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Place of Bone Scintigraphy in the Assessment of Extension and Follow-Up of Breast Cancer in Senegal: Study of 165 Cases in the Nuclear Medicine Department of Idrissa Pouye General Hospital (Dakar)

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Open Journal of Medical Imaging 2024年第1期14卷 10-30页

作者： el hadji a.a.ou lamine bathily Mamoudou Salif Djigo Djimby Ba Gora Thiaw ousseynou Diop Kalidou Gueye Olatounde Herbert Fachinan Boucar Ndong Omar Ndoye Ma.a.ou Mbodj Nuclear Medicine Department Idrissa Pouye General Hospital (HOGIP) Dakar Senegal Biophysics Laboratory FMPO UCAD Dakar Senegal Nuclear Medicine Department Hospital Dalal Jamm Dakar Senegal Nursing and Obstetrics Training Institute Parakou University Parakou Benin

Introduction: Breast cancer is the most common cancer in women worldwide, accounting for an estimated 22% of all female cancers. It is the leading cause of cancer mortality in women, almost all of which is due to metastases, with 73% of metastases occurring in the bone. In oncology, metastable technetium 99-labelled methylene bisphosphonate bone scintigraphy (BS) remains the standard examination for detecting and assessing the extent of bone metastases. The aim of this study was to assess the role of BS in the evaluation and follow-up of breast cancer in Senegal. Methodology: This was a retrospective study of breast cancer patients who underwent bone scintigraphy with 99mTc-HMDP in the nuclear medicine department of Idrissa Pouye General Hospital (IPGHO), from July 2009 to June 2022. Results: We enrolled 165 patients, mean age 46.79 years (27 - 87 years). BS was performed in 94.37% of cases for post-therapeutic monitoring and in 5.63% for pre-therapeutic assessment. Results were contributory in 131 patients (92.25%), of whom 72 cases (50.70%) were normal and 59 cases (41.55%) positive or presenting bone metastases;and non-contributory or doubtful in 11 cases (7.75%). Secondary bone locations were multiple in 57 cases (96.61%) and single or solitary in 2 cases (3.39%). The scintigraphic appearance of bone metastases was hyper-fixative in 58 cases (98.31%) and mixed in 1 case (1.69%). Bone lesions were quantified using the Soloway’s grading classification. Conclusion: BS with 99mTc-labelled bisphosphonates remains the examination of choice for skeletal exploration, in the detection and extension of bone metastases in breast cancer. Performance has been enhanced by the development of SPECT coupled with CT (SPECT-CT).

关键词： Breast Cancer Bone Scintigraphy 99mTc-HMDP Bone Metastases

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Contribution of Bone Scintigraphy in the Metastatic Extension Assessment of Prostate Cancer: A Study of 288 Cases in the Nuclear Medicine Department of Idrissa Pouye General Hospital, Dakar

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Open Journal of Biophysics 2024年第2期14卷 79-98页

作者： el hadji a.a.ou lamine bathily ousseynou Diop Mamoudou Salif Djigo Gora Thiaw Kalidou Gueye Mohamed Chekhma Olatounde Herbert Fachinan Boucar Ndong Omar Ndoye Ma.a.ou Mbodj Department of Nuclear Medicine Idrissa Pouye General Hospital (HOGIP) Dakar Senegal Biophysical Laboratory FMPO Cheikh Anta Diop University (UCAD) Dakar Senegal Department of Nuclear Medicine Hospital Dalal Jamm Dakar Senegal

