Department of Medical Imaging and Clinical Oncology

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Browsing Department of Medical Imaging and Clinical Oncology by Author "Andronikou, Savvas"

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    Accuracy of patients' self-reporting of pregnancy and awareness of risks to the fetus from x-ray radiation
    (Health and Medical Publishing Group (HMPG), 2008) Vadachia, Yousuf; Els, Hein; Andronikou, Savvas
    [No abstract available]
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    Diffusion tensor imaging point to ongoing functional impairment in HIV-infected children at age 5, undetectable using standard neurodevelopmental assessments
    (BMC (part of Springer Nature), 2020-05-19) Ackermann, Christelle; Andronikou, Savvas; Saleh, Muhammad G.; Kidd, Martin; Cotton, Mark F.; Meintjes, Ernesta M.; Laughton, Barbara
    Background: Perinatal HIV infection negatively impacts cognitive functioning of children, main domains affected are working memory, processing speed and executive function. Early ART, even when interrupted, improves neurodevelopmental outcomes. Diffusion tension imaging (DTI) is a sensitive tool assessing white matter damage. We hypothesised that white matter measures in regions showing HIV-related alterations will be associated with lower neurodevelopmental scores in specific domains related to the functionality of the affected tracts. Methods: DTI was performed on children in a neurodevelopmental sub study from the Children with HIV Early Antiretroviral (CHER) trial. Voxel-based group comparisons to determine regions where fractional anisotropy and mean diffusion differed between HIV+ and uninfected children were done. Locations of clusters showing group differences were identified using the Harvard–Oxford cortical and subcortical and John Hopkins University WM tractography atlases provided in FSL. This is a second review of DTI data in this cohort, which was reported in a previous study. Neurodevelopmental assessments including GMDS and Beery-Buktenica tests were performed and correlated with DTI parameters in abnormal white matter. Results: 38 HIV+ children (14 male, mean age 64.7 months) and 11 controls (4 male, mean age 67.7 months) were imaged. Two clusters with lower fractional anisotropy and 7 clusters with increased mean diffusion were identified in the HIV+ group. The only neurodevelopmental domain with a trend of difference between the HIV+ children and controls (p = 0.08), was Personal Social Quotient which correlated to improved myelination of the forceps minor in the control group. As a combined group there was a negative correlation between visual perception and radial diffusion in the right superior longitudinal fasciculus and left inferior longitudinal fasciculus, which may be related to the fact that these tracts, forming part of the visual perception pathway, are at a crucial state of development at age 5. Conclusion: Even directed neurodevelopmental tests will underestimate the degree of microstructural white matter damage detected by DTI. The visual perception deficit detected in the entire study population should be further examined in a larger study.
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    FAST as a predictor of clinical outcome in blunt abdominal trauma
    (AOSIS, 2011) Terry, Benjamin M.; Blehar, David; Gaspari, Romolo; Maydell, Arthur Thomas; Bezuidenhout, Fourie Abraham; Andronikou, Savvas
    Background. Peer-reviewed literature demonstrates increasing support for the use of focused abdominal sonography in trauma (FAST) in the setting of blunt trauma, one study demonstrating the sensitivity and specificity of FAST for the detection of free fluid to be 0.64 - 0.98 and 0.86 - 1.00, respectively, compared with abdominal CT. Utilising ultrasound in trauma triage increases efficiency and cost-effectiveness and reduces reliance on CT, compared with using CT alone. There is little evidence to support relying solely on a negative FAST and physical examination for patient management. Method. A retrospective descriptive study of 172 adult patients who received FAST for the evaluation of blunt abdominal trauma between 22 July 2007 and 21 January 2008 at Tygerberg Hospital was performed. Ultrasound findings were correlated with CT scan findings, operative findings if managed surgically, clinical outcomes whether managed surgically or conservatively, as well as postmortem findings in deceased patients. Results. FAST was negative in 147 (85.5%) patients. Twenty-four (16.3%) of these patients died from all-cause mortality, none of which was due to intra-abdominal injury. Seven patients with negative FAST underwent CT scan owing to change in clinical course, and 3 patients with negative FAST underwent laparotomy owing to change in clinical course, with positive findings in 2 patients – a bowel injury requiring resection (not seen on CT) and a diaphragmatic rupture seen on CXR. A negative FAST was shown to be an excellent predictor for the absence of significant intra-abdominal trauma. The mortality rate among 25 FAST positive patients was 24% (N=6). Only one of these patients (with a splenic rupture) was suspected to have died from abdominal pathology.
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    Pentastomiasis (armillifer armillatus infestation)
    (Health and Medical Publishing Group (HMPG), 2007-10) Du Plessis, Vicci; Birnie, Andrew J.; Eloff, Ivor; Reuter, Helmuth; Andronikou, Savvas
    Pentastomiasis, also known as ‘tongue worm’ infestation or porocephalosis, is a parasitic zoonosis endemic to western and central Africa. In 1847, Pruner described the first human infection by a pentastomid in Cairo. The definitive hosts are snakes and other reptiles, while the intermediate hosts are carnivorous mammals and, rarely, humans. Most cases of human pentastomiasis are caused by two species of pentastomids, both of which have characteristics of arthropods and annelids, viz. Armillifer armillatus and Linguatula serrata.
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    Usefulness of lateral radiographs for detecting tuberculous lymphadenopathy in children - confirmaiton using sagittal CT reconstruction with multiplanar cross-referencing
    (AOSIS Publishing, 2012-09-10) Andronikou, Savvas; Van der Merwe, Dirk Johannes; Goussard, Pierre; Gie, Robert P.; Tomazos, Nicolette
    ENGLISH SUMMARY : Background: Diagnosis of pulmonary tuberculosis (PTB) in children remains difficult. Lateral chest radiographs are frequently used to facilitate diagnosis, but interpretation is variable. In this study, lateral chest radiographs (CXRs) are evaluated against sagittal CT reconstructions for the detection of mediastinal lymphadenopathy. Aim: To correlate suspected lymphadenopathy on lateral CXR with sagittal CT reconstructions and determine which anatomical group of lymph nodes contributes to each lateral CXR location. Methods and materials: Thirty TB-positive children’s lateral CXRs were retrospectively reviewed for presence of mediastinal lymphadenopathy in 3 pre-determined locations in relation to the carina: retrocarinal, subcarinal and precarinal. Findings of the CT sagittal reconstructions were then correlated with the CXRs for the presence of lymphadenopathy in the same 3 pre-determined areas across the width of the mediastinum. Axial and coronal CT crossreferencing confirmed the position of the lymphadenopathy. Results: The most frequent locations for lymphadenopathy were the subcarinal (28) and right hilar (25). Sensitivity and specificity values of the CXRs were moderate, with the precarinal region having the best sensitivity and specificity for presence of lymphadenopathy. Contribution to each zonal group on lateral CXR were from multiple anatomical lymph node sites. Conclusion: The precarinal zone on CXR had the best specificity and sensitivity, and represented mainly subcarinal and right hilar lymph node groups. Attention should be paid to this area on lateral CXRs for detecting lymphadenopathy in children with suspected PTB.