Faculty of Medicine

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Author: search.filters.author.Todorova-Stefanovski, Dushica

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    Polyostotic Fibrous Dysplasia in a Six-year-Old Boy
    (Galenos Yayinevi, 2023-06-20)
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    Todorova-Stefanovski, Dushica
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    Fibrous dysplasia (FD) is a rare congenital benign bone disease that manifests as a defect in the bone remodeling process, affecting the function, differentiation, and maturation of osteoblasts. This process is located in the bone marrow, where the normal marrow tissue is replaced with immature bone islands and fibrous stroma. The etiology is unclear so far, but it is known to be connected with a point mutation of the gene that encodes Gs α protein at the time of embryogenesis, and because of that, all of the affected somatic cells become dysplastic. It is important to determine whether the mutation occurred earlier in the process of embryogenesis so that there will be more mutant cells and the disease will appear in a more severe form. The clinical presentation of FD is variable, so there are plenty of potential differential diagnoses. The most common include Paget disease, non-ossifying fibroma, osteofibrous dysplasia, aneurysmal bone cyst, adamantinoma, giant cell tumor, fracture callus, and low-grade central osteosarcoma.
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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.