Prostate Cancer Liver Metastases Presenting as Relatively Photopenic Lesions on 18F-Fluciclovine PET/CT
A 66-year-old man with prostate adenocarcinoma status post radical retropubic prostatectomy and bilateral pelvic lymph node dissection, followed by salvage external beam radiation therapy to the prostate bed 1 year after surgery. Over the course of 17 years, the patient underwent multiple lines of systemic treatment for recurrent disease. He was referred for restaging 18F-fluciclovine PET/CT due to rising serum prostate-specific antigen levels. Contrast-enhanced 18F-fluciclovine PET/CT images demonstrated multiple new liver metastases, which were relatively photopenic in comparison with the physiologic radiotracer activity...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

An Incidental Uptake of 18F-Choline at PET/CT in Gastric Neuroendocrine Tumor
We present a case of neuroendocrine tumor localized in the gastric mucosa, incidentally detected by 18F-choline PET/CT in a 69-year-old man with prostate cancer. 18F-choline PET/CT scan showed an increased activity in the stomach, later diagnosed as a well-differentiated neuroendocrine tumor, at biopsy. A careful attention of reading 18F-choline PET/CT images should be made, in order to avoid the missing of potential concomitant neoplasia in patients with prostate cancer. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Adenocarcinoma of the Lung With Initial Presentation as Painful Testicular Metastasis: 18F-FDG PET/CT Findings in an Unusual Case
We present an unusual case of adenocarcinoma lung, presenting initially with right testicular pain. Further workup with 18F-FDG PET/CT demonstrated primary malignancy of the left lung with nodal and right testicular metastasis. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Is 68Ga–Prostate-Specific Membrane Antigen PET/CT Superior than 18F-FDG PET/CT for Evaluation of Metastatic Osteosarcoma?
We present the case of a 75-year-old man with osteosarcoma of the sternum in whom 68Ga-prostate-specific membrane antigen (PSMA) PET/CT showed high radiotracer activity in the primary tumor and metastatic lesions than 18F-FDG PET/CT. The present case shows that 68Ga-PSMA PET/CT is very useful for staging of osteosarcoma due to in vivo expression of PSMA. 68Ga-PSMA PET/CT can have potential effects on prognosis and in response assessment following treatment in osteosarcoma. The use of PSMA-targeted radioligand treatments may be beneficial especially in metastatic chemorefractory osteosarcoma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Oligodendroglioma in 68Ga-PSMA-11 and 18F-Fluciclovine PET/CT
We report a case of an 83-year-old man with known oligodendroglioma and biochemically recurrent PC who shows a high focal 68Ga-PSMA-11 and 18F-fluciclovine uptake in the brain. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET/CT in Hyalinized Cholecystitis
We present the 18F-FDG PET/CT and MRI findings of this rare subtype of chronic cholecystitis. Hyalinizing cholecystitis should be kept in mind in the differential diagnosis of gallbladder wall thickening with intense 18F-FDG uptake. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Diffuse Subcutaneous Metabolic Activity in Post Bone Marrow Transplant Hodgkin Lymphoma
We present a 14-year-old adolescent boy with Hodgkin lymphoma. He had prior completed chemotherapy with ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) regimen followed by bone marrow transplantation 6 months ago. Currently, he has neither specific clinical complaint nor receiving any specific medication. Follow-up FDG PET/CT scan demonstrated diffuse increased metabolic activity in the entire body subcutaneous tissue. This finding is rarely reported in the literature and may represent an underlying active inflammatory process, most likely attributed to the received treatments. This could impair the diagnostic qual...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET/CT of Hepatosplenic Actinomycosis After Laparoscopic Cystojejunostomy for Pancreatic Pseudocyst
