Primary Hepatocellular Carcinoma With Intense 68Ga-PSMA Uptake But Slight 18F-FDG Uptake on PET/CT Imaging
68Ga-PSMA PET/CT imaging is an emerging imaging modality in prostate cancer. PSMA expression is also reported for nonprostate malignancies, including primary hepatocellular carcinoma. Herein, we present a case of a 74-year-ald man with recently diagnosed hepatocellular carcinoma who was referred for 18F-FDG PET/CT imaging for initial staging. The patient underwent 18F-FDG PET/CT as part of staging procedure; he also underwent 68Ga-PSMA PET/CT. PET/CT images revealed only slight 18F-FDG uptake in the liver lesion, but intense 68Ga-PSMA uptake, without any metastatic lesion seen elsewhere in the body. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

An Uncommon Initial Presentation of T-Cell/Histiocyte-Rich B-Cell Lymphoma: Acute Renal Failure
We present a case of T-cell/histiocyte-rich B-cell lymphoma who had acute renal failure at initial presentation with bilateral lymphomatous infiltration depicted on FDG PET/CT scan. Four months after the treatment, a repeat FDG PET/CT scan revealed complete resolution of the renal lesions, indicative of the complete remission for kidneys. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Presacral Anastomotic Sinus After Low Anterior Resection Mimicking Recurrent Rectal Cancer
We present a case of progressive inflammation in anastomotic sinus demonstrated by serial FDG PET/CT scans. Despite its benign nature, increased FDG uptake in this nonnegligible condition, which could lead to further detrimental complications including secondary cancer, may have clinical implications. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

FDG PET/CT of a Supraclavicular Silicone Granuloma at Follow-up of a Breast Carcinoma
We report herein the case of a 33-year-old woman who was referred for FDG PET/CT staging prior to pregnancy after a 4-year lost to follow-up for a breast invasive ductal carcinoma (pT2N1 SBRII). FDG PET/CT revealed right supraclavicular lymphadenopathy potentially caused by breast carcinoma recurrence. No additional site was involved. Supraclavicular ultrasonography showed typical “snowstorm” appearance. MRI revealed signs of breast implant intracapsular rupture and signal intensity of silicone within a supraclavicular node. Fine-needle aspiration and microbiopsy of adenopathy finally confirmed silicone granulo...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Successful Intra-arterial Peptide Receptor Radionuclide Therapy of DOTATOC-Negative High-Grade Liver Metastases of a Pancreatic Neuroendocrine Neoplasm Using 177Lu-DOTA-LM3: A Somatostatin Receptor Antagonist
We report our experience treating a young patient with DOTATOC-negative high-grade liver metastases of a pancreatic neuroendocrine neoplasm who underwent intra-arterial peptide receptor radionuclide therapy using SSTR antagonist 177Lu-DOTA-LM3, demonstrating an excellent response, nearly complete remission according to molecular imaging criteria and morphological partial remission, without any significant toxicity. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Extracranial Metastases From Glioblastoma With Primitive Neuronal Components on FDG PET/CT
A 17-year-old girl with World Health Organization grade IV glioblastoma with primitive neuronal components (histone H3 G34-mutant and IDH1 wild type) underwent whole-body FDG PET/CT staging due to vertebral metastases on initial MRI. PET/CT revealed extracranial metastatic disease with spinal leptomeningeal dissemination, osseous metastases, and peritoneal seeding via a ventriculoperitoneal shunt. Glioblastoma is uncommon in pediatric patients and particularly those with primitive neuronal components. Extracranial metastases from glioblastoma are more common in those with primitive neuronal components. This case demonstrat...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

An Extraordinary Case of Brown Fat Distribution
We report the case of a 27-year-old woman who underwent an 18F-FDG PET/CT, after administration of 20 mg propranolol, 20 minutes preinjection, to investigate B-symptoms as well as right-sided shoulder pain. Unilateral hypermetabolism was seen in the left cervical, thoracic, and paravertebral brown fat, without any uptake on the contralateral side. The patient was born with neuroblastoma in the right thoracic area. She underwent surgery a few days after birth. As brown fat activation is under sympathetic control, we hypothesize that a surgical lesion to the right orthosympathetic trunk resulted in sympathetic denervation, r...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

