Quality and Safety in Healthcare, Part LXVIII: Consequences and More Solutions Regarding Poor Well-Being in Medical Students: Reply
No abstract available (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Letters to the Editor Source Type: research

Re: Quality and Safety in Healthcare, Part LXVIII: Consequences and More Solutions Regarding Poor Well-Being in Medical Students
No abstract available (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Letters to the Editor Source Type: research

Radiation-Induced Meningioma in a Case of Medulloblastoma Treated 11 Years Ago—Detected on 68Ga-DOTANOC PET/CT
We report one such rare case, in a patient who completed treatment for medulloblastoma 11 years ago, was in remission, and now presented with dural-based lesions. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Two Cases of Epstein-Barr Virus–Positive Mucocutaneous Ulcer Mimicking Head and Neck Cancers in 18F-FDG PET/CT
Epstein-Barr virus–positive mucocutaneous ulcer is a newly recognized clinicopathological entity among mature B-cell neoplasms according to the 2016 revision of the World Health Organization diagnostic criteria. Here, we present FDG PET/CT images of 2 Epstein-Barr virus–positive mucocutaneous ulcer cases. Both cases shown in the images mimicked head and neck cancers, which are similar to carcinomas of the tonsil and gingiva, respectively, and both lesions showed intense FDG uptake on PET scan. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Identification of Acute Mesenteric Ischemia on 18F-FDG PET/CT
We present a 39-year-old woman with portal vein thrombosis who was sent for 18F-FDG PET/CT evaluation of a suspected pancreatic head neoplasm but was unexpectedly found to have ischemic and necrotic small bowel secondary to mesenteric venous infarction. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

68Ga-PSMA-11 PET/CT in Isolated Bilateral Adrenal Metastases From Prostate Adenocarcinoma
A 65-year-old man with treated prostate adenocarcinoma underwent 68Ga-PSMA-11 PET/CT scan for restaging due to significantly increased serum PSA levels. PET/CT showed bilateral adrenal masses with high 68Ga-PSMA-11 uptake. There was no other lesion suspicious for metastasis. The laboratory and imaging findings were consisted with isolated bilateral adrenal metastases from prostate adenocarcinoma. The patient received docetaxel chemotherapy in combination with androgen deprivation therapy. PSA levels gradually decreased during chemotherapy. Follow-up MRI showed the bilateral adrenal masses significantly decreased in size. T...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET/CT Imaging of G-CSF–Producing Dedifferentiated Liposarcoma
We report a case of G-CSF–producing dedifferentiated liposarcoma. 18F-FDG PET/CT showed abnormal 18F-FDG uptake throughout the bone marrow and in the primary site. When a diffuse bone marrow 18F-FDG uptake was observed on 18F-FDG PET/CT, G-CSF–producing dedifferentiated liposarcoma should be included in the differential diagnosis. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Benign Bone Cyst Mimicking Bone Metastasis Demonstrated on 68Ga-FAPI
A 59-year-old woman with lobular breast cancer was referred to nuclear medicine department for a 68Ga-FAPI PET/CT study after completion of treatment to rule out the possibility of metastatic disease. It revealed a lytic lesion showing increased FAPI accumulation in the right acetabulum, highly suspicious for bone metastasis. In comparison to an initial 18F-FDG PET/CT study done 2 years before, the lytic lesion showing no FDG uptake in the right acetabulum remained unchanged, and the findings were consistent with bone cyst. This case highlighted that benign bone cyst may demonstrate increased 68Ga-FAPI uptake mimicking bon...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

