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        Metastatic Neuroendocrine Tumour in a Renal Transplant Recipient: Dual-Tracer PET-CT with 18F-FDG and 68Ga-DOTANOC in This Rare Setting

        Sellam Karunanithi,Shambo Guha Roy,Punit Sharma,Rajni Yadav,Chandrasekhar Bal,Rakesh Kumar 대한핵의학회 2015 핵의학 분자영상 Vol.49 No.1

        Recipients of renal transplant are at increased risk ofdeveloping various malignancies, especially post-transplantlymphoproliferative disorder (PTLD) and skin cancers. Neuroendocrine tumours (NET) of the gastrointestinal tracthave not been reported in this setting. Here we describe thecase of a 75-year-old male who had undergone renal transplant8 years back and now presented with significant weight lossand backache, clinically suspected as PTLD. 18FFluordeoxyglucose(18F-FDG) positron emission tomographycomputedtomography (PET-CT) showed hypermetabolic lesionsin the liver and rectum, raising the suspicion of PTLD. However, biopsy from the liver lesion showed poorly differentiatedNET. 68Ga-labelled [1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid]-1-NaI3-octreotide (68Ga-DOTANOC) PET-CT was then done, which confirmed theprimary lesion in the rectum with liver metastases.

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        Quantitative histology-based classification system for assessment of the intestinal mucosal histological changes in patients with celiac disease

        Prasenjit Das,Gaurav PS Gahlot,Alka Singh,Vandana Baloda,Ramakant Rawat,Anil K Verma,Gaurav Khanna,Maitrayee Roy,Archana George,Ashok Singh,Aasma Nalwa,Prashant Ramteke,Rajni Yadav,Vineet Ahuja,Vishnu 대한장연구학회 2019 Intestinal Research Vol.17 No.3

        Background/Aims: The existing histological classifications for the interpretation of small intestinal biopsies are based on qualitative parameters with high intraobserver and interobserver variations. We have developed and propose a quantitative histological classification system for the assessment of intestinal mucosal biopsies. Methods: We performed a computer-assisted quantitative histological assessment of digital images of duodenal biopsies from 137 controls and 124 patients with celiac disease (CeD) (derivation cohort). From the receiver-operating curve analysis, followed by multivariate and logistic regression analyses, we identified parameters for differentiating control biopsies from those of the patients with CeD. We repeated the quantitative histological analysis in a validation cohort (105 controls and 120 patients with CeD). On the basis of the results, we propose a quantitative histological classification system. The new classification was compared with the existing histological classifications for interobserver and intraobserver agreements by a group of qualified pathologists. Results: Among the histological parameters, intraepithelial lymphocyte count of ≥25/100 epithelial cells, adjusted villous height fold change of ≤0.7, and crypt depth-to-villous height ratio of ≥0.5 showed good discriminative power between the mucosal biopsies from the patients with CeD and those from the controls, with 90.3% sensitivity, 93.5% specificity, and 96.2% area under the curve. Among the existing histological classifications, our quantitative histological classification showed the highest intraobserver (69.7%–85.03%) and interobserver (24.6%–71.5%) agreements. Conclusions: Quantitative assessment increases the reliability of the histological assessment of mucosal biopsies in patients with CeD. Such a classification system may be used for clinical trials in patients with CeD.

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