Introduction: Newborn screening (NBS) is a system of organized search in the entire neonatal population for specific diseases. In Bosnia and Herzegovina, two diseases are included in NBS, congenital hypothyroidism (CH), and phenylketonuria. The screening for CH is based on determination of thyroid stimulating hormone (TSH) levels in blood obtained by heel prick method. The aim of this study is to evaluate the effectiveness of NBS program for CH based on TSH and establish the mean age of diagnosis of CH.Methods: TSH was measured by time-resolved fluoroimmunoassay (DELFIA Neonatal hTSH kit). The TSH cutoff value was 9 μU/mL. Neonates with TSH < 9 μU/mL had a negative NBS result. Neonates with TSH ≥ 9 μU/mL were recalled for a confirmation test and thyroid hormones were determined from venous blood to establish diagnosis of CH.Results: A total of 24,351 neonates were subjected to NBS in our institution. A total of 164 newborns with TSH ≥ 9 μU/ml were sent to additional testing (mean recall rate of 0.68%) at a mean age of 11.4 ± 0.5 days of life. In this group, diagnosis of CH was confirmed in 22 neonates (13.41%). The mean rate of false positive results of NBS was 0.59%. The incidence of CH in Sarajevo Canton ranged from 1/2477 in 2018 to 1/641 in 2020. The mean incidence of CH over a 5-year period was 1/1085, while the mean age at the time of diagnosis was 16.5 ± 1.2 days.Conclusion: The analysis of NBS on congenital hypothyroidism data showed the satisfactory recall and false positive rate and indicated well selected TSH cutoff value. The mean age at the time of diagnosis assures early treatment and good neurological outcome in neonates with CH.

Abstract Rationale: Pentalogy of Cantrell (POC) is an extremely rare syndrome with an estimated incidence of 1:65,000 to 200,000 live births. Its complete form includes a midline epigastric abdominal wall defect, defects affecting the lower sternum, anterior diaphragm, diaphragmatic pericardium, and various intracardiac defects. Patient concerns: We report a case of complete POC affecting only the first-born of a set of premature dizygotic twins. Diagnosis: A giant omphalocele with an eviscerated liver and bowel on prenatal, obstetric ultrasonography at 24 gestational weeks was observed. At birth, physical examination confirmed a massive (10 × 8 cm) epigastric omphalocele in which a significant part of the liver was seen. A postnatal echocardiogram revealed the presence of an ostium secundum atrial septal defect, perimembranous ventricular septal defect, and moderate pulmonary stenosis. X-ray showed an abnormal intrathoracic positioned stomach, which was confirmed with a plain x-ray of the upper intestinal tract with hydrosoluble contrast. Computed tomography (CT) scan revealed the sternum's absence and a close connection between the pericardial sac and the stomach wall. Interventions: The patient underwent surgical intervention at 18 days of age. Outcomes: Despite adequate and appropriate postoperative treatment, the baby rapidly deteriorated and died 72 hours after surgery. Lessons: POC is a complex, high-mortality syndrome whose management requires a multidisciplinary approach and meticulous planning. Despite all efforts, POC carries a poor prognosis, particularly in patients affected by its complete form.

OBJECTIVE The aim of the study was to evaluate the prognostic value of the maximum standardized uptake value (SUVmax) of 18F-Fluorodeoxyglucose (18F-FDG) PET/CT in patients with metastatic colorectal cancer, and to compare it with classical prognostic markers. MATERIALS AND METHODS The study included 70 patients with metastatic colorectal cancer who had not been treated for the metastatic disease. The patients underwent 18F-FDG PET/CT as part of their routine diagnostic reevaluation. During the analysis, the value of the largest tumor diameter and SUVmax was determined for the lesion with the highest SUVmax observed. The values of CEA and CA 19-9 were recorded 7 days before the PET/CT analysis. RESULTS SUVmax and Carbohydrate antigen (CA)19-9 were found to be independent prognostic markers of disease progression within 12 months. Based on the Receiver Operating Characteristics (ROC) curve analysis, the patients could be divided into two groups: SUVmax≤4.1 vs. SUVmax>4.1. Patients with SUVmax values of 4.1 or less had significantly better progression-free survival within 12 months with an HR (95% CI) of 2.97 (1.4-6.3), relative to patients with SUVmax values above 4.1. CONCLUSION SUVmax may be used as a novel prognostic marker of disease progression among patients with metastatic colorectal cancer. Values of SUVmax can be used to select patients with a more aggressive type of disease and higher risk for progression within 12 months of PET/CT analysis.

Poster: "ECR 2020 / C-11002 / A spectrum of imaging findings in the hydatid disease in the pediatric population: A pictorial essay " by: " M. Becircic 1, I. Sefic-Pasic1, D. Bulja1, O. Ali Abud2, S. Vegar-Zubovic1; 1Sarajevo/BA, 2Sarajevo, sarajevo/BA"

Introduction: Fetal Magnetic Resonance Imaging (MRI) is an imaging method for displaying anatomical structures of the fetus without ionizing radiation and it has been in use since the MRI has been used for the analysis of the adult human body. Aim: The aim of our paper is the two-year retrospective analysis of fetal MRI examinations for the purpose of presenting various pathological conditions of the fetuses. Methods: A total of 59 fetal MRI examinations were performed on pregnant women in the time period 2016 to 2018 at the Radiology Clinic at Sarajevo University Clinical Center, on Siemens and Toshiba 1.5 Tesla scanners. All cases were referred by gynecologists who suspected a fetal pathology. The comparison of the fetal age at which the congenital anomalies are usually detected is performed using the univariate analysis of variance and the Student t test, at the 95% level of confidence. Results: Of the total of 59 fetal MRI examinations, 2 fetuses (3,4%) were healthy, while pathology of the head and CNS was found in 26 fetuses (44,2%), thoracic cavity pathology in 5 fetuses (8,5%), abdominal cavity pathology in 18 fetuses (30,6%), pathology of extremities in 2 fetuses (3,4%), spinal cord pathology in one fetus (1,7%), and in 3 fetuses associated anomalies were found (5,1%). The pathology of the uterus and placenta was found in two pregnant women (3,4%). Conclusion: Prenatal MRI provides extremely useful information in cases where the ultrasound examination of the fetus is insufficient due to the size and position of the fetus. MRI is a key tool in deciding whether to continue or stop the further development of the fetus.

Introduction: The objective of this research was to determine whether vesicoureteral reflux(VUR) was associated with evolution to renal scarring (RS) following a febrile urinary tract infection (UTI) in infants. Materials and methods: Our research included 100 infants, ages up to 1 year with a first febrile UTI. The diagnostic was based on results of: laboratory findings, ultrasonography (USG), voiding cystourethrography (VCUG) and initial and control renal scintigraphy (DMSA renal scan) withtechnetium99mTcsuccimer (dimercaptosuccinic acid), to assess the acute pyelonephritis (APN), VUR and RS. Results: APN was proven with DMSA renal scan in 66 (66%) infants. Twenty-two infants (33.3%) had VUR in-group of patients with APN. On the control DMSA scan, performed 6 months after the first DMSA, the presence of RS was found in 18 (27.27%) infants. In infants with renal scars VUR were discovered in 9 of them (50%). Conclusions: The pathogenesis of RS after febrile UTI in young children is multifactorial. Children with VUR have an increased risk for APN and RS. However, VUR is not the only precondition for RS. Creating a renal scarring cannot be imagined without the inflammatory process of the upper urinary system. Therefore, early detection and treatment of febrile UTIs in children and identify children at risk for RS are of primary importance.