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Clinical Nuclear Medicine

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https://read.qxmd.com/read/30762830/hyperfunctioning-papillary-microcarcinoma-diagnosed-by-124i-pet-ultrasound-fusion-imaging
#1
Philipp Seifert, Falk Gühne, Martin Freesmeyer
A 49-year-old woman presented with a multinodular goiter, causing local symptoms and hyperthyroisdism. Besides a hypofunctioning benign nodule (TIRADS 3, benign in FNAC), the conventional diagnostic revealed another small hyperfunctioning nodule with suspicious ultrasound features (TIRADS 4C). To rule out a trapping-only nodule and topographical misalignments, a I PET/ultrasound fusion was performed and confirmed elevated iodine uptake within the suspicious nodule. Further disseminated autonomous areas are suspected to be additionally responsible for the low TSH-level...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762829/an-isolated-osseous-rosai-dorfman-disease-shown-on-fdg-pet-ct
#2
Mahdi Zirakchian Zadeh, Zhe Wen, Lisa J States, Hongming Zhuang
Rosai-Dorfman disease is typically presented as lymphadenopathy, especially in the neck. Extranodal diseases also frequently occur but are generally concurrent with nodal disease. We report FDG PET/CT findings of solitary femoral Rosai-Dorfman disease without any lymphadenopathy in a pediatric patient.
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762828/18f-choline-pet-ct-imaging-for-intracranial-hemangiopericytoma-recurrence
#3
Nina Jehanno, Thibaut Cassou-Mounat, Hamid Mammar, Marie Luporsi, Virginie Huchet
We report the case of a 50-year-old man, with previous history of grade 3 intracranial hemangiopericytoma with initial complete surgical resection, addressed for local recurrence. Surgical revision performed 18 months after initial surgery allowed only partial resection, leaving residual disease along the optic nerve. Complementary radiotherapy with proton was decided. F-FDG PET/CT and F-choline PET/CT were both performed for treatment planning. F-FDG PET showed no uptake of the residual tumor, whereas F-choline depicted highly metabolic residual disease uptake with excellent delineation of local recurrence...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762827/inflammatory-activity-of-tumoral-calcinosis-in-a-patient-with-fever-of-unknown-origin
#4
Falk Gühne, Robert Drescher, Philipp Seifert, Martin Busch, Martin Freesmeyer
Unexpected inflammatory activity of tumoral calcinosis periarticular to the shoulders and hips in a man with recurrent fever of unknown origin and dialysis-dependent kidney insufficiency was revealed by FDG PET/CT. In absence of other pathologies, the calcinosis was deemed to be the cause of the fever. An infectious or malignant disease could be ruled out, so further therapeutic steps were enabled.
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762826/99mtc-llec-renal-dynamic-scan-in-a-patient-with-pelvic-neuroblastoma
#5
Sreenivasa Reddy Konudula, Peethamber L, Madhusudhanan Ponnusamy, Dhanapathi H, Nandini Pandit
A 5-month-old boy with ultrasonography showing bilateral hydronephrosis, referred for renal scan. On Tc-L,L,ethylenedicysteine (Tc-LLEC) renal scan, tracer blush in flow images in the region of urinary bladder was seen and tumor mass was suspected. Contrast-enhanced CT showed a soft tissue mass in sacrococcygeal region. Histopathological examination of biopsy tissue revealed malignant round cell tumor and immunohistochemistry consistent with neuroblastoma. I-MIBG scan revealed uptake in the pelvic mass with no distant metastasis...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762825/novel-functional-renal-pet-imaging-with-18f-fds-in-human-subjects
#6
Rudolf A Werner, Alvaro A Ordonez, Julian Sanchez-Bautista, Charles Marcus, Constantin Lapa, Steven P Rowe, Martin G Pomper, Jeffrey P Leal, Martin A Lodge, Mehrbod S Javadi, Sanjay K Jain, Takahiro Higuchi
The novel PET probe 2-deoxy-2-F-fluoro-D-sorbitol (F-FDS) has demonstrated favorable renal kinetics in animals. We aimed to elucidate its imaging properties in 2 human volunteers. F-FDS was produced by a simple 1-step reduction from F-FDG. On dynamic renal PET, the cortex was delineated and activity gradually transited in the parenchyma, followed by radiotracer excretion. No adverse effects were reported. Given the higher spatiotemporal resolution of PET relative to conventional scintigraphy, F-FDS PET offers a more thorough evaluation of human renal kinetics...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762824/concurrent-pancreatic-metastasis-from-lung-adenocarcinoma-and-primary-cholangiocarcinoma-on-fdg-pet-ct-imaging
