Molecular Imaging and Radionuclide Therapy

Systemic juvenile idiopathic arthritis (sJIA) is an important autoinflammatory disease whose first symptom is usually fever, and life-threatening conditions such as macrophage activation syndrome can develop when diagnosis and treatment is delayed. sJIA is an exclusion diagnosis, and there is no specific test that distinguishes it from other febrile diseases. We report the positron emission tomography/computed tomography (PET/CT) findings of sJIA in a 12-year-old girl who presented with fever, rash, and arthralgia...

Internal herniation may be seen more frequently in patients with intra-abdominal surgery and malignancy history. We presented a 58-year-old male patient diagnosed with rectal adenocarcinoma seven years ago with a history of surgery and pelvic radiotherapy. When the abdominal computed tomography (CT) image was taken during routine oncology follow-up, a lesion mimicking a serosal implant on the anterior abdominal wall was detected. 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT imaging was performed the suspicion of recurrence...

A 40-year-old woman with a palpable mass lesion in her right breast suggested as breast cancer was admitted to 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) unit for the metabolic characterization of the lesion and for the staging of the disease. The patient had no fever and no evidence of weight loss or night sweats. 18 F-FDG PET/CT revealed an isolated solid mass lesion with increased 18 F-FDG uptake in the upper outer quadrant of the right breast and increased 18 F-FDG uptake in the lymph nodes of the right axilla suspected as primary breast cancer and its local lymph node metastasis...

Pulmonary intimal sarcoma (PAS) is a highly aggressive malignant mesenchymal tumor affecting the central pulmonary arteries. Similar clinical presentation and indeterminate laboratory parameters often result in misdiagnosis of this condition as pulmonary thromboembolism, which is a relatively common disease. Certain imaging features can however allow differentiation between these two diagnoses. We present one such case of PAS that was initially treated as pulmonary embolism; and briefly review the relevant imaging characteristics to avoid overlooking PAS especially in patients with an atypical clinical history for thromboembolism...

Subcutaneous panniculitis such as T-cell lymphoma (SPTCL) is a very rare disorder. Patients usually present with multiple subcutaneous nodules on the extremities without visceral disease. Dissemination to extra-cutaneous sites is unusual. Only a few cases of SPTCL have been reported in the literature describing the findings of 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Here, we represent an interesting and unusual case of diffuse SPTCL with snow Leopard skin appearance on 18 F-FDG PET/computed tomography...

Sixty two years old man referred to our clinic due to suspicion of thymic mass. The hypermetabolic nodular lesion in the right lung upper lobe was seen in 18 F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) in addition to the mass in the anterior mediastinum which was found to without malignancy. The patient underwent wedge resection and final diagnosis was pulmonary giant cell carcinoma. In follow-up 18 F-FDG PET/CT multiple lesions with pathological activity were observed in the cerebrum, right postauricular region, bilateral adrenal, stomach, pancreas, pelvic soft tissue, mesenteric, left femur and bilateral lung parenchyma 6 months after...

A 59-year-old man, previously submitted to anterior resection due to rectal cancer, underwent a contrast-enhanced computed tomography (ce-CT) for restaging before eventual chemotherapy. Because ce-CT showed a moderate enlargement of the descending colonic lumen, in despite the lack of symptoms, positron emission tomography (PET)/CT 18 F-fluorodeoxyglucose (FDG) was carried out. 18 F-FDG PET/CT demonstrated highly increased tracer incorporation along the colon walls. Two days after the PET/CT examination, complaints of diarrhea and abdominal pain began...

Lymphomatoid granulomatosis is a rare extranodal Epstein-Barr virus-driven B-cell lymphoproliferative disease, involving predominantly lung, less often skin, kidney, and central nervous system. Here, we present a pediatric case with primary immunodeficiency, diagnosed with pathologically proven pulmonary grade-III lymphomatoid granulomatosis. 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging demonstrated 18 F-FDG avid pulmonary masses with central air-bronchograms and cavitations...

The authors present Tc-99m methylene diphosphonate (MDP) uptake in the right parietotemporal area at whole-body bone scan (WBBS) in 75 years male patient with prostate adenocarcinoma Gleason score 3+4 (pT2N0Mx). No residual or metastatic disease was detected in the patient's Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography four months before WBBS. The patient had undetectable prostate-specific antigen levels and underwent WBBS to restage prostate cancer due to equivocal findings in previous WBBS...

A 70-year-old man with a tumor in the nasal and paranasal space, was pathologically diagnosed with an alveolar rhabdomyosarcoma, with right cervical lymph node metastasis. Magnetic resonance imaging revealed a primary tumor in the nasal and paranasal sinuses, with associated intracranial infiltration. 11 C-methionine positron emission tomography/computed tomography (PET/CT) revealed increased uptake in the primary tumor and right cervical lymph node metastasis. 18 F-fluorodeoxyglucose PET/CT also revealed increased uptake in the primary tumor and right cervical lymph node...

