Nuclear Medicine Review. Central & Eastern Europe

BACKGROUND: Nuclear medicine uses radionuclides in medicine for diagnosis, staging, therapy, and monitoring the response to therapy. The application of radiopharmaceutical therapy for the treatment of certain diseases is well-established, and the field is expanding. Internal dosimetry is multifaceted and includes different workflows, as well as various calculations based on patient- specific dosimetry. AIM: The objective of this study was to introduce the technical issues which might occur during iodine-131 (¹³¹I) dosimetry performed in nuclear medicine departments...

BACKGROUND: The purpose of the study was to present the cardiological procedures performed and scintigraphic devices used in Poland in 2019-2021 - based on the results of a nationwide survey. MATERIAL AND METHODS: Forty-three (100%) institutions performing scintigraphic cardiology tests responded to the survey: 29 classic nuclear medicine centers (NM), 4 PET centers, and 10 institutions performing NM and PET examinations. RESULTS: In 2021, 51 SPECT devices (including 5 dedicated cardiocentric semiconductor cameras, 12 SPECT gamma cameras, and 39 hybrid SPECT/CT devices) and 15 PET devices (14 PET/CT and 1 PET/MR) were used for cardiological examinations...

A case involving a 64-year-old woman with ovarian carcinoma on maintenance therapy who underwent 18-fluorodeoxyglucose positron emission tomography with computed tomography ([18F]FDG PET/CT) restaging due to rapid cancer antigen 125 (Ca-125) rise. This revealed recurrent disease within the pelvis and large volume, peritoneal carcinomatosis including an avid umbilical deposit, consistent with the rarely seen Sister Mary Joseph nodule (SMJN). This case elegantly demonstrates not only the anatomy of the peritoneal surfaces through avid disease deposition but also highlights the sensitive depiction of disease burden in peritoneal carcinomatosis, including the detection of rare manifestations such as SMJN...

Prostate-specific membrane antigen (PSMA) is a membrane protein originally discovered in prostate cancer cells. It is widely used at all stages of prostate cancer diagnosis. Several studies have highlighted its possible wide application in other cancers. This review discusses the potential use of positron emission tomography with labelled PSMA for the diagnosis or differentiation of intracranial lesions. Given the numerous reports on the usefulness of PSMA in the diagnosis of brain tumours of glial origin, the focus is on lesions of a different aetiology...

BACKGROUND: As a result of constantly improving surgical methods, an increasing number of patients have medical devices implanted in the cardiovascular system (including vascular grafts and endografts). Such patients are characterised by their high risk of infectious complications due to the possibility of biofilm formation on implanted material. This work aims to analyse the utility of 2-[18F]FDG PET/CT in diagnosing vascular graft and endograft infections. MATERIAL AND METHODS: The study was undertaken on a group of 58 patients, of whom 34 were in the study group, and 24 were in the control group...

BACKGROUND: This study aims to evaluate the performance of a deep learning enhancement method in PET images reconstructed with a shorter acquisition time, and different reconstruction algorithms. The impact of the enhancement on clinical decisions was also assessed. MATERIAL AND METHODS: Thirty-seven subjects underwent clinical whole-body [18F]FDG PET/CT exams with an acquisition time of 1.5 min per bed position. PET images were reconstructed with the OSEM algorithm using 66% counts (imitating 1 min/bed acquisition time) and 100% counts (1...

BACKGROUND: A challenge for modern medicine is the development of clinical protocols for precise diagnosis and therapy. This study aimed to propose a simple method for modification of 2-[18F]FDG used routinely in hospitals in a way, appropriate for patients' personalized radiopharmaceuticals approach. MATERIAL AND METHODS: For the purposes of the presented study chemo selective method for indirect radiofluorination was applauded to custom synthesized aminooxy- and hydrazine-functionalized tetrazines for 18F-glycolation via oxime or hydrazone formation...

Incidental uptake in [18F]FDG PET/CT is not uncommon, but uptake in the oral and sinonasal regions was less frequently reported. We present a case of incidental focal [18F]FDG PET/CT uptake within the hard palate, which was later revealed to be an ossifying fibroma. We also reviewed some relevant literature and suggested that further investigation may be necessary for some patients with incidental [18F]FDG PET/CT uptake in the oral and sinonasal regions.

BACKGROUND: The exact role of positron emission tomography with fluorine-18-deoxyglucose ([18F]FDG PET/CT) in an early diagnosis of relapsed ovarian cancer is not clearly defined. The aim of the study was to assess the value of [18F]FDG PET/CT in the detection and differentiation of recurrent ovarian cancer. MATERIAL AND METHODS: Eighty-four patients with suspected recurrent ovarian cancer underwent [18F]FDG PET/CT examination. Results of PET/CT were analyzed taking into account clinical data of the patients, histological diagnosis, and 6-month follow-up...

INTRODUCTION: Nuclear medicine (NM) methods play an important role in the evaluation of renal function in a wide range of clinical indications. The aim of our study was to evaluate the correlation between measured GFR (mGFR) obtained by the three-plasma sample slope-intercept NM method (TPSM) - reference method vs. estimated GFR (eGFR) using Fleming's single plasma sample method (SPSM) at 120 min, 180 min, and 240 min and correlation of reference method with eGFR with camera-based Gates' protocol...

