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Khangembam Bangkim Chandra,Abhinav Singhal 대한핵의학회 2021 핵의학 분자영상 Vol.55 No.6
Purpose Hypermetabolic macrovascular invasion (MVI) and extrahepatic metastasis (EHM) occur in aggressive hepatocellularcarcinoma (HCC) and carry unfavorable prognosis. [18F] FDG PET/CT, despite having low sensitivity in primary HCC,is valuable in patients with aggressive HCC for detection of hypermetabolic MVI and EHM. The study aimed at identifyingthe parameters that could predict hypermetabolic MVI and/or EHM in treatment naive HCC patients for tailored approachto utilize [18F] FDG PET/CT. Methods Data of 131 treatment naive HCC patients (median age, 60 years; range, 21–80 years; 90.8% males) who underwent[18F] FDG PET/CT were retrospectively analyzed to determine the proportion of patients with hypermetabolic MVI and/orEHM. Logistic regression analysis was performed to define independent predictors of hypermetabolic MVI and/or EHM. Results 78/131 (59.5%) patients had hypermetabolic MVI and/or EHM. 52/131 (39.7%) patients had EHM. 56/131 (42.7%)patients had hypermetabolic MVI of which, 30 had concomitant EHM with majority (90%; 27/30) having distant metastasis. 26/131 (19.8%) patients had hypermetabolic MVI without EHM while 22/131 (16.8%) patients had EHM without hypermetabolicMVI of which, majority (95.5%; 21/22) had distant metastasis. Hypermetabolic MVI was associated with EHM( 2=7.868; p value=0.007). AFP>93.7 ng/ml, SUVmax>3.5, and maximum tumor size>5.0 cm were the independentpredictors of hypermetabolic MVI and/or EHM. Conclusion In treatment naive HCC patients with AFP>93.7 ng/ml or maximum tumor size>5.0 cm, [18F] FDG PET/CTcan be valuable.
Recurrent Arterial Thrombosis as a Presenting Feature of a Variant M3-Acute Promyelocytic Leukemia
Pranit N. Chotai,Kalenda Kasangana,Abhinav B. Chandra,Atul S. Rao 대한혈관외과학회 2016 Vascular Specialist International Vol.32 No.2
Acute limb ischemia (ALI) is a common vascular emergency. Hematologic malignancies are commonly associated with derangement of normal hemostasis and thrombo-hemorrhagic symptoms during the course of the disease are common. However, ALI as an initial presenting feature of acute leukemia is rare. Due to the rarity of this presentation, there is a scarcity of prospective randomized data to optimally guide the management of these patients. Current knowledge is mainly based on isolated cases. We report our experience managing a patient who presented with ALI and was found to have occult leukemia. A review of all cases with ALI as a presenting feature of acute leukemia is also presented.
Can a Point-of-Care Troponin I Assay be as Good as a Central Laboratory Assay? A MIDAS Investigation
W. Frank Peacock,Deborah Diercks,Robert Birkhahn,Adam J. Singer,Judd E. Hollander,Richard Nowak,Basmah Safdar,Chadwick D. Miller,Mary Peberdy,Francis Counselman,Abhinav Chandra,Joshua Kosowsky,James N 대한진단검사의학회 2016 Annals of Laboratory Medicine Vol.36 No.5
Background: We aimed to compare the diagnostic accuracy of the Alere Triage Cardio3 Tropinin I (TnI) assay (Alere, Inc., USA) and the PathFast cTnI-II (Mitsubishi Chemical Medience Corporation, Japan) against the central laboratory assay Singulex Erenna TnI assay (Singulex, USA). Methods: Using the Markers in the Diagnosis of Acute Coronary Syndromes (MIDAS) study population, we evaluated the ability of three different assays to identify patients with acute myocardial infarction (AMI). The MIDAS dataset, described elsewhere, is a prospective multicenter dataset of emergency department (ED) patients with suspected acute coronary syndrome (ACS) and a planned objective myocardial perfusion evaluation. Myocardial infarction (MI) was diagnosed by central adjudication. Results: The C-statistic with 95% confidence intervals (CI) for diagnosing MI by using a common population (n=241) was 0.95 (0.91-0.99), 0.95 (0.91-0.99), and 0.93 (0.89-0.97) for the Triage, Singulex, and PathFast assays, respectively. Of samples with detectable troponin, the absolute values had high Pearson (RP) and Spearman (RS) correlations and were RP =0.94 and RS=0.94 for Triage vs Singulex, RP =0.93 and RS=0.85 for Triage vs PathFast, and RP =0.89 and RS=0.73 for PathFast vs Singulex. Conclusions: In a single comparative population of ED patients with suspected ACS, the Triage Cardio3 TnI, PathFast, and Singulex TnI assays provided similar diagnostic performance for MI.