Visualization of Tumor Heterogeneity in Advanced Medullary Thyroid Carcinoma by Dual-Tracer Molecular Imaging: Revealing the Theranostic Potential of SSTR- and PSMA-Directed Endoradiotherapy
We present the case of a 60-year-old man with medullary thyroid carcinoma and hepatic, osseous, and lymph node metastases who underwent peptide receptor radionuclide therapy with 177Lu-DOTATOC. After 2 cycles, 68Ga-DOTATOC PET/CT revealed multiple nonavid lesions. To assess whether the patient would be eligible for prostate-specific membrane antigen (PSMA)–targeted radioligand therapy, a PSMA PET/CT was conducted. PSMA PET/CT identified increased PSMA expression in both 68Ga-DOTATOC–avid and nonavid lesions. As such, dual-radiotracer PET/CT may allow for insights into the complexities of tumor heterogeneity in patients...
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Positive FAPI PET/CT in a Bilateral Mammary Angiosarcoma Patient With Less Impressive FDG PET/CT Images
We describe a case with bilateral angiosarcoma of the breast well visualized on 68Ga-FAPI PET/CT in a 30-year-old woman with a history of right breast–conserving surgery. However, the lesions are less impressive on 18F-FDG PET/CT. No additional findings including lymph node and distant metastases were noted. The patient underwent bilateral mastectomy, and histopathology revealed well-differentiated angiosarcoma that involved bilateral breast parenchyma and the left nipple. Our case illustrates that 68Ga-FAPI PET/CT can be more sensitive in detecting well-differentiated angiosarcoma of the breast. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

An Unusual False-Positive Uptake of Radioiodine Caused by Breast Implants
A 40-year-old woman with a history of papillary thyroid cancer underwent ablative 131I therapy. Postablation whole-body 131I scintigraphy revealed not only increased activity in the thyroid bed but also in the anterior part of the chest. SPECT/CT images localized the activity in the bilateral breast implants. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

A 68Ga-FAPI-46 PET/CT Imaging Pitfall in Assessing Residual Gastric Cancer Early After Chemotherapy
After neoadjuvant chemotherapy, preoperative imaging with 68Ga-FAPI-46 PET/CT showed a similar level of tracer uptake at the location of the primary tumors in 2 patients with gastric cancer. Postoperative histopathology revealed residual malignant cells only in one of the patients, whereas the elevated FAPI uptake in the other patient correlated to an inflammatory reaction and fibrosis. With this case, we would like to highlight that an increased FAPI uptake in inflammatory and fibrotic tissue early after chemotherapy may represent a potential interpretation pitfall. Further studies evaluating the clinical application of F...
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

