Description of MR and brain 18F-FDG PET/CT imaging characteristics in Alzheimer’s Disease patients in National Hospital of Geriatrics SUMMARY Purpose : Study realised is aimed to describe MRI features as well as brain 18F-FDG PET/CT characteristics of Alzheimer’s Disease patients in the National Hospital of Geriatrics. Methods: From 2014 to 2015, it is the first time in Vietnam, brain 18F-FDG PET/CT scan applied in studying Alzheimer disease with 32 cases including 16 Aalzheimer patients in pathologic group and 16 non-demential elderly individuals (“Normals” or NLs) in control group, brain 18F-FDG PET/CT scans performed at the Center of Nuclear Medicine and Oncology - Bach Mai Hospital. Brain MRI investigation was also realized for all Alzheimer patients. 18F-FDG PET/CT data in Alzheimer group was confronted to Nls group. Results: Mean age in AD patients is 65.1± 8.2 years old. Most of AD patients examined at moderate to severe stage (90%). Brain MRI shows 93% AD patients with brain atrophy (mild to severe level), 75% with pathological medial temporal lobe atrophy (abnormal MTA scale) and 81.3% having parietal cortical atrophy. Evan index is higher than normal in 65% of cases. No abnormal regional cortical glucose hypometabolism on brain 18F-FDG PET/ CT imaging seen in all persons in Nls group. On the other hand, in Alzheimer group, 93,8% of cases having a hypometabolism occurred in temporo-parietal association region and 81.3% of cases on right side, meanwhile all Alzheimer patients suffering from a glucose hypometabolism affecting bilateral posterior cingulate gyrus as well as left hippocampus. Occipital glucose metabolism in Alzheimer group is principally well reserved and hypometabolism extending to frontal regions in about a half of all cases. Conclusion : Most of Alzheimer patients having cerebral degenerative abnormalities on brain MRI presented by multi-grade cerebral parenchymal atrophy. Characteristic atrophic regions in Alzheimer patients include medial temporal and parietal lobes. Glucose hypometabolisme imaging in 18F-FDG PET/CT scans in Alzheimer group is quite specific with anatomically regional hypometabolism patterns seen in temporo-parietal association regions as well as in posterior cingulate gyri, with dominance on left side. Brain MRI and brain 18F-FDG PET/CT scan are wellknown as imaging technics with a high sensibility, high medical safety which are objective valued imaging technics and applied more and more in clinical and recherch Alzheimer disease in particular as well as in dementia in general, helping and taking part in to improve definitive and discriminative diagnostic ability of Alzheimer disease and other dementia. Key words: Alzheimer’s Disease (AD), MRI, Brain 18F-FDG PET/CT, dementia.

Selective internal radiation therapy forliver cancer with Y-90 microsphere at Bachmai hospital SUMMARY Selective Internal Radiation Therapy (SIRT) for liver cancer is a method to inject Y-90 labeled resin microsphere into the hepatic arteries supplying the tumor. Cancer cells will be annihilate by irradiation with ionizing radiation emitted from Y-90. Theprocedure has been standardized and applied in treatment of liver cancer patients at the Nuclear Medicine & Oncology Center, Bach Mai hospital. Aims of study: To establish and standardize the procedure of SIRT with Y-90 microsphere for liver cancer. - To assess initial results of SIRT for liver cancer at The Nuclear medicine & Oncology Center, Bach Mai hospital. Subject and method : 36 patients with primary or secondary liver cancer confirmation. These patients had been treated with Y-90 microsphere and follow-up assessments after treatment 1 and 3 months. Descriptive and propective study. Establishing a standard SIRT with Y-90 microsphere for liver cancer. Results of study: Procedure of SIRT with Y-90 microsphere for liver cancer has been standardized. Contents of protocol included indications and contraindications; workflow: Arteriographic assessment to map tumor-perfusing vessels and assess portal vein patency; SPECT with Tc 99m MAA to optimize the treatment planning (by dosimetric evaluation) and evaluate hepatopulmonary shunting; inject Y-90 microsphere into the vessels supplying the tumor, SPECT or PET/CT to evaluate the distribution of Y-90 microsphere; Evaluate the outcomes and safety. The initial treatment results of SIRT forprimary liver cancer patients: more than 80% patients responded with treatment, no patient had complication. AFP level reduced in 77.8% and no change in 22.2% patients, AFP reduced from 4660.3ng/ml to 248.4ng/ml; 72.2% patients mean tumor size was decreased from 7.2 cm to 4.3 cm and was stable in 27.8% patients.The patient with secondary liver cancer from colon cancer: CEAreducedfrom1000 ng/ml to 40ng/ml, tumor size 7.0 cm reduced to 3,0 cm. Conclusion: Selective internal radiation therapy with Y-90 microsphere for liver cancer is a new, effective and safe method. Procedure of the technique was standardized and applied for liver cancer treatment at the Nuclear medicine & Oncology Center, Bach Mai hospital. The initial results show the efficacy and safety of the technique and it should be disseminated for primary and secondary liver cancer treatment. Keywords : Y-90 microsphere, liver cancer, Selective Internal Radiation Therapy: SIRT.

