Journal of Nuclear Medicine Technology

The GPT-3.5-powered ChatGPT was released in late November 2022 powered by the generative pretrained transformer (GPT) version 3.5. It has emerged as a readily accessible source of patient information ahead of medical procedures. Although ChatGPT has purported benefits for supporting patient education and information, actual capability has not been evaluated. Moreover, the March 2023 emergence of paid subscription access to GPT-4 promises further enhanced capabilities requiring evaluation. Methods: ChatGPT was used to generate patient information sheets suitable for gaining informed consent for 7 common procedures in nuclear medicine...

Invasive lobular carcinoma (ILC) is the second most common subtype of invasive breast cancer and sometimes presents with an unusual metastatic pattern. Its gastric metastasis is difficult to differentiate from primary adenocarcinoma. This report presents a case of breast ILC for which the initial presentation was gastric metastasis. A 62-y-old woman presented with gastric outlet obstruction secondary to a gastric mass that had been diagnosed on upper gastrointestinal endoscopy and biopsy. The patient had been referred for 18 F-FDG PET/CT for staging...

The clinical utility of 18 F-FDG PET/CT is being increasingly recognized in histiocytic disorders. We report the case of a 23-y-old woman who presented with slowly progressive, yellowish-brown papules, plaques, and nodules over her face and flexures. Besides the multiple cutaneous lesions, lesions of the brain, stomach, gallbladder, and marrow were additionally revealed by baseline 18 F-FDG PET/CT. Skin biopsy and the overall clinical picture were consistent with xanthoma disseminatum. Subsequent PET/CT after cladribine therapy revealed a decrease in the extent and metabolic activity of most lesions, suggestive of a favorable response...

Clinical imaging research is a fast-growing, complex, and integral part of drug and therapy discovery and development. Research sponsors rely on outside vendors to manage their trials and deliver results they hope will demonstrate the efficacy of their product. Specialized vendors known as imaging contract research organizations have teams of highly trained and specialized professionals who lend their expertise to all aspects of imaging research management, of which nuclear medicine technologists are key team members...

Pheochromocytoma and paraganglioma are rare in children, at only 1 in every 50,000 cases. Even though some cases are sporadic, they have been connected to syndromes such as von Hippel-Lindau, multiple endocrine neoplasia types IIa and IIb, neurofibromatosis type 1, and hereditary pheochromocytoma-paraganglioma syndromes. A genetic mutation causes around 60% of pheochromocytomas and paragangliomas in children under 18. Methods: A 15-y-old child with a 6-y history of back discomfort is presented. The justification for using 2 functional imaging modalities, 68 Ga-DOTATATE PET/CT and 123 I- meta -iodobenzylguanidine SPECT/CT, is examined in this case study...

Metastases to the female genital tract are rare, especially from extragenital primaries. The most common extragenital sites associated with genital metastasis are the gastrointestinal tract (37.6%) followed by the breast (34.9%). It is crucial to differentiate primary from metastatic involvement of the uterus for appropriate patient management. We present one such case of endometrial metastasis in a patient who presented clinically with abnormal uterine bleeding and was diagnosed with primary breast cancer via 18 F-FDG PET/CT...

We report a case of a large abdominal pseudocyst detected on scintigraphy in a patient with a history of ventriculoperitoneal shunt placement who presented with headache and suspected shunt malfunction.

With an aging U.S. population, advancements in the treatment of Alzheimer disease (AD) and other neurodegenerative diseases are key to the maximization of health span. The recent approval of 2 antiamyloid antibodies, which decrease brain amyloid load, places us on the cusp of breakthrough therapies that target the mechanism of the disease rather than just treating the symptoms. Although the trials that led to these approvals studied patients with mild early symptoms, multiple ongoing trials have enrolled cognitively normal patients screened for AD biomarkers including risk factors for amyloid positivity, family history, and genetic markers...

We present 2 cases of metastatic castration-resistant prostate carcinoma with discordant lesions on dual-tracer PET/CT (68 Ga-PSMA-11 and 18 F-FDG PET/CT), which on subsequent histopathologic evaluation revealed second primary malignancies of combined hepatocellular carcinoma and cholangiocarcinoma and poorly differentiated squamous cell carcinoma. These case illustrations emphasize the need to evaluate discordant lesions on dual-tracer PET/CT, which can lead to early diagnosis of second primary malignancies and thereby can provide better management in these patients...