First Metatarsal Bone Metastasis From Clear Cell Renal Cell Carcinoma on SPECT/CT
We report metatarsal metastasis in SPECT/CT in a 65-year-old man, 5 years after radical right nephrectomy. Tumor from first metatarsal was histopathologically proven from clear cell renal cell carcinoma. Metatarsal metastasis is very rare. Less than 0.01% of patients have metastases in the foot bone. Tumor histotype is mainly lung cancer. Metastases from renal carcinoma are often lytic with a poor osteoblastic response, there may be limited uptake of the 99mTc-MDP tracer, and all uncertain regions should be diagnosed with SPECT/CT, if it is possible. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Features of Systemic Immune Response From COVID-19 Vaccination on 18F-FDG PET/CT
The rapid rollout of COVID-19 vaccination is accompanied by incidental findings on 18F-FDG PET/CT. Most cases describe reactive axillary lymphadenopathy. A 46-year-old woman with previous history of stage 3A breast cancer underwent follow-up 18F-FDG PET/CT, which demonstrated avid left axillary nodes and intense diffuse splenic uptake and moderate diffuse bone marrow uptake. She had been administered COVID-19 vaccination in the left deltoid 1 week earlier and required hospitalization for 24 hours due to fever. Symptoms settled with supportive treatment. One month after the PET/CT scan, she remained well. Sites of uptake we...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Osteoblastoma of the Lumbar Spine: Findings in SPECT/CT
We present the case of a 16-year-old adolescent boy with lower back pain that radiated down the right thigh. Lumbar MRI and CT findings were consistent with a long-standing osteoid osteoma located in the right laminae and pedicle of L3. SPECT/CT with 99mTc-DPD showed a highly increased osteogenic activity within the lesion, especially in the core region, also suggesting an osteoid osteoma. Surgical en bloc resection was performed with a final histological diagnosis of osteoblastoma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Colon Transit Scintigraphy in Schaaf-Yang Syndrome
We present colon transit scintigraphy of a 6-year-old boy with history of chronic constipation with poor response to medical treatment, clinical characteristics, and gene mutations consistent with this syndrome. After oral administration of 111In-DTPA, planar and SPECT/CT images showed rapid proximal colonic transit and anorectal retention. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

A Stromal Tumor Presenting as a Pseudoaneurysmal Dilation of the Small Bowel Mimicking a Lymphoma on FDG PET/CT
An 84-year-old woman visited our hospital with hematochezia for 1 month. Abdominal CT and FDG PET/CT showed local thickening of the small intestine, resembling an intestinal aneurysmal dilatation. Thus, a lymphoma was suspected, and surgical resection was performed. The final pathology revealed an exophytic small bowel stromal tumor with perforation, causing pseudoaneurysmal dilation of the small bowel. This case emphasized the importance of considering a small bowel stromal tumor when faced with similar FDG PET/CT findings. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