Introduction: Prostate cancer is the most frequently diagnosed male malignancy and the fifth leading cause of cancer death in men worldwide. Since the advent of screening methods such as Prostate Specific Antigen (PSA) assay, digital rectal examination (DRE) and prostate biopsy, its incidence has increased significantly. The aim of our study was to analyse aspects of bone scintigraphy (BS) as part of the metastatic extension assessment of prostate cancer in Senegal. Patients and Methods: This was a retrospective descriptive and analytical study, running from January 1er 2022 to August 31 2023. Patients with histologically confirmed prostate cancer were included. Whole-body scans (WBS) were performed using a dual-head SPECT gamma camera (Mediso Nucline TM Spirit DH-V type), 3 hours after intravenous injection of 8 MBq/kg (555 to 740 MBq) of 99mTc-HMDP. Results: A total of 288 patients with a mean age of 68.37 ± 7.79 years were included. The median total PSA level was 97.6 ng/ml, with 144 patients having a level greater than or equal to 20 ng/ml. All patients had adenocarcinoma, and the Gleason score was available in 202 (70.13%) patients, 75.75% of whom had a score greater than or equal to 7. BS was contributory in 70.48% of cases, with 30.90% positive and 39.58% negative. The result was inconclusive in 85 patients (29.51%). The mean PSA for patients with a positive scan was 190.2 ng/ml and 40.6 ng/ml for those with a negative scan. Multiple metastatic lesions predominated (87.35% of cases). Metastatic lesions occurred preferentially in the axial skeleton, with a proportion of 68% versus 32% in the appendicular skeleton. Classification of bone metastases according to the SOLOWAY score revealed grade I (62.07%), grade II (35.63%) and grade IV (2.30%). Conclusion: In Senegal, prostate cancer is generally diagnosed in men of advanced age. The presence of bone metastases is frequent in its evolution, transforming a curable localized disease into a g

关键词： Prostate Cancer Bone Metastasis Bone Scintigraphy Senegal

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Contribution of Bone Scintigraphy in the Diagnosis of a Case of SAPHO in the Nuclear Medicine Department of Idrissa Pouye General Hospital (Dakar, Senegal)

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Open Journal of Medical Imaging 2024年第1期14卷 1-9页

作者： el hadji a.a.ou lamine bathily Kalidou Gueye Serigne Moussa Badiane Mamoudou Salif Djigo Gora Thiaw ousseynou Diop Olatounde Herbert Fachinan Papa Mady Sy Alfonse Rodrigue Djiboune Kokou Fofo Toussaint Adambounou Louis Augustin Diaga Diouf Boucar Ndong Gora Mbaye Omar Ndoye Mounibé Diarra Ma.a.ou Mbodj Nuclear Medicine Department Idrissa Pouye General Hospital (HOGIP) Dakar Senegal Biophysical Laboratory FMPO Cheikh Anta Diop University (UCAD) Dakar Senegal Biophysical Laboratory UFR2S Gaston Berger University (UGB) Saint-Louis Senegal Nuclear Medicine Department Hospital Dalal Jamm Dakar Senegal Laboratory of Physical and Pharmaceutical Biophysics FMPO Cheikh Anta Diop University Dakar Senegal Biophysical Laboratory University of Lome Lome Togo

Introduction: The acronym SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) is a syndrome combining osteoarticular and cutaneous manifestations. It occurs mainly between the ages of 30 and 50. Sternocostoclavicular hyperostosis is one of the main distinguishing features. We report a case of SAPHO in Dakar diagnosed by bone scintigraphy. Observation: 28-year-old Senegalese women presented with left shoulder pain and relative functional impotence for over 2 years. Examination revealed right sternoclavicular hyperostosis and left shoulder pain on palpation. Questioning revealed a history of acne and hyperostosis of the right first toe. Bone scintigraphy, performed after injection of 630 MBq of 99mTc-HMDP, revealed: hyperfixation of the bilateral (right++) manubrio-sternal and sternoclavicular junction, producing the classic bull’s horn image;hyperfixation of the left shoulder with an inflammatory appearance;hyperfixation of the sacroiliac joints suggestive of bilateral sacroiliitis;hyperfixation of the right first toe;two mandibular hyper fixations probably related to dental damage. This scintigraphic appearance in one was strongly suggestive of SAPHO syndrome. Conclusion: SAPHO syndrome, related to spondyloarthropathy, associates cutaneous and osteoarticular signs. It is characterized by frequent delays in diagnosis due to poor recognition. Soy is an invaluable diagnostic tool, enabling us to assess the extent of the disease and its evolution.