We report the 18F-FDG PET/CT appearance of abdominal actinomycosis in a 48-year-old immunocompetent woman with a history of laparoscopic cystojejunostomy for pancreatic pseudocyst previously. 18F-FDG PET/CT demonstrated multiple hypermetabolism in the liver, spleen, cystojejunostomy anastomosis, greater omentum, and umbilical region. Actinomycosis was verified by biopsy. Hepatosplenic actinomycosis secondary to cystojejunostomy is extremely rare and easily to be misdiagnosed. PET/CT is helpful for auxiliary diagnosis, guiding biopsy, and exploring the extent of the disease. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Infection Control of COVID-19: Surgical Mask–Related Facial Cutaneous Artifact on FDG PET/CT
In accordance with published international COVID-19 pandemic guidance (American College of Nuclear Medicine, British Nuclear Medicine Society, and European Association of Nuclear Medicine), the use of face masks has become an essential part of infection control for both patients and staff. A 56-year-old man with mantle cell lymphoma underwent staging FDG PET/CT, which demonstrated avid lymphadenopathy below the diaphragm and an unusual diffuse FDG uptake projected over the face, raising the suspicion of cutaneous lymphomatous involvement. On reflection of the clinical scenario and scanning conditions, cutaneous involvement...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Usual and Rare Abdominal Location of Giant Cell Arteritis Diagnosed and Follow-up With 18F-FDG PET/CT
We reported the case of a 61-year-old woman with common giant cell arteritis pattern on 18F-FDG PET/CT (aorta and large arteries) and uptakes in all aorta branches, mainly impressive and uncommon in the abdomen. After 2 years of therapeutic optimization including IV tocilizumab and monitoring with 18F-FDG PET/CT, a complete metabolical response was assessed. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Rapidly Evolving Diffuse Omental Carcinomatosis of Prostate Cancer in 68Ga-PSMA PET/CT
An 81-year-old man received androgen deprivation therapy for a locally advanced prostate cancer and, 6 months later, a curative radiation therapy. Half a year later, the patient presented with a steeply increased PSA value (32 ng/mL) and a suppressed testosterone level (0.48 nmol/L). The consecutively performed 68Ga-PSMA PET/CT revealed, besides local tumor remains and several PSMA-positive lymph node and soft tissue metastases, an extensive, diffuse PSMA ligand accumulation in the omentum, which was immunohistochemically proven to be a carcinomatosis of prostate cancer. None of the extraprostatic lesions were present in t...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Collision of Solid Pseudopapillary Tumor and Neuroendocrine Tumor of the Pancreas on 18F-FDG PET/CT
We report a rare case of pancreatic collision tumor of solid pseudopapillary tumor and neuroendocrine tumor in a 43-year-old woman. A pancreatic mass was found by abdominal ultrasound. A mainly cystic mass with solid component progressive enhancement was revealed using abdominal enhanced CT. Staging 18F-FDG PET/CT demonstrated a pancreatic tail mass with an increased uneven 18F-FDG uptake. Distal pancreatectomy was performed. Postoperatively, the mass was diagnosed as pancreatic collision tumor of solid pseudopapillary tumor and neuroendocrine tumor. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Metastatic Poorly Differentiated Thyroid Cancer With Heterogeneous Distribution of 18F-FDG, 68Ga-DOTATATE, and 68Ga-PSMA on PET/CT
We present a case of a 55-year-old man with a history of poorly differentiated metastatic thyroid cancer, which is rare and shows aggressive behavior. The patient had radioactive iodine–negative multiple metastasis on 18F-FDG PET/CT, therefore 68Ga-DOTATATE and 68Ga-PSMA PET/CT were performed whether an opportunity exist for DOTATATE or PSMA-directed radionuclide therapy. Different patterns of tumoral uptakes were detected on 18F-FDG, 68Ga-DOTATATE, and 68Ga-PSMA PET/CT, as a demonstration of tumor heterogeneity. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Panniculitis in a Woman With Opportunistic Pulmonary Coinfection by Pneumocystis jirovecii and Cryptococcus neoformans: 18F-FDG PET/CT Revealing the Infection and Assessing Treatment Response