FDG PET/CT in Isolated Spermatic Cord Metastasis From Colon Cancer
We describe FDG PET/CT findings in a case of isolated spermatic cord metastasis from colon cancer detected 27 months after colectomy. The tumor showed intense focal FDG uptake in the right spermatic cord mimicking a primary spermatic cord malignancy. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Intratumoral Heterogeneity in a Patient With Metastatic Thymic Carcinoma on 18F-FDG, 68Ga-DOTATATE, and 68Ga-FAPI04 PET/CT
Herein, we present a 72-year-old woman with metastatic thymic carcinoma, referred for salvage peptide receptor radionuclide therapy with 177Lu-DOTATATE after completing all treatment options according to current clinical practice and guidelines. However, the patient was not eligible for 177Lu-DOTATATE peptide receptor radionuclide therapy and underwent 68Ga-FAPI04 PET/CT to assess the potential for a FAP-targeted therapy. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Complete Resolution of Disease After Peptide Receptor Radionuclide Therapy in a Patient of Metastatic Insulinoma
A 48-year-old man, a case of metastatic insulinoma, who failed transarterial chemoembolization of liver metastases underwent multiple cycles of peptide receptor radionuclide therapy with 177Lu-DOTATATE, following which a complete morphologic and metabolic response was demonstrated on 68Ga-DOTATATE PET/CT. Patient had a remarkable improvement in his quality of life as intractable hypoglycemic episodes resolved after treatment. Peptide receptor radionuclide therapy is a promising targeted radionuclide therapy in patients of metastatic insulinomas that can result in reduced tumor burden and improved quality of life, particula...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Detection of Diffuse Peritoneal and Omental Metastases From Prostate Cancer With 18F-PSMA-1007 PET/CT
We report a case of an 80-year-old man who was suspected of prostate carcinoma metastasis and underwent 18F-PSMA-1007 PET/CT for restaging the disease. PET/CT imaging presented intense tracer uptake in the prostate gland, multiple lymph nodes, and bones. Interestingly, we found extremely increased radioactive uptake of diffuse peritoneum and omentum on 18F-PSMA-1007 PET/CT images, which are very rare metastatic sites for prostate cancer. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Peptide Receptor Radionuclide Therapy by 177Lu-DOTATATE of a Secreting Cervical Paraganglioma
A 59-year-old man with a parapharyngeal paraganglioma incidentally discovered on a cervical swelling was referred to our nuclear medicine department for a morpho-metabolic assessment. An 18F-FDG PET/CT was initially performed and found an intense hypermetabolism of the lesion and a hypermetabolism of the periadrenal brown fat evoking catecholamine secretion. An additional 68Ga-DOTATOC PET/CT was performed, showing an overexpression of the somatostatin receptors of this isolated paraganglioma. After multidisciplinary discussion, a peptide receptor radionuclide therapy with somatostatin analogs using 177Lu-DOTATATE as a comp...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Incidentally Detected High SSTR Expression in Uterine Leiomyoma on DOTANOC PET/CT
A 38-year-old woman with a 2-month history of per vaginal bleeding and episodes of palpitations, headache, and vomiting underwent 68Ga-DOTANOC PET/CT for evaluation, which revealed a left suprarenal mass and a large uterine mass, both of which were intensely tracer avid. Histopathology of the masses after surgery revealed a left pheochromocytoma and uterine leiomyoma. SSTR-expressing leiomyoma is an uncommon finding and must be kept in mind as a differential diagnosis of DOTANOC-avid uterine mass. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

11C-Methionine Uptake in the Lactating Human Breast
A 33-year-old nursing mother who underwent resection of a glioblastoma of the right hemisphere was referred for a 11C-methionine PET/MR scan to exclude cancer recurrence. In whole-body PET imaging, a slight radiotracer uptake could be observed in the mammary glands, reflecting lactation status. In this case report, we initially describe 11C-methionine uptake in the human breast and discuss any consequences arising from this special situation. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Incidental Pituitary Adenoma on MIBI Parathyroid Imaging
A 77-year-old man with a case of hyperthyroidism with high parathyroid hormone (41 pmol/L), low vitamin D, and normal thyroid-stimulating hormone. The SPECT/CT fused images confirmed the evidence of retrotracheal hyperdense mass approximately 1.0 cm of diameter below the lower pole of the right thyroid lobe with increased uptake, highly suggestive of typical parathyroid adenoma. The most significant point is that there was an incidental finding: high focal uptake in the sellar/suprasellar region corresponding to heterogenous soft tissue lesion suspicious for pituitary adenoma. According to the previous scans, nuclear medic...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Single Adrenal Metastasis From Prostate Cancer Detected by 68Ga-PSMA PET/CT and Confirmed by Biopsy: A Case Report
This image demonstrates an unusual presentation of an adrenal metastasis from prostate cancer detected by 68Ga–prostate-specific membrane antigen PET/CT and confirmed by biopsy. A 68-year-old man with prostate cancer persisted with elevated levels of prostate-specific antigen after radical prostatectomy. Imaging identified a single abnormal uptake in the left adrenal gland. A biopsy was performed showing a metastatic prostatic adenocarcinoma. The patient received systemic treatment, and his prostate-specific antigen level decreased significantly. Our objective is to illustrate an unusual and single site of prostate c...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Detection of Chyle Leakage Site With Lymphoscintigraphy SPECT/CT in a Patient With Chylothorax Secondary to T-Cell Lymphoblastic Leukemia
We present a pediatric case with T-cell lymphoblastic leukemia and persistent chylothorax who was referred to lymphoscintigraphy to identify the site of leakage. Planar lymphoscintigraphy with SPECT/CT revealed hot spots at the left jugulovenous angle and the confluens of the vena brachiocephalica to vena cava, which were compatible with the sites of leakage. Hybrid imaging with SPECT/CT technique have great impact on accurate detection of the defects in the lymphatic system in patients with chylothorax. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