BACKGROUND: Our aim is to determine the accuracy of [68Ga]Ga-PSMA PET/CT in showing PSMA expression in primary prostate cancer and to investigate the relationship between SUVmax and immunohistochemical PSMA expression, Gleason score, and PSA value. MATERIAL AND METHODS: We retrospectively analyzed 66 male patients who were diagnosed with primary prostate adenocarcinoma, underwent pre-treatment [68Ga]Ga-PSMA PET/CT examination for staging, and performed radical prostatectomy between March 2018-August 2020...

We present a case of a 79-year-old asymptomatic patient with prostate adenocarcinoma, Gleason score 9 (4 + 5), with the initial prostate-specific antigen (PSA) level of 17 ng/mL, treated with radiotherapy and hormonotherapy, who was diagnosed with the rapid growth of PSA levels up to 78.8 ng/mL. Due to suspected bone metastases, first, bone scintigraphy was performed. However, it showed only one intense "hot" lesion in the Th7 projection. This image was not consistent with a high level of PSA, for which reason a computed tomography (CT) scan was performed...

Secondary anemia in hemoglobinopathies like thalassemia can cause expansion of the bone marrow cavities because of compensatory marrow hyperplasia. This case demonstrates spontaneous osteonecrosis of the distal left femur in a patient with β-thalassemia that may be secondary to ischemic infarction secondary to occlusion of the microvasculature within the expanded cancellous bone. This subject was referred to Hazrat Rasool Akram Hospital because of fever, cough, and bone pain. In the CT scan she had scattered peripheral CGO in both lungs due to COVID-19 with two paravertebral masses due to extramedullary hematopoiesis...

Brown tumours are rare bone lesions occurring in patients with severe hyperparathyroidism (HPT) because of increased osteoclastic activity due to high levels of parathyroid hormone (PTH). We report the case of 30-year-old woman with secondary hyperparathyroidism due to severe chronic kidney diseases who underwent [18F]F-choline PET/CT scan for localization of the hyperfunctioning parathyroid gland before surgical treatment. [18F]F-choline PET/CT scan showed increased choline uptake in the lower left parathyroid gland and in multiple bone lytic lesions...

BACKGROUND: This study aimed to evaluate the diagnostic accuracy of [18F]FDG PET/MR versus [18F]FDG PET/CT in the thoracic staging of patients with non-small cell lung cancer (NSCLS). MATERIAL AND METHODS: The Preferred Reporting Items for Systematic Reviews (PRISMA) were followed in conducting the present study. All available research was collected through Embase (Elsevier), PubMed, as well as Cochrane Library databases up to June 2021. Only studies covering both [18F]FDG PET/MRI and [18F]FDG PET/CT techniques in the same group were included...

A 65 years old man with high-risk prostate adenocarcinoma underwent bone scintigraphy with 99mTc-methylene diphosphate (99mTc-MDP). The scan revealed a focus of radiotracer uptake in the left pubic region, which was suspicious for metastatic involvement. Additional imaging with single photon emission computed tomography (SPECT/CT) confined the uptake to be extra-osseous and contributed to the calcified zone in the prostate bed. Prostatic bed calcification with 99mTc-MDP uptake mimics metastasis and can be easily missed on planar images...

BACKGROUND: Malignant melanoma stands out as a disease with highly aggressive behavior and frequent recurrences. It is crucial to find a non-invasive method for early recurrence detection which allows early and radical treatment. Our aim was to assess the diagnostic and clinical value of [18F]FDG PET/CT in the follow-up regimen of patients after radically treated first regional recurrence and for early detection of operable disease progression. MATERIAL AND METHODS: We performed [18F]FDG PET/CT in 96 consecutive patients who had a histologically proven regional recurrent disease that was radically treated...

A cold vertebral defect is an uncommon finding, especially in Gallium-67-citrate ([67Ga]Ga-citrate) - and [18F]fluorodeoxyglucose ([18F]FDG) - avid lymphomas, representing a diagnostic challenge. Here, we present the case of a patient with non-Hodgkin lymphoma (NHL), in whom the [67Ga]Ga-citrate and [18F]FDG scans showed a diffuse skeletal uptake pattern with concomitant appearance of a cold vertebral defect. Awareness of the different causes of such uptake patterns and accurate clinical information is important to avoid misinterpretation of nuclear studies in oncologic patients...

BACKGROUND: To evaluate the effect of patient-related factors such as age, gender, body mass index (BMI), blood glucose (BG), diabetes, serum creatinine and injected dose on 18F-Fluorodeoxyglucose ([18F]FDG) uptake of tumor and normal organs, as well impact of [18F]FDG uptake of tumor on normal organs, in clinical positron emission tomography-computed tomography (PET/CT). MATERIAL AND METHODS: In this retrospective study, data of 200 patients who underwent clinical [18F]FDG PET/CT with (n = 192) and without (n = 8) intravenous contrast was evaluated...

BACKGROUND: The frequency of bone metastases in individuals increases at advanced stages of cancer, mostly in patients suffering from lung, breast, or prostate cancer. The study aims to evaluate the effectiveness of bone metastases diagnosis of nuclear medicine, CT scan, and MRI in detecting bone metastases among patients with lung, breast, and prostate carcinoma. MATERIAL AND METHODS: Retrospective study design was adopted for the analysis of 120 recruited patients (with the presence of bone metastasis) following a series of examinations and tests...