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Primary malignant giant cell tumor (PMGCT): Diagnosis and management challenges in low resource settings Prasad, Roshan; Shukla, Samarth; Acharya, Sourya; Mittal, Gaurav; Wanjari, Mayur
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1088

Abstract

Bone primary malignant giant cell tumor (PMGCT) cases are extremely rare, and the optimal management remains unclear. This case report details the diagnosis and successful management of PMGCT in a 45-year-old female presenting with left knee pain, swelling, and restricted movement for one year. Accompanying weight loss and loss of appetite led the patient to seek tertiary care after unsuccessful prior treatment. Imaging, including X-ray and magnetic resonance imaging (MRI), revealed a tumor measuring 7.9 × 7.7 × 6.6 cm, and histopathological examination using fine needle aspiration cytology confirmed the diagnosis of PMGCT. A multidisciplinary approach was taken, involving orthopedic surgery to remove the tumor successfully, and physiotherapy for post-operative care. The patient underwent tumor excision and curettage under spinal and epidural anesthesia, followed by a week of bed rest, and then physiotherapy was started to aid in limb mobilization. Post-operative care involved blood transfusions, femoral artery stenting, continued physiotherapy and adjuvant radiotherapy, initiated two weeks post-surgery, with a total dose of 50 Gy delivered in 25 sessions to reduce the risk of recurrence. Initial monthly follow-ups, later transitioning to quarterly, showed improved joint mobility and function, with no recurrence at the 9-month follow-up. This case highlights the importance of early diagnosis and a multidisciplinary approach in managing PMGCT. Collaboration across specialties contributed to the positive outcome, even in a resource-limited setting. Long-term monitoring remains essential to detect recurrence, and further research is needed to refine treatment strategies for malignant GCTs.
Artificial intelligence-based deep learning algorithms for ground-glass opacity nodule detection: A review Shah, Henil P.; Naqvi, Agha SAH.; Rajput, Parth; Ambra, Hanan; Venkatesh, Harrini; Saleem, Junaid; Saravanan, Sudarshan; Wanjari, Mayur; Mittal, Gaurav
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1361

Abstract

Ground-glass opacities (GGOs) are hazy opacities on chest computed tomography (CT) scans that can indicate various lung diseases, including early COVID-19, pneumonia, and lung cancer. Artificial intelligence (AI) is a promising tool for analyzing medical images, such as chest CT scans. The aim of this study was to evaluate AI models' performance in detecting GGO nodules using metrics like accuracy, sensitivity, specificity, F1 score, area under the curve (AUC) and precision. We designed a search strategy to include reports focusing on deep learning algorithms applied to high-resolution CT scans. The search was performed on PubMed, Google Scholar, Scopus, and ScienceDirect to identify studies published between 2016 and 2024. Quality appraisal of included studies was conducted using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, assessing the risk of bias and applicability concerns across four domains. Two reviewers independently screened studies reporting the diagnostic ability of AI-assisted CT scans in early GGO detection, where the review results were synthesized qualitatively. Out of 5,247 initially identified records, we found 18 studies matching the inclusion criteria of this study. Among evaluated models, DenseNet achieved the highest accuracy of 99.48%, though its sensitivity and specificity were not reported. WOANet showed an accuracy of 98.78%, with a sensitivity of 98.37% and high specificity of 99.19%, excelling particularly in specificity without compromising sensitivity. In conclusion, AI models can potentially detect GGO on chest CT scans. Future research should focus on developing hybrid models that integrate various AI approaches to improve clinical applicability.