COVID Lessons Continue: Postvaccination Somatostatin Receptor–Positive Axillary Nodes on DOTATATE Imaging
We present a case of DOTATATE-avid nonpathologically enlarged lymph nodes in ipsilateral axilla and linear tracer uptake in the deltoid muscle on a patient imaged for a recent diagnosis of rectal neuroendocrine neoplasm. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Fibroblast Activation Protein–Targeted PET Imaging of Metastatic Castration-Resistant Prostate Cancer Compared With 68Ga-PSMA and 18F-FDG PET/CT
This report highlights the theranostic potential of FAP imaging in mCRPC, particularly in patients with heterogeneous tumor phenotypes. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET/CT Findings of Myeloid Sarcoma in the Pancreas
Myeloid sarcoma (MS) is a rare neoplasm of leukemic cells that infiltrates an extramedullary soft tissue. MS may present at initial diagnosis of any myeloproliferative disease or relapse after treatment. It is most commonly associated with acute myeloid leukemia. The incidence of pancreatic involvement of MS is very rare. Herein we present FDG PET/CT findings of a rare case of MS involving the pancreas, which was initially misdiagnosed as pancreatic carcinoma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Hepatic Lesion of Mucosa-Associated Lymphoid Tissue Lymphoma Revealed by Al18F-NOTA-FAPI-04 PET/CT
A middle-aged man was newly diagnosed with mucosa-associated lymphoid tissue lymphoma with secondary liver involvement. The hepatic lesion was not shown on FDG PET/CT but FAPI (fibroblast-activated protein inhibitor) PET/CT, which revealed abnormal FAPI accumulation. This case demonstrated that FAPI PET/CT might provide value in hepatic mucosa-associated lymphoid tissue lymphoma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Positive Multifocal PSMA PET/CT in a Patient With Prostate Cancer and Follicular Lymphoma
Prostate-specific membrane antigen (PSMA) PET/CT is a highly reliable nuclear tracer for diagnostic imaging of prostate cancer. However, PSMA is also expressed by some nonprostatic tissues such as benign tumors, inflammatory processes, and malignant neoplasms. This case presents a patient with prostate cancer and follicular lymphoma undergoing PSMA PET/CT. Remarkably, both tumor entities were clearly detected in the scan. Yet, the 2 malignancies demonstrated rather different ranges in terms of SUVmax uptake values and therefore still enabled precise and accurate discrimination of prostate cancer and follicular lymphoma. (S...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

