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Clinical Nuclear Medicine

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https://www.readbyqxmd.com/read/29659400/peliosis-hepatis-simulating-metastatic-liver-disease-on-fdg-pet-ct
#1
Daniel Levin, Nir Hod, Reut Anconina, Dina Ezroh Kazap, Ruthy Shaco-Levy, Sophie Lantsberg
A 20-year-old man with gastrointestinal symptoms and weight loss underwent FDG PET/CT, which revealed multiple hypermetabolic hepatic lesions concerning for metastatic liver disease. The outcome of liver biopsy was consistent with the diagnosis of peliosis hepatis which is a rare benign disease characterized by multiple blood-filled cystic spaces in the hepatic parenchyma. The findings of peliosis on FDG PET/CT are not well reported in the literature. These interesting images emphasize the importance of including peliosis hepatis in the differential diagnosis of multiple hypermetabolic hepatic lesions on FDG PET/CT, which could simulate malignancy...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659399/top-down-systematic-approach-to-interpretation-of-fdg-pet-for-dementia
#2
David M Sawyer, Phillip H Kuo
Dementia is an important cause of morbidity and mortality worldwide and encompasses a very heterogenous group of disease processes. Positron emission tomography (PET) of the brain using fluorodeoxyglucose (FDG) is a useful modality for differentiating types of dementia. Because FDG does not bind to pathologic proteins, FDG-PET requires that the reader recognize characteristic patterns of glucose hypometabolism to identify pathology. These patterns have been documented in the literature for both primary neurodegenerative disorders and secondary causes of dementia...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659398/mixed-epithelial-and-stromal-tumor-of-the-kidney-mimicking-malignancy-on-18f-fdg-pet-ct-in-a-patient-with-breast-cancer
#3
Chongjiao Li, Yueli Tian, Meijuan Shen, Bing Wen, Yong He
Mixed epithelial and stromal tumor of the kidney (MESTK) is a rare renal tumor composed of solid and cystic components. Mixed epithelial and stromal tumor of the kidney has no pathognomonic imaging feature. It is difficult to distinguish MESTK from other cystic renal neoplasms using current radiological methods. We report a rare case of MESTK that was diagnosed in a 46-year-old woman with breast cancer. F-FDG PET/CT and contrast-enhanced CT features of MESTK are presented, which could potentially provide useful information in the differential diagnoses of cystic renal neoplasms...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659397/scintigraphic-and-sonographic-findings-of-subcapsular-cortical-necrosis-in-a-transplanted-kidney
#4
Bulent Yazici, Emrah Gunay, Aysegül Akgün, Sait Sen, Suha Sureyya Ozbek
Renal transplant scintigraphy, performed in a 23-year-old man who had renal graft from a living donor, showed nearly normal perfusion and moderately low function of the graft. But the margins of the graft were blurred, and it was interestingly appearing enlarged late in the study. Ultrasound demonstrated a hypoechoic rim surrounding the whole kidney. Biopsy revealed necrosis besides normal cortical tissue. Necrosis was thought to be limited to the subcapsular cortical area. It should be considered that these scintigraphic findings could be due to greatly reduced and delayed perfusion of edematous subcapsular necrotic area of the graft even in normal perfusion images...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659396/sequential-sentinel-node-scintigraphy-with-planar-and-spect-ct-images-revealed-contralateral-drainage-from-ipsilateral-breast-tumor-relapse-in-a-patient-with-bilateral-breast-cancer
#5
Mitsuru Koizumi, Masamichi Koyama, Hidetomo Morizono, Yumi Miyagi
Radio-guided sentinel node (SN) biopsy is routinely performed in patients with early breast cancer. However, repeated SN scintigraphy in ipsilateral breast tumor relapse (IBTR) often shows extra-axillary drainage, including contralateral axilla. A patient diagnosed with bilateral breast cancer, of which one was IBTR, was studied by sequential radio-guided SN mapping, radiocolloid injection to an IBTR breast and scanning, and then radiocolloid injection to the other breast and scanning. This revealed the lymphatic flow from the IBTR breast to the contralateral axilla...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659395/loss-of-psma-expression-in-non-neuroendocrine-dedifferentiated-acinar-prostate-cancer
#6
Peter Bronsert, Kathrin Reichel, Juri Ruf