A 56-year-old woman, with history of psoriasis well controlled on ustekinumab, underwent 18F-FDG PET/CT to explore first onset of histologically proven skin panniculitis of unknown origin. PET/CT showed high uptake in panniculitis lesions in limbs and in a lung opacity suggestive of pneumonia. Based on PET/CT findings, a bronchoalveolar lavage revealed pulmonary coinfection by Pneumocystis jirovecii and Cryptococcus neoformans. Thus, hematogenous dissemination of infection was suspected as etiology of panniculitis. She was treated with fluconazole and trimethoprim-sulfamethoxazole, leading to total resolution of skin lesio...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Liver Abscess With High 18F-FDG Uptake and No 18F-Fluorothymidine Uptake
We report a case of liver abscess during therapy of pancreatic cancer that underwent FDG PET/CT and FLT PET/CT studies. Although FDG PET/CT demonstrated several regions of increased uptake in the liver, FLT PET/CT showed no increased uptake in the liver. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Case Report of 18F-FDG PET/CT Features of Polyacrylamide Hydrogel Mammoplasty
A 57-year-old woman with a history of previous bilateral breast polyacrylamide hydrogel injection presented for 18F-FDG PET/CT imaging to investigate recurrent retroperitoneal liposarcoma. Incidental symmetrical FDG-positive accumulation was noted in the bilateral axillae tracking between the interpectoral planes. The finding is consistent with a chronic inflammatory process secondary to the migration of the polyacrylamide hydrogel injections. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-Sodium Fluoride PET/CT Findings in Osteitis Condensans Ilii
We report cases of 2 women with breast cancer referred for 18F-NaF PET/CT for skeletal staging. Both cases show characteristic findings of OCI on CT images, with 18F-NaF PET uptake in symptomatic patient and no uptake in asymptomatic. 18F-NaF PET CT can be useful in evaluating back pain and may be used as an adjunctive biological maker for assessing OCI as a potential cause of pain. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Angiosarcoma of the Abdominal Aorta After Endovascular Aneurysm Repair: 18F-FDG PET/CT Imaging Findings
Primary angiosarcomas of the aorta are rare, highly aggressive malignant tumors for which there have been limited documented cases in the medical literature. Diagnosis is challenging due to nonspecific symptomatology and imitation of common aortic pathologies. A subset of these primary aortic angiosarcoma cases is seen in association with endovascular aneurysm repair, or EVAR; however, the connection between the 2 entities is not completely understood. Here, we present 18F-FDG PET/CT imaging findings of an angiosarcoma of the aorta in a 69-year-old man status post EVAR. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Intense Hypermetabolic Tumefactive Demyelination on 18F-FDG PET and MRI Related to Multiple Sclerosis Relapse After Fingolimod Suspension
A 57-year-old woman with a history of multiple sclerosis presented with a 5-day history of progressive headache and confusion, followed by left hemiparesis. The patient had stopped her previous fingolimod usage during the last 8 weeks. Brain MRI and 18F-FDG PET showed a subcortical tumefactive lesion with an intense peripheric rim of hypermetabolism and central hypometabolism, with central hyperintensity, thin isointense rim, and peripheral finger-like “tentacles” of edema with an irregular and thick border enhancement on postcontrast T2-weighted MRI. Brain biopsy showed features suggestive of relapsing MS. The...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET/CT in a Rare Case of Poland Syndrome and Gastric Cancer