A Recanalized Umbilical Vein Hypermetabolic Thrombosis Mimicked an Hepatocellular Carcinoma Recurrence: A New Pitfall?
A transarterial left hepatic artery radioembolization involving 90Y microspheres was performed on a cirrhotic man with hypermetabolic 18F-FDG segment III hepatocellular carcinoma. During the 18F-FDG PET/CT follow-up, the disappearance of the hypermetabolic lesion was initially observed. Then, a focal segment III hypermetabolism reappeared mimicking a recurrence before disappearing without any treatment. Finally, the hepatic MRI demonstrated that the transitory segment III hypermetabolism matched a thrombus of the dilated recanalized umbilical vein. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Intense 68Ga-FAPI Uptake in a Patient With Myositis Ossificans: Mimicking Bone Malignancy
A 72-year-old man presented with right hip pain, difficulty in walking, and a mass in his right hip for 3 months. CT suggested osteonecrosis of the right femoral head and a mass in the right hip with calcification. A malignancy was suspected, and the patient was subsequently enrolled in the clinical trial of 68Ga-FAPI. 68Ga-FAPI PET/CT showed a mass in his right hip with intense FAPI activity. It was also highly suggestive of malignancy. The pathological examination after right-hip surgery confirmed the diagnosis of myositis ossificans. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Adamantinoma-Like Ewing Sarcoma of the Mandible Evaluated on 18F-FDG PET/CT
Ewing sarcoma is the second most common primary bone tumor in children. Typical Ewing sarcoma most frequently occurs in long bones and within the pelvis. ALES (adamantinoma-like Ewing sarcoma) is a rare subtype of Ewing sarcoma that is characterized by epithelial differentiation in addition to small round blue cells. Unlike typical Ewing sarcoma, ALES has been described in several cases in the head and neck. Herein, we describe a case of a 9-year-old boy with ALES of the mandible evaluated on 18F-FDG PET/CT with correlative MRI scans. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET/CT in Primary Intraosseous Squamous Cell Carcinoma
We reported the 18F-FDG PET/CT findings of primary intraosseous squamous cell carcinoma of the mandible in a 42-year-old man. 18F-FDG PET/CT identified a cystic lesion in the mandible with irregular annular uptake of 18F-FDG, which has been confirmed as primary intraosseous squamous cell carcinoma pathologically. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Comparison of 68Ga-FAPI and 18F-FDG PET/CT in Dermatofibrosarcoma Protuberans
Dermatofibrosarcoma protuberans is a rare soft tissue sarcoma with a high recurrence rate. Herein, we present 68Ga-FAPI and 18F-FDG PET/CT findings of dermatofibrosarcoma protuberans in a 45-year-old man. Dermatofibrosarcoma protuberans only shows limited FDG uptakes on 18F-FDG PET/CT, but demonstrated intense tracer uptakes on 68Ga-FAPI PET/CT. In this case, 68Ga-FAPI was superior to 18F-FDG PET/CT in detecting dermatofibrosarcoma protuberans. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Incremental Value of 18F-PSMA-1007 PET/CT in Detection of Metastatic Renal Cell Carcinoma to the Brain
We report a case of 44-year-old man known to have renal cell carcinoma who underwent 18F-PSMA and 18F-FDG PET/CT for restaging after radical nephrectomy. A well-defined solitary cerebellar lesion with marked PSMA expression and equivocal FDG uptake was noted. MRI brain confirmed a matching cerebellar metastatic lesion. 18F-PSMA expression in the metastatic RCC raises a prospective guide to futuristic theragnostic uses. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Aducanumab-Related Amyloid-Related Imaging Abnormalities: Paean or Lament?
When the FDA granted accelerated approval of Biogen's Alzheimer disease drug, aducanumab (marketed as Aduhelm), it deviated from its mission of guaranteeing drug safety and efficacy because the approval was based exclusively on a perceived dose-dependent reduction in brain amyloid deposits and not upon a proven clinical effect. We believe that the amyloid-PET scans, perceived as showing decreasing amyloid deposits, are an expression of increased cerebral cell death due to aducanumab treatment, so that with time one should instead expect a worsening and not an improvement in the treated patients' condition. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Opinion Paper/Commentary Source Type: research

Sentinel Node Biopsy Imaging in Breast Cancer: Scatter Reduction Using 3-Dimensionally Printed Lead Shields
Background Point of injection scatter (SPI) confounds breast cancer sentinel lymph node detection. Round flat lead shields (FLSs) incompletely reduce SPI, requiring repositioning. We designed lead shields that reduce SPI and acquisition time. Methods Two concave lead shields, a semioval lead shield (OLS) and a semispherical lead alloy shield (SLS), were created with a SICNOVA JCR 1000 3D printer to cover the point of injection (patent no. ES1219895U). Twenty breast cancer patients had anterior and anterior oblique imaging, 5 minutes and 2 hours after a single 111 MBq nanocolloid in 0.2 mL intratumoral or periare...
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Decentralized Distributed Multi-institutional PET Image Segmentation Using a Federated Deep Learning Framework
Conclusion The developed federated DL model achieved comparable quantitative performance with respect to the centralized DL model. Federated DL models could provide robust and generalizable segmentation, while addressing patient privacy and legal and ethical issues in clinical data sharing. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Dose-Limiting Bone Marrow Toxicities After Peptide Receptor Radionuclide Therapy Are More Prevalent in Women Than in Men
Conclusions Female neuroendocrine tumor patients more often experienced PRRT-induced toxicities of platelets and hemoglobin than males, but this did not lead to a lower cumulative activity. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Original Articles Source Type: research

Fully Automatic Quantitative Measurement of 18F-FDG PET/CT in Thymic Epithelial Tumors Using a Convolutional Neural Network
Conclusions Our DL-based model provides comparable segmentation performance and metabolic parameter values to manual measurements in TETs. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - June 14, 2022 Category: Nuclear Medicine Tags: Original Articles Source Type: research