Lipid-Poor Renal Angiomyolipoma Mimicking Renal Cell Carcinoma on 68Ga-FAPI-04 PET/CT
We describe 68Ga-FAPI-04 PET/CT findings in 1 case with lipid-poor renal angiomyolipoma and 1 case with high-grade clear cell renal cell carcinoma. Both tumors showed intense 68Ga-FAPI-04 uptake. These 2 cases indicate that lipid-poor renal angiomyolipoma should be included in the differential diagnosis of FAPI-avid renal tumors. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Unusual Metastatic Prostate Cancer in Subcarinal Lymph Node and Peritoneal Nodule Found on 18F-PSMA PET/CT With Rising PSA of 0.4 ng/mL
A 79-year-old man with metastatic prostate cancer underwent radical prostatectomy and bilateral lymph node dissection and received multiple lines of systematic treatment for his biopsy-proven peritoneal carcinomatosis. During the disease course, his prostate-specific antigen rose from 0.1 ng/mL to 0.4 ng/mL in 4 months, and testosterone level was (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Hyperparathyroidism Caused by Coexisting Parathyroid Hyperplasia and Unilateral Bifocal Parathyroid Carcinoma
The coexistence of parathyroid hyperplasia and carcinoma is uncommon. Here we report findings of 99mTc-sestamibi SPECT/CT study in a case of unilateral bifocal parathyroid carcinoma coexisting with parathyroid hyperplasia in a 49-year-old man. The images showed 4 foci of elevated activity around the thyroid. Histopathology confirmed the 2 lesions of the left side as parathyroid hyperplasia and the other 2 lesions of the right side as parathyroid carcinoma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Extrauterine Endometrial Stromal Sarcoma Mimicking Colorectal Cancer With Metastases
We describe 18F-FDG PET/CT findings of EESS in the sigmoid colon and rectum in a 46-year-old woman who complained diarrhea. 18F-FDG PET/CT revealed multiple hypermetabolic lesions in the abdomen and pelvis, including the sigmoid colon and rectum. Therefore, colorectal cancer with metastases was initially suspected; however, ultimately low-grade EESS was pathologically confirmed. Widespread EESS with intestine involvement revealed by 18F-FDG PET/CT should be carefully distinguished from colorectal cancer with metastases. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
68Ga-FAPI-04 Versus 18F-FDG PET/CT in Detection of Epithelioid Malignant Pleural Mesothelioma
We describe 68Ga-FAPI (fibroblast activation protein inhibitor)-04 and 18F-FDG PET/CT findings in a case with epithelioid malignant pleural mesothelioma. Compared with 18F-FDG PET/CT, 68Ga-FAPI-04 PET/CT more clearly showed the pleural tumors and lymph node metastases and detected more pleural lesions because the tumors showed higher 68Ga-FAPI-04 activity. This case indicates that 68Ga-FAPI-04 PET/CT may be a promising new tool in evaluation of malignant pleural mesothelioma, which needs further investigation. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Synchronous Metastatic Medullary Thyroid Carcinoma and Paraesophageal Parathyroid Adenoma Detected on 18F-Ethylcholine PET/US Fusion Imaging
An 80-year-old woman with osteoporosis without fractures was referred with asymptomatic primary hyperparathyroidism and elevated calcitonin level. Ultrasound, 99mTc-pertechnetate scintigraphy, 99mTc-MIBI scintigraphy, and CT revealed a suspicious thyroid nodule and enlarged submandibular lymph nodes. However, no parathyroid adenoma was depictable. 18F-choline PET/CT showed increased uptake of the proximal esophagus, but neither CT nor US revealed a parathyroid lesion, and only 18F-choline PET/US fusion imaging confirmed a paraesophageal parathyroid adenoma. Resection of both medullary thyroid carcinoma and ectopic parathyr...
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
18F-FDOPA and MRI Findings in a Case of Multiple Sclerosis
A 39-year-old woman with no significant medical history underwent a brain MRI because of headaches and dysarthria having lasted 3 weeks. A tumor lesion was suspected. PET imaging was decided. She underwent FDG and FDOPA PET, leading to the diagnosis of low-grade glioma. Three months later, a new imaging assessment was organized. It showed a decrease in the hypermetabolism of the lesion and the appearance of a second lesion questioning the diagnosis. Further assessment led to the conclusion of a multiple sclerosis. This case illustrates that FDOPA PET uptake should be interpreted with caution in patients with suspected prim...