Poland syndrome is a rare congenital anomaly characterized by unilateral aplasia of the sternoclavicular head of pectoralis major muscle with varying degree of same side upper limb anomalies. A 44-year-old man, with a case of adenocarcinoma of stomach, whose CECT chest revealed complete absence of pectoralis major and minor muscles on the left side, was diagnosed with Poland syndrome without presence of typical ipsilateral limb anomalies. Follow-up PET/CT revealed metabolically active recurrent disease with typical findings of Poland syndrome. It is important to be aware of oncologic association in a patient of Poland synd...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Cerebral Infarction With Increased Uptake on 123I-FP-CIT SPECT
A 76-year-old woman underwent 123I-FP-CIT brain SPECT due to postural reflex impairment. The transverse slices demonstrated increased uptake in the right middle cerebral artery territory. MR images obtained 2 weeks earlier showed cerebral infarction in the corresponding area. 123I-FP-CIT has high binding affinity for dopamine transporters, especially in the nerve endings of nigrostriatal dopaminergic neurons. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Delayed 68Ga-PSMA PET/CT Image-Guided Biopsy for Low-Grade Adenocarcinoma in Benign Prostatic Hyperplasia
Image-guided biopsy of prostate with multiparametric MRI is being adopted in the workup of prostate adenocarcinoma (PAC). 68Ga-PSMA PET/CT-guided biopsy has also been shown to be equally sensitive in the evaluation of higher-grade tumors with increased PSMA expression. The sensitivity of 68Ga-PSMA PET/CT, however, reduces with lesser PSMA expression in low-grade PAC. Herein, we demonstrate a case where delayed 68Ga-PSMA PET/CT imaging helped in detecting low-grade PAC in BPH. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Not All Heart Uptakes on 99mTc-DPD Scintigraphy Are Amyloidosis: Chloroquine-Induced Cardiomyopathy
This was the case of a 61-year-old woman with a medical history significant for hypertension and rheumatoid arthritis treated with chloroquine for the last 10 years. She was admitted to our hospital for heart failure symptoms. Echocardiography revealed severe concentric left ventricular hypertrophy. Serum and urine immunofixation electrophoresis and serum light chain assay were negative. No late gadolinium enhancement was observed on cardiovascular magnetic resonance. 99mTc-99mTc-DPD (3,3-diphosphono-1,2-propanodicarboxylic acid) scintigraphy showed myocardial uptake (Perugini score 2/3). Genetic testing excluded hereditar...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Novel Experience in Hybrid Tracers: Clinical Evaluation of Feasibility and Efficacy in Using ICG-: 99m: Tc Nanotop for Sentinel Node Procedure in Breast Cancer Patients
Purpose The clinical introduction of a radioactive and fluorescent hybrid tracer allowed for preoperative lymphatic mapping and intraoperative real-time fluorescence tracing of the sentinel lymph node (SLN) by a single injection. The aim of this feasibility study is to evaluate the first-in-human use of the hybrid tracer by combining indocyanine green (ICG) and radiocolloid based on Nanotop compound (99mTc Nanotop) for SLN biopsy (SLNB) in breast cancer patients. Methods The day before surgery, ICG-99mTc Nanotop was injected periareolarly in breast cancer patients scheduled for SLNB. Planar lymphoscintigraphic (...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Original Article Source Type: research

False-Positive Uptake of 131I From Basal Cell Papilloma in a Patient With Metastatic Papillary Thyroid Cancer
A 64-year-old woman with metastatic papillary thyroid cancer underwent a total thyroidectomy followed by 2 courses of 131I therapy. The posttherapeutic whole-body scan after the second dose of 131I therapy showed multifocal bone metastasis. In addition, there is focal abnormal intense radiotracer uptake at the right inguinal region. SPECT/CT revealed that this abnormal focal radioactivity was from a superficial skin lesion. Further physical examination revealed a raised, approximately 1-cm, irregular grayish-brown lesion on the right groin skin. Histopathological examination confirmed the diagnosis of basal cell papilloma ...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Incidental 18F-Fluciclovine Uptake in a Desmoid Tumor Detected in a Patient Undergoing PET/CT Imaging for Prostate Cancer