68Ga-PSMA Uptake Patterns of Clear Cell Renal Carcinoma Across Different Histopathological Subtypes
68Ga–prostate-specific membrane antigen (PSMA) PET/CT is a well-established imaging modality in patients with prostate cancer; however, PSMA expression is also reported in the tumor-associated neovasculature, including but not limited to hepatocellular carcinoma, breast cancer, and renal cell carcinoma. Herein, we present 2 patients diagnosed with different histopathological subtypes of renal cell carcinoma who underwent 68Ga-PSMA PET/CT before surgery. Both cases have different PSMA expression characteristics and are presented along with pathological findings. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET Uptake in the Scalp After Platelet-Rich Plasma Therapy
We report a case of 43-year-old woman with right breast cancer who underwent surgery, chemotherapy, and radiotherapy 2 years ago and is currently on hormonal therapy. 18F-FDG PET/CT demonstrate incidental findings of increased FDG avidity in the scalp after platelet-rich plasma therapy. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Solitary Contralateral Adrenal Metastasis of Renal Cell Carcinoma: 68Ga-DOTATATE PET/CT Findings
68Ga-DOTATATE PET/CT is an imaging technique used in the diagnosis of neuroendocrine tumors. Since renal cell carcinoma (RCC) expresses the somatostatin receptors, 68Ga-DOTATATE PET/CT could be used in the surveillance of RCC. However, limited cases showing 68Ga-DOTATATE uptake in the metastases of RCC have been reported before. Herein, we report a case of a 55-year-old woman with a history of left nephrectomy for clear cell renal cell carcinoma 2 years before, and referred to 68Ga-DOTATATE PET/CT for the evaluation of adrenal mass. 68Ga-DOTATATE PET/CT showed intense 68Ga-DOTATATE uptake on the adrenal mass. Histopatholog...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET/CT Imaging of Immune Checkpoint Inhibitor–Related “Retroperitoneal Panniculitis”
A 71-year-old woman was operated on for undifferentiated lung adenocarcinoma. Four months after surgery, she developed bone and adrenal metastases. She underwent palliative radiation therapy of left scapula and right iliac bone. Thereafter, she started immune checkpoint inhibitor (ICI) therapy with anti–PD-1 antibodies achieving complete tumor response. Twenty months later, a follow-up 18F-FDG PET/CT confirmed tumor response and revealed high radiotracer accumulation in correspondence of retroperitoneal and subcutaneous fat opacities. The contiguous fasciae were mildly thickened. The temporal relation with ICI therap...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Orbital Plasmablastic Lymphoma: A Rare Variant of Diffuse Large B-Cell Lymphoma Staged and Followed Up by: 18: F-FDG PET/CT
We present a case of PBL involving the bilateral orbits in an immunocompetent patient with 1-year follow-up on 18F-FDG PET/CT scan. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Papillary Thyroid Carcinoma in Ectopic Thyroid Tissue Within a Suspected Cervical Paraganglioma
We present a rare case of a confirmed synchronous, orthotopic, and heterotopic (in lateral ectopic thyroid tissue) differentiated thyroid carcinoma in a patient who was previously misdiagnosed as having a cervical paraganglioma, based on compatible clinical, analytical, and imagenological (both structural and functional) findings. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

The Importance of SPECT/CT in Preoperative Localization of Sentinel Lymph Nodes in 2 Patients With Acral Melanoma in the Foot
A 68-year-old woman with melanoma in the left heel underwent sentinel node lymphoscintigraphy and radioguided biopsy. The sentinel node lymphoscintigraphy with SPECT/CT detected 3 foci of increased activity in the popliteal fossa and inguinal region. When coregistered to CT, the sentinel node was localized in the inguinal region, and the popliteal foci were considered tracer retention in lymphatic vessel. In another patient with melanoma in the foot, sentinel node lymphoscintigraphy detected 3 foci of increased activity in the popliteal fossa and inguinal region, which were all identified to be nodal uptake in SPECT/CT. Th...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

