Molecular Imaging and Radionuclide Therapy

The uptake of Tc-99m-uptake of Tc-99m-methylene diphosphonate (MDP) on bone scintigraphy can be seen at sites other than bone in a varying number of benign and malignant conditions. Extraosseous metastatic calcifications can occur in ovarian papillary serous adenocarcinoma (PSAC). These extraosseous calcifications show Tc-99m-MDP uptake. We report a case of a female in her sixties who had a previous history of PSAC of the ovary. The patient had undergone neoadjuvant chemotherapy (NACT) followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy...

Intrathyroidal parathyroid adenoma is a rare anomaly with an incidence of 1.4-6%. A cause of failure in the therapeutic management of hyperparathyroidism is the ectopic localization of the adenoma, particularly intrathyroidal. This is the case of a 51-year-old patient with no particular pathological history who presented with neck pain and whose clinical examination revealed a goiter. Parathyroid myocardial perfusion imaging (MIBI) scintigraphy revealed an elective MIBI-fixing focus with an upper left polar projection compatible with a parathyroid origin...

A 68-year-old woman with low back pain for 2 months was admitted. T2-weighted fat-saturated imaging revealed hyperintense lesions in multiple lumbar regions, suggesting the possibility of bone metastases. Multiple osteolytic and mixed osteolytic-osteoblastic lesions with significant 18 F-fluorodeoxyglucose (18 F-FDG) uptake, as well as multiple osteoblastic lesions with mild 18 F-FDG uptake, were observed on subsequent 18 F-FDG positron emission tomography/computed tomography without an identifiable primary lesion...

Bone marrow necrosis (BMN) is usually associated with malignancies and is characterized by multiple geographic signal abnormalities on magnetic resonance imaging (MRI). We report a 28-year-old female with BMN and underlying diffuse large B-cell lymphoma. Diffuse abnormal signal intensities through the vertebral column were demonstrated on her pretreatment MRI, and the diagnosis of BMN was challenging. Positron emission tomography/computed tomography (PET/CT) for lymphoma staging showed multiple decreased or absent 18 F-fluorodeoxyglucose (18 F-FDG) uptake within the vertebrae and pelvis...

68 Ga-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography imaging successfully detects bone metastases in prostate cancer (PCa). However, assuming that all detected PSMA-avid bone lesions are metastases should be avoided. It is essential to evaluate PCa patients with clinical findings and to consider possible differential diagnoses, especially in low-risk patients. Herein, we present the case of a 62-year-old male patient recently diagnosed with low-risk prostate adenocarcinoma with a PSMA-avid bone lesion corresponding to Paget's disease...

Bronchial carcinoids are low-grade neuroendocrine tumors with slow growth rates and the potential to spread to nearby lymph nodes. Here we present a challenging case of bronchial carcinoid visualized alongside an adjacent benign bronchocele. Chest computed tomography (CT) identified the endobronchial mass with unclear morphological and diagnostic insights. A differential diagnosis of several benign and malignant etiologies was made. Subsequently, an endobronchial biopsy confirmed lung carcinoid. For better evaluation, a 68 Ga-labeled 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid-d-Phe1-Tyr3-octreotide (68 Ga-DOTATOC) positron emission tomography/CT scan was performed...

A 73-year-old woman with known diagnosis of chronic hepatitis B infection referred for 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) and magnetic resonance imaging (MRI) after detection of a liver mass with 9 cm diameter in contrast enhanced CT. However, 18 F-FDG PET/CT and MRI revealed diffuse infiltrating hepatocellular carcinoma lesions other than previously defined mass. After 9 months of Sorafenib treatment serum alpha feto protein levels dropped from 60,500 ng/mL to 801 ng/mL...

A man in his 30s awaiting end-of-treatment 18 F-fluorodeoxyglucose positron emission tomography/CT (18 F-FDG PET/CT) for primary mediastinal B-cell lymphoma developed chest pain and pericardial effusion. His interim 18 F-FDG PET/CT showed complete metabolic responses. His blood test revealed elevated levels of inflammatory markers, including C-reactive protein of 204.1 mg/L and erythrocyte sedimentation rate of 106 mm/h. His pericardial biopsy revealed organizing fibrinous pericarditis with hemosiderin pigment deposition and no evidence of malignancy or granuloma...

Prostatic adenocarcinoma is characterized by elevated phosphatidylcholine metabolism. 18 F-choline positron emission tomography/computed tomography (PET/CT) is widely used for patients with biochemical recurrence and a prostate-specific antigen threshold above 2 ng/mL. We report a case of a patient with high-risk prostatic adenocarcinoma undergoing 18 F-choline PET/CT for biochemical recurrence. In addition to hypermetabolic abdominal lymph nodes, an unexpected right testicular hypermetabolism was observed...

Paragangliomas (PGLs) are neuroendocrine tumors originating from the neural crest. They usually arise from the adrenal medulla and sympathetic or parasympathetic ganglions. Approximately 10% of PGLs are located in the extra-adrenal gland. Renal PGL is a rare condition. In this case report, we present the 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and 68 Ga-DOTATATE PET/CT findings of polycystic kidney-derived PGL.