A 74-year-old man with biochemical recurrent prostate cancer underwent 18F-fluciclovine PET/CT for restaging to determine subsequent treatment strategy. 18F-fluciclovine PET/CT imaging demonstrated incidental focal heterogeneous increased 18F-fluciclovine uptake corresponding to a soft tissue nodule within the musculature of the left anterior abdominal wall. Subsequent ultrasound-guided biopsy of the lesion revealed histopathology compatible with a desmoid tumor. Consequently, the patient underwent surgical resection with wide local excision of the lesion. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

COVID-19 mRNA Vaccination–Induced Lymphadenopathy Mimics Lymphoma Progression on FDG PET/CT
We present here a 72-year-old man with mantle cell lymphoma who has completed chemotherapy and achieved complete metabolic response to the therapy 10 months ago. Series follow-up FDG PET/CT scans have been negative for lymphoma. Current FDG PET/CT scan showed a new cluster of subcentimeter left axillary lymphadenopathy with avid FDG uptake. There was also focal FDG uptake in the left upper arm deltoid muscle and adjacent subcutaneous soft tissue, with no other abnormal FDG-avid lesion or suspicious CT image findings. The medical history revealed that the patient received COVID-19 mRNA vaccine 2 days before the FDG PET/CT e...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Cortisol-Producing Adrenal Adenomas With Intense Activity on 68Ga-Pentixafor PET/CT
We report intense 68Ga-pentixafor activity of cortisol-producing adrenal adenomas in 2 patients with adrenocorticotropic hormone–independent Cushing syndrome. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET/CT Imaging of Prostate Stromal Tumor of Uncertain Malignant Potential
A 79-year-old man presented with dysuria and increased serum prostate-specific antigen level (21 ng/mL). MRI revealed bulky prostate enlargement but was inconclusive in revealing neoplastic lesions. Nevertheless, because of high clinical suspicion for neoplasm, transrectal biopsy revealed stromal tumor of uncertain malignant potential mixed with foci of low-grade primitive prostate stromal sarcoma. 18F-FDG PET/CT showed high FDG uptake consistent with neoplasm in the lower part of the hypertrophic prostate gland and focal areas of elevated FDG uptake, consistent with metastases in the spine, ribs, and femur. (Source: Clini...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Gastrointestinal Stromal Tumor Incidentally Detected on 18F-Fluciclovine PET/CT
We present a case of metastatic gastrointestinal stromal tumor incidentally detected on 18F-fluciclovine PET/CT. A 68-year-old man with history of intermediate-risk prostate cancer (Gleason score 4 + 3 = 7; pT2cN0M0) previously treated with retropubic radical prostatectomy, adjuvant whole pelvis radiation, and androgen deprivation therapy (leuprolide) presented with slowly rising serum prostate-specific antigen over 3 years, concerning for recurrent prostate cancer. To identify potential sites of recurrent disease, an 18F-fluciclovine PET/CT was obtained. Multiple tracer-avid mesenteric masses and enlarged lymph nodes were...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

68Ga-FAPI and 18F-FDG PET/CT in Perineum Extramammary Paget Disease
Extramammary Paget disease is a rare skin intraepithelial adenocarcinoma. Our case presents 68Ga-fibroblast activation protein inhibitor and 18F-FDG PET/CT imaging in a patient with perineum extramammary Paget disease. Compared with 18F-FDG PET/CT, the primary tumor, enlarged pelvic lymph nodes and right maxillofacial lesion showed higher uptake in 68Ga-fibroblast activation protein inhibitor PET/CT. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

68Ga–Prostate-Specific Membrane Antigen PET/CT in Sinonasal Glomangiopericytoma—Exploring Theranostic Avenues!
