John Awad

University of Texas Health Science Center at Houston, Houston, Texas, United States

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Publications (2)3.93 Total impact

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    ABSTRACT: The aim of this study was to evaluate the role of single photon emission computed tomography and/or computed tomography (SPECT/CT) in differentiating metastatic from benign solitary skull lesions. Consecutive patients who had a SPECT/CT of the head subsequent to a whole-body bone scan (WBS) for the evaluation of a single skull lesion were selected. A single skull lesion on the WBS was further evaluated with SPECT/CT to characterize the lesion. The results of the SPECT/CT were correlated with other radiologic examinations performed within 2 weeks. An average follow-up interval after the SPECT/CT was 8.9 months to correlate with additional radiologic imaging studies and clinical information. A total of 19 lesions in 19 patients were seen on the WBS and 2 additional lesions on the SPECT/CT. All lesions demonstrated focal increased tracer uptake. The SPECT/CT correctly identified 3 out of 3 metastatic lesions and 12 out of 17 benign lesions, that is 71% of lesions were correctly classifised as metastatic or benign lesions. Only 1 patient was classified incorrectly as metastatic lesion with SPECT/CT when it was proven benign by other imaging modalities and follow-up. The sensitivity, specificity, positive and negative predictive values of SPECT/CT images in identifying metastatic lesions were 100%, 92%, 75%, and 100%, respectively. Five lesions remained indeterminate even after the SPECT/CT interpretation and were confirmed benign by other imaging modalities. SPECT/CT can help identify benign versus metastatic solitary skull lesions in most of the patients with high sensitivity and specificity.
    Clinical nuclear medicine 07/2011; 36(7):538-41. DOI:10.1097/RLU.0b013e31821773dd · 3.93 Impact Factor
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    ABSTRACT: Aim: This study aims to investigate the value of single photon emission computed tomography-computed tomography (SPECT-CT) imaging as part of bone scans for evaluation of a variety of pathologies of the lower extremities. Methods: The study included patients who had undergone SPECT-CT imaging as part of a bone scan between February, 2008 and May, 2009. Patients who had multiple bony metastases were excluded. Two expert readers, informed only of the site of pain, independently interpreted planar images, planar plus SPECT images, and Planar plus SPECT-CT images. The interpreta-tions were graded as: Not certain of etiology (NS), Somewhat certain (SC), and Certain (C). Changes or additions to diagnosis and/or location of pathology were graded as (D). Results: A total of 35 consecutive patients were included, 19 females and 16 males, with an average age of 44 years. There was agreement between the two readers on the site of pathology in 32 out of 35 patients. The degree of certainty for both readers increased significantly with the addition of SPECT-CT. The certainty of diagnosis increased from 26%, using planar images alone, to 44%, with the addition of SPECT, to 74%, with the addition of SPECT-CT, for Reader 1, and from 40%, to 54%, to 69%, respectively, for Reader 2. SPECT alone added six (17%) new sites of pathology to those identified from planar images, changed the diagnosis for one patient, and added a diagnosis for one other (6%). SPECT-CT changed the diagnosis for three patients, and added another diagnosis for one more patient (11%). Conclusion: SPECT-CT increased the certainty of location and diagnosis of bony pathology in the lower extremity by at least 30% across a wide variety of abnormalities.