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
68Ga-FAPI-46 PET/CT in a Metastatic Castration-Resistant Prostate Cancer Patient With Low PSMA Expression
A 70-year-old man with mCRPC (metastatic castration-resistant prostate cancer) was referred for 68Ga-PSMA PET/CT for restaging and the possibility of targeted molecular radioligand therapy with 177Lu-PSMA. Numerous 68Ga-PSMA–avid skeletal metastases with low SUVs were noted. Because of low PSMA expression, a 68Ga-FAPI-46 PET/CT was performed to evaluate the eligibility for FAPI-based radioligand therapy. There were some discordant findings between 68Ga-PSMA and 68Ga-FAPI PET/CT scans regarding the detectability of lesions and SUVs. Our case signifies that 68Ga-FAPI theragnostic may have a potential role in the treatment ...
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Advanced Achalasia Mimicking Delayed Gastric Emptying During Standard Gastric Emptying Scintigraphy
An 82-year-old man underwent outpatient nuclear medicine gastric-emptying scintigraphy (GES) for dysphagia and regurgitation. Standard solid-meal GES showed significant elongated tracer retention with calculated 96% retention rate at 3 hours, with a presumed diagnosis of delayed gastric emptying. Subsequent CT of the chest and abdomen and upper gastrointestinal fluoroscopy instead showed normal size and function of the stomach but an enormously dilated esophagus with food debris, compatible with achalasia. Attention should be made on the location and shape of the visualized “stomach” and recognize that significantly di...
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Diffuse Bone Marrow Involvement of Multiple Myeloma on [18F]PSMA-1007 PET/CT: Is There a Theranostic Potential?
A 71-year-old man presented with chronic anemia (hemoglobin 7.3 g/dL). Further serum analyses showed elevated prostate-specific antigen (13 ng/mL), suggestive of prostate cancer. However, ultrasound-guided transrectal sextant biopsy did not find any evidence of prostate cancer. In order to improve guidance of intended repeated biopsy, [18F]prostate-specific membrane antigen (PSMA) 1007 PET/CT was performed, which showed a solitary lesion with strong PSMA expression in the left peripheral zone in the prostate gland. Surprisingly, also a diffuse bone marrow involvement with predominantly osteolytic lesions was observed. This...
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
High 11C-Methionine Uptake in a Parasellar Inflammatory Pseudotumor
A 20-year-old man had left visual impairment and homonymous hemianopsia. MRI findings suggested enlargement of an optic glioma, because optic glioma was indicated by MRI 14 years earlier without a definite pathological diagnosis. 11C-methionine (MET) PET showed high uptake in the tumor in the parasellar region. Transnasal endoscopic biopsy was performed, and an inflammatory pseudotumor (IPT) was diagnosed based on histopathological findings. High MET uptake in a parasellar IPT has apparently not been previously reported. Clinicians should be aware of the possibility of high MET uptake in IPT, because this image could provi...
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Metastatic Giant Cell Tumor Causing Small Bowel Intussusception on 18F-FDG PET/CT
An 89-year-old man with a history of a malignant giant cell tumor of soft parts in the right thigh with recurrent/metastatic tumor in the right pelvis was found to have pulmonary nodules concerning for metastatic disease. Subsequent PET/CT unexpectedly demonstrated a right lower quadrant intussusception with a hypermetabolic mass serving as a lead point. Pathology of the resected mass causing the intussusception was compatible with a metastasis from the patient's malignant giant cell tumor of soft parts. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Striking Size Reduction of Rapidly Growing Pancreatic Neuroendocrine Carcinoma Metastatic Nodal Conglomerate After Only 2 Cycles of 177Lu-DOTATATE
Peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE has shown great treatment efficacy in patients with well-differentiated metastatic neuroendocrine tumors and a metastatic size reduction of ~20% for metastatic lesions (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Baseline 18F-FDG PET/CT May Portend the Prognosis of Patients With Waldenström Macroglobulinemia/Lymphoplasmacytic Lymphoma After First-Line Treatment
Conclusions
The metabolic indices of TLG and MTV in baseline 18F-FDG PET/CT were independent prognostic factors to predict PFS and TTNT in patients with WM/LPL. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Original Articles Source Type: research
Comparison of Internal Dosimetry of 18F-PSMA-1007 and 68Ga-PSMA-11-HBED-CC
Conclusion
Whole-body effective dose from 18F-PSMA-1007 is higher compared with 68Ga-PSMA-11-HBED-CC. 18F-PSMA-1007 shows lesser urinary bladder clearance compared with 68Ga-PSMA-11-HBED-CC, which can allow better interpretation of prostatic bed without significant radioactive urine interference. 18F-PSMA-1007 is a cyclotron-produced alternative to generator-produced 68Ga-PSMA-11-HBED-CC and can emerge as a good diagnostic surrogate for patients planned for 177Lu-PSMA-617 therapy. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - October 17, 2022 Category: Nuclear Medicine Tags: Original Articles Source Type: research