Prostate-specific membrane antigen (PSMA) is expressed in the tumor-associated endothelial neovasculature of various nonprostatic benign and malignant neoplasms. A 25-year-old man with recurrent sinonasal glomangiopericytoma underwent whole-body 68Ga PSMA PET/CT to explore its theranostic role. There was intense PSMA uptake (SUVmax = 23.9) noted in the tumor. The uptake was more than that of the salivary glands, lacrimal glands, aorta, spleen, and the liver. Performance of PSMA PET/CT in sinonasal glomangiopericytoma opens up new frontiers concerning radiological imaging, early recurrence identification, and perhaps even r...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

124I-PET/CT–Guided Diagnosis and Personalized Treatment of Metastatic Papillary Thyroid Cancer to the Pancreas
Metastasis to the pancreas from differentiated thyroid carcinoma is rare. A new pancreatic lesion was identified on surveillance imaging of a man with metastatic papillary thyroid carcinoma 7 years after initial diagnosis. Imaging with 124I-PET/CT was performed to noninvasively confirm metastatic thyroid cancer and provide prospective dosimetry to guide selection of a safe and effective administered activity of 131I. This case demonstrates the emerging role of 124I-PET/CT as a useful diagnostic scan, pretherapy scan, and dosimetric tool to deliver personalized therapy for patients with metastatic thyroid cancer. (Source: C...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Lung Perfusion Scintigraphy in Pulmonary Vein Occlusion After Radiofrequency Ablation
We describe functional and anatomical imaging findings in an 86-year-old woman who was treated for paroxysmal atrial fibrillation 5 years ago with radiofrequency ablation. She had been symptom-free for 4 years. Five years after the ablation, she presented with exertional dyspnea of several months’ duration. She had left bundle branch block and aortic insufficiency with normal ejection fraction on 2-dimensional echocardiogram, none of which explained her symptoms. A CT coronary angiogram showed no obstructive coronary artery disease: Coronary Artery Disease Reporting and Data System category 1. Complete occlusion of t...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Variable 131I Activity in Renal Stone in a Patient With Thyroid Cancer
A 42-year-old woman underwent 131I radiotherapy for thyroid papillary cancer. A focal elevated 131I activity in the right kidney was revealed on the initial whole-body posttherapeutic images, which was located in the region of a renal stone. However, on the follow-up 131I images acquired 6 months later, there was no longer any increased activity in the region of this stone, which had moved into right ureter. Our case indicates that the 131I activity accumulated in the region of urinary stone is due to stagnated radioactive urine rather than due to the stone per se. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Two Cases of Decreased 123I-Metaiodobenzylguanidine Lung Uptake in Metaiodobenzylguanidine Scintigraphy While Taking Selective Serotonin Reuptake Inhibitor/Serotonin Noradrenaline Reuptake Inhibitor
123I-metaiodobenzylguanidine scintigraphy is used to differentiate Lewy body disease from other neurodegenerative disorders. We identified 2 cases with remarkably changed pulmonary uptake between 2 metaiodobenzylguanidine scintigraphies; pulmonary uptake was reduced when patients were taking selective serotonin reuptake inhibitor/serotonin noradrenaline reuptake inhibitor and preserved during the medication-naive or withdrawal state, suggesting that pulmonary uptake involves not only the noradrenaline transporter, but also the serotonin transporter. Pulmonary accumulation may affect the heart-to-mediastinum ratio as the re...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Follicular Thyroid Carcinoma Metastases on Round Ligament of Liver
We describe a case of a 69-year-old woman with follicular thyroid cancer of long evolution, with thyroidectomy 20 years before, who had remained clinically stable until now, when she started to present abnormal levels of serum thyroglobulin. An 123I whole-body scan showed a high uptake in the upper right half of her abdomen, and an 18F-FDG PET/CT located this focus at the liver’s round ligament. Pathology findings after surgery showed the focus to be a differentiated thyroid cancer metastasis. This is an unusual presentation of differentiated thyroid cancer metastasis. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Quality and Safety in Healthcare, Part LXVIII: Consequences and More Solutions Regarding Poor Well-Being in Medical Students
Suggestions to improve the well-being in medical students include establishing learning communities, having pass-fail grading at least in the freshman and sophomore years, giving the students some control over their learning environment (such as with evaluations and serving on the curriculum committee), encouraging more protected time and more money for faculty teaching and mentoring, and eliminating mistreatment of medical students. Also, the Medical Student and Physician Well-Being Index should be freely available to the medical students and staff for both self-evaluation and for evaluating the learning environment. Burn...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: From the American College of Nuclear Medicine Source Type: research