The introduction of tracers targeting the prostate-specific membrane antigen (PSMA) has revolutionized PET imaging of acinar prostate adenocarcinoma. In general, an increasing PSMA expression is assumed with increasing dedifferentiation. Whereas loss of PSMA expression has been reported in case of neuroendocrine dedifferentiation, we present a patient with acinar prostate adenocarcinoma with a loss of PSMA expression after chemotherapy on PET/CT and in histological and immunohistochemical analyses. All tissue samples indicated the retention of acinar features but no expression of neuroendocrine markers (NSE, synaptophysin, chromogranin, and CD56), corresponding to nonelevated serum NSE...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659394/a-bizarre-bone-scan-of-fibrodysplasia-ossificans-progressiva
#7
Tzyy-Ling Chuang, Kuo-Wei Ho, Yuh-Feng Wang
A 27-year-old woman had progressive bony ankylosis over both hands since she was 5 years old. Bony ankylosing over the peripheral joints and spine slowly progressed, and scoliosis surgery was performed at age 14. Recently, she developed difficulty walking, changing position, and opening her mouth. A neurologist was consulted and ruled out the suspicion of narcolepsy. Chest CT showed ankylosing spondylitis. A bone scan showed a bizarre pattern with radiouptake to the left maxilla, bilateral sacroiliac joints, left middle third femur, and soft tissue uptake over bilateral arms, legs, and pelvis...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659393/unexpected-vesicoureteral-reflux-into-a-nonfunctioning-transplant-kidney-on-renal-scintigraphy
#8
Adam Cruz, Daniel J Wale, Ka Kit Wong, Brett M Arnkoff, Benjamin L Viglianti
Vesicoureteral reflux after renal transplantation is associated with increase risk of urinary tract infections, renal scarring, and graft failure. We describe a case of a 46-year-old woman with 2 transplant kidneys, one functioning and another nonfunctioning, presenting with pelvic pain after a bilateral periureteral bulking procedure. Diuretic renography was performed to exclude iatrogenic ureteral obstruction. This showed a normally functioning transplant kidney without obstruction and subsequent vesicoureteral reflux into the collecting system of the nonfunctioning transplant kidney...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659392/pedunculated-hepatocellular-carcinoma-mimicking-right-adrenal-tumor-on-fdg-pet-ct
#9
Aisheng Dong, Xinping Zhong, Yang Wang
Pedunculated hepatocellular carcinoma is an unusual form of hepatocellular carcinoma protruding from the liver with or without a pedicle. We present a case of pedunculated hepatocellular carcinoma misdiagnosed as right adrenal tumor on MRI and FDG PET/CT. Intraoperative exploration revealed the mass was attached to the liver, but the right adrenal gland was intact. Laparoscopic biopsy revealed poorly differentiated hepatocellular carcinoma. This case indicates it may be difficult to diagnose pedunculated hepatocellular carcinoma because it is hard to define its origin on imaging...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659391/pediatric-patient-with-cerebral-metastasis-from-papillary-thyroid-cancer
#10
Katrina Korhonen, Hongming Zhuang
Brain metastasis from papillary thyroid carcinoma is uncommon. Concurrent cerebral and pulmonary metastases from papillary thyroid carcinoma is rare, especially in pediatric patients. We report a case of a brain metastasis revealed on post-therapy I scan in a 12 year old girl with thyroid cancer who also had diffuse pulmonary metastases which were partially responsive to sequential I therapy.
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659390/combined-18f-fluoroethylcholine-pet-ct-and-99mtc-macroaggregated-albumin-spect-ct-predict-survival-in-patients-with-intermediate-stage-hepatocellular-carcinoma
#11
Markus Hartenbach, Stefan Weber, Magdalena Pilz, Sabrina Hartenbach, Mathias J Zacherl, Philipp M Paprottka, Reinhold Tiling, Peter Bartenstein, Marcus Hacker, Alexander R Haug, Nathalie L Albert
AIM: The aim of this study was to retrospectively analyze the prognostic value of combined Tc-macroaggregated albumin (MAA) SPECT/CT and [F]-fluoroethylcholine (FEC) PET/CT before radioembolization for survival of patients with intermediate-stage hepatocellular carcinoma. METHODS: Twenty-four patients with known hepatocellular carcinoma Barcelona Clinic Liver Cancer stage B were eligible for this analysis. All patients were scheduled for radioembolization and received a pretherapeutic [F]FEC PET/CT scan as well as Tc-MAA SPECT/CT for hepatopulmonary shunting...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659389/fdg-pet-ct-focal-uptake-on-an-ocular-prosthesis
#12
Alessandra Repetto, Carolina Igua, Pablo Sopena, Pilar Bello
We present a case of an unexpected focally increased radiotracer uptake in an artificial eye in an FDG-PET/CT scan that was performed on a woman with a history of choroidal melanoma. It is crucial to know the type of prosthesis used and the timing of replacement for a correct interpretation of the findings. Recently, an FDG PET/CT was proposed to monitor the vascularity of the prosthesis instead of gadolinium MRI or of Tc bone scintigraphy.
