Background/Objectives: Although the role of PET/CT imaging is well established in oncology, its diagnostic value in routine monitoring for recurrent colorectal cancer (CRC) is still controversial. The aim was to evaluate the diagnostic value of F-18 FDG PET/CT in detecting recurrent CRC in correlation with CEA, CA 19-9 levels, and conventional imaging modalities (CIM). Methods: Between 2009 and 2023, a retrospective study was performed including 134 CRC patients referred for PET/CT imaging on the suspicion of recurrence, based on elevated CEA and/or CA 19-9 and/or equivocal CIM findings. According to our institution’s Tumor Board CRC protocol, after the initial treatment, which was dependent on the TNM stage (neoadjuvant therapy, primary resection, or adjuvant treatment), patients underwent a standard 5-year surveillance including CEA and CA 19-9 measurements, CIM, and colonoscopy, every six months. The statistics, including univariate and multivariate analyses were conducted using the IBM SPSS 20.0 statistical software. p-values < 0.05 were considered statistically significant. Results: Recurrent CRC was confirmed in 54/134 (40.3%) patients with elevated tumor markers. PET/CT showed high diagnostic performance in detecting recurrent CRC with sensitivity, specificity, PPV, NPV, and accuracy of 94.4%, 82.5%, 78.5%, 95.7%, and 87.3%, respectively. The CEA showed a high sensitivity of 98.1% but both low specificity and accuracy of 15% and 48.5%, respectively. The sensitivity, specificity, and accuracy for CA 19-9 and CIM for diagnosis of CRC recurrence were 44.4%, 67.5%, 58.2%, and 51.9%, 98.8%, 79.9%, respectively. The AUC for PET/CT, elevated CEA levels, CIM, and elevated CA 19-9 levels was 0.885 (95% CI: 0.824–0.946; p < 0.001), 0.844 (95% CI: 0.772–0.916; p < 0.001), 0.753 (95% CI: 0.612–0.844; p < 0.001), and 0.547 (95% CI: 0.442–0.652; p = 0.358), respectively. Univariate analysis showed that both PET/CT and CIM positive results were highly associated with CRC recurrence (p < 0.001 and p < 0.001, respectively). At the same time, gender, mucinous tumor type, presence of initial lymph node metastasis (N+), and presence of initial distant metastasis (M+) had no significance (p = 0.211, p = 0.158, p = 0.583, and p = 0.201, respectively). Our multivariate analysis showed that independent predictors for CRC recurrence are positive PET/CT scans (p < 0.001), positive CIM results (p = 0.001), and elevated CA 19-9 levels (p = 0.023). Although CA 19-9 was not detected as a statistically significant predictor in the univariate analysis (p = 0.358), in a multivariate analysis it was recognized as a significant predicting factor in detecting the CRC recurrence (p = 0.023). Conclusions: F-18 FDG PET/CT showed high diagnostic efficacy in CRC recurrence detection, in correlation with CEA levels, CA 19-9 levels, and CIM. This imaging modality should be routinely integrated into the post-operative follow-op in patients with elevated tumor markers.

Background and Objectives: The aim of our study was to assess the diagnostic accuracy of four imaging modalities—digital mammography (DM), digital breast tomosynthesis (DBT), ultrasound (US), and breast magnetic resonance imaging (MRI)—applied individually and in combination in early cancer detection in women with dense breasts. Methods: This single-center retrospective study was conducted from January 2021 to September 2024 at the Oncology Institute of Vojvodina in Serbia and included 168 asymptomatic and symptomatic women with dense breasts. Based on the exclusion criteria, the final number of women who were screened with all four imaging methods was 156. The reference standard for checking the diagnostic accuracy of these methods is the result of a histopathological examination, if a biopsy is performed, or a stable radiological finding in the next 12–24 months. Results: The findings underscore the superior diagnostic performance of breast MRI with the highest sensitivity (95.1%), specificity (78.7%), and overall accuracy (87.2%). In contrast, DM showed the lowest sensitivity (87.7%) and low specificity (49.3%). While the combination of DM + DBT + US demonstrated improved sensitivity to 96.3%, its specificity drastically decreased to 32%, illustrating as ensitivity–specificity trade-off. Notably, the integration of all four modalities increased sensitivity to 97.5% but decreased specificity to 29.3%, suggesting an overdiagnosis risk. DBT significantly improved performance over DM alone, likely due to enhanced tissue differentiation. US proved valuable in dense breast tissue but was associated with a high false-positive rate. Breast MRI, even when used alone, confirmed its status as the gold standard for dense breast imaging. However, its widespread use is constrained by economic and logistical barriers. ROC curve analysis further emphasized MRI’s diagnostic superiority (AUC = 0.958) compared with US (0.863), DBT (0.828), and DM (0.820). Conclusions: This study provides a unique, comprehensive comparison of all four imaging modalities within the same patient cohort, offering a rare model for optimizing diagnostic pathways in women with dense breasts. The findings support the strategic integration of complementary imaging approaches to improve early cancer detection while highlighting the risk of increased false-positive rates. In settings where MRI is not readily accessible, a combined DM + DBT + US protocol may serve as a pragmatic alternative, though its limitations in specificity must be carefully considered.

