Hashem Al-Hashem

King Saud Medical City

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Priya A. Jamidar

Yale University

Federico Rossi

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Visvanathan Muralidharan

Saint Francis Hospital & Medical Center

Mustafa Al-Mubarak

King Faisal Specialist Hospital & Research Centre

Omar Alshaer

Ministry of Health

Ahmed Badran

King Faisal Specialist Hospital & Research Centre

Alberto Ocaña

Centro de Investigación Biomédica en Red de Cáncer

Uzma D. Siddiqui

University of Chicago

Francisco Vera-Badillo

Queen's University

BŠ

Boštjan Šeruga

Institute of Oncology Ljubljana

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King Faisal Specialist Hospital & Research Centre

Alfaisal University

Princess Margaret Cancer Centre

University of Toronto

Yale University

Cairo University

Ain Shams University

King Fahd Medical City

University Health Network

King Abdulaziz Medical City

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Pattern of use of positron emission tomography/computed tomography (PET/CT) scan in non-colorectal gastrointestinal cancers at KFSHRC, Riyadh, Saudi Arabia

The Egyptian Journal of Radiology and Nuclear Medicine (2019)

Ali Husain Aljubran Ahmed Badran Omar Alshaer Hashem Al-Hashem Aymen Omar

Abstract Background Positron emission tomography/computed tomography (PET/CT) scan is useful if clinically indicated. It is not for conventional routine use due to its high cost. Moreover, it can be confusing if ordered in non-indicated conditions. We evaluate if the pattern of PET/CT ordered in gastrointestinal cancers (non-colorectal origin) has followed evidence-based guidelines and whether it helped in the improvement of patient’s outcome. This study included non-colorectal gastrointestinal cancer patients from 2007 to 2008 who had one or more PET/CT scans done during their management. In each case, data collected revealed whether PET/CT affected the management or the stage or not. Patients were identified through the hospital tumor registry software CNExT (C/NET Solutions, Berkeley, CA). Tabulation and statistical data analysis were done using JMP-SAS statistical software application (version 9.4: SAS Institute, Cary, NC, USA). The scan report quality and use indications were outlined. Results Seventy-seven patients were identified, with 107 PET/CT scans done. Their median age is 59 (21–86) years. Males were 45 (58.5%). Tumor origin was 46.8% esophageal and gastroesophageal junction cancer, 15.6% gastric cancer, 11.7% pancreatic cancer, 11.7% hepatobiliary tumors, 10.4% neuroendocrine tumors, 2.6 % gastrointestinal stromal tumors, and 1.3% small bowel cancer. Indications of the PET/CT were as follows: staging in 59.8%, follow-up after finishing treatment in 14.9%, restaging at relapse in 8.4%, assessing response after/during treatment in 3.7%, follow-up of previous PET/CT in 12.1%, and others in 0.9%. PET/CT changed the stage in 19.6% and affected the management plan in 11.2% only. Fifty-two scans needed pathological pursuit as decided by investigators; of them, PET/CT for the lesions that could have changed the stage reported indeterminate/equivocal results in 32 (29.9%) of all scans. The pathological pursuit for the equivocal lesions on PET/CT scans was done in only 12 of 52 (23.1%) scans. Conclusions Local guidelines for ordering PET/CT scan are suggested because overuse was documented, and an evidence-based approach should be respected before its use.

PET-CT

Gastrointestinal cancer

10.1186/s43055-019-0067-y

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Citations (2)

MOESM1 of Pattern of use of positron emission tomography/computed tomography (PET/CT) scan in non-colorectal gastrointestinal cancers at KFSHRC, Riyadh, Saudi Arabia

Figshare (2019)

Ali Aljubran Ahmed Badran Omar Alshaer Hashem Al-Hashem Aymen Omar

Additional file 1: Database.

Positron emission

10.6084/m9.figshare.11292815

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Citations (0)

Gestational trophoblastic neoplasia: treatment outcomes from a single institutional experience

Clinical & Translational Oncology (2014)

Hamed Alhusaini Hussein Soudy Atef M. Darwish Marwa Ahmed A. Eltigani

Gestational trophoblastic neoplasia

10.1007/s12094-014-1251-1

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Citations (21)

Response to: “Optimal Intervention in Pregnant Patients With Gallstone Pancreatitis—Routine Endoscopic Sphincterotomy or Selective Laparoscopic Cholecystectomy?”