关键词： SAPHO Bone Scintigraphy Young Woman Senegalese

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Iodine 131 Treatment in Graves’ Disease in a West African Country: Preliminary Study about 25 Cases in Senegal

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Open Journal of Biophysics 2024年第1期14卷 56-72页

作者： el hadji a.a.ou lamine bathily Serigne Moussa Badiane Mamoudou Salif Djigo Gora Thiaw Kalidou Gueye ousseynou Diop Boucar Ndong Kokou Fofo Toussaint Adambounou Alphonse Rodrigue Djiboune Papa Mady Sy Ma.a.ou Soumbounou Mohamed Chekhma Louis Augustin Diaga Diouf Gora Mbaye Omar Ndoye Mounibé Diarra Ma.a.ou Mbodj Nuclear Medicine Department General Hospital of Idrissa Pouye (HOGIP) Dakar Senegal Biophysical Laboratory Cheikh Anta Diop University (UCAD) Dakar Senegal Biophysical Laboratory Gaston Berger University (UGB) Saint-Louis Nuclear Medicine Department Hospital Dalal Jamm Dakar Senegal Biophysical Laboratory University of Lome Lome Togo Laboratory of Physical and Pharmaceutical Biophysics Cheikh Anta Diop University Dakar Senegal

Introduction: Graves’ disease is the most common cause of hyperthyroidism. Its treatment uses synthetic antithyroid drugs but the use of aggressive radical therapy such as surgery or non-aggressive therapy such as iodine-131 is not uncommon. Treatment of Graves’ disease with radioactive iodine or iratherapy is a simple, inexpensive, well-tolerated treatment. It was introduced in Senegal in 2016. We report through this work the preliminary assessment of the only nuclear medicine service in Senegal in the management of Graves’ disease by iodine-131. Patients and Methods: Retrospective study of the first cases of Graves’ disease treated with iratherapy in Senegal. Socio-demographic, clinical, paraclinical, therapeutic and evolutionary aspects were studied. Radiation protection rules have been implemented and contraception has been effective for six months in women of childbearing age. Results: 25 patients were collected with a mean age of 45 years, twenty women (80%), a family goiter in 24% and a psycho-affective context in 64% of cases. Thyrotoxicosis syndrome was associated with goiter in 68% of patients and exophthalmos in 64%. Thyroid ultrasound performed in 20 patients showed vascular goiter in 80% and thyroid scintigraphy in 3 patients, homogeneous and diffuse hyperfixation. TRAK dosed in 8 patients was still positive. All patients had received first-line medical treatment. The average duration of this treatment was more than 18 months in 92%. The empirically used iodine-131 activity averaged 15.35 mCi. Oral corticosteroid therapy was prescribed in 7 patients for the prevention of malignant orbitopathy. No early side effects were noted. The remission rate at 3 months was 52% and at 6 months was 88% to 92%. Conclusion: The effectiveness of radioactive iodine, in particular ablative doses in the treatment of hyperthyroidism, is no longer to be demonstrated. Taking into account our socioeconomic context, iratherapy should be a treatment of choice for hyperthyroidism

关键词： Graves’ Disease Iratherapy Iodine-131 Senegal

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Contribution of <sup>99m</sup>Tc-DPD Scintigraphy in the Diagnosis of Cardiac Amyloidosis in Black Africans

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Open Journal of Biophysics 2022年第1期12卷 27-37页

作者： Djigo Mamoudou Salif Ndong Boucar bathily el hadji a.a.ou lamine Diop ousseynou Gueye Kalidou Thiaw Gora Ndoye oumar Mbodj Ma.a.ou Department de Medecine Nucleaire Hô pital General Idrissa Pouye Dakar Senegal Department de Medecine Nucleaire Hô pital Dalal JAMM Dakar Senegal

Cardiac amyloidosis presents a picture of hypertrophic cardiomyopathy with heart failure with preserved ejection fraction. It is largely underdiagnosed, especially in black Africans, and therefore falls under the category of heart disease classified as idiopathic. Light chain amyloidosis (AL) is mainly found in Caucasian subjects and the mutant variant of transthyretin (TTRm) in negroid subjects. Numerous studies have shown that ATTRm was found predominantly in black American and black British patients. In African countries the entity of idiopathic heart failure is quite important because of lack of diagnosis, ETT, MRI and immuno-histochemistry are expensive or not available. We can probably assume that the proportion of cardiac amyloidosis is quite important in black Africans. The question is if 99mTc-DPD really easy to perform, can probably help to investigate in the nuclear medicine department in Africa. No large-scale study has been able to demonstrate the prevalence or not of cardiac amyloidosis in black-African subjects and by extension reduce this nosological entity of idiopathic heart disease. The 99mTc-DPD scintigraphy using Perrugini’s visual sore allows localization and classification of amyloid damage. The mechanism of binding of 99mTc-DPD to amyloid fibril deposits is not well known, its binding to TTR-type (mutated or wild type) amyloidosis is greater than the AL variant. In the diagnostic algorithm, endomyocardial biopsy is the gold standard but remains invasive, ETT with the strain allows a presumptive diagnosis and remains an operative examination dependent and is not reproducible. Cardiac MRI allows some localization of amyloid deposits but still remains less sensitive than scintigraphy. In addition, performing the whole-body MRI is very restrictive (time, antenna change and cost). The aim of this literature review was to show the superiority of 99mTc-DPD scintigraphy compared to other diagnostic modaliti