Introduction. Hepatocellular carcinoma (HCC) is the most frequent type of liver malignancy. As a carcinogen, aflatoxin B1 (AFB1) causes HCC by inducing deoxyribonucleic acid adducts that lead to genetic changes in liver cells and may be the cause of HCC in up to 30% of cases. The incidence of HCC has been on the rise and is an issue in the countries of the Western Balkans. Case Outline. This paper presents a case of a 37-year-old woman who was diagnosed with HCC, without hepatitis B, hepatitis C, or liver cirrhosis. The patient consumed milk and dairy products in quantities of over two liters per day over the course of 20 years, which indicates the impact of aflatoxin in milk on HCC. A positive signal for the presence of AFB1 was detected by ELISA (enzyme-linked immunosorbent assay) in-house using immunoperoxidase screening test. Conclusion. As carcinogenic difuranocoumarin derivative, aflatoxin B1 is the most likely cause of malignant transformation of hepatocytes, which resulted in hepatocellular carcinoma in this patient.

We present the case of a 39-years old man who underwent three surgeries because of spinal ependymoma located in cauda equina region. He presented at the Oncology Institute of Vojvodina for combined adjuvant chemo- and radiotherapy after the second surgery. An MRI examination performed after six cycles of therapy showed no signs of disease. 26 months later, a follow-up MRI showed recurrence of disease in the form of small drop metastasis. Six months later, the patient underwent the third surgery. The patient is currently receiving another cycle of radiotherapy, and is scheduled for additional cycles of chemotherapy. Ependymomas are the most common spinal cord malignancy in adults. The symptoms are nonspecific which often causes a delay in diagnosis. An MRI examination of the spine with contrast admission is the study of choice for detecting spinal cord masses. Surgery is the first-line therapy for ependymomas. Recurrence rate is associated with the extent of surgical resection, with en bloc and gross-total resection being associated with lower rates of disease recurrence. In children under 3 years, adjuvant chemotherapy is advocated, while older children and adults undergo adjuvant radiotherapy or combined chemo- and radiotherapy in cases of subtotal resection or tumor recurrence.

Choriocarcinoma is a subtype of gestational trophoblastic disease. It is a very rare neoplasm, with incidence of about 1 case in 40.000 pregnancies. Gestational form of choriocarcinoma arises most commonly after abortion, while nongestational form develops from pluripotent germ cells. Choricarcinoma is highly malignant and highly chemosensitive type of tumor. A 43-year-old patient diagnosed with extra uterine pregnancy in September 2017 was treated with methotrexate with no response and had surgical removal of right Fallopian tube. Choriocarcinoma was diagnosed one and a half year after extra uterine pregnancy. Radiological imaging before treatment showed pulmonary and inguinal lymph node metastases and tumor invasion of the anterior uterine wall. Surgery was performed due to heavy bleeding and uterine wall invasion. As high risk patient she received chemotherapy. She was followed radiologically and her serum ?-HCG was monitored. Refractivity to the chemotherapy protocol during treatment was observed. Therapy response was achieved after administration of EMA-EP protocol modification i.e. three consecutive negative follow-up values of ?-HCG were obtained and radiological findings were disease free. One month after treatment patient had no signs of disease and ?-HCG level was normal.