False-Positive 18F-FDG and 18F-Fluorothymidine Uptake in a Patient With Round Atelectasis
A 64-year-old man with no significant medical history demonstrated a right lower lobe opacity on routine chest radiography. Transaxial CT showed a round, well-circumscribed, pleural mass with comet-tail sign in the right lower lobe and pleural thickening with pleural effusion. 18F-FDG PET/CT showed hypermetabolic activity in the mass (SUVmax 9.61). 18F-fluorothymidine PET/CT also showed mild increased uptake in the mass (SUVmax 3.26). Lung biopsy and follow-up CT scan revealed round atelectasis. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Multifocal Urinary Bladder Paragangliomas With Negative 68Ga-DOTATATE Uptake and Positive 123I-MIBG Uptake
We report a case of an adult male patient with multifocal urinary bladder paragangliomas, which were negative on 68Ga-DOTATATE PET/CT scan, but positive on 123I-MIBG SPECT/CT scan. While the 68Ga-DOTA analog PET/CT exhibits superior performance in diagnosis and staging of pheochromocytoma and paraganglioma, our case demonstrates negative somatostatin receptor expression in this rare entity and indicates that 123I-MIBG SPECT/CT still plays a vital role in characterization of bladder paraganglioma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

A Case of Primary Localized Small Bowel Amyloidosis Studied by 18F-Choline and Contrast-Enhanced 18F-FDG PET/CT
We report a case of localized small bowel amyloidosis studied by 18F-choline and 18F-FDG–iodinated PET/CT performed for staging an aggressive prostatic cancer. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

68Ga–Prostate-Specific Membrane Antigen 11 PET/CT Detects Residual Glioblastoma After Radical Surgery in a Patient With Synchronous Recurrent Prostate Cancer: A Case Report
Prostate-specific membrane antigen (PSMA) is a transmembrane enzyme also known as folate hydrolase 1 highly expressed by prostate cancer (PCa) cells. However, PSMA overexpression by tumor-associated neovasculature of a variety of solid tumors, including glioblastoma (GBM), has also been proven. This clinical case reports about a 67-year-old man with a history of PCa who underwent radical surgery for GBM and performed a 68Ga-PSMA-11 PET/CT to restage PCa. PET imaging showed PSMA uptake in GBM residual disease after surgery. This finding suggests a possible role of PSMA inhibitors as diagnostic and therapeutic agents in pati...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

99mTc-HDP Bone Scintigraphy, SPECT/CT, and 18F-FDG PET/CT Diagnosis Imaging of Incidental Pleural Mesothelioma in a Patient With Biochemical Recurrences of Prostate Cancer: Is it Really a Coincidence?
We present the case of a 69-year-old man with history of prostate carcinoma treated with prostatectomy and subsequently with external beam radiotherapy and hormone therapy because of biochemical recurrences. More than 10 years after the diagnosis, follow-up 99mTc-HDP bone scans and SPECT/CT images demonstrated an incidental diagnosis of osteoblastic pleural plaques that quickly evolve to mesothelioma. PET/CT achieved the definitive diagnosis by guiding the biopsy to the highest and most accessible focus of glucidic hypermetabolism. Our case report raises the association between prostate cancer patients treated with externa...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Progressive Hydrocephalus Due to Ventriculoperitoneal Shunt Infection: Detection With FDG PET CT
Ventriculoperitoneal shunt malfunction is common in patients after shunt surgery. Imaging is done to reveal the underlying cause and confirm the diagnosis. Shunt infection is one of the common causes of shunt malfunction. FDG PET CT is an accepted infection imaging tool and can be used to diagnose shunt infection accurately in a patient with high clinical suspicion. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