68Ga-DOTA-FAPI-04 PET/CT in Neuroendocrine Carcinoma of the Liver With Elevated AFP Level: Comparison With: 18: F-FDG PET/CT
A 68-year-old woman with a mass lesion in right hepatic lobe had an elevated α-fetoprotein level (>54,000 ng/mL). The lesion showed higher 68Ga-DOTA-FAPI-04 uptake than 18F-FDG uptake in consecutive PET/CT images. The histopathological examination revealed neuroendocrine carcinoma with Ki-67 proliferation index of 80%. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Correlation of PET/CT and Brain MRI Findings in Human African Trypanosomiasis Encephalitis
A 49-year-old woman from Cameroon presented with history of several months of worsening headache, lethargy, left arm weakness, and generalized lymphadenopathy. Brain MRI demonstrated multifocal signal abnormality and enhancement involving the bilateral basal ganglia and cerebral white matter. FDG PET/CT performed as part of lymphadenopathy evaluation demonstrated patchy areas of increased metabolic activity of the brain parenchyma. Human African trypanosomiasis or African sleeping sickness is a protozoan infection caused by Trypanosoma brucei gambiense transmitted by the tsetse fly in sub-Saharan Africa. It is important to...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Appendiceal Neuroendocrine Tumor Detected by 18F-FDG PET/CT
We report the 18F-FDG PET/CT findings in a patient with an appendiceal neuroendocrine tumor. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Incidental Finding of Endometrioid Adenocarcinoma of the Ovary on 131I Whole-Body Scan
A 57-year-old woman was referred for radioactive iodine therapy 12 weeks after completion thyroidectomy and left modified radical neck dissection for pT2N1Mx follicular variant papillary thyroid carcinoma. After 4 weeks of l-thyroxine withdrawal, stimulated serum thyroglobulin level was less than 0.1 ng/mL with positive thyroglobulin antibody. Posttherapy 131I scintigraphy with SPECT/CT of the head and abdominopelvic region showed thyroid residual in the neck, occipital bone metastasis, and heterogenous tracer uptake in a large peritoneal mass, likely arising from the left ovary. Left salpingo-oophorectomy was performed, a...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

COVID-19 Lung Findings Detected by 68Ga-PSMA PET/CT for Staging Purposes in Patients With Prostate Cancer
We report 3 patients with COVID-19 findings in 68Ga-PSMA PET/CT taken for staging. The first patient, A 64-year-old man with prostate cancer, who had COVID-19 in November 2020 and whose treatment was completed, was observed to continue with COVID-19 findings in 68Ga-PSMA PET/CT in December 2020 before surgery. Other patients were asymptomatic for the disease. It was determined that a PSMA uptake in the lungs corresponding to the CT findings of COVID-19 had increased in 68Ga-PSMA PET/CT. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

False-Positive Uptake in Splenic Hemangioma on 68Ga-PSMA PET/CT Scan for Late Biochemical Recurrence of Prostate Cancer
A 71-year-old man underwent 68Ga-PSMA PET/CT for evaluation of a late biochemical recurrence after radical prostatectomy. An intense PSMA uptake was identified in spleen. Additional evaluation with a contrast-enhanced MRI showed a splenic lesion consistent with splenic hemangioma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

FDG PET/CT in a Case of Lynch Syndrome With Synchronous Inverted Urothelial Papilloma of the Bladder, Urothelial Carcinoma of the Ureter, and Jejunal Adenocarcinoma
A 64-year-old man was referred because of the right ureteral obstruction. CT urography showed an intraluminal enhancing mass in the right midureter and an enhancing nodule in the bladder wall. FDG PET/CT showed increased FDG uptake of the ureteral mass and an unexpected hypermetabolic lesion in the jejunum. The patient underwent transurethral resection of the bladder tumor, right laparoscopic nephroureterectomy, and partial enterectomy. Inverted urothelial papilloma of the bladder, high-grade urothelial carcinoma of the right ureter, and jejunal adenocarcinoma were confirmed by histopathology. Genetic testing of the jejuna...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

68Ga-FAPI-04 PET/CT Imaging for Fibrous Dysplasia of the Bone
We report a case of a patient with polyostotic fibrous dysplasia who showed widespread and intense metabolic activity on 68Ga-FAPI PET/CT. Physicians should be aware that fibrous dysplasia can also cause elevated FAPI activity. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Unilateral Breast Uptake of 99mTc-MIBI in a Lactating Woman During Myocardial Perfusion Imaging
A 34-year-old woman, who was 11 months postpartum, underwent 99mTc-MIBI myocardial perfusion SPECT imaging for atypical symptomatology with normal baseline electrocardiogram and 2-dimensional echocardiography. She was lactating on and off, preferentially from the right breast. Analysis of the raw images revealed unilateral intense tracer uptake in the right breast region that persisted in the delayed spot views (24-hour postinjection). Although bilateral breast uptake of 99mTc-MIBI may be seen in postpartum scenario, unilateral breast uptake can also occur in patients with preferential lactation from 1 breast as seen in th...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