The value of diffusion-weighted imaging in the detection of prostate cancer SUMMARY Purpose: The aim of study was to determine the value of DWI in diagnosis of prostate carcinoma especially for differentiating benign from malignant lesion of the prostate. Materials and methods : During a period of 4/2014-3/2015, 41 consecutive patients with elevated PSA level were evaluated with DWI of the prostate. The results were confirmed by TRUSguided biopsy. We compare two groups (prostate carcinoma/PCa and prostate non-carcinoma/PNCa) by variants: tissue diffusivity, mean of ADC… Analyzing ROC curve to find the value of DWI in differentiating benign from malignant tissue of the prostate. Results: Patients ranged in age from 50 to 94 years (mean 73±10year). 18 patients were confirmed to have PNCa (44%), whereas 23 patients had Pca (56%). The mean of ADC values for PNCa and PCa were 829.2±119.2 and 544.6±102.7x10-3 mm2/s respectively. The mean ADC value of PCa was significantly lower than PNCa (p<0.05). On ROC curve, using the discrimination threshold of ADC is 633x10-3 mm2/s, the DWI provided a sensitivity of 82.6%, specificity of 94.4% and accuracy of 96%. Conclusions: Diffusion-weighted imaging of the prostate can be used to differentiate benign from malignant tissue of the prostate with high accuracy. Key words: Prostatic carcinoma, non-carcinoma, diffusion magnetic resonance imaging, ADC, TRUS.

Ultrasound features of thyroid cancer SUMMARY urpose: To find features of thyroid malignancy nodule on the ultrasound. Material and Methods: A total 307 thyroid nodules of 272 patients (146 malignant nodules on the 146 patients, 161 benign nodules on the 126 patients), who underwent thyroid ultrasound examintation. There ultrasound features are compared with pathologic result for evaluation value. Result: The following US features showed a significant association with malignancy: solid component, hypoechogenicity (Sensitivity 80.82%; Specificity 59.01%), marked hypoechogenicity (Sensitivity 16.44%, Specificity 98.76%), irregular margins (Sensitivity 77.4%, Specificity 92.55%), microcalcifi cations (Sensitivity 69.18%, Specificity 97.52%), and taller-than-wide shape (Sensitivity 69,86%, Specificity 94.41%). Conclusion: High-resolution thyroid US is the most useful diagnostic tool for evaluating thyroid nodules. Ultrasound features of thyroid nodules malignancy include a hypoechonic, mark hypoechonic, taller than wide, irregular margins and microcalcification. Keyword: Thyroid ultrasound, thyroid, ultrasound.

