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All Journal Journal of Medicine and Health Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Medicine and Health
Hendra Budiawan
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Generalized Lymphadenopathy due to Chronic Lymphocytic Leukemia (CLL) : 18F-FDG PET Imaging Basuki Hidayat; Febby Hutomo; Ryan Yudistiro; Ivana D. Mulyanto; Hendra Budiawan; Johan S. Masjhur
Journal of Medicine and Health Vol. 1 No. 3 (2016)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (222.033 KB) | DOI: 10.28932/jmh.v1i3.520

Abstract

Lymphadenopaty is a common clinical finding with a broad differential diagnosis, withCarcinoma of Unknown Primary (CUP) as one of it’s most common causes. Flourine-18 fluoro-2 deoxy glucose (18F- FDG) positron emission tomography (PET) is a Nuclear Medicinescintigraphy procedure commonly used to localize suspected a primary lesion by depicting ametabolic status. However, in the expertise of 18F FDG PET study, clinical finding andepidemiologic data must be considered to get a better conclusion. We describe 18F-FDG PETstudy in the presence of generalized lymphadenopathy due to chronic lymphocytic leukemia(CLL), a rare disease which is initially suspected of having CUP.Keywords: 18F-FDG PET, lymphadenopathy, lymphoma, leukemia
Generalized Lymphadenopathy due to Chronic Lymphocytic Leukemia (CLL) : 18F-FDG PET Imaging Basuki Hidayat; Febby Hutomo; Ryan Yudistiro; Ivana D. Mulyanto; Hendra Budiawan; Johan S. Masjhur
Journal of Medicine and Health Vol 1 No 3 (2016)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v1i3.520

Abstract

Lymphadenopaty is a common clinical finding with a broad differential diagnosis, withCarcinoma of Unknown Primary (CUP) as one of it’s most common causes. Flourine-18 fluoro-2 deoxy glucose (18F- FDG) positron emission tomography (PET) is a Nuclear Medicinescintigraphy procedure commonly used to localize suspected a primary lesion by depicting ametabolic status. However, in the expertise of 18F FDG PET study, clinical finding andepidemiologic data must be considered to get a better conclusion. We describe 18F-FDG PETstudy in the presence of generalized lymphadenopathy due to chronic lymphocytic leukemia(CLL), a rare disease which is initially suspected of having CUP.Keywords: 18F-FDG PET, lymphadenopathy, lymphoma, leukemia
Diagnostic Performance of Imaging Modalities in Persistent or Recurrent Hyperparathyroidism: A Network Meta-Analysis of 18F-Fluorocholine PET/CT, 4D-CT, and Scintigraphy Hendry Johan Renaldy Tandra; Endah Indriani; Hendra Budiawan; Basuki Hidayat
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1424

Abstract

Background: The surgical management of persistent or recurrent primary hyperparathyroidism (PHPT) is critically dependent on accurate preoperative localization of ectopic or residual hyperfunctioning glands within a scarred anatomical field. While 18F-Fluorocholine Positron Emission Tomography/Computed Tomography (18F-FCH PET/CT), four-dimensional computed tomography (4D-CT), and 99mTc-Sestamibi scintigraphy are employed, a definitive evidence-based hierarchy to guide their use is absent. This study aimed to establish this hierarchy by comparing their diagnostic performance through a network meta-analysis. Methods: A systematic search of PubMed, Embase, and Scopus was conducted for comparative studies published between January 2015 and August 2025 evaluating these modalities in persistent/recurrent PHPT. A Bayesian bivariate network meta-analysis was performed to calculate pooled sensitivities and specificities on both a per-patient and per-lesion basis. Modalities were ranked using Surface Under the Cumulative Ranking (SUCRA) scores. Methodological quality, inconsistency, and heterogeneity were formally assessed. Results: Seven studies involving 687 patients were included. On a per-patient analysis, 18F-FCH PET/CT demonstrated the highest sensitivity at 94.1% (95% Credible Interval [CrI]: 89.8%–97.5%), significantly outperforming 4D-CT (82.5%; 95% CrI: 75.1%–88.9%) and scintigraphy with SPECT/CT (60.3%; 95% CrI: 51.2%–69.1%). Specificities were uniformly high. Per-lesion analysis confirmed this hierarchy. SUCRA rankings identified 18F-FCH PET/CT as the superior modality for both per-patient (98.7%) and per-lesion (99.1%) detection. No significant network inconsistency was detected. Conclusion: 18F-FCH PET/CT exhibits superior diagnostic accuracy for localizing culprit parathyroid glands in persistent or recurrent PHPT. Its performance, grounded in robust metabolic targeting that overcomes the challenges of a reoperative field, supports its positioning as the primary imaging modality in this setting. These findings advocate for a revision of current diagnostic algorithms to enhance surgical planning and improve patient outcomes.
Co-Authors Basuki Hidayat Endah Indriani Febby Hutomo Hendry Johan Renaldy Tandra Ivana D. Mulyanto Johan S. Masjhur Ryan Yudistiro