Nuclear Medicine and Molecular Imaging

In this case report, we present the clinical management of a 52-year-old female patient with a recurrent right temporo-parietal glioblastoma multiforme (GBM). The patient presented with symptoms of headache and loss of balance and recurrence on magnetic resonance imaging (MRI). To evaluate the fibroblast activation protein inhibitor (FAPi) expression in the recurrent lesion, an exploratory [68  Ga]Ga-DOTA.SA.FAPi PET/CT scan was performed. The imaging results revealed FAPi expression in the lesion located in the right temporo-parietal region...

We report a case of cervicofacial actinomycosis mimicking malignant sarcoma in a 78-year-old man with diabetes. High lesion uptake and decreased cerebral uptake on [18 F]FDG PET/CT provide a potentially important diagnostic clue suggesting infectious disease in a poorly controlled diabetic patient.

A 79-year-old man with prostate cancer (PCa) was referred to our center to perform a [11 C]Choline PET/CT for biochemical recurrence. Positron emission tomography/computed tomography (PET/CT) scan detected PCa recurrence in the prostate gland and several pelvic and abdominal lymph nodes. Two abnormal uptakes were also identified in the right breast and in the liver, respectively. Breast histological findings turned out to be gynecomastia, while the liver lesion resulted in a benign perfusion anomaly at follow-up magnetic resonance imaging (MRI)...

The field of nuclear medicine is entering a new era of gamma-camera technology. Solid-state SPECT/CT systems will gradually replace the thallium-activated sodium-iodide NaI(Tl) systems. This digital technology allows drastic improvements in image quality, radiotracer dose reduction, and procedure efficiency. This pictorial review presents our initial experience on an NM/CT 870 CZT system (GE Healthcare), equipped with dual-head cadmium zinc telluride (CZT) detectors, for I-123 metaiodobenzylguanidine (MIBG) imaging in pediatric neuroblastoma...

OBJECTIVE: This study aimed to investigate the risk of second primary malignancy after radioiodine (RAI) therapy in patients with thyroid cancer, using the National Health Insurance Service (NHIS) database. METHODS: We extracted data from the NHIS database of South Korea, which covers the entire population of the nation. Risk of second primary malignancy in the thyroid cancer patients who received RAI therapy were compared with the thyroid cancer patients who received surgery only...

Somatostatin receptor scintigraphy is a key diagnostic tool in the initial staging and therapeutic evaluation of neuroendocrine tumors. Its specificity can be compromised by the presence of false positives. We illustrate here the case of a vertebral hemangioma detected on 99m Tc-Tektrotyd scintigraphy as an incidental finding in a 34-year-old man referred for the staging of a well-differentiated neuroendocrine tumor of the ampulla of Vater (Fig. 1).

Prostate cancer (PC) and colorectal cancer (CRC) are two of the leading causes of cancer-related mortality. The incidence of synchronous neoplasms in patients with CRC is increasing, though synchronous PC and CRC remains a rare occurrence in clinical practice. Early diagnosis, accurate staging, and characterization of tumors are essential for selecting patient-tailored therapy. The origin of metastatic disease in synchronous cases presents a challenge for conventional imaging modalities, but advances in molecular imaging have addressed this limitation...

PURPOSE: The growing incidence of differentiated thyroid cancer (DTC) demands dependable prognostic factors to guide follow-up and treatment plans. This study investigated the prognostic value of response to therapy (RTT) assessment using TSH stimulated-thyroglobulin (sti-Tg) and nonstimulated-thyroglobulin (nonsti-Tg) and evaluates whether RTT using nonsti-Tg (nonstiRTT) can replace RTT using sti-Tg (stiRTT) in clinical practice to improve patients' quality of life during assessment...

We present a case of an 83-year-old man with underlying colorectal cancer who underwent a gallium-68 prostate specific membrane antigen-11 positron emission tomography/computed tomography (68  Ga-PSMA-11 PET/CT) for the initial staging of prostate cancer. PET / CT revealed two mildly PSMA-avid lung nodules without evidence of PSMA-avid nodal or bony metastasis. Subsequently, a wedge pulmonary resection was performed and the histopathology and immunohistochemistry of the nodules were consistent with synchronous primary lung cancer...