Imaging characteristics and the invasion, abdominal metastases of gastric cancer with MDCT SUMMARY Purposes: Describe imaging characteristics and assess value of MDCT in evaluating the invasion, abdominal metastase of gastric adenocarcinoma based on the 7 th AJCC guidelines. Materials and methods: From 4/2014 to 3/2015, there are 32 consecutive patients with gastric adenocarcinoma were undergone 64-slide-CT. All of them were undergone operation with pathology after surgery. Results: The average age is 63 years old, and male/ female=2/1. In 37.2% of cases gastric carcinoma is located on antrum. About macroscopic type, the forth type (linitis plastica) rates are highest 68.8%. The thickness of gastric cancer is pricipal 15-19 mm, all of cases heterogeneous enhancement. There are 17 cases invasion adjacent organs, in which tranverse colon is 8 cases and pancreas is 7 cases. Evaluating the value of diagnosis peritoneal metastase between MDCT and surgical resection is appropriated with medial level Kappa = 0.53, the sensitivity is 75%, the specificity is 89.3%. The overall accuracy of T staging is 62.5% (T1 66.7%, T2-T3 69.2%, T4a 44.4%, and T4b 71.4%). Diagnosis lymph nodes metastasis based on the diameter has got the low valuation with p>0.05, based on the short axis diameter is < 8mm and ≥8mm has got p <0.05. About the shape of lymph nodes, based on irregular shape, peripheral enhancement and round shape to evaluate metastasis with p <0.05. Conclusion: MDCT with multi-planar reformatted images has increased the accuracy of T and N staging, evaluated the invasion, abdominal metastase of gastric cancer on MDCT.

Interventional Radiology in Cancer-related Pain Management SUMMARY Pain is a clinical symptom affecting the life quality in patients with cancer. Pain can be induced from different sources; therefore, pain management is also varied following pain mechanisms. Apart from traditional pain care therapies, interventional radiology may help in managing pain with minimal invasive techniques. This review focuses on imaging guided pain management methods used in patients with severe pain in advanced cancer stages when traditional pain control shown ineffective. Key word: Interventional Radiology, Pain management, Cancer.

Imaging characteristic and role of MRI in diagnostic perianal fistula SUMMARY The aims of this study: To determine imaging chacteristic and the concordance in evaluation of perianal fistula between MRI image and operative result. Materials and methods: Descriptive study was performed from January 2014 to September 2015 at Ha Noi Medical University Hospital. 95 patients with clinically suspected fistula-inano underwent preoperative MRI and operated at HMU hospital. MRI scanning was performed on GE 1.5Tesla system with pelvis phased-array coil. Results: There were 95 patients including 81 males and 14 female. Value of MRI sequences in detection of perianal fituas is high. The ability of T2W, STIR and T1W fat sat +Gado in detection of fistulas are 94.7%, 95.7% and 98.9% respectively. In the classification of primary tracts, the concordance rate between MRI image and operative result was 84.2%, most of which were transphinteric fistulas. The concordance rate in identification of the internal opening and the extensive lesions were 96.6% and 94% respectively. Conlusions : MRI is a good imaging modality in preoperative evaluation of perianal fistulas with high accuracy (classification of primary tracts, detection of internal opening and assessment extensions). Keywords : Anal fistula, MRI, classification of fistulas.

The image characteristic and the value of CT-Scanner in diagnosis of non-small cell lung cancer and follow-up post chemotherapy SUMMARY Lung cancer is non-small cell type common , accounting for 80% of all lung cancers and is the kind of good response to chemotherapy. The problem of early diagnosis and follow-up after treatment chemicals tumors is essential. Objective : Describe some features computerized tomography images of lung cancer non-small cell and rating the value of computerized tomography in monitoring chemotherapy lung cancer non -small cell. Subjects and Methods: The study conducted on 47 patients diagnosed with lung cancer non -small cell had computed tomography movie multiple slices at Medical University Hospital from 5/2012 to Hanoi in May / 201. Study design: descriptive cross-sectional, prospective combined with retrospective. Results : In 47 patients with 28 patients with tumors in the (R) 59.6%, 19 patients with tumors in the (L) 40,46%. Smallest tumor size 2,4cm, the largest 8.2 cm, medium 5.3 cm. Before average injection of contrast 100% of tumors with low levels < 50 Hu, after injecting drug absorbed 100% u > 20 HU. Bo irregular tumor (lobe segments) or fringed or hemp (100%). In 38 patients with metastases that 100% cost- compartment shaft size > = 15 mm and soaked after dye injection drugs. Which necrotic nodes, adhesive 9 patients (23.7%), Lymphadenopathy mere 29 patients (76.3%). Results after 6 round treatment chemicals according to RECIST Version 1.1: Complete response of 25 patients (53.3%), can meet 17 patients (36.1%), Stable 5 patients (10.6%), Progress: 0 patients (0%) Conclusion : CLVT valuable in the diagnosis and monitoring of cancer chemotherapy -small cell lung. Keywords: Lung cancer, lung cancer non-small cell, computed tomography.