Sheila Rankin

Guy's and St Thomas' NHS Foundation Trust, Londinium, England, United Kingdom

Are you Sheila Rankin?

Claim your profile

Publications (28)88.7 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine whether to use 18F‐fluorodeoxyglucose positron emission tomography (FDG PET) scans in the preoperative staging of bladder cancer (BC).
    BJU International 09/2014; 114(3). DOI:10.1111/bju.12608 · 3.13 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine whether to use 18F FDG PET scans in the preoperative staging of bladder cancer. All patients (N=233) with muscle invasive (MIBC) or high risk non-muscle invasive (NMIBC) bladder cancer being considered for radical surgery between 2005 and 2011 had FDG-PET and CT scan chest, abdomen and pelvis to assess for pelvic nodal involvement or distant metastases. Sensitivity and specificity for detecting pelvic lymph nodal involvement was determined by comparing the results of the scans to the histopathology reports in patients undergoing radical cystectomy. These parameters for distant metastases were determined from biopsy results or follow up imaging. In patients who did not undergo surgery, follow up imaging was used to evaluate the sensitivity and specificity. Patients were excluded from analysis if they either had neo-adjuvant chemotherapy or had less than 10 nodes removed at lymphadenectomy. The PET scan was able to detect metastatic disease outside of the pelvis with a sensitivity of 54% compared to 41% for the staging CT (N=207). Both scans had similar specificities of 97% and 98%. There were 13 PET avid lesions not visualised on the corresponding staging CT scans. These proved to be metastatic bladder cancer (n=6), a synchronous primary colonic cancer (n=1), colonic adenomas (n=1), basal cell tumour of the parotid gland (n=1) and inflammatory lesions (n=4). The sensitivity and specificity of the CT scans for pelvic lymph nodal involvement was 45% and 98% respectively (N=93). Using combination of the PET and CT scan, the sensitivity for detecting metastatic disease in nodes increased to 69% with a 3% reduction in specificity to 95%. PET scan when used in conjunction with a standard CT scan provides a small improvement in preoperative staging of bladder cancer. However, this advantage is not significant enough to justify the additional cost. Hence we recommend use of dual imaging only in highly selected patients.
    BJU International 12/2013; · 3.13 Impact Factor
  • European Urology Supplements 03/2013; 12(1):e477-e478. DOI:10.1016/S1569-9056(13)60960-4 · 3.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: (18)F-fluoro-2-deoxy-D: -glucose positron emission tomography ((18)F-FDG PET/CT) has developed into the standard of care for investigating patients with non-small cell lung cancer (NSCLC) to determine the optimal treatment. However, although the majority of patients with NSCLC do have intense uptake of tracer, false negatives do occur and should be considered. We report cases of patients that have synchronous NSCLCs. In both cases, there was intense uptake of FDG in one tumour type, with very low grade uptake in the separate tumour. Histology confirmed separate lung malignancies, demonstrating that differential FDG uptake may not always be inflammatory and should be considered to have a separate malignant aetiology.
    Annals of Nuclear Medicine 05/2011; 25(4):299-302. DOI:10.1007/s12149-010-0457-8 · 1.51 Impact Factor
  • Source
    S Rankin
    [Show abstract] [Hide abstract]
    ABSTRACT: [18F]Fluorodeoxyglucose-positron emission tomography/computed tomography (CT) is recognized as a useful adjunct to conventional imaging with CT and endoscopic ultrasonography for the staging of oesophageal cancer, for response assessment and identification of recurrent disease and it may provide prognostic information.
    Cancer Imaging 01/2011; 11 Spec No A:S156-60. DOI:10.1102/1470-7330.2011.9040 · 1.29 Impact Factor
  • Source
    S Rankin
    [Show abstract] [Hide abstract]
    ABSTRACT: Computed tomography (CT) and magnetic resonance imaging (MRI) are excellent modalities for the localization of mediastinal masses and there are often features that may allow the correct diagnosis to be made. However, CT and MRI cannot usually assess the aggressiveness of masses or identify viable tumour in residual masses after chemotherapy. Metabolic imaging using [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography/CT, although not required in many cases, may be helpful for further characterization of masses and to guide the most appropriate site for biopsy.