A 50-year-old man undergone total thyroidectomy and histopathology revealed papillary thyroid carcinoma with a tumor size of 4.5 cm. The patient was referred to a nuclear medicine clinic for radioiodine therapy. Since the thyroglobulin level before the treatment was 495 ug/L, low-dose (185 MBq) I-131 scan was performed. In addition to multiple liver metastases, bone metastases were detected in the sacrum and right 7th rib in I-131 whole body scanning and single photon emission computed tomography/computed tomography (CT) imaging at the time of initial staging...

A 66-year old man known case of metastatic castration resistant prostate cancer underwent successful 6 cycles treatment with 177Lu- prostate-specific membrane antigen. On the last post therapy whole body scan a new lesion in the skull was noted, suspected for disease progression. One week later, the patient complained from weakness of left upper extremity and brain magnetic resonance imaging revealed a brain tumor, confirmed as glioblastoma pathologically.

OBJECTIVES: Attenuation correction (AC) using transmission scanning-like computed tomography (CT) is the standard method to increase the accuracy of cardiac single-photon emission computed tomography (SPECT) images. Recently developed dedicated cardiac SPECT do not support CT, and thus, scans on these systems are vulnerable to attenuation artifacts. This study presented a new method for generating an attenuation map directly from emission data by segmentation of precisely non-rigid registration extended cardiac-torso (XCAT)-digital phantom with cardiac SPECT images...

OBJECTIVES: 18 F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) is a useful staging method in pancreatic cancer. The prognosis of pancreatic adenocarcinoma is affected by the tumor stage and resectable state. Maximum standardized uptake value (SUVmax ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of primary tumors are related to prognostic parameters in pancreatic cancer. This study compared 18 F-FDG PET/CT findings with prognostic factors and overall survival of patients with pancreatic cancer...

OBJECTIVES: The aim of this study is to evaluation of Tc-99m-hexamethylpropyleneamineoxime (HMPAO)-labeled leukocytes in terms of radiochemical, biochemical, and microbiological quality controls and to examine the effect of leukocyte numbers of the blood obtained from patients and the medications currently used by the patients on the radiochemical yields of Tc-99m-HMPAO-labeled leukocytes, and imaging quality was evaluated. METHODS: Thirty paients were included in our study who applied to Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Nuclear Medicine for Tc-99m-HMPAO-labeled leukocyte scintigraphy...

OBJECTIVES: Oligometastases may generate secondary to indolent tumor biology. In this study, we investigated whether semiquantitative measures of 18 F-fluorodeoxyglucose (FDG) and gallium-68 (68 Ga) prostate-specific membrane antigen (PSMA) uptake of metastatic lesions and prostatic sites are different between oligometastatic (OM) and multimetastatic (MM) disease of prostate carcinoma (PC). METHODS: Patients with PC, who underwent positron emission tomography/computed tomography (PET/CT) from October 2012 to February 2020 were retrospectively reviewed...

OBJECTIVES: To compare vaccinated-side axillary lymph node uptake on 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) after coronavirus disease-2019 (COVID-19) and influenza vaccination. METHODS: We retrospectively analyzed 177 patients who underwent 18 F-FDG PET/CT after COVID-19 or influenza vaccination. We compared the uptake of the vaccinated-side axillary lymph nodes of 109 COVID-19 vaccinated patients with those of a lot of influenza-vaccinated patients...

OBJECTIVES: Regular follow-up of patients with lung cancer treated surgically is crucial to detect local recurrence or distant metastasis of the tumor. Postoperative follow-ups are performed with thorax computed tomography (CT) and, if necessary, positron emission tomography (PET)/CT. Sometimes, inflammatory tissue reactions due to the materials used during the surgery for hemostasis may cause the appearance of tumor recurrence in imaging modalities. In this study, we presented that oxidized regenerated cellulose (ORC) used intraoperatively may cause false tumor recurrence on PET/CT...

OBJECTIVES: To evaluate the diagnostic performance of 18 F-dihydroxyphenylalanine (FDOPA) positron emission tomography/computed tomography (PET/CT) in the detection of medullary thyroid carcinoma (MTC) recurrence in patients with elevated calcitonin levels. METHODS: The patients who had undergone 18 F-FDOPA PET/CT imaging for elevated calcitonin levels after primary surgery of MTC were included in the study. addition, if available 18 F-fluorodeoxyglucose (FDG) PET/CT and Gallium-68 (68 Ga)- DOTATATE PET/CT images of the patients were evaluated retrospectively...

A 56-year-old female patient who had involuntary weight loss underwent 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for detection of malignancy. The scan revealed non-metabolic soft tissue density in the posterior wall of the stomach requiring endoscopy. Endoscopical examination was performed 9 days after PET/CT and cascade stomach was detected. Cascade stomach is a rare entity that can be diagnosed by radiographic barium evaluations and endoscopy, the appearance on CT is largely incidental and CT has rarely been relied on for the diagnosis...