FDG PET/CT and MRI in Primary Spinal Cord Glioblastoma
Glioblastoma is the most common primary malignant tumor of the central nervous system, most of which occur in the brain. Primary spinal cord glioblastoma is extremely rare. A 47-year-old woman presented with recurrent and progressive paresthesia and paralysis of right lower extremity. MR examination revealed a marked nodular enlargement of spinal cord at the T12 level, showing heterogeneous enhancement. FDG PET/CT showed this intraspinal lesion with high FDG uptake. Imaging findings indicated a possible diagnosis of malignant neoplasm. Surgical resection was performed, and the pathologic results confirmed a primary spinal ...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Bilateral End-Organ Endophthalmitis in Setting of Serratia marcescens Urosepsis on 18F-FDG PET/CT
We present the case of an 89-year-old man with Serratia marcescens urosepsis with multifocal end-organ infection on 18F-FDG PET/CT including aortitis, splenic abscess, septic arthritis, thoracolumbar discitis-osteomyelitis, and culture-confirmed bilateral endogenous endophthalmitis. Endophthalmitis-related intraconal ocular space uptake was clearly distinguishable from normal conal space extraocular muscle activity. Although sepsis responded to treatment, endophthalmitis led to complete vision loss. This case report presents PET/CT description of a rare and difficult-to-treat Serratia marcescens endogenous endophthalmitis,...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Which Is the Optimal Scan Time of 18F-DOPA PET/CT in Patients With Recurrent Medullary Thyroid Carcinoma?: Results From a Dynamic Acquisition Study
Conclusions Our study, showing a very fast 18F-DOPA uptake in MTC lesions, suggests the utility to obtain early PET/CT images, already at 2 to 5 minutes after tracer injection, when maximum lesion tracer uptake is reached. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Tumor SUVs on 18F-FDG PET/CT and Aggressive Pathological Features in Esophageal Squamous Cell Carcinoma
In this study, we examined the relationships between tumor SUVs on FDG PET/CT and aggressive pathological features in resected ESCC patients. Methods A total of 220 patients with surgically resected clinical stage I–II ESCC without neoadjuvant treatment were retrospectively analyzed. SUVmax of the primary tumor was measured on pretreatment FDG PET/CT. Pathological features included depth of tumor invasion, lymph node metastasis, tumor differentiation, lymphatic vessel tumor embolus, perineural invasion, Ki-67 index, and p53 protein expression. Receiver operating characteristic curve analysis was used to determine ...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Re: Hepatocellular Carcinoma Mimicking Neuroendocrine Tumor Metastasis on 68Ga-DOTATATE PET/CT
No abstract available (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Letter to the Editor Source Type: research