Renal cell carcinoma (RCC) is a significant cause of mortality worldwide. To date, many atypical metastatic sites have been observed and reported in patients with RCC. However, to the best of our knowledge, there have been no reported cases of thyroid cartilage metastasis in the context of RCC metastasis. Herein, we present the case of a 68-year-old man who developed left arm pain that led to an RCC diagnosis. First, evaluation by pan-computed tomography (CT) denoted right kidney RCC and identified left humeral metastasis...

OBJECTIVES: The aim of our study was to evaluate the cooccurrence of capsular liver lesions along with peritoneal carcinomatosis and hematogenous metastases in other regions of the body in ovarian cancer patients on follow-up F-18 fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) studies. METHODS: Consecutive 18 F-FDG PET/CT studies of 54 women with ovarian cancer between August 2012 and January 2020 and a total of 192 scans were analysed retrospectively...

OBJECTIVES: The aim of this study was to evaluate the prognostic value of 18 F-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) in the uterine cervix cancer patients. METHODS: Thirty-two women (mean age: 52.7±12.6) who underwent 18 F-FDG PET/CT for staging of uterine cervix cancer were retrospectively recruited for the study. Maximum standardized uptake value (SUVmax ), SUVmean , metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumors, lymph nodes, and distant metastases were calculated from 18 F-FDG PET/CT images using the 40% threshold...

OBJECTIVES: This study aimed to investigate the ability of radiomics features extracted from magnetic resonance imaging (MRI) images to differentiate between responders and non-responders for hepatocellular carcinoma (HCC) cases who received Y-90 transarterial radioembolization treatment. METHODS: Thirty-six cases of HCC who underwent MRI scans after Y-90 radioembolization were included in this study. Tumors were segmented from MRI T2 images, and then 87 radiomic features were extracted through the LIFEx package software...

OBJECTIVES: The purpose of this study was to investigate whether 18 F-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) parameters have a role in differentiating invasive mucinous lung adenocarcinoma (IMA) from lepidic predominant lung adenocarcinoma (LPA). Additionally, we compared the 18 F-FDG-PET/CT features between survivors and non-survivors. METHODS: Tumors were divided into 2 groups according to CT appearance: Group 1: nodular-type tumor; group 2: mass- or pneumonic-type tumor...

OBJECTIVES: Attenuation correction is a critical phenomenon in quantitative positron emission tomography (PET) imaging with its own special challenges. However, computed tomography (CT) modality which is used for attenuation correction and anatomical localization increases patient radiation dose. This study was aimed to develop a deep learning model for attenuation correction of whole-body 68 Ga-DOTATATE PET images. METHODS: Non-attenuation-corrected and computed tomography-based attenuation-corrected (CTAC) whole-body 68 Ga-DOTATATE PET images of 118 patients from two different imaging centers were used...

Neuroendocrine tumors (NETs) of the breast represent 1% of breast carcinomas. Histopathological misinterpretation of breast NET is common. We present the case of a female patient who had a breast mass diagnosed as invasive ductal carcinoma initially by histopathological examination. Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) revealed 2 ametabolic hypodense liver lesions. Subsequently, the patient underwent fibroblast activation protein inhibitor (FAPI)-PET/CT, which did not reveal any FAP expression in the liver lesions, but increased FAP expression was observed in the soft tissue mass of the mesenteric root...

A 71-year-old female patient with a known history of signet-ring cell carcinoma presented with diffuse bone pain and anemic symptoms. An 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography study revealed diffuse heterogeneous hypermetabolic sclerotic lesions in the axial and proximal appendicular skeleton. No other 18 F-FDG-avid lesions were detected. Subsequent bone marrow biopsy confirmed the diagnosis of metastatic carcinoma originating from the gastric primary site. Palliative treatment was initiated; however, the patient's condition deteriorated, and she succumbed to the disease two months later...

Spindle cell sarcoma is a malignant tumor with low incidence. They can occur in the soft tissue, bone, or viscera. The characteristics of morphology, density, and metabolism of spindle cell sarcoma are related to the location of the lesion. A 61-year-old woman presented with vomiting after eating for 2 weeks. Signs of peritoneal irritation were involved, but no response for symptomatic treatment included antiemetic and antispasmodic therapy. Abdominal computed tomography (CT) indicated a mass in the intestinal tract in the pelvic cavity...

Epithelial-myoepithelial carcinoma (EMC) is a rare low-grade salivary gland neoplasm. Distant metastasis is rare, and 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) has been used to determine the metastatic disease in EMC. 68 Ga-fibroblast activation protein inhibitors (FAPI) PET/CT is a promising imaging modality for diagnostic and theognostic purposes in various malignancies. Comparison studies with 18 F-FDG have investigated the role of 68 Ga-FAPI PET/CT. Herein, we present 18 F-FDG and 68 Ga-FAPI-04 PET/CT findings of a 51-year-old woman with metastatic EMC arising from ex-pleomorphic adenoma of the parotid...