关键词： Amyloidosis TTRm AL 99mTc-DPD Bone Scintigraphy

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Kohonen’s Algorithm Applied to the Scintigraphic Image for an Aid in the Diagnosis of Prostate Cancer Metastasis

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Open Journal of Medical Imaging 2022年第2期12卷 37-47页

作者： Boucar Ndong el hadji a.a.ou lamine bathily Mamoudou Salif Djigo Ma.a.ou lamine Mboup François Kaly Kanta Ka ousseynou Diop Ibrahima Thiam Gora Mbaye Omar Ndoye Ma.a.ou Mbodj Biophysics and Nuclear Medicine Laboratory Cheikh Anta Diop University Dakar Senegal Sustainable Development and Society Doctoral School Thies University Thies Senegal Laboratoire du traitement de l’information/ESP/UCAD Senegal Radiotherapy Department of the National Hospital University Center Dalal Jamm Guédiawaye Dakar Sénégal Physics Pharmaceutical Laboratory Cheikh Anta Diop University Dakar Senegal

To partition the scintigraphic image, several methods are used, among which is Kohonen’s self-organizing map algorithm. The objective of this study was to perform an ascending hierarchical classification (HAC) on the results of the Kohonen self-organizing map. This makes it possible to carry out the second phase necessary for the elaboration of the classifier by grouping the neurons as well as possible into 3 classes then by reconstituting the scintigraphic image from the 3 classes. This partition proceeds by successive groups, thus merging at each iteration two subsets of neurons using a measure of similarity which is Ward’s method. In this method, the algorithm aggregates the nearest neurons into classes. This allows us to obtain a dendrogram that looks like a tree. And this one needs to be cut. And to have an adequate cut-off level, we have established the variation of the Davies Bouldin index as a function of the number of classes. The minimum value of this index gave the optimal number of classes which corresponded to 3 in the study. These three groups A, B, C have a variable intensity. This intensity can be high, it can be medium or low. The high, medium and low intensities corresponded respectively to metastases for class A, to degenerative or inflammatory phenomena for class B and to normal radiopharmaceutical uptake for class C. To confirm this strong suspicion, we performed reconstructions using a filter. And after this reconstruction, we had images like at the entrance. And for the interpretation of these images, we used a visual metric. This enabled us to note that for the interval [0 - 50[, the image is not contrasted and no lesion could be detected. Over the interval [50 - 200[, we observed the distribution of the radiopharmaceutical over the entire skeletal whole body. On this reconstruction interval, the visual metric shows hypofixation in the bladder and areas suspected of metastases. Over the interval [200 - 250[, we detected hyperfixations linked

关键词： Neural Networks Hierarchical Ascending Classification Scintigraph

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Contribution of Scintigraphy in the Assessment of Extension of Osteophilic Cancers in Senegal from 2018 to 2021

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Open Journal of Biophysics 2023年第1期13卷 1-13页

作者： Olatoundé Herbert Fachinan el hadji lamine bathily Ma.a.ou Salif Djigo Gilles David Houndétoungan Djibrillou Moussa Issoufou Boucar Ndong Kuassi Marcellin Amoussou-Guénou Ma.a.ou Mbodj Institut de Formation en Soins Infirmiers et Obstétricaux Université de Parakou Parakou Bénin Service de Médecine Nucléaire H&ocirc pital Général Idrissa Pouye Dakar Sénégal Laboratoire de Biophysique Médecine Nucléaire Université Cheikh Anta Diop Dakar Sénegal Unité D’Enseignement et de Recherche de Biophysique et Médecine Nucléaire Faculté des Sciences de Santé Université d’Abomey-Calavi Cotonou Bénin Département de Médecine Nucléaire Institut des Radio-Isotopes Niamey Niger