Anaplastic Large Cell Lymphoma Involving 7 Different Organs in a Pediatric Patient Demonstrated by FDG PET/CT
An 11-year-old girl presented with vomiting, abdominal pain, nausea, and scleral icterus for 7 days. FDG PET/CT demonstrated multiple FDG-avid lesions in muscle, bone, kidney, pancreas, ovary, lymph nodes, and central nervous system. Biopsy from the lesion in the muscle of the right upper arm demonstrated ALK-positive anaplastic large cell lymphoma. The present case highlights the advantage of FDG PET/CT in better staging pediatric patients with anaplastic large cell lymphoma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Increased FDG Uptake on Juxtaglomerular Cell Tumor in the Left Kidney Mimicking Malignancy
Juxtaglomerular cell tumor is a rare and benign tumor arising from the juxtaglomerular apparatus that overproduces renin, resulting in secondary hypertension. A 29-year-old woman was incidentally found to have a left renal mass by ultrasonography in a routine health examination. Contrast-enhanced CT results suggested renal cell carcinoma. FDG PET/CT performed for metastatic workup showed increased FDG uptake to the left renal mass and did not reveal any other abnormal FDG-avid lesions. The renal mass was surgically resected and pathological examination confirmed the juxtaglomerular cell tumor of the left kidney. (Source: C...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Remember the Pitfall: Intrapancreatic Accessory Spleen Mimicking Neuroendocrine Neoplasm
We report of a 71-year-old woman with a 2-cm somatostatin receptor–positive intrapancreatic lesion almost misdiagnosed as neuroendocrine neoplasm. By additional red blood cell scintigraphy with heat-damaged erythrocytes, the lesion was identified as an intrapancreatic accessory spleen, and unnecessary operation (which was already planned) could be avoided. This case report reminds colleagues to consider accessory spleen as differential diagnosis for somatostatin receptor–positive lesions even when located inside the pancreas. In doubtful cases, a scintigraphy with heat-damaged erythrocytes is a very useful and ...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Pseudomyogenic Hemangioendothelioma: Distinctive FDG PET/CT Findings With Numerous Multilayer Lesions in a Single Distal Extremity
Pseudomyogenic hemangioendothelioma is a rare vascular tumor described as a fibroma-like variant of epithelioid sarcoma. There were scant publications about FDG PET/CT findings of pseudomyogenic hemangioendothelioma. A 20-year-old man with biopsy-confirmed pseudomyogenic hemangioendothelioma of the left tibia had FDG PET/CT for evaluation of the lesion extent and metastasis, which demonstrated numerous, multilayer FDG-avid lesions of the left lower extremity below the knee. Although pathologic examination is mandatory for diagnosis, FDG PET/CT of the case showed distinctive image finding of pseudomyogenic hemangioendotheli...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Diffuse Hepatosplenic 99mTc-Pyrophosphate Activity Caused by Amyloidosis
A 46-year-old man underwent 99mTc-pyrophosphate scan to evaluate possible infiltrative myocardiopathy revealed by echocardiography. The images did not show abnormal cardiac activity. However, diffuse abnormal activity in the liver and spleen was noted. Pathological examination from the specimen acquired from hepatic biopsy demonstrated amyloidosis, light chain type. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

SPECT/CT Demonstrating 131I Accumulation in Gallbladder Stone in a Thyroid Cancer Patient
The radioiodine in the gallbladder usually mimics focal hepatic activity on the planar 131I whole-body scintigraphy. Here we describe an abnormal uptake in the hepatic region on postablative 131I scintigraphy in a 37-year-old woman with papillary thyroid cancer. The SPECT/CT images revealed this “hepatic activity” corresponded to gallbladder stone. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Peptide Receptor Radionuclide Therapy Using 225Ac-DOTATOC Achieves Partial Remission in a Patient With Progressive Neuroendocrine Liver Metastases After Repeated β-Emitter Peptide Receptor Radionuclide Therapy
We present here a case with β-radiation–refractory metastatic neuroendocrine tumors, who demonstrated an excellent therapy response after 1 cycle of 225Ac-DOTATOC, without any significant adverse effects even after 10 cycles of β-emitter peptide receptor radionuclide therapy followed by α-peptide receptor radionuclide therapy. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

