Hellenic Journal of Nuclear Medicine

Main pulmonary artery (MPA) involvement of lymphomatoid granulomatosis (LYG) is extremely rare. We described fluorine-18-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) findings in a case with LYG originated from the MPA. Fluorine-18-FDG PET/CT demonstrated nodular hypermetabolic foci in the MPA, corresponding well to the intraluminal filling defects on CT pulmonary angiography, and the secondary right heart dysfunction was observed. Final diagnosis was made after transcatheter MPA biopsies and multi-disciplinary consultation...

We presented a case involving a 56-year-old man who had been experiencing shoulder and back pain for over a year, with extensive bone metastases revealed by a bone scan. To identify the primary source of these issues, the patients underwent a fluorine-18-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) scan, which indicated moderate uptake in the right renal soft mass and low uptake in multiple osteolytic lesions. Pathological examination and immunohistochemical staining of the renal mass supported the diagnosis of neuroendocrine tumors...

Technetium-99m-methoxy isobutyl isonitrile (99m Tc-MIBI) myocardial perfusion imaging (MPI) is a functional imaging method with relatively poor specificity but high sensitivity. Wepresent 48-year-old man with cardiac involvement due to muscular dystrophies (MD). Myocardial perfusion imaging rest images revealed regional myocardial perfusion decrease in multiple walls, enlarged heart and decreased left ventricular systolic function. The lesion location of MPI was consistent with that seen on CMR. Our case showed MPI was useful for detection and evaluation of the MD patient with cardiac involvement...

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Cerebrospinal fluid (CSF) shunting is an established long-term treatment option for hydrocephalus, and is one of the most commonly performed neurosurgical procedures in western countries.Despite advances in CSF shunt design and management, its failure rates remain high and is most commonly due to obstruction and infection.Cerebrospinal fluidshunt failure diagnosis should be prompt and accurate in establishing timely if its revision is appropriate. Radionuclide shuntography with technetium-99m-diethylenetriaminepetaacetic acid (99m Tc-DTPA) is a useful technique for evaluation CSF shunts and management of patients presenting with shunt-related problems, in particular it can avoid unnecessary replacement interventions...

The hepatopulmonary syndrome (HPS) is characterized by arterial oxygenation defect induced by intrapulmonary vascular dilatations in the setting of liver disease. We report a 57-year-old woman with a history of liver cirrhosis presented with progressive cyanosis, exertional dyspnea and a dry cough. Oxyhemoglobin saturation was 88.5% on room air. Contrast transthoracic echocardiography (cTTE) and technetium-99m-macroaggregated albumin (99m Tc-MAA) scintigraphy showed an intrapulmonary shunting and confirmed HPS...

OBJECTIVE: Our study aims to head to head compare the application of gallium-68-fibroblast activation proteininhibitor (68 Ga-FAPI) positron emission tomography/computed tomography (PET/CT) and fluorine-18-fluorodeoxyglucose (18 F-FDG) PET/CT in primary and metastatic lesions of gastric tumor to determine the superior diagnostic tool. MATERIALS AND METHODS: A systematic search, up to March 31, 2023, across PubMed, Embase, and Cochrane Library databases utilized a data-specific Boolean logic strategy...

OBJECTIVE: Recently, gallium-68-prostate-specific membrane antigen-11 (68 Ga-PSMA-11) positron emission tomography/computed tomography (PET/CT) has become a key imaging method in prostate carcinoma staging and biochemical progression, with varying sensitivities in different studies (from 40% to 80%). After four years of experience with 68 Ga-PSMA-11 PET/CT, we found that it is possible to detect lesions with increased PSMA expression in patients with undetectable prostate specific antigen (PSA) levels after radical prostatectomy...

OBJECTIVE: CD19-targeted chimeric antigen receptor T (CAR-T) cell therapy provides a durable response in patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). The role of fluorine-18-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) for early evaluation of responsein patients with that immunotherapy was evaluated. SUBJECTS AND METHODS: Three separate 18 F-FDG PET/CT examinations of 53 patients (29 males, 24 females; median 62 years old) with R/R DLBCL were conducted; before bridging therapy [time of decision (TD)], before CAR-T (tisagenlecleucel, n=37; lisocabtagenemaraleucel, n=16) infusion [time of CAR-T infusion (IT)], and one month (M1) after CAR-T infusion...

OBJECTIVE: In patients with normal liver function, patients with acute or chronic thyroid disease are more likely to develop liver dysfunction. Although the mechanisms underlying this process are not yet fully understood, it has been shown that hypothyroidism can lead to hepatic injury. We evaluated haematological function trends in patients with differentiated thyroid cancer (DTC) at baseline and approximately 4 weeks after l-thyroxine withdrawal before radioactive iodine ablation. SUBJECTS AND METHODS: This is a retrospective study, and 157 patients were enrolled...