The aim of this study was to highlight the contribution of bone scintigraphy in the assessment of extension of osteophilic cancers in Senegal. This was a retrospective study, with a descriptive and analytical purpose, carried out over a period of four (04) years between January 01, 2018 and December 31, 2021. It focused on the files of patients who underwent bone scintigraphy for extension assessment of an osteophilic cancer during the study period. According to the study, prostate cancer was by far the most representative primary cancer (86.9%). Scintigraphy contributed in 75% of cases (362 cases) with 35% positive scintigraphy and 40% negative scintigraphy. The result was doubtful in 25% of cases (120 cases). The metastatic lesions were located preferentially at the level of the axial skeleton and only one case was of an exclusive appendicular site. More than half of patients with metastases (70%) had a poor prognosis with the SOLOWAY score greater than or equal to II. With the improvement of the nuclear imaging technical platform in Senegal (performance of SPECT/CT examinations), doubtful cases in our sample could be better explored with the advantage of adequate patient care.

关键词： Bone Scintigraphy Osteophilic Cancers Bone Metastases

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Knowledge of Togolese Doctors on Biological Effects of Ultrasound and Their Attitudes towards the Ultrasonographic Explorations Performed in Lome (Togo)

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Open Journal of Biophysics 2018年第1期8卷 1-8页

作者： Kokou Adambounou el hadji a.a.ou lamine bathily Amegninou Mawuko Yao Adigo Pihou Gbandé Kpalma Duga Bakpatina-Batako Lantam Sonhaye Théophile Lincoln Tapsoba Komlanvi Adjenou Laboratoire de Biophysique Médicale Université de Lome Lome Togo Service d’Imagerie Médicale CHU Campus Lome Togo Service de Médecine Nucléaire CHU YO Ouagadougou Burkina-Faso Service de Médecine Nucléaire HOGGY Dakar Senegal Service de Médecine Nucléaire CHU YO Ouagadougou Burkina-Faso

We evaluate the level of knowledge of clinician doctors asking for echographies on the biological effects of ultrasounds and their attitudes towards ultrasounds examinations performed in Lome. Transverse study based on a survey led from August 16th till November 30th, 2013 including 105 doctors applicant of ultrasound in Lome (Togo). The middle age of the applicant doctors was of 34 years with a sex-ratio of 4/1 and more than half practiced in public facilities. Approximately ten percent applicants thought that the ultrasound is an irradiant exam and those practicing for less than 5 years were the ones who had a good level of knowledge on the not irradiant character of the ultrasounds. The existence of the thermal and mechanical effects of the ultrasounds was known only by 4.8% of the applicants and only 1.9% of the doctors had information on the thermal index (TI) and the mechanical index (MI). More than half (66.7%) analyzed the ultrasound images joined to the report but none verified the conformity with the standards of the values of the TI and at MI shown on the images. They were 43.5% to read only the conclusion. The level of knowledge of the doctors on the biological effects of the ultrasounds is unsatisfactory. The ultrasounds although not irradiant, have biological effects imposing precautionary measures which have to guide the attitude of the applicants towards the ultrasonographic explorations.

关键词： Ultrasound Biological Effect Echography Precaution Measures Lome

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Inventory of Radiation Protection in Hospitals of Level III in Senegal

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Open Journal of Biophysics 2021年第4期11卷 397-406页

作者： Boucar Ndong Sidi Ahmed Dia Ma.a.ou Salif Djigo Herbert Fachinan el hadji lamine bathily ousseynou Diop Kanta Ka Gérard Léra Kelvin Akpo el hadji Fallou Diouf Louis Auguinstin Diaga Diouf Pape Mady Sy Alphonse Djiboune Gora Mbaye Maguette Diagne Omar Ndoye Ma.a.ou Mbodji Laboratoire de Biophysique Médecine Nucléaire Universite Cheikh Anta Diop Dakar Senegal Service de Médecine du Travail Universite Cheikh Anta Diop Dakar Senegal Faculté de Médecine Université de Parakou Parakou Benin Service de Radiothérapie de Dalal Jamm Dakar Senegal Service de Radiologie de l’Hô pital Aristide Le Dantec Dakar Senegal Laboratoire de Physique Pharmaceutique Universite Cheikh Anta Diop Dakar Senegal Service de Radiothérapie de l’Hô pital Aristide Le Dantec Dakar Senegal