68Ga–Prostate-Specific Membrane Antigen Uptake in Cerebral Tuberculosis
A 71-year-old man with a history of high-risk prostate adenocarcinoma (Gleason score 4 + 5 = 9) treated with brachytherapy in 2016 was referred for a 68Ga–prostate-specific membrane antigen (PSMA)–HBED–CC PET/CT scan for suspected cancer recurrence on a background of slowly rising serum prostate-specific antigen (0.95 ng/mL; reference, (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Asymmetric 67Ga Activity in the Head Related to Prior Head Trauma
67Ga study was performed in a 10-year-old boy who had a history of motor vehicle accident to evaluate occult infection. No abnormal activity typical of active infection was noted. However, there was significantly decreased activity in the right side of the head, which was related to his head trauma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Abdominal Wall Granulomatous Inflammation Mimicking Malignancy on FDG PET/CT
An old woman with abdominal pain complained a palpable mass on the right anterior abdominal wall. On PET/CT images, the lesion presented as a soft tissue mass with irregular shape, invading adjacent peritoneum and showing intense FDG uptake. Based on imaging findings, a malignancy was suspected, and she underwent surgical resection. However, the abdominal wall mass was diagnosed as granulomatous inflammation with a little necrosis by pathological results. Awareness of this benign disease is helpful for an accurate diagnosis of abdominal wall mass. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Radioguided Surgery for Meckel Diverticulum: Nuclear Medicine Aspects
We present the case of a 13-year-old boy with bleeding complications from a Meckel diverticulum (MD), which was scintigraphically confirmed. A first exploratory laparoscopy was unsuccessful in identifying the diverticulum. A new 99mTc-pertechnetate scintigraphy (including SPECT/CT), 3 years later, suggested the anatomical location and was helpful during the surgical exploration for the MD by radioguided surgery. Radioguidance is helpful in pathologies characterized by small size or variable anatomical location. A MD with ectopic gastric mucosa can be distinguished from the rest of the small bowel based on selective 99mTc-p...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Solitary Cerebellar Metastasis of Ovarian Cancer Detected by FDG PET/CT
We presented a 58-year-old woman complaining of headaches 9 months after debulking surgery and chemotherapy due to ovarian cancer. The serum CA125 level was elevated. FDG PET/CT was then recommended to identify potential malignancy and showed a hypermetabolic mass in the right cerebellum. The cerebellar mass was surgically removed, and the pathology confirmed metastasis from ovarian cancer. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Nodular Fat-Sparing Hepatic Parenchyma as 11C-Choline–Avid Finding on PET/CT
Focal nodular fat sparing of the liver may show, on PET/CT imaging, prominent tracer uptake over a background of less metabolic features of steatosis. This finding, already reported with 18F-FDG, may mimic primary or secondary neoplasms of the liver. The authors present an additional case of nodular fat-sparing hepatic parenchyma exhibiting 11C-choline avidity during PET/CT assessment for biochemical recurrence of prostate cancer. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

99mTc Tamoxifen for Imaging Estrogen Receptor Expression in Metastatic Breast Cancer Patient
We present noninvasive imaging of estrogen receptors with 99mTc tamoxifen that can identify the active tumor and approachable sites for biopsy. It may help in selection of patients for hormone replacement therapy and in assessment of receptor status in recurrent disease and also in response evaluation. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Hürthle Cell Thyroid Adenoma Showing Avid Uptake on 18F-PSMA-1007 PET/CT
We report the case of a 74-year-old man with suspected recurrent prostate carcinoma who underwent 18F-PSMA-1007 PET/CT for restaging the disease. PET/CT imaging presented an incidentaloma with intense 18F-PSMA-1007 uptake in the right thyroid lobe. Biopsy and genomic sequencing test confirmed the diagnosis of Hürthle cell thyroid adenoma. Therefore, it is important to raise awareness of this benign lesion in the differential diagnosis of incidental thyroid nodules with high 18F-PSMA-1007 activity. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Posttreated POEMS Syndrome With Concurrent Follicular Lymphoma Revealed by 18F-FDG and 68Ga-Pentixafor PET/CT
A 59-year-old man with history of POEMS syndrome was found with a painless mass in the right neck for 9 months. In 18F-FDG and 68Ga-pentixafor PET/CT, there were multiple neck nodes and left inguinal nodes that showed intense 18F-FDG and 68Ga-pentixafor uptake. In addition, osteoblastic bone lesions with mild 18F-FDG and 68Ga-pentixafor uptake were noted in the pelvis, which was consistent with posttreated osseous involvement of POEMS syndrome. However, considering lymphoadenopathy with such intense 18F-FDG uptake is not usually seen in POEMS syndrome, the patient underwent biopsy of the right cervical nodes. The histopath...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