#7
Wei Wang, Ying Kan, Xu Yang, Jie Liu, Jigang Yang
A 67-year-old man with a history of left upper lobe resection of poorly differentiated adenocarcinoma 1 year ago underwent FDG PET/CT for restaging. The images demonstrated a round cystic lesion with peripheral FDG uptake and centrally photopenic region. Additional focus of increased activity was detected in the left lobe of the liver. The patient underwent the Whipple and partial hepatectomy. The surgical pathology demonstrated concurrently the metastasis to the pancreas from the lung adenocarcinoma and a primary moderately differentiated cholangiocarcinoma...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762823/hereditary-leiomyomatosis-and-renal-cell-carcinoma-syndrome-associated-renal-cell-carcinoma-showing-high-fdg-uptake
#8
Zhengguang Xiao, Aisheng Dong, Yang Wang
Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome is a rare autosomal-dominant disease, characterized by the development of cutaneous and uterine leiomyomas and renal cell carcinoma (RCC). Approximately 20% to 30% of patients with HLRCC syndrome develop RCC resembling sporadic type 2 papillary RCC, which is aggressive and associated with a poor prognosis. Information on the clinical usefulness of FDG PET/CT in HLRCC syndrome-associated RCC is limited. We present a case of HLRCC syndrome-associated RCC showing high FDG uptake in both the primary RCC and retroperitoneal lymph node metastases...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762822/meningeal-metastasis-relapse-with-focal-involvement-of-cranial-bone-flap-a-case-resolved-by-18f-dopa-pet-mri
#9
Nicolas Louarn, Aurélie Dauta, Emmanuèle Lechapt-Zalcman, Paul Kauv, Emmanuel Itti
A 63-year-old woman was referred to our PET/MRI platform to evaluate the possible relapse of a meningeal metastasis, complicating an invasive ductal carcinoma of the left breast. This metastasis was diagnosed on a left hemiparesis and treated by surgery and radiation therapy. One year later, the same symptoms led to another brain MRI examination that found a contrast-enhanced lesion in the operating site. We decided to perform a F-DOPA PET/MRI to document this lesion, which confirmed the diagnosis of a probable relapse and revealed a focal uptake on the bone flap...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762821/a-case-of-intramuscular-cryptococcosis-mimicking-a-malignant-tumor-on-fdg-pet-ct
#10
Ling Wang, Xiangwu Zheng, Jie Lin, Kun Tang
Intramuscular cryptococcosis is extremely rare. In this case, a 76-year-old man with history of acute myeloid leukemia presented a painful mass in the right upper arm. FDG PET/CT demonstrated a low-density irregular-shaped mass in the triceps muscle of the right upper arm with adjacent bone erosion. The lesion presented with significantly increased activity with an SUVmax of 23.4, which could be misdiagnosed as a malignant tumor. The lesion was confirmed as cryptococcosis by periodic acid-Schiff stain and culture of biopsied specimen...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762820/multifocal-small-bowel-carcinoid-evaluation-by-68ga-dotatate-pet
#11
Michael Clark, Mark Nathan, Stephen Broski
Carcinoid is a subtype of neuroendocrine tumor, a rare group of tumors that are known to express somatostatin receptor 2. Ga-DOTATATE is a somatostatin analog that is specific for somatostatin receptor 2 and therefore allows visualization of neuroendocrine tumors. We present 2 cases of primary multifocal small bowel carcinoid evaluated using Ga-DOTATATE PET/CT, along with contrast-enhanced CT corollary findings. Given the increased sensitivity of Ga-DOTATATE PET/CT compared with CT and In-octreotide scintigraphy, we expect multifocal carcinoid to become increasingly recognized...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762819/a-case-of-radioactive-iodine-uptake-found-in-artificial-eye
#12
Il-Hyun Kim, Joon-Kee Yoon, Su Jin Lee, Eugene Jeong, Young-Sil An
Radioactive iodine (RAI) therapy is widely used as an adjunctive treatment in patients with differentiated thyroid cancer. Although I has high avidity in the functioning thyroid, and in differentiated thyroid cancer lesions, physiological and nonspecific uptake of I in healthy or benign tissue may contribute to false-positive findings on an I scan. Here, we present an interesting image of RAI uptake in the eye region post-RAI treatment, which has been identified as tear contamination in the artificial eye.
