Background and Objectives: Risk-adapted therapy for children with HL is
directed toward high survival, minimal toxicity and optimal quality of life,
with long term follow up. We assess the impact of prognostic factors associated
with local treatment failure of pediatric HL patients with unfavorable
criteria treated with combined modality: Alternating ABVD (Doxorubicin,
Bleomycin, Vinblastine and Decarbazine) and COEP (Cyclophosphamide,
Oncovin, Etoposide and Prednisone) chemotherapy and response-based, involved-
field radiation for newly diagnosed unfavorable pediatric HL patients,
also will detect toxicities and long-term complications observed in the patients.
Methods: This prospective study was carried out from January 2010 to
January 2018, with a median follow up of 74 months (range 8 - 103 months).
54 patients were eligible for this study stratified into two groups: intermediate
risk (IR) and high-risk group (HR). Patients were treated with (4 - 6 cycles)
and (6 - 8 cycles) respectively of alternating ABVD/COEP chemotherapy followed
by involved-field radiation therapy (IFRT): 15 Gy for patients achieved
complete response, and 25.5 Gy for those achieved a partial response. Results:
27 patients were IR and 27 patients were HR. There were 16 treatment failures;
5 patients had progressive disease; and 11 patients had a relapse. 9 patients
died from their disease progression. The 5-year overall survival (OS)
and event-free survival (EFS) rates (±SE) were 81.8% ± 5.7% and 71.8% ±
6.2% respectively. Multivariate analysis revealed that the only independent
factor for inferior OS was radiotherapy. Conclusion: Treatment results of
unfavourable HL patients in our study are satisfactory for with IR group but
not for HR group who needs intensification of therapy. Radiotherapy is considered
as a cornerstone in the treatment of the patients with unfavourable
How to cite this paper: Ali, A.M., Mo

Background

To prospectively demonstrate the feasibility of performing dual-phase SPECT/CT for the assessment of the small joints of the hands of rheumatoid arthritis (RA) patients, and to evaluate the reliability of the quantitative and qualitative measures derived from the resulting images.

Methods

A SPECT/CT imaging protocol was developed in this pilot study to scan both hands simultaneously in participants with RA, in two phases of ^99mTc-MDP radiotracer uptake, namely the soft-tissue blood pool phase (within 15 minutes after radiotracer injection) and osseous phase (after 3 hours). Joints were evaluated qualitatively (normal vs. abnormal uptake) and quantitatively [by measuring a newly developed metric, maximum corrected count ratio (MCCR)]. Qualitative and quantitative evaluations were repeated to assess reliability.

Results

Four participants completed seven studies (all four were imaged at baseline, and three of them at follow-up after 1-month of arthritis therapy). A total of 280 joints (20 per hand) were evaluated. The MCCR from soft-tissue phase scans was significantly higher for clinically abnormal joints compared to clinically normal ones; P<0.001, however the MCCR from the osseous phase scans were not different between the two joint groups. Intraclass Correlation Coefficient (ICC) for MCCR was excellent [0.9789, 95% confidence interval (CI): 0.9734–0.9833]. Intra-observer agreement for qualitative SPECT findings was substantial for both the soft-tissue phase (kappa =0.78, 95% CI: 0.72–0.83) and osseous-phase (kappa =0.70, 95% CI: 0.64–0.76) scans.

Conclusions

Extracting reliable quantitative and qualitative measures from dual-phase 99mTc-MDP SPECT/CT hand scans is feasible in RA patients. SPECT/CT may provide a unique means for assessing both synovitis and osseous involvement in RA joints using the same radiotracer injection.

Background and aim: In spite of approval of new therapeutic modalities, the clinical outcome of patients with acute myeloid leukemia (AML) remains unsatisfactory. Accurate risk stratification of patients is crucial for improving their outcome. Programmed death receptor-ligand 1 (PD-L1) plays an important role in the progression of malignant disorders. So we aimed to analyze PD-L1 expression on AML cells by flow cytometry and its relation to post induction response.

Objective

High-grade gliomas (HGGs) carry dismal prognosis with survival typically reported as less than a year. We explored the predictive value of qualitative and quantitative evaluations of post-treatment 99m-technetium-labelled methoxyisobutylisonitrile (^99mmTc-MIBI) brain single-photon emission computed tomography-computed tomography (SPECT/CT) tumor uptake in relation to overall survival (OS) in patients with HGG.

Methods

Thirty patients with pathologically or radiologically documented high-grade glioma (HGG) were prospectively recruited for this study (24 male, 6 female; mean age 43 ± 14 years). All patients had a clinical or radiological suspicion of residual/recurrent tumor after initial therapy. ^99mTc-MIBI brain SPECT/CT scanning was performed, and the scans were evaluated qualitatively on a five-point probability score (1–5, scores ≥3 considered positive for residual/recurrent tumor); and quantitively via drawing volumes of interest (VOI) on the suspected lesions and normal contralateral brain tissue. All patients were followed up for 1 year or till death.

Results

Positive visual MIBI results were associated with poor survival. Among 10 patients with negative MIBI scores, only two patients died (OS = 75%), while 11/20 patients reported positive on MIBI died, with a median survival of 9 months (OS = 14.5%; P = 0.03). All patients with active isocontour volume ≤1.96 cm³ were alive at the end of the study, compared to a median survival of 9 months and OS of 12% for patients with an isocontour volume of >1.97% (P = 0.003).

Conclusion

In patients with HGG, post-therapy brain SPECT/CT with ^99mTc-MIBI can provide useful prognostic information.