A 35-year-old woman received a surgery of sigmoid colon highly differentiated mucosal adenocarcinoma with greater omentum and peritoneum metastasis.The follow-up contrast-enhanced computed tomography (CT) revealed a new enhanced nodule on the transverse mesocolon about 6 months after surgery. Fluorine-18-fluorodeoxyglucose (18 F-FDG) and 18 F-fibroblast activation protein inhibitor (FAPI) positron emission tomography (PET)/CT were both performed to evaluate the potential lesions systematically, PET/CT images showed low 18 F-FDG activity but very little 18 F-FAPI activity in the nodule on the transverse mesocolon...

Pericardial inflammatory myofibroblastic tumor (IMT) is very rare. Herein, we report fluorine-18-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) findings of pericardial IMT in a 57-year-old woman. On conventional image, it presented as a pericardial mass with heterogeneous delay enhancement. On 18 F-FDG PET/CT image, this lesion had mild 18 F-FDG uptake with a maximum standardized uptake value (SUVmax ) of 1.84. The postoperative pathology supported a diagnosis of IMT...

Direct radionuclide cystography (DRC) is a safe and reliable method for the detection and follow-up of vesico-ureteral reflux (VUR). Since the first DRC was performed, during the early 60s , the method has undergone many refinements. Themanometric approach, which was first introduced in 1984, provides a correlation between the bladder pressure and VUR visualization. In this study the sources of error that may alter the results of DRC are discussed and a novel, standardized low costmanometric apparatus is suggested...

Extrastriatal accumulation on technetium-99m-([2-[[2-[[[3-(4-chlorophenyl)-8-methyl-8-azabicyclo[3,2,1]oct-2-yl]methyl](2-mercaptoethyl)amino]ethyl]amino]- ethanethiolato(3-)-N2,N2',S2,S2']oxo-[1R-(exo-exo)])(99m Tc)-TRODAT-1 is unexpected during nuclear medicine nigrostriatal pathway examinations on 99m Tc-TRODAT-1 brain single photon emission computed tomography (SPECT). An 86-year-old female with a history of right hemiparesis, speech expressive difficulties, unstable gait, and bradykinesia on right side was reported...

Eosinophilic esophagitis (EoE) is a rare immune-mediated chronic inflammatory disease of the esophagus. The main symptoms are dysphagia, retrosternal pain, and repeated food impaction. Esophageal eosinophilic infiltration is seen on histopathological examination. Progressive esophageal stenosis and other complications may occur if not detected and treated. We report a patient with pathologically confirmed EoE whose disease was detected on fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT)...

OBJECTIVE: Vitamin D (VitD) plays various roles, promotes musculoskeletal health, maintains parathyroid hormone levels and supports the immune processes. Vitamin D deficiency is common among cancer patients including thyroid cancer. Since some data indicate that preoperative VitD levels in cancer patients correlate with the further prognosis of the disease. Therefore, it is worthwhile to investigate this in the most common cancer of the thyroid gland, papillary thyroid cancer (PTC). The aim of this study was to evaluate serum VitD levels in patients with PTC concerning age, gender, body mass index (BMI), cancer stage, thyroid hormone levels, thyroglobulin concentration and the efficiency of VitD3 supplementation in these patients...

OBJECTIVE: In bone scintigraphy, it is difficult to compare quantitative values, such as standardized uptake value (SUV), obtained from 2 different single-photon emission computed tomography combined with computed tomography (SPECT/CT) devices owing to differences of imaging acquisition and analysis methods. Therefore, the purpose of this study was to compare the SUV obtained from different SPECT/CT devices using the ratio to normal bone, and to analyze the correlation between them. SUBJECTS AND METHODS: A total of 27 prostate cancer patients who underwent bone scintigraphy either using Symbia T16 or Symbia Intevo (Siemens Medical Solutions, Erlangen, Germany) were retrospectively analyzed...

OBJECTIVE: The purpose of this study was to evaluate the contribution of single photon emission computed tomography/computed tomography (SPECT/CT) standardized uptake value (SUV) metrics in classifying patients with suspected transthyretin cardiac amyloidosis (ATTR-CA) among the different Perugini grades. SUBJECTS AND METHODS: One hundred four patients suspected of ATTR-CA underwent planar scintigraphy with bone seeking tracer (99m Tc pyrophosphate-PYP). Patients were classified according to the Perugini scale, the H/CL, H/Bone and H/Bkg ratios...

Cardiac amyloidosis is a rare condition characterized by the accumulation of abnormal proteins called amyloids in the heart tissue. These amyloids can disrupt the normal functioning of the heart and lead to a variety of symptoms and complications.

Artificial Intelligence (AI) currently occupies the headlines in the media as well as the medical press, with messages of its emerging unlimited potential, but also tales of doom and gloom predicting risks for the extinction of humanity! One such headline in the London TIMES of 6th June 2023 reads: - "Two years to save the world, says AI adviser". To the uninformed, AI is nothing more than the processing of a colossal amount of data with lightning speed, now achievable with the latest spectacular developments in computing...