“Eye-Black” Sign Secondary to Nivolumab Immunotherapy
A 54-year-old woman with known chest wall melanoma (post–wide local excision) presented for imaging after a yearlong therapy with nivolumab. 18F-FDG PET/CT was performed 1 day after she completed the immunotherapy. Maximum intensity projection images showed bilateral relatively symmetrical uptake in the facial region. On fused PET/CT images, the uptake was seen corresponding to subcutaneous malar prominence underneath the orbits (like eye-black stripe used in sports) with subcutaneous malar calcification. Repeat PET/CT performed after 3 months revealed significant decrease in the malar uptake. Interval resolution of ...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Asymptomatic Metastasis to Thyroid Cartilage Detected by 18F-Choline and 64Cu-PSMA PET/CT as a Single Site of Disease Relapse in a Patient With Castration-Resistant Prostate Carcinoma
We report a case of an 83-year-old man with castration-resistant prostate cancer in whom a metastasis to the thyroid cartilage was the only site of relapse. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

The Hot Pleura: Isolated Pleural Metastases From Renal Cell Carcinoma
We report one such case of a 60-year-old woman, a known case of RCC of the left kidney who underwent nephrectomy, and on follow-up, PET/CT scan revealed diffuse thick nodular hypermetabolic left pleural thickening, which was later biopsied and turned out to be pleural metastases from RCC. No other site of metastases was found. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET/CT Evaluation of Crizotinib and Lorlatinib Therapy in Metastatic ROS-1–Positive Non–Small Cell Lung Cancer
We report the use of lorlatinib as second-line with a complete tumoral response after only 3 months of treatment. This case shows the major role of 18F-FDG PET/CT in treatment evaluation and monitoring targeted therapy in metastatic NSCLC. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

The Great Mimicker—Tuberculosis Involving Prostate and Vertebrae Posing as Metastatic Prostate Carcinoma on FDG PET/CT
A 65-year-old man underwent FDG PET/CT for evaluation of vertebral lesions, radiologically suspected to be metastases. The scan showed hypermetabolism in D8 to D9 vertebrae, retroperitoneal lymph nodes, and both the lobes of prostate. Transrectal ultrasound-guided biopsy of prostate was performed with suspicion of prostate malignancy. The biopsy revealed caseating granulomatous lesions in prostate suggestive of tuberculosis. Post antitubercular treatment patient showed excellent clinical response. Possibility of infective pathologies mimicking malignancy should be kept in mind while evaluating hypermetabolic foci seen on P...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Role of 68Ga–Prostate-Specific Membrane Antigen PET/CT in Disease Assessment in Glioblastoma Within 48 Hours of Surgery
We present a case of a 39-year-old man with recurrence glioblastoma of the right frontal lobe and underwent resurgery. After surgery, 68Ga–prostate-specific membrane antigen PET/CT showed residual disease along the posterior and inferior margin of the postoperative cavity. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Posterior Reversible Encephalopathy Syndrome After 90Y-Resin Microspheres Radioembolization
A 66-year-old man with colorectal carcinoma and liver-only metastases underwent radioembolization using 90Y-loaded, resin-based microspheres. One day after radioembolization, the patient experienced severe hypertension and multiple seizures. On MRI, symmetric edematous areas in the cerebellum and the parietal and occipital lobe were observed, a typical finding for posterior reversible encephalopathy syndrome (PRES). The PRES is associated with, for example, renal failure or blood pressure fluctuations leading to cerebral endothelial dysfunction. Antihypertensive and antiepileptic therapies led to normotensive blood pressur...
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Quality and Safety in Healthcare, Part LVI: Wellness Leaders
All members of the healthcare system should make positive contributions to improve the overall level of wellness. However, leaders should have certain specific responsibilities to prevent burnout and increase happiness and wellness at work. It has been proposed that a chief wellness officer direct the initiatives to improve wellness, in collaboration with many others including those in the executive suite. Part of improving joy in the workplace is improving efficiency, quality care for patients, safety for patients and workers, meaningful work for the workers, and respect and fairness for all. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: From the American College of Nuclear Medicine Source Type: research