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762818/pachymeningitis-demonstrated-on-gallium-spect-ct-scan
#13
Veronica C Wong, Grace Yung, Robert Russo, Stephen W Reddel, Robert Mansberg
A 34-year-old woman presented with a 3-month history of right-sided headaches associated with photophobia and pulsatile tinnitus. Investigations including lumbar puncture revealed elevated opening CSF pressure, increased protein, and presence of monocytosis consistent with an inflammatory/infective process. Brain MRI showed an area of thickened enhancing dura around the venous sinus posteriorly. Ga scintigraphy demonstrated focal intracranial uptake in the posterior occipital region, and biopsy confirmed a chronic inflammatory infiltrate with no granulomas...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30762817/18f-fdg-pet-ct-demonstrates-renal-cell-cancer-in-a-transplant-with-synchronous-intestinal-infection
#14
Anwin Joseph Kavanal, Joyita Bharati, Shelvin Kumar Vadi, Krishan Lal Gupta, Rajender Kumar, Bhagwant Rai Mittal
We present a case of a 22-year-old man with history of allogenic renal transplantation on immunosuppression, who underwent F-FDG-PET/CT to characterize a lesion in the transplanted kidney on ultrasonogram and contrast-enhanced computed tomography imaging. PET/CT revealed FDG avid lesion in the transplanted kidney and mural thickening involving the distal ileum, ileocecal junction, and ileocolic lymph nodes. Subsequent histopathological examination from the renal lesion revealed renal cell carcinoma in the transplanted kidney...
February 8, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30688750/similar-appearance-on-dynamic-images-of-meckel-scintigraphy-caused-by-different-etiologies-the-value-of-lateral-views
#15
Zhe Wen, Lorianne Salerno, Hongming Zhuang
Positive gastric mucosa Meckel diverticulum generally shows nonmoving activity in the right abdomen, which appears early in the study at about the same time of the appearance of the stomach. However, a stoma from ileostomy can result in similar findings on dynamic images. The difference between a true Meckel diverticulum and stoma can be exposed by lateral views.
January 25, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30688749/superscan-18f-fluciclovine-pet-ct-of-psa-negative-prostate-cancer-bone-metastases
#16
Bo Chen, Homer A Macapinlac, Yang Lu
A 76-year-old man presented with recently diagnosed prostate adenocarcinoma, Gleason score of 4 + 4, and a Super bone scan with concurrent PSA of 1.7 ng/mL. Approximately 3.5 months later, an F-fluciclovine PET/CT was performed despite of a decreased PSA of 0.3 ng/mL. A Superscan fluciclovine PET/CT was identified, and bone metastasis were later confirmed at biopsy.
January 25, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30688748/remarkable-response-of-pulmonary-metastases-rather-than-remnant-thyroid-in-131i-therapy-of-follicular-thyroid-cancer
#17
Tian Tian, Yu Chen, Yongzhao Xiang, Lina Liu, Bin Liu
A 66-year-old man with follicular thyroid cancer after total thyroidectomy was referred for I therapy. Thyroid function tests before I administration exhibited severe thyrotoxicosis although the patient did not take levothyroxine after thyroidectomy. A 185 MBq I whole-body scintigraphy and SPECT/CT revealed multiple iodine-avid pulmonary metastases with the largest tumor diameter of 1.4 cm and remnant thyroid. A diagnosis of thyrotoxicosis caused by hyperfunctioning pulmonary metastases was then made. The patient was administered 7...
January 25, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30688747/lymphadenopathy-due-to-kimura-s-disease-mimicking-lymphoma-on-fdg-pet-ct
#18
MingMing Yu, ZhenGuang Wang, Jing Zhao, FengYu Wu
Kimura's disease is a clinically rare, chronic, benign lymphoproliferative disorder of unknown etiology. A 36-year-old man presented with painless axillary swelling, which was suspected as lymphoma. PET/CT was performed for staging. The images showed multiple foci of increased activity in bilateral axillary and right inguinal lymph nodes. Laboratory tests revealed an increased eosinophil ratio and eosinophil count. Pathological examination from dissected axillary lymph nodes was consistent with Kimura's disease...
January 25, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30688746/68ga-psma-11-pet-mr-can-be-false-positive-in-normal-prostatic-tissue
#19
Daniela A Ferraro, Niels J Rupp, Olivio F Donati, Michael Messerli, Daniel Eberli, Irene A Burger
Prostate-specific membrane antigen (PSMA) is a transmembrane glycoprotein expressed in the cytosol of normal prostate tissue and highly overexpressed on the membrane of prostate cancer, therefore increasingly used to image prostate cancer. We report a case of a 65-year-old man with two focal PSMA-positive areas on a Ga-PSMA-11 PET/MR, one corresponding to a prostate carcinoma (Gleason score 4 + 3) and another region without any evidence of malignancy, but with corresponding high PSMA-expression on immunohistochemistry...
January 25, 2019: Clinical Nuclear Medicine
https://read.qxmd.com/read/30688745/68ga-psma-uptake-in-prostate-cancer-sciatic-nerve-metastasis
#20
Patrícia Barros Gouveia, Liliana Catarina Sobral Violante, Ricardo Jorge Valpaços Teixeira, Luís Hugo da Silva Trindade Duarte
Most prostate cancers spread to regional lymph nodes, axial skeleton and lungs. Perineural malignant involvement is very rare. We present a Ga-PSMA PET/CT image of a sciatic nerve metastasis in a 65-year-old man with recurrent prostate cancer.
January 25, 2019: Clinical Nuclear Medicine
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