Recent studies have outlined the emerging role of 68 Ga-PSMA-11 PET/CT in the diagnostic algorithm of clear cell renal cell carcinoma (ccRCC). We report a unique intra-patient comparison of bilateral primary ccRCC imaged with 68 Ga-PSMA-11 PET/CT. Although both tumors resulted 68 Ga-PSMA-11 avid, we found a remarkable discrepancy in uptake intensity between the high grade and the low grade ccRCC. This case confirms previous evidence reporting that SUVmax on 68 Ga-PSMA-11 PET/CT could be used to discriminate aggressive high grade from more indolent low grade ccRCC, due to their different endothelial expression of PSMA...

PURPOSE: To assess the diagnostic efficacy of 99m Tc-sulfur colloid lymphoscintigraphy in chylothorax and chylous ascites, and the utility of single-photon emission computed tomography-computed tomography (SPECT/CT) in localizing the sites of leaks. METHODS: Data from patients who underwent lymphoscintigraphy for clinical suspicion of chylothorax or chylous ascites were retrospectively analyzed. Biochemical fluid analysis was taken as the reference standard. Pleural fluid triglyceride level > 110 mg/dL (with pleural fluid/serum ratio > 1) and a cholesterol level < 200 mg/dL (with pleural fluid/serum ratio < 1) were considered confirmatory for chylothorax...

Fibrous dysplasia (FD) is a fibro-osseous disorder that manifests with distinct or overlapping clinical patterns. FD may be monostotic or polyostotic and commonly associated with syndromes such as McCune-Albright syndrome and Mazabraud syndrome. We report a case of polyostotic FD with bilateral involvement of craniofacial bones in a distinct pattern and propose this characteristic appearance as the 'eye mask sign' on 99m Tc-Methylene Diphosphonate (MDP) skeletal scintigraphy and SPECT/CT. Other unusual skeletal scintigraphic features noted in this case are also described (Figs...

PURPOSE: Deep learning (DL) has been widely used in various medical imaging analyses. Because of the difficulty in processing volume data, it is difficult to train a DL model as an end-to-end approach using PET volume as an input for various purposes including diagnostic classification. We suggest an approach employing two maximum intensity projection (MIP) images generated by whole-body FDG PET volume to employ pre-trained models based on 2-D images. METHODS: As a retrospective, proof-of-concept study, 562 [18 F]FDG PET/CT images and clinicopathological factors of lung cancer patients were collected...

[This corrects the article DOI: 10.1007/s13139-020-00636-9.].

No abstract text is available yet for this article.

A 47-year-old woman with history of hepatocellular carcinoma was referred for 18 F-fluorocholine PET/CT evaluation due to elevated alpha-fetoprotein. The examination showed several peritoneal uptakes and two nodular pelvic foci. Coelioscopic exploration allowed confirmation and resection of multiple peritoneal metastases from hepatocellular carcinoma while pelvic biopsies revealed endometriosis and endosalpingiosis. However, alpha-fetoprotein kept rising: subsequent 18 F-fluorodesoxyglucose PET/CT exploration found no pelvic uptake, while 18 F-fluorocholine PET/CT revealed intense tracer accumulation in the two pelvic masses corresponding to bilateral ovarian metastases of hepatocellular carcinoma...

Prostate-specific membrane antigen (PSMA) PET/CT is being increasingly utilized as a hybrid imaging modality for the evaluation of prostate cancer (PCa). We report a case of a 50-year-old man with biopsy-proven high-risk PCa in which multiple tracer avid perirenal fascia deposits were identified on 68 Ga-PSMA-11 PET/CT, in addition to multi-focal prostatic primary, extensive nodal, and skeletal metastases. This case highlights that perirenal fascia is an uncommon metastatic site in PCa.

Magnetic resonance imaging (MRI) is the most popular imaging modality for investigating intervertebral disc herniation. However, it has a high chance for identifying incidental findings that are morphologically or structurally abnormal but not responsible for patients' symptoms. Although a previous study suggested that 18 F-fluorodeoxyglucose (18 F-FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) may help identify neuroinflammation in lumbar radiculopathy, there is currently no direct evidence obtained from surgery...

No abstract text is available yet for this article.

Mycosis fungoides is the major form of primary cutaneous T cell lymphoma. Its staging is based on the percentage of body surface involvement and biopsy-proven extra cutaneous nodal or visceral involvement. Literature shows F-18 FDG accumulation in disease-involved nodes and viscera with non-specific uptake due to co-existing inflammation limits its specificity. We report an interesting case of mycosis fungoides with bilateral upper limb edema and share its findings on F-18 FDG PET/CT.