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659388/imaging-of-metastatic-epithelioid-trophoblastic-tumor-with-18f-fdg-pet-ct
#13
Tirth Patel, Jorge Oldan
Epithelioid trophoblastic tumors are exceptionally rare malignant forms of gestational trophoblastic neoplasia arising from the placenta. We present here a case of a 33-year-old woman with an epithelioid trophoblastic tumor with metastatic disease to the lungs that was initially thought to represent cervical carcinoma. After appropriate diagnosis and treatment, the tumor responded to therapy and was in remission. The cancer recurred 5 years later with new lung metastases. F-FDG PET/CT was used for initial tumor staging, to evaluate treatment response, and to help detect the recurrence...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659387/bilateral-adrenal-hyperplasia-due-to-adrenocorticotropic-hormone-secreting-esthesioneuroblastoma-on-fdg-pet-and-111in-pentetreotide-scintigraphy
#14
Yohji Matsusaka, Tadaki Nakahara, Isao Kurihara, Yu Iwabuchi, Masahiro Jinzaki
A 53-year-old woman with metastatic esthesioneuroblastoma was referred for FDG PET/CT imaging. FDG PET/CT showed symmetrical uptake in bilaterally enlarged adrenal glands, in addition to abnormal uptake in bone and lymph node metastases. In-pentetreotide scintigraphy was further performed and revealed the lack of adrenal uptake. The patient's serum adrenocorticotropic hormone (ACTH) level was extremely high, suggesting that hyperplastic condition in the adrenal glands due to ACTH stimulation from the metastatic esthesioneuroblastoma was responsible for increased FDG uptake...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659386/added-value-of-spect-ct-in-the-evaluation-of-sacral-fracture-in-patients-with-lung-cancer
#15
Zhen Zhao, Ke Zhou, Bin Liu
We describe the sacral fractures from 2 lung cancer patients that were confirmed by SPECT/CT. The utilization of SPECT/CT in lung cancer patients can help characterizing the nature of sacral lesions on planar bone scintigraphy.
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659385/lateral-recumbent-or-prone-positioning-for-pet-of-the-urinary-bladder
#16
Marc R J Ten Broek, Peter J Ausems, Erik T Te Beek
Evaluation of the urinary bladder on PET with F-FDG is hampered by accumulation of activity in the urinary bladder due to physiological excretion of F-FDG in urine. We present 2 examples that demonstrate the utility of delayed scanning in lateral recumbent or prone position to improve evaluation of the bladder by differentiating between active bladder wall lesions and intraluminal activity. Changing the body position from a supine to a lateral recumbent or prone position can result in migration of intraluminal activity due to gravitational force, whereas F-FDG uptake in bladder wall lesions will show no migration...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659384/tumor-induced-osteomalacia-caused-by-a-parotid-basal-cell-adenoma-detected-by-68ga-dotanoc-pet-ct
#17
Qiao He, Zeqing Xu, Bing Zhang, Wanming Hu, Xiangsong Zhang
Tumor-induced osteomalacia is a rare paraneoplastic syndrome, usually caused by small benign mesenchymal tumors. The tumors most arise within the extremities, whereas occurrence within the parotid gland is quite rare. A 54-year-old woman who presented with bone pain and muscle weakness for 2 years was clinically suspected of having tumor-induced osteomalacia. A Ga-DOTANOC PET/CT was performed for localization of the causative tumor. The images demonstrated intense radiotracer accumulation in a soft tissue nodule in deep lobe of the right parotid gland...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29659383/prostate-specific-membrane-antigen-negative-metastases-a-potential-pitfall-in-prostate-specific-membrane-antigen-pet
#18
Benjamin Noto, Katharina Auf der Springe, Sebastian Huss, Thomas Allkemper, Lars Stegger
Ga-PSMA-11 PET/CT was performed in a 74-year-old man because of biochemical recurrence of prostate cancer following radiation therapy of the prostate gland 24 months earlier. Besides focal nuclide accumulation in the prostate gland suggestive of local recurrence, PET scan revealed no further pathologic uptake. However, CT showed multiple pulmonic nodules suggestive of metastases. Thoracotomy and pathologic examination revealed the nodules to be prostate cancer metastasis. Furthermore, immunohistochemical staining with PSMA antibodies demonstrated a virtual lack of PSMA expression...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29629914/123i-fp-cit-spect-and-mri-findings-in-a-patient-with-parkinsonism-after-fenpyroximate-intoxication
#19
Kyeong Joon Kim, Jong-Min Kim, Yun Jung Bae, Yoo Sung Song, Sang Eun Kim
Fenpyroximate is a widely used acaricide. Its main action is to inhibit the mitochondrial respiratory chain. Chronic exposure to fenpyroximate is associated with dopaminergic cell loss and parkinsonism; however, to date, there has not been a reported case of parkinsonism as a result of acute fenpyroximate intoxication. Here, we report a 58-year-old man who developed parkinsonism after deliberate fenpyroximate intoxication, but with normal presynaptic I-Ioflupane SPECT image.
April 6, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29629913/automated-reporting-of-dxa-studies-using-a-custom-built-computer-program
#20
Joseph R England, Patrick M Colletti
Dual-energy x-ray absorptiometry (DXA) scans are a critical population health tool and relatively simple to interpret but can be time consuming to report, often requiring manual transfer of bone mineral density and associated statistics into commercially available dictation systems. We describe here a custom-built computer program for automated reporting of DXA scans using Pydicom, an open-source package built in the Python computer language, and regular expressions to mine DICOM tags for patient information and bone mineral density statistics...
April 6, 2018: Clinical Nuclear Medicine
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