Our objective was to demonstrate, through computer simulations, radiation exposure levels from a 90 Y contamination event during radioembolization procedures to calculate the radiation doses from various contamination scenarios. We also provide reasonable safety protocols to prevent contamination and minimize radiation exposure during decontamination. Methods: Simulations were performed using the computer code VARSKIN+, version 1.0, to determine the amount of radiation exposure resulting from different contamination scenarios...

We performed a 68 Ga-DOTATOC PET/CT scan on a 25-mo-old female patient who presented with opsoclonus myoclonus ataxia syndrome and had negative initial anatomic imaging. The scan showed a somatostatin receptor-overexpressing cervical tumor in favor of a cervical neuroendocrine tumor, with subsequent histopathologic findings of ganglioneuroblastoma.

No abstract text is available yet for this article.

The objective was to compare estimated total blood-absorbed doses obtained by applying 4 methods to the same group of patients. In addition, these results were compared with those for the patients of other researchers, who used various other techniques over a period of more than 20 y. Methods: Twenty-seven patients (22 women and 5 men) with differentiated thyroid carcinoma were enrolled in the study. Whole-body measurements were performed as conjugate-view (anterior and posterior) counts by scintillation camera imaging...

Malignancy in struma ovarii is rare and observed in only 5%-10% of patients. Here, we present a patient with malignant struma ovarii and coexisting intrathyroidal papillary thyroid carcinoma, with recurrence (large pouch-of-Douglas mass) and metastases (bilateral pulmonary and iliac nodal metastases) presenting 12 y after surgery. The notable features in this case were a concurrent intrathyroidal follicular variant of papillary carcinoma; the highly functioning nature of the malignant lesions, characterized by a low level of thyroid-stimulating hormone even without thyroxine suppression; and the low-grade 18 F-FDG avidity of these lesions, consistent with their well-differentiated nature...

Academic integrity has been challenged by artificial intelligence algorithms in teaching institutions, including those providing nuclear medicine training. The GPT 3.5-powered ChatGPT chatbot released in late November 2022 has emerged as an immediate threat to academic and scientific writing. Methods: Both examinations and written assignments for nuclear medicine courses were tested using ChatGPT. Included was a mix of core theory subjects offered in the second and third years of the nuclear medicine science course...

The study aim was to evaluate the adaptation of collimators to 123 I- N -fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl)nortropane (123 I-FP-CIT) dopamine transporter SPECT (DAT-SPECT) by a high-resolution whole-body SPECT/CT system with a cadmium-zinc-telluride detector (C-SPECT) in terms of image quality, quantitation, diagnostic performance, and acquisition time. Methods: Using a C-SPECT device equipped with a wide-energy, high-resolution collimator and a medium-energy, high-resolution sensitivity (MEHRS) collimator, we evaluated the image quality and quantification of DAT-SPECT for an anthropomorphic striatal phantom...

Due to high iodine loading from iodinated contrast media, the thyroid uptake of common radiopharmaceuticals ([99m Tc]NaTcO4 and [123 I]NaI) can be influenced up to 2 mo after administration. In such cases, and generally when differential diagnosis between productive and destructive thyrotoxicosis is necessary, [99m Tc]Tc-sestamibi scintigraphy could be an option. This case highlights the role of [99m Tc]Tc-sestamibi in the evaluation of thyrotoxicosis in a patient with a blocked thyroid gland as a result of stable iodine saturation...

In September 2020, the Journal of Nuclear Medicine and Technology published a continuing education article, "Breast Cancer: Evaluating Tumor Estrogen Receptor Status with Molecular Imaging to Increase Response to Therapy and Improve Patient Outcomes," that reviewed a promising new PET tracer, 16α-18 F-fluoro-17β-fluoroestradiol (18 F-FES). This tracer had the potential to be a valuable tool for medical oncologists and breast surgeons in noninvasively evaluating the estrogen receptor site status of their patients' recurrent tumor and secondary metastatic lesions...

ChatGPT chatbot powered by GPT 3.5 was released in late November 2022 but has been rapidly assimilated into educational and clinical environments. Method: Insight into ChatGPT capabilities was undertaken in an interview-style approach with the chatbot itself. Results: ChatGPT powered by GPT 3.5 exudes confidence in its capabilities in supporting and enhancing student learning in nuclear medicine and in supporting clinical practice. ChatGPT is also self-aware of limitations and flaws in capabilities and the risks these pose to academic integrity...

No abstract text is available yet for this article.