Agreement Between 18F-FDG PET/CT and Whole-Body Magnetic Resonance Compared With Skeletal Survey for Initial Staging and Response at End-of-Treatment Evaluation of Patients With Multiple Myeloma
Conclusions Our results suggest the study of MM patients should include WB-MR and/or 18F-FDG PET/CT, whereas SS is only useful for the skull. Whole-body MR and 18F-FDG PET/CT are complementary techniques, because both of them show good concordance in almost every location. It is still necessary to individualize the indication of each technique according to patient characteristics. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Lymph Node Assessment in Prostate Cancer: Evaluation of Iodine Quantification With Spectral Detector CT in Correlation to PSMA PET/CT
Purpose The aims of this study were to evaluate spectral detector CT (SDCT)–derived iodine concentration (IC) of lymph nodes diagnosed as metastatic and benign in prostate-specific membrane antigen (PSMA) PET/CT and to assess its potential use for lymph node assessment in prostate cancer. Patients and Methods Thirty-four prostate cancer patients were retrospectively included: 16 patients with and 18 without lymph node metastases as determined by PSMA PET/CT. Patients underwent PSMA PET/CT as well as portal venous phase abdominal SDCT for clinical cancer follow-up. Only scan pairs with a stable nodal status...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Clinical Evaluation of MR-Gated Respiratory Motion Correction in Simultaneous PET/MRI
Purpose The recently available gated T1-weighted imaging with the Dixon technique enables the synchronized gating signal for both MR acquisition and PET reconstruction. Herein, we evaluated the clinical value of this MR-gated PET reconstruction in the thoracic-abdominal PET/MRI compared with non–MR-gated method. Methods Twenty patients (28 hypermetabolic target lesions) underwent PET/MRI. Four types of PET images were reconstructed: non–MR-gating + gated attenuation correction (AC) (group A), MR-gating + gated AC (group B), non–MR-gating + breath-hold (BH) AC (group C), and MR-gating + BH AC (g...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Original Articles Source Type: research

FDG PET/CT and MRI Features of Pathologically Proven Schwannomas
Conclusions Schwannomas may be large, be intensely FDG avid, and demonstrate significant heterogeneity, features typically associated with malignant peripheral nerve sheath tumors. A significant proportion exhibit FDG activity above cutoff levels previously thought useful in differentiating malignant from benign peripheral nerve sheath tumors. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Optimal Time for 124I PET/CT Imaging in Metastatic Differentiated Thyroid Cancer
The objective of this study was to determine the optimal time for 124I PET/CT imaging to maximize the detection of locoregional and/or distant metastases of differentiated thyroid cancer. Methods Differentiated thyroid cancer patients suspected of having metastatic disease were prepared with low-iodine diet and appropriate thyroid-stimulating hormone stimulation. 124I PET and low-dose localization CT were performed over 4 days after oral administration of 31.5 or 62.9 MBq (0.85 or 1.7 mCi) of 124I. Each scan was independently reviewed by 2 nuclear medicine physicians. All foci of activity were categorized, and the v...
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Impact of 18F-FDG PET, PET/CT, and PET/MRI on Staging and Management as an Initial Staging Modality in Breast Cancer: A Systematic Review and Meta-analysis
Conclusions Currently available literature suggests that the use of 18F-FDG PET, PET/CT, or PET/MRI leads to significant modification of staging and treatment in newly diagnosed breast cancer patients. Therefore, there may be a role for routine clinical use of PET imaging for the initial staging of breast cancer. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - March 11, 2021 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Altered FDG Biodistribution in Subcutaneous White Fat on PET/CT Following l-Asparaginase Chemotherapy
A 13-year-old boy with mediastinal T-cell lymphoblastic lymphoma demonstrated an altered biodistribution with diffuse activity in subcutaneous white adipose tissue and decreased visceral activity on interim posttreatment FDG PET/CT. This altered biodistribution was attributed to administration of the chemotherapeutic enzyme l-asparaginase 3 hours preceding the PET/CT, altering adipocytes amino acid and glucose metabolism. Treatment response assessment was adversely affected by the altered biodistribution, emphasizing the importance of maximizing the time between chemotherapy and PET/CT during successive oncologic treatment...
