Tirthraj Adhikari

Molecular Imaging
600+ km trek across the Himalayas for cancer therapy
It takes on average 18 hours by bus for patients to reach the cancer hospital in Nepal, and many of them travel over 600 km. Now the pandemic has made it even more difficult to get treatment, writes Tirthraj Adhikari, a medical physicist trained in Italy. He gives a personal account of the challenges faced by patients and staff.
September 22, 2020
2020 09 23 15 29 5985 Nepal Village 400
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Dual PET imaging in Case Two illustrates a patient with discordant disease. FDG PET (b & d) shows FDG uptake in tail of pancreas primary lesion (yellow arrow), as well as multiple hepatic metastases (yellow boxes), with enlarged liver span. DOTATATE PET on left (a) shows several hepatic metastases that do not demonstrate DOTATATE uptake above background of liver parenchyma. The liver lesions in (c) demonstrate moderate FDG uptake in liver lesions, with no corresponding DOTATATE avidity (white box) or central photopenia (white arrow). This discordance in dual PET imaging corresponds to a NETPET score of 5. This suggests de-differentiated disease and a less favorable prognosis. The patient was not suitable for Lutate treatment and received chemotherapy.
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