Journal of Clinical Gastroenterology (2009)

Hashem Al-Hashem Visvanathan Muralidharan Hartley Cohen Priya A. Jamidar

Al-Hashem, Hashem MD*; Muralidharan, Visvanathan MD†; Cohen, Hartley MD‡ §; Jamidar, Priya MD∥ Author Information

10.1097/mcg.0b013e3181af5554

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Analysis of endoscopic management of occluded metal biliary stents at a single tertiary care center

Gastrointestinal Endoscopy (2008)

Jason N. Rogart Ara Boghos Federico Rossi Hashem Al-Hashem Uzma D. Siddiqui

Tertiary care

Self-expandable metallic stent

Single Center

10.1016/j.gie.2008.03.1064

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Citations (56)

Cancer Management in Saudi Arabia: Recommendations by the Saudi Oncology HeAlth Economics ExpeRt GrouP (SHARP)

Saudi Pharmaceutical Journal (2020)

Nora Alkhudair Majed Alshamrani Hadeel Samarkandi Hajer Almodaheem Hana Alabdulkarim

Cancer is widely recognized as a major global health problem and is estimated to rank as one of the leading causes of death worldwide. Saudi Arabia has undergone remarkable socioeconomic development in the past 40 years which has contributed to the increase in cancer incidence. The high costs of new oncology medications in combination with uncertainty of long-term effectiveness and safety outcomes highlight the importance of considering value, in terms of clinical outcomes, relative to cost. We convened a group of experts to discuss key factors impacting the current state of cancer management in Saudi Arabia and to agree on a list of recommendations, with a focus on value-based care, considering evidence, patients, and costs.

Clinical Oncology

Cancer Incidence

10.1016/j.jsps.2020.12.005

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Citations (11)

Effect of multifocality and multicentricity on outcome in early stage breast cancer: a systematic review and meta-analysis

Breast Cancer Research and Treatment (2014)

Francisco Vera-Badillo Marc Napoleone Alberto Ocaña Arnoud J. Templeton Boštjan Šeruga

10.1007/s10549-014-3018-3

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Citations (82)

Impact of Geographic Region on Benefit of Approved Anticancer Drugs Evaluated in International Phase III Clinical Trials

Clinical Oncology (2015)

Hashem Al-Hashem Mustafa Al-Mubarak Francisco Vera-Badillo Arnoud J. Templeton Alberto Ocaña

10.1016/j.clon.2015.09.010

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Biliary Disease in Pregnancy With an Emphasis on the Role of ERCP

Journal of Clinical Gastroenterology (2008)

Hashem Al-Hashem Visvanathan Muralidharan Hartley Cohen Priya A. Jamidar

The incidence of gallstones during pregnancy is estimated to be between 3% and 12%. About one-third of pregnant patients with cholelithiasis become symptomatic and may require surgical intervention. Choledocholithiasis during pregnancy although infrequent usually requires therapeutic intervention. Abdominal ultrasonography is insensitive for the detection of common bile duct stones. Magnetic resonance imaging is not being associated with known adverse effects and seems to be an excellent diagnostic modality in this context. Paramagnetic contrast agents have been associated with increased spontaneous abortion rates and other abnormalities in animals and should only be used when absolutely necessary. Endoscopic ultrasonography is highly accurate for the detection of common bile duct stones and may be useful before consideration of endoscopic retrograde cholangiopancreatography (ERCP) in select patients. The second trimester seems to be the safest time to perform surgery, as organogenesis is complete and the incidence of spontaneous abortion lower. ERCP followed by sphincterotomy and stone extraction is very effective and can be performed safely during all trimesters of pregnancy with a premature delivery rate less than 5%. All efforts to minimize radiation exposure should be undertaken. These include lead shielding and avoiding hard copy radiographs. When possible, category B (such as meperidine) or C drugs only should be used for sedation during pregnancy. Therapeutic ERCP is now the standard of care for treating choledocholithiasis during pregnancy. Endoscopic sphincterotomy for symptomatic patients with normal cholangiograms is controversial. Consideration of ERCP demands a judicious approach, paying careful attention to risks and benefits of intervention.

Magnetic resonance cholangiopancreatography

10.1097/mcg.0b013e31818acf80

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Citations (44)

The Frequency and Management of Metal Stent Occlusion in Patients with Malignant Obstructive Jaundice

Gastrointestinal Endoscopy (2006)

Arah Boghos Priya A. Jamidar Federico Rossi Hashem Al-Hashem Uzma D. Siddiqui

Gastric Outlet Obstruction

10.1016/j.gie.2006.03.817

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Citations (1)