    Cancer Imaging 09/2010; 10 Spec no A(1A):S156-60. DOI:10.1102/1470-7330.2010.9026 · 1.29 Impact Factor
  • Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 06/2010; 5(6):921-3. DOI:10.1097/JTO.0b013e3181db6ddd · 5.80 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the role of 18-fluorodeoxyglucose positron emission tomography-computed tomography (18-FDG-PET-CT) in the surveillance of patients after multimodality treatment of malignant pleural mesothelioma. Retrospective study of patients who had chemotherapy, radical surgery, extrapleural pneumonectomy or pleurectomy/decortication, and radiotherapy for mesothelioma in our unit. PET-CT was performed after multimodality therapy to evaluate response to treatment or when disease recurrence was suspected. 18-FDG-PET scans were acquired from skull base to upper thigh with low-dose CT scans for attenuation correction and image fusion. Forty-four patients had extrapleural pneumonectomy (21) or pleurectomy/decortication (23) between January 2004 and July 2008. Twenty-five patients had PET-CT performed after multimodality therapy. This was performed in 11 patients in whom disease recurrence was suspected at a median of 9 (range, 6-16) months after treatment. PET-CT correctly diagnosed recurrent disease in eight patients and missed microscopic recurrence in one. Surveillance PET-CT was performed in 14 asymptomatic patients at a median of 11 (range, 7-13) months after treatment. It showed unsuspected recurrences in four patients. The standard uptake value max of recurrent mesothelioma was 8.9 +/- 4.0 (4-18.4). PET-CT had a sensitivity of 94%, a specificity of 100%, and the positive and negative predictive values of 100 and 88%, respectively. 18-FDG-PET-CT is useful in diagnosing disease recurrence after multimodality therapy for malignant pleural mesothelioma. We propose a prospective study to fully assess its value in this group of patients.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 03/2010; 5(3):385-8. DOI:10.1097/JTO.0b013e3181cbf465 · 5.80 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: It has been previously reported in the literature that intractable hiccups (singultus) may indicate a serious underlying pathology [1]. In particular, there have been well-documented cases that intractable hiccups are associated with cerebral toxoplasmosis in human immunodeficiency virus (HIV) patients [2–4]. We present a case using F-18flurodeoxygluocose (FDG) positron emission tomography (PET) that demonstrates the effect of intractable hiccups on FDG uptake in a PET scan. A 30-year-old man with HIV was referred for a FDGPET/CT scan to further investigate an enhancing lesion in the right frontal lobe found with magnetic resonance imaging. The patient was suffering from intractable hiccups during the FDG uptake period. The PET/CT showed an area of hypometabolism in the right frontal lobe surrounded by a rim of low-grade increased uptake in keeping with toxoplasmosis (arrow, A). In addition, as a result of the intractable hiccups, there was avid FDG accumulation within the muscles of respiration (intercostal and diaphragmatic muscles), and the accessory muscles of respiration in the low neck. This is shown in both axial (B) and coronal
    European Journal of Nuclear Medicine 10/2009; 36(11):1901. DOI:10.1007/s00259-009-1256-0 · 5.22 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recurrent respiratory papillomatosis (RRP) is the most common benign tumor of the larynx in children. Papillomas in RRP are usually benign and are localized to the larynx. Lung involvement is rare. The papillomas in the laryngotracheal and bronchioloalveolar region may undergo malignant degeneration to squamous cell carcinoma and are reported to have a poor prognosis. A 28-year-old woman presented with hemoptysis. She had known RRP in the trachea but no previous lung involvement. A chest radiograph and CT scan revealed multiple nodules, some of which were cavitating and some were with a predominantly cystic appearance. PET/CT showed increased F-18 FDG uptake in these nodules and guided biopsy.
