Pretherapy gallium-67 scanning in paediatric patients with Hodgkin's disease

To investigate the correlation between gallium-67 [67Ga] uptake and histological subtypes of Hodgkin's disease [HD] in paediatric patients. Subjects and Fifty-eight patients [45 males and 13 females aged 9.2 +/- 4 years, range 1.5-17 years] with histologically diagnosed HD underwent pretherapy 67Ga scanning on days 2, 5, 12 or 14 days after intravenous administration of 25-50 MBq [0.7-1.4 mCi] of 67Ga citrate. The scans were evaluated both visually and quantitatively using the activity of 67Ga in the liver as a reference. Clinical outcome of 11 patients with high diffuse 67Ga skeletal uptake was compared with that of 17 patients showing normal distribution of 67Ga in the skeleton. Of the 58 patients, the 67Ga scans were positive in 47 patients with 117 lesions. Visual analysis did not differentiate between the histological variants of HD. However, quantitative analysis of lesion-to-liver ratios showed significantly higher values of 67Ga uptake in the mixed cellularity type than in the nodular sclerosis type [t = -3.7, p < 0.001]. Patients with high skeletal uptake had a higher relapse rate [6/11] than those with normal skeletal uptake [3/17]. The findings show that quantitative analysis of 67Ga uptake can differentiate between the two main subtypes of HD [mixed cellularity and nodular sclerosis]. Further diffuse skeletal uptake of 67Ga indicates a higher relapse rate

Role of iodine-131 MIBG scanning in the management of paediatric patients with neuroblastoma

To evaluate the role of iodine-131 metoiodobenzylguanidine [iodine-131 MIBG] scanning in the management of paediatric patients with neuroblastoma. Subjects and Forty-three iodine-131 MIBG scans were performed on 26 children, 18 male and 8 female, ranging in age from 8 months to 11 years. Bone scan, computed tomography [CT] images and findings of bone marrow biopsy were compared with the iodine-131 MIBG scan findings. Of the 26 patients, 18 [69%] showed abnormal iodine-131 MIBG avidity and were proven to have a neural crest tumour on histology. The remaining 8 [31%] patients had normal iodine-131 MIBG scans, and histology showed a malignancy other than a neural crest tumour. Iodine-131 MIBG scans showed the primary site in 16 of 17 patients while CT showed 14 primary sites. In follow-up studies, the results were as follows: iodine-131 MIBG showed no evidence of disease in 4 compared with 3 on CT, persistent disease in 2 on iodine-131 MIBG and 4 on CT; recurrence in 1 on iodine-131 MIBG and 0 on CT; MIBG scans detected double the number of bony lesions compared with bone scans. The findings on iodine-131 MIBG scans and bone marrow biopsy were in agreement in 16/18 cases. Patients in whom iodine-131 MIBG scans showed disease resolution had better clinical outcomes. The findings indicate that iodine-131 MIBG scanning is useful for the diagnosis, staging, evaluation of response to therapy and detection of recurrences in patients with neuroblastoma. It exhibited a clear advantage over CT in detecting the primary site and soft issue metastases and was also superior to bone scanning in detecting skeletal metastases. It also reliably demonstrated bone marrow involvement

Mental disorders in cancer patients: observations at a tertiary care centre in Pakistan

To study the frequencies of mental disorders among adult cancer patients in relation to their age, gender, marital status and type of malignancy. Socio-demographic characteristics and cancer diagnoses were recorded on a data capture form. Diagnoses of mental disorders were made on the basis of Diagnostic and Statistical Manual [DSM - IV] fourth edition. Shaukat Khanum Memorial Cancer Hospital and Research Centre. Two hundred and twenty newly diagnosed cancer patients were interviewed by a clinical psychologist before commencing any cancer treatment. Diagnosis of any mental disorder was transcribed using DSM-IV criteria and data thus collected were analyzed using SPSS for Windows. Observed frequencies of various mental disorders were compared with respect to patient's age, gender, marital status and type of cancer. Sixty five percent patients presented with various mental disorders. Adjustment disorders and mood disorders accounted for 34% each, while anxiety disorder was seen in 30% and remaining had delirium and somatoform disorders. Mental disorders were more common in males and in younger age group. The oncologists and physicians treating cancer patients should carefully evaluate their patients for symptoms of any associated mental disorder and provide the required clinical support