Prostate-Specific Membrane Antigen Expression in Primary Juvenile Nasal Angiofibroma—A Pilot Study
Conclusions Assessment of PSMA expression in JNA by PSMA PET/CT opens up a new window of opportunity with respect to its radiological staging, vascularity assessment, and molecular characterization. A potential role in identification of the difficult residual-recurrent disease is anticipated and perhaps also in radioligand therapy for residual/recurrent JNA. Clinical Trials Registry of India (CTRI/2018/08/015479). (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Comparison of 18F-FDG PET/CT Criteria for the Prediction of Therapy Response and Clinical Outcome in Patients With Metastatic Melanoma Treated With Ipilimumab and PD-1 Inhibitors
Conclusions 18F-FDG PET/CT performed after 3 to 4 months since starting immunotherapy can correctly evaluate response to treatment and can also able to predict long-term clinical outcome. Performance of 18F-FDG PET/CT and criteria for response assessment is influenced by the class of treatment. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Prognostic Value of 18F-FDG PET/CT—Metabolic Parameters at Baseline and Interim Assessment in Pediatric Anaplastic Large Cell Lymphoma
Conclusions Whole-body tumor burden assessment with MTV and interim response may help to identify high-risk patients who might get benefitted from intensive therapy. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Limited Usefulness of 18F-FDG PET/CT in Predicting Tumor Regression After Preoperative Chemotherapy for Noncardia Gastric Cancer: The Italian Research Group for Gastric Cancer (GIRCG) Experience
Conclusions The present study suggests that 18F-FDG PET/CT has limited usefulness in predicting cancer regression. The lack of metabolic response in serial measurements indicates the probable ineffectiveness of preoperative treatment. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 7, 2020 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Ectopic Corticotropin-Releasing Hormone–Secreting Pancreatic Neuroendocrine Tumor: Excellent Response of Liver Metastases to Peptide Receptor Radionuclide Therapy as Demonstrated by: 68: Ga-DOTATOC and: 18: F-FDG PET/CT Imaging
We report here the case of a 54-year-old man who experienced CRH-secreting pancreatic neuroendocrine tumor causing Cushing syndrome, initially detected by SSTR (somatostatin receptor) scintigraphy, then significantly progressed with multiple liver metastases, demonstrating significantly increased SSTR expression on 68Ga-DOTATOC PET/CT and a “mismatch” imaging pattern on 18F-FDG PET/CT. The patient underwent peptide receptor radionuclide therapy with 177Lu/90Y-DOTATOC and demonstrated excellent response to the treatment. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - January 8, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Isolated Immunoglobulin G4–Related Disease of Nasal Septum and Maxilla: Diagnosis and Follow-up With: 18: F-FDG PET/CT
We present the case of a middle-aged woman presenting with isolated IgG4-RD of left maxilla and nasal septum, confirmed with 18F-FDG PET/CT. She achieved complete metabolic response with multiple pharmacologic treatment, but 1 year later, she experienced local relapse, and FDG PET/CT found new additional lesions in humeral vasculature and lungs. This case illustrates the usefulness of FDG PET/CT for initial evaluation and monitoring of IgG4-RD with unusual nasomaxillary involvement. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - January 8, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Incidental Detection of Pleomorphic Sarcoma on 68Ga-PSMA PET/CT in a Patient With Prostate Cancer
We report a case of a 72-year-old man with recently diagnosed adenocarcinoma of prostate, incidentally found to have pleomorphic sarcoma on the staging 68Ga-PSMA PET/CT. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - January 8, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Severe Contralateral Striatal Hypometabolism in a Case of Diabetic Nonketotic Hyperglycemic Hemichorea on 18F-FDG PET/CT Brain
We present a case of elderly diabetic woman with poorly controlled blood glucose levels, presenting with choreiform movements limited to the right side. 18F-FDG PET/CT showed marked hypometabolism in the basal ganglia contralateral to the side with hemichorea. The metabolic dysfunctions lead to nonketotic hyperglycemic chorea, although poorly understood; the index case demonstrated severe glucose hypometabolism in the striatum and adds to the other reported differential diagnoses for striatal hypometabolism. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - January 8, 2020 Category: Nuclear Medicine Tags: Interesting Images Source Type: research