually increased in size without any difficulty faced to the patient. Fine needle aspiration cytology of the swelling revealed pleomorphic adenoma. The patient underwent surgery in 2018 under general anesthesia at another facility, and no post-operative documents were available with the patient. Over time, the swelling recurred in the same region. The patient sought medical attention at IGIMS, ENT department, where fine needle aspiration cytology of the swelling revealed pleomorphic adenoma once again. Magnetic Resonance Imaging showed a heterogeneous mass involving both the superficial and deep lobes of parotid. Subsequently, the patient underwent left parotidectomy for the same condition. The post-operative biopsy and immunohistochemistry suggestive of acinic cell carcinoma with cystic and solid patterns. After confirming the absence of metastasis with PET scan, radiation therapy was recommended due to the recurrence involving the deep lobe. Acinic cell carcinoma is initially considered benign but later reclassified as malignant due to its metastatic and recurrence capability. It commonly affects parotids (85% cases) and constitutes 6-16% of major salivary gland malignancies. Its clinical course is uncertain, with better prognosis in pediatric cases. Family history, radiation exposure, and certain genetic transformations are risk factors. Radiological assessments are inadequate for characterization many times. Surgical resection is the main treatment modality. Chemotherapy is ineffective, but adjuvant radiation can be considered. Recurrences are common, but prognosis is generally good. Correct diagnosis is crucial for effective treatment and recurrence prevention.
Adeel Riaz, Syed Mohsin Raza, Ayesha Afzal, Mariam Arif, Abu Hurairah, Varisha A. Hussain, Daniyal Ahmed Sami and Muhammad Mohsin Fareed
Objective: Locoregional failure after trimodailty treatment is a crucial problem for locally advanced esophageal carcinomas. The goal of this study is to assess outcomes of preoperative chemoradiation followed by esophagectomy in locally advanced esophageal carcinomas. Material and Methods: Patients with cT3-T4 or node+ esophageal carcinomas receiving trimodality treatment (2017-2020) were analyzed retrospectively. Demographics, histology, grade, stage, dose, fractionation, chemotherapy, surgery and resection margins were analyzed. Primary end points were Disease Free Survival (DFS) and Overall Survival (OS). Results: 122 patients were included, mean follow-up of 13.4 months. 99 (82%) patients had cT3 and 58(47.5%) had cN1 disease. Most common histology was Squamous Cell 102 (83.6%), grade was moderate 92 (75.4%) and most patients received chemotherapy, induction (n=99, 81%) vs. concurrent (n=116, 95%). Chemoradiation 50 Gy in 25 fractions with platinum-based chemotherapy was the most common regimen. 65 patients were treated with definitive intent; and 57 patients with pre-operative intent, of whom 56 (98%) underwent surgery. Most common surgery was 3-stage esophagectomy. In the pre-operative group, R0 resection was achieved in 38 patients (66.7%). 2-year OS was better in pre-operative group compared to definitive group (72% vs. 32%, p=0.001). Similarly, 2-year DFS was better in pre-operative group compared to definitive group (78% vs. 52%, p=0.03). R0 resection and radiation dose of 50Gy were associated with better overall survival on MVA. Disease recurrence was seen in 34 (27.9%) with local recurrence in 10 (8.2%), distant metastasis in 20 (16.4%) and both in 4 (3.3%) patients. Conclusion: Trimodality treatment with standard preoperative radiation dose and chemotherapy yielded a high pathologic complete response rate and better 2-year DFS and OS. R0 resection and 50 Gy radiation dose were associated with better OS.
Introduction: Technologists working in Nuclear Medicine are exposed to radiation when doing tasks such as labeling/synthesis of radiopharmaceuticals, radiopharmaceutical administration, scan acquisition, and radiation survey. When working with therapeutic radiopharmaceuticals, the radiation dose could be significantly higher. The radiation dosage to the technologist in this study involved synthesis of Lu-177-DOTATATE (DOTA-Tyr3-octreotate) and PSMA-617(Prostate specific membrane Antigen) was estimated.
Aim: The purpose of this study is to calculate the whole-body radiation dose to a technologist who is involved in the labelling of two different Lu-177 labelled compounds, namely Lu-177 DOTATATE and Lu-177- PSMA, and to compare the occupational burden to the dose limits recommended by India's Atomic Energy Regulatory Board.
Materials and methods: A survey meter cum contamination monitor was used to detect radiation levels before the start of the labelling in the Hot lab by maintaining it at the area where the technologist generally stands during synthesis. An instant personal monitoring device like electronic pocket dosimeter was used by the technologist at chest level, performing the labelling of Lu177 (135mci to 520mci) received fortnightly by our department. Data were collected for 16 syntheses of Lu-177 DOTATATE and13 syntheses of Lu-177 PSMA-617 followed by the quality control. Mean time required to complete synthesis of Lu-177 DOTATATE and Lu-177 PSMA-617 was 52.68min and 52.39min respectively. Mean whole body radiation dose was 0.041 ± 0.004 mSv and 0.037±0.002mSv. Higher dose was obtained during the synthesis of Lu-177 DOTATATE.
Conclusion: Data suggest that during the manual radio labelling of Lu -177 compounds, the whole-body radiation exposure to technologist is within the limits prescribed by AERB.
Ai-ka Abneh Awad* and Attieh Ola
Aim: The aim of this study is to detect the value of 18F-FDG PET/CT in detecting local recurrence or distant metastases in patient who underwent radical nephrectomy for renal cell carcinoma.
Materials and Methods: This retrospective study includes 88 patients diagnosed to have renal cell carcinoma underwent radical nephrectomy. Both 18F-FDG PET/CT and CT scan were done in the post-operative period for follow up. Sites of the relapse were categorized into local recurrence and distant metastasis. The final diagnosis of disease status was made on subsequent follow up by conventional imaging CT and 18F-FDG PET/CT with histopathology confirmation for all of the cases.
Results: PET/CT was positive and detected recurrence in 48/88 patients, of which confirmed to be recurrence via biopsy 46/48 and was negative in 40/88 patients, 3 of them were falsely negative. 11/48 had local renal bed recurrence and 35/48 patients had distant metastases. PET/CT classified: 46/48 of cases to be true-positive, 2/48 false-positive and 3/40 false-negatives. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 93.9%, 94.9%, 94.3%, 95.8%, and 92.5%, respectively.
Conclusion: 18F-FDG PET/CT scan proved its efficiency in post-surgical renal cell carcinoma patients as a follow up tool in local recurrence and distant metastasis. In particular detection of renal bed recurrence and bone metastasis. This can be considered as a base for future studies with larger population number.
Subhashini Swaminathan* and Shweta Kailash Pal
Radiation and radiation technology has risen too much from the last few years, hence the chances of radiation contamination increased over the past few years. The need to study radiation protection has become necessary. Commercially available chemical radioprotectors having too many side effects and hence limiting the use. Since the last decade, the study on marine algae has gained impact through the experimental studies marine algae is considered to have many Radioprotective phytochemicals, such as phlorotannins, polysaccharides, carotenoids and other compounds. Chemical radioprotectors having many side effects of the human hence limiting the use. Natural radioprotectors can be used in place of artificial to reduce the side effect and can be used in the long run. Marine algae exhibiting a broad spectrum of antioxidant properties can be used widely as radioprotectors.
Jesica Callag*
Nuclear Medicine & Radiation Therapy received 706 citations as per Google Scholar report
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