    Clinical nuclear medicine 09/2009; 34(8):521-2. DOI:10.1097/RLU.0b013e3181abb71c · 2.86 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Many studies demonstrate a high accuracy for PET in staging lymphoma, but few assess observer variation. This study quantified agreement for staging lymphoma with PET/CT. The PET/CT images of 100 patients with lymphoma who had been referred for staging were reviewed by 3 experienced observers, with 2 observers reviewing each series a second time. Ann Arbor stage and individual nodal and extranodal regions were assessed. Weighted kappa (kappa(w)) and intraclass correlation coefficient were used to compare ratings. Intra- and interobserver agreement was high for Ann Arbor stage (kappa(w) = 0.79-0.91), number of nodal regions involved (intraclass correlation coefficient, 0.83-0.93), and presence of extranodal disease (kappa = 0.74-0.86). High agreement was also observed for all nodal regions (kappa(w) > 0.60) except hilar (kappa(w) = 0.56-0.82) and infraclavicular (kappa(w) = 0.14-0.55). Lower agreement was observed for bowel involvement (kappa(w) = 0.37-0.71). Experienced observers had a high level of agreement using PET/CT for lymphoma staging, supporting its use as a robust noninvasive staging tool. Further research is needed to evaluate observer variability for restaging during and after chemotherapy.
    Journal of Nuclear Medicine 09/2009; 50(10):1594-7. DOI:10.2967/jnumed.109.064121 · 5.56 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Conventional publicly funded out-patient services in many specialties are characterised by delays, fragmented diagnostic processes, and overloaded clinics. This is bad for patients as it is clinically dangerous; bad for managers who spend hours managing the failure; bad for doctors who respond by overloading clinics; and bad for purchasers who have to fund the multiple out-patient visits needed. Sound clinical and financial reasons exist for introducing more efficient diagnostic processes. A total of 330 consecutive patients referred to the urology department of Guy's and St Thomas' NHS Foundation Trust were invited to attend one of nine one-stop clinics staffed by consultant urologists with specialist registrars, nurses, and clerical staff. Pre-clinic blood and urine tests were ordered based on the referral letter. Clinics had facilities to perform cystoscopy, ultrasound, and urinary flow studies. Correspondence was generated in real time, and a copy given to the patient. Overall, 257 patients attended the clinics. Twenty-three patients cancelled appointments and 50 patients did not attend. Pre-clinic tests were requested in 133 patients and were completed by 86% of the patients who attended. Of patients, 42% were diagnosed and discharged; 28% were listed for surgery, extracorporeal shock wave lithotripsy (ESWL), or referred to another specialty. About 30% of patients needed further out-patient review; in approximately two-thirds to complete a diagnosis and one-third to review the results of therapy initiated. An estimated 350 appointments and 550 patient visits to hospital were saved. A one-stop method of consultation is efficient across a range of urological presenting complaints, and dramatically reduces the need for follow-up consultations. It has potential to: (i) reduce delays to being seen in out-patients; (ii) lead to more cost-effective care; and (iii) increase safety and patient satisfaction. It should become the standard of care in urology, and is probably applicable in many other disciplines.
    Annals of The Royal College of Surgeons of England 05/2009; 91(4):305-9. DOI:10.1308/003588409X391802 · 1.22 Impact Factor
  • European Urology Supplements 03/2009; 8(4):350-350. DOI:10.1016/S1569-9056(09)60903-9 · 3.37 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Error and variation in reporting remains one of the weakest features of clinical imaging despite enormous technological advances in nuclear medicine and radiology. The aim of this study was to evaluate agreement amongst experienced readers in staging non-small-cell lung cancer (NSCLC) with PET-CT. A series of (18)F-FDG PET-CT scans from 100 consecutive patients were reviewed independently by three experienced readers, with two readers reviewing each scan series a second time. Individual mediastinal lymph node stations were assessed as benign/inflammatory, equivocal or malignant, and AJCC N and M stage were also assigned. Kappa (kappa) was used to compare ratings from two categories and weighted kappa (kappa(w)) for three or more categories, and kappa values were interpreted according to the Landis-Koch benchmarks. Both intra- and interobserver agreement for N and M staging were high. For M staging there was almost perfect intra- and interobserver agreement (kappa = 0.90-0.93). For N staging, agreement was either almost perfect or substantial (intraobserver kappa(w) = 0.79, 0.91; interobserver kappa(w) = 0.75-0.81). Importantly, there was almost perfect agreement for N0/1 vs N2/3 disease (kappa = 0.80-0.97). Agreement for inferior and superior mediastinal nodes (stations 1, 2, 3, 7, 8, 9) was either almost perfect or substantial (kappa(w) = 0.71-0.88), but lower for hilar nodes (10; kappa(w) = 0.56-0.71). Interreporter variability was greatest for aortopulmonary nodes (5, 6; kappa(w) = 0.48-0.55). Amongst experienced reporters in a single centre, there was a very high level of agreement for both mediastinal nodal stage and detection of distant metastases with PET-CT. This supports the use of PET-CT as a robust imaging modality for staging NSCLC.