FDG PET/CT of Primary Ewing Sarcoma of the Peritoneum
We present a case of a 46-year-old man with ES of the peritoneum in whom FDG PET/CT showed high radiotracer activity in the primary tumor. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Quality and Safety in Healthcare, Part LXXIV: Combating Disruptive Behavior in Healthcare Workers
Disruptive behavior has major adverse consequences for patient care, morale of the staff, and institutional reputation. Disruptive actions must be confronted as soon as is feasible. Usually, such behavior will not recur following 1 more firm conversations by officials of the healthcare institution, but if necessary disciplinary measures and/or remediation may be necessary. Rarely, because of egregious or repeated offenses, it may be obligatory to suspend the privileges of the individual permanently or until there is further evaluation, such as by a subcommittee of the medical executive committee or perhaps by a fitness-for...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: From the American College of Nuclear Medicine Source Type: research

Burkitt Lymphoma/Leukemia Presented on 68Ga-Pentixafor and 18F-FDG PET/CT
An 18-year-old man with newly diagnosed Burkitt lymphoma/leukemia was referred for 18F-FDG and 68Ga-Pentixafor PET/CT. 68Ga-Pentixafor PET/CT revealed similar radioactivity uptake pattern to the 18F-FDG PET/CT in superior phrenic lymph node, ascending colon, ileocecum, peritoneal, marrow, and spleen. This case highlighted that it might be interesting to further investigate the role of 68Ga-Pentixafor PET/CT imaging in staging, treatment evaluation, and especially the feasibility of CXCR4-directed radioligand therapy in Burkitt lymphoma with positive expression of CXCR4. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Thyroid Metastasis in Whole-Body 18F-FDG PET/CT Restaging of Small Cell Lung Cancer
Incidental findings of thyroid lesions, some of which show increased FDG uptake, are common in whole-body FDG PET/CT imaging of oncological patients. As metastases to the thyroid are extremely rare, it is often a matter of debate, whether thyroid lesions should be considered as benign goiter or evaluated further. Here, we present the case of a 65-year-old woman with history of small cell lung cancer and multiple thyroid lesions, classified as benign nodular goiter. Because in restating using 18F-FDG PET/CT these lesions showed an increased FDG uptake and growth progression, decision was made for fine-needle aspiration, whi...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

A Rare Collecting Duct Carcinoma With Widespread Metastasis Visualized by 18F-FDG PET/CT
Collecting duct carcinoma is a rare and highly aggressive renal tumor with a poor prognosis. The presence of metastasis is common at collecting duct carcinoma diagnosis, but widespread metastases involving multiple soft tissues are extremely unusual. Here, we describe a 65-year-old man presenting with fever and lower leg pain as the first and main manifestations. After receiving anti-infective therapy for over 6 weeks without improvement, 18F-FDG PET/CT revealed a primary renal carcinoma with widespread metastases. A biopsy from the tubercle of fascicular spinal muscle indicated a diagnosis of collecting duct carcinoma. (S...
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Pineal Yolk Sac Tumor Producing α-Fetoprotein Detected by 68Ga-FAPI PET/MRI
This study reported a case of pineal YST with α-fetoprotein production revealed by 18F-FDG and 68Ga-FAPI PET/MRI. In the PET images, 68Ga-FAPI showed a far better tumor-to-background ratio than 18F-FDG in the pineal YST because there is little 68Ga-FAPI uptake in the brain. This case indicates that 68Ga-FAPI PET/MRI may be a useful tool for evaluating intracranial YST and other types of tumors in central nervous system. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - December 16, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research