Faculty of Medicine

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Author: search.filters.author.Angjeleska, Meri

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    F-18 FDG PET/CT Imaging in Diagnosis and Staging of Gallbladder Adenocarcinoma-Case Report
    (2019)
    Beshliev, Simon
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    Todorova Stefanovski, Dusica
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    Tasevski, Slavko
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    Angjeleska, Meri
    Aim: To present a case with suspected gallbladder cancer where 18-FDG PET/CT proved to be useful imaging modality for the diagnosis and staging. Method: Fifty seven years old female was referred to PET/CT scan due to inconclusive findings from ultrasonography (US), computed tomography (CT), an magnetic resonance imaging (MRI) and core biopsy of the liver. Pathohistological examination of the tumor mass in the liver confirmed hepatic metastasis from unknown origin. PET/CT scan was performed from the vertex of the skull to the toe, 3 minutes per bad on a SIMENS Biograph 40 PET/CT one hour after intravenous administration of 347Mbq of F-18 FDG with low dose CT scan without intravenous or gastrointestinal contrast. Prescan level of glucose was 5.1 mmol/L. The maximum standard uptake value (SUVmax) measured 3.9 in the region of the liver (segment VI). Results: A PET/CT scan demonstrated increased FDG uptake (SUVmax=11.3) in a hypodense unhomogenous mass that involved the gallbladder and the liver in segment IV/VIII. Two metabolically active focuses (SUVmax=4.3) were detected in the liver in the segment III and VI and two enlarged nodules near the pancreatic head (SUVmax=4.3). Conclusion: The PET/CT confirmed the suspected diagnosis of gallbladder cancer and because of the spread in the liver and lymph nodes surgery was not performed. Gallbladder cancer is a rare malignancy that grows rapidly with local invasion into the liver and with distant spread to lymph nodes. Despite the routine use of ultrasonography, computed tomography and magnetic imaging, in this case report, PET/CT scan proved to be very useful due to its capability of whole body imaging and possibility of showing additional lesions and providing optimal pre-treatment staging in patient that allowed appropriate treatment plan to be tailored.
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    DEDICATED HEAD AND NECK 18F-FDG PET/CT PROTOCOL IN DETECTING CERVICAL LYMPH NODE METASTASIS
    (2022)
    Todorova-Stefanovski, Dushica
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    Beshliev,Simon
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    Angjeleska, Meri
    PURPOSE: The purpose of this study is to compare dedicated head and neck PET/CT protocol to standard torso PET/CT protocol in detecting cervical lymph node metastasis in patients with head and neck cancer. MATERIALS AND METHODS: Retrospective study consisted of patients with head and neck cancer who underwent 18F-FDG PET-CT examination in the last six months in our institution after chemo or/and radiotherapy. All of the PET/CT examination consisted of dedicated head and neck scanning (cranial base to the thoracic inlet in an arm-down position, three bed positions - 3 min per bed position), followed by standard torso scanning (skull base through the proximal thighs with arms in a raised position - 2 min per bed position). CT scan parameters were identical in both scanning: 120 kVp, 30 mAs (reference, Siemens CareDose), 5 mm slice thickness and FOV of 50 cm. FDG uptake was evaluated visually and number of lesions were compared. RESULTS: 30 patients (21 men, 9 women; age range, 23-72 years) underwent 18- FDG PET-CT. In 9 patients (9/30, 30%) increased metabolic activity was detected in lymph nodes suggestive of metastasis. 26 metastasis were detected using dedicated head and neck scanning, compared to 23 with standard torso scanning (26 vs 23). Only in two patients (2/30, 6%).additional lessions was seen with the dedicated head and neck scanning. CONCLUSION: Dedicated head and neck scanning helped us detect additional lesions in only 6% of the patients and consequently did not influenced the treatment plan.