The aim of this study was to evaluate the level of protection of employees who are exposed to radiation in a level III hospital establishment. It was a descriptive cross-sectional survey of six months’ duration, involving eight level III Hospitals (Aristide Le Dantec, Fann, Hoggy, Hear, Abass Ndao, Pikine, Touba, and Thiès) in Senegal. Sixty-one of the one hundred questionnaires were recovered (overall response rate of 61%). The population of the study was mainly female (54.1%). The average age was 38.57 with extremes ranging from 23 to 65 years old. In the places where ionizing radiation sources are handled, only at the Aristide Le Dantec Hospital did we find a “competent person in radiation protection”. This explained the lack of a classification of employees and work areas. Forty out of sixty-one (73.77%) had no knowledge of the basic principles of radiation protection (justification, optimisation, dose limitation) and had not ever taken radiation holidays. For radiovigilance, exposure time limits to ionizing radiation concerned only 29/61 or 47.54% of the study population. The inverse square law of distance was known by only 40 workers, of whom 15 had no compliance. We found the presence of dosifilms in only 7/61 or 11.47% of the workers. On the other hand, the use of lead aprons was well established and concerned 57/61 workers, i.e., 93.44%. In sum, ionizing radiation causes adverse health effects. The absence of a good radiation protection culture in Senegal requires the presence of at least 4 to 5 competent persons in radiation protection for quality training of workers in radiobiology, radiopathology and radiation protection.

关键词： Ionizing Radiation Radiation Protection Workers Senegal

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Contribution of Bone Scintigraphy in the Diagnosis of a Calcaneus Fatigue Fracture in a Case at the Nuclear Medicine Department of Idrissa Pouye General Hospital (HOGIP) in Dakar

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Open Journal of Medical Imaging 2020年第1期10卷 62-71页

作者： el-hadji a.a.ou lamine bathily B. Ndong O. Diop M. S. Djigo K. Gueye A. Kokou G. Thiaw G. Mbaye L. A. D. Diouf M. Soumboundou A. R. Djiboune P. M. Sy O. Ndoye M. Diarra M. Mbodj Nuclear Medicine Department General Hospital of Idrissa Pouye (HOGIP) Dakar Senegal Biophysical Laboratory FMPO Cheikh Anta Diop University (UCAD) Dakar Senegal Nuclear Medicine Department Hospital Dalal Jamm Dakar Senegal Biophysical Laboratory University of Lome Lome Togo Laboratory of Physical and Pharmaceutical Biophysics FMPO Cheikh Anta Diop University Dakar Senegal

Introduction: Fatigue fractures are secondary to excessive, unusual, repeated mechanical stress, occurring on healthy bone. Bone scintigraphy (BS) with 99mTc-HMDP is an excellent means of diagnosis. We report a case of stress fracture of the calcaneus with scintigraphic diagnosis, in a marathon runner. Patient and Methods: He is a 40-year-old athlete in overtraining with right calcaneal pain on running, intense at first, moderate in the middle and then persistent after exercise. The interrogation found no trauma to the right foot and the x-ray of the foot was without abnormality. The so 3 phases were performed following an injection of 564 MBq of 99mTc-HMDP, with a SPECT gamma camera. Results: Bone scintigraphy found in the early phase, hyper-perfusion and hyper-fixation of the right calcaneal region compared to its left counterpart and in the bone phase persistence of focal hyperfixation opposite the right calcaneus. This scintigraphic aspect of the right calcaneus in an overtrained marathon runner, in a painful context and in front of a normal X-ray, made us evoke a fracture of fatigue. A complementary CT scan performed two days after the BS was without abnormality. Conclusion: Fatigue fractures are micro-fractures generally not noticed on radiography and CT. BS due to its high sensitivity is an excellent or the best tool for the early diagnosis of stress fractures.

关键词： Fatigue Fracture Bone Scintigraphy Sports

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