Source: Clinical Nuclear Medicine - February 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Calcified Adrenal Metastasis of High-Grade Osteosarcoma on FDG PET/CT
Classic type of high-grade osteosarcoma is the most common type of skeletal malignancy in children and adolescents. Metastasis of osteosarcoma frequently occurs in the lung. Adrenal metastasis of osteosarcoma is extremely rare, with only few reported case in the literature. Herein, we present the case of a 13-year-old boy with adrenal metastasis of high-grade osteosarcoma, which was seen as a solitary calcified hypermetabolic adrenal lesion on FDG PET/CT. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Focal Liver 18F-FDG Uptake in a Patient Who Underwent Thrombolysis for Brachiocephalic and Subclavian Thrombosis: A Potential Pitfall
A 19-year-old woman presented with a primary mediastinal B-cell lymphoma invading the superior vena cava with associated thrombosis of the left brachiocephalic and subclavian vein. She underwent thrombolysis followed by chemotherapy. The midtreatment 18F-FDG PET/CT demonstrated important regression of the primary mediastinal B-cell lymphoma, but showed intense focal hepatic uptake in segment IV, without a corresponding lesion on ultrasonography, non–contrast-enhanced low-dose CT, and MRI. This focal uptake disappeared on a subsequent 18F-FDG PET/CT study when the radiotracer was injected in the foot, suggesting an an...
Source: Clinical Nuclear Medicine - February 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Acute Brain Stroke Evolution Detected by 18F-FDG PET/CT and MRI Justifies the Discordance of Lesions in a Patient With Lymphoproliferative Syndrome
A 50-year-old man with angioimmunoblastic T-cell lymphoma in complete response to treatment presented new hypermetabolic brain lesions on 18F-FDG PET/CT suggestive of malignancy. These findings were correlated by MRI that showed cortical-subcortical peripheral lesions typical of acute ischemic infarction. A restaging 18F-FDG PET/CT showed that hypermetabolic lesions were replaced by ametabolic areas, supporting chronic infarction. Early ischemia presents transitory FDG increase. Brain lymphomas are highly FDG avid and difficult to differentiate from acute cerebral infarction. In view of the discordance of abnormal areas of...
Source: Clinical Nuclear Medicine - February 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-Fluciclovine Uptake in Thymoma Demonstrated on PET/MRI
A 68-year-old man with a history of prostate cancer post–primary treatment presented with rising prostate-specific antigen levels and was referred for 18F-fluciclovine PET/MRI to localize recurrent disease. PET/MRI revealed a solitary focus of uptake in a soft tissue nodule in the anterior mediastinum, which was resected and found to be a type B2 thymoma. 18F-fluciclovine uptake is mediated by amino acid transporters, primarily alanine-serine-cysteine transporter 2 and l-type amino acid transporter 1, previously demonstrated to be expressed on thymic carcinomas. This case highlights the possibility of overexpression ...
Source: Clinical Nuclear Medicine - February 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Detection of Dural Metastases Before the Onset of Clinical Symptoms by 16α-[18F]Fluoro-17β-Estradiol PET in a Patient With Estrogen Receptor–Positive Breast Cancer
We present a case of a woman with ER-positive metastatic breast cancer and high [18F]-FES uptake in the dural region on PET imaging, without associated clinical symptoms. These lesions were missed on [18F]-FDG PET because of physiological [18F]-FDG uptake in the brain. This case highlighted some difficulties in the interpretation of imaging of brain metastases and demonstrated the added value of [18F]-FES PET imaging. [18F]-FES PET could be used to prove the presence of ER-positive metastases in the brain. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - February 11, 2021 Category: Nuclear Medicine Tags: Interesting Images Source Type: research