    European Journal of Nuclear Medicine 11/2008; 36(2):194-9. DOI:10.1007/s00259-008-0946-3 · 5.22 Impact Factor
  • Sheila C. Rankin
    [Show abstract] [Hide abstract]
    ABSTRACT: Correct staging of non-small cell lung cancer (NSCLC) is vital to undertake appropriate management and improve prognosis. Initial staging is usually performed with computerized tomography (CT), which has well recognized limitations, and increasingly functional imaging using integrated positron emission tomography and CT (PET/CT) is being used to provide more accurate staging, to guide biopsies, to assess response to therapy, and to identify recurrent disease. Staging and response to therapy will be discussed in this review.
    Targeted Oncology 07/2008; 3(3):149-159. DOI:10.1007/s11523-008-0085-6 · 3.46 Impact Factor
  • Source
    Sheila Rankin
    [Show abstract] [Hide abstract]
    ABSTRACT: Correct staging of non small cell lung cancer (NSCLC) is vital for appropriate management. Initial staging is usually performed with computerised tomography (CT), but increasingly functional imaging using integrated positron emission tomography and CT (PET/CT) is being used to provide more accurate staging, guide biopsies, assess response to therapy and identify recurrent disease.
    Cancer Imaging 02/2008; 8 Spec No A:S27-31. DOI:10.1102/1470-7330.2008.9006 · 1.29 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We set out to find a policy for the management of the pneumonectomy space which would minimise risk and be acceptable to all the surgeons. We believe this will reduce opportunities for error, be welcomed by nursing staff, and improve adherence to protocols. We sought evidence in the scientific and educational literature. Finding no sure guidance, we audited our own experience of two policies, with the emphasis on minimising risk. There was no evidence from randomised trials. There was no cohesive advice in the text books. Our data indicated that it was improbable that randomised controlled trial (RCT) would have the power to find the evidence. Unable to establish the best strategy, we chose what appeared to be the lowest risk management policy. It is instructive that such a fundamental question should be unanswered. We have adopted a low risk and well established strategy--an unclamped underwater seal drain--but have no evidence base other than clinical experience. This is illustrative of much of what we do in clinical surgical practice. Avoiding major risk is often more important than proving small differences in benefit.
    Heart, Lung and Circulation 05/2007; 16(2):103-6. DOI:10.1016/j.hlc.2006.11.002 · 1.17 Impact Factor
  • Source
    S C Rankin
    [Show abstract] [Hide abstract]
    ABSTRACT: The prognosis for oesophageal cancer is poor with a median survival of 3-5 months and recurrences are frequent. The best chance of cure is successful surgery and pre-operative chemoradiotherapy is used to try and improve outcomes. However, patients may either not respond or may progress during therapy and it is important to differentiate the responders from non-responders. Clinical parameters such as weight gain and improvement in swallowing can be assessed but imaging is used in an attempt to improve outcomes.
    Cancer Imaging 02/2007; 7 Spec No A(Special issue A):S67-9. DOI:10.1102/1470-7330.2007.9019 · 1.29 Impact Factor
  • The Journal of thoracic and cardiovascular surgery 12/2006; 132(5):1239-40. DOI:10.1016/j.jtcvs.2006.05.054 · 3.99 Impact Factor
  • Lung Cancer 10/2006; 54. DOI:10.1016/S0169-5002(07)70262-3 · 3.74 Impact Factor