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Clinical Nuclear Medicine

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https://www.readbyqxmd.com/read/29232247/salivary-gland-activity-obscures-mandibular-metastasis-of-prostate-carcinoma-on-68ga-prostate-specific-membrane-antigen-pet
#1
Thabo Lengana, Ismaheel Lawal, Tebatso Boshomane, Kehinde Ololade, Florette Reyneke, Chimbabantiu Kaoma, Neo Mokgoro, Mariza Vorster, Mike Sathekge
We report a case of a 65-year-old man with prostate cancer; his treatment history included radical prostatectomy followed by radiation therapy and subsequent androgen deprivation therapy for more than 5 years. He currently presented with a history of rising prostate-specific antigen and complained of jaw aches. Ga-prostate-specific membrane antigen PET/CT study performed for suspected biochemical recurrence demonstrated vertebral lesions and lesion in his jaw. Subsequent biopsy of jaw lesion demonstrated prostate cancer metastases...
December 11, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29232246/the-role-of-fdg-pet-in-diabetic-myonecrosis-a-rare-and-underrecognized-complication-of-diabetes
#2
Guillaume Chaussé, Gad Abikhzer
A 66-year-old man with poorly controlled type 2 diabetes was admitted for acute bilateral calf pain in the context of coronary artery disease, chronic renal failure, and peripheral neuropathy. Lower-extremity Doppler ultrasound excluded deep vein thrombosis. FDG-PET was performed to exclude a suspected infection because of elevated white blood cells and inflammatory markers but normal creatinine kinase levels. PET scan demonstrated intense bilateral calf muscle and left thigh muscle uptake, which in combination with the patient's history was consistent with diabetic myonecrosis, a rare end-stage complication of diabetes...
December 11, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29232245/intense-68ga-psma-uptake-in-diverticulum-of-the-sigmoid-colon
#3
Mads Ryø Jochumsen, Kirsten Bouchelouche
We present a case of a diverticulum of the sigmoid colon with intense prostate-specific membrane antigen (PSMA) activity on Ga-PSMA PET/CT. CT scan and colonoscopy showed no signs of inflammation or malignancy. This case presents an addition to the collection of benign pitfalls when reporting PSMA PET/CT; however, a Ga-PSMA up-taking focus in the colon should always cause further examination, as malignant etiology must be ruled out.
December 11, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29232244/-occipital-tunnel-sign-on-fdg-pet-for-differentiating-dementias
#4
David M Sawyer, Phillip H Kuo
PET using FDG is a critical tool for evaluation of dementias, with characteristic patterns of hypometabolism suggesting specific diagnoses. Hypometabolism in the occipital region is recognized as an important finding associated with dementia with Lewy bodies and posterior cortical atrophy. We describe here the novel "occipital tunnel" sign, which results from relative sparing of FDG uptake in the medial occipital (primary visual) cortex compared with more severe loss in the surrounding lateral occipital (visual association) cortex...
December 11, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29232243/artifactual-hepatic-metastasis-on-fdg-pet-ct-secondary-to-cryoablation-for-adrenal-metastasis
#5
Joseph Frankl, Naghmehossadat Eshghi, Tamara F Lundeen, Phillip H Kuo
A 65-year-old woman with metastatic lung cancer was referred for CT-guided cryoablation of a right adrenal metastasis. For cryoablation, probes were placed into the adrenal region. FDG PET/CT 3 months later showed new activity in hepatic segment 6 initially suspected to be metastasis. Proximity of the hepatic lesion to the adrenal metastasis was a strange coincidence and prompted review of imaging from the cryoablation. CT showed the probe entered the liver, and postablation image demonstrated injury to the liver adjacent to the adrenal metastasis...
December 11, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29232242/prediction-of-posthepatectomy-liver-failure-proposed-by-the-international-study-group-of-liver-surgery-residual-liver-function-estimation-with-99mtc-galactosyl-human-serum-albumin-scintigraphy
#6
Yoichi Mizutani, Toshinori Hirai, Shigeki Nagamachi, Atsushi Nanashima, Koichi Yano, Kazuhiro Kondo, Masahide Hiyoshi, Naoya Imamura, Tamasa Terada
PURPOSE: The International Study Group of Liver Surgery (ISGLS) proposed a definition and grading system for posthepatectomy liver failure (PHLF). We evaluated the usefulness of residual liver function estimation using Tc-galactosyl human serum albumin (Tc-GSA) for the prediction of PHLF. METHODS: Patients with liver tumors (n = 136) and scheduled for hepatectomy underwent Tc-GSA scintigraphy. Based on their imaging data, the maximal GSA removal rate (GSA-Rmax)was calculated using multicompartment analysis...
December 11, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215416/cardiac-fibroma-an-uncommon-cause-of-a-fixed-defect-on-myocardial-perfusion-imaging
#7
Sarah Pittman, Pooja Sethi, Robert R Flavell, Miguel Hernandez Pampaloni
A 66-year-old woman was referred for evaluation of coronary artery disease. Myocardial perfusion imaging (MPI) was performed, and showed a medium-sized, severe fixed perfusion defect in the inferior and inferolateral wall from apex to midcavity. On review of prior imaging, it was noted that the patient had an incidental finding of an intramural cardiac mass on chest CT performed 8 years prior. Subsequent cardiac MRI showed findings consistent with a cardiac fibroma in the left ventricle, at the location of the perfusion defect on MPI...
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215415/epstein-barr-virus-associated-hemophagocytic-lymphohistiocytosis-mimicking-lymphoma-on-fdg-pet-ct
#8
Qingqing Pan, Yaping Luo, Huanwen Wu, Yanru Ma, Fang Li
A 15-year-old boy with fever, pancytopenia, and hepatosplenomegaly was diagnosed as hemophagocytic lymphohistiocytosis (HLH). F-FDG PET/CT showed hypermetabolic foci in the liver, spleen, and bone marrow, as well as multiple FDG-avid lymph nodes, which were highly suggestive of lymphoma. Specimens from splenectomy depicted a large number of macrophages/histiocytes with hemophagocytosis of erythrocytes, without evidence of malignancy. Considering increased Epstein-Barr virus (EBV) DNA in peripheral blood and positive staining for EBV-encoded RNA in the spleen, EBV-associated HLH was confirmed...
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215414/unexpected-detection-of-urethral-stone-on-18f-naf-pet-ct
#9
Fuqiang Shao, Li Chen, Yu Wang, Shumao Zhang, Yue Chen
A 48-year-old man was referred for an F-NaF PET/CT to examine his lower back pain. The images did not identify any osseous lesion. Unexpectedly, the images showed elevated activity in a urethral stone. The patient received urinary surgery for stone removal.
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215413/fdg-pet-ct-guided-biopsy-in-angiosarcoma-of-bone-diagnosis-staging-and-beyond
#10
Antonella Matti, Andrea Farolfi, Tommaso Frisoni, Stefano Fanti, Cristina Nanni
Primary angiosarcoma of the bone (PAB) is a particularly rare and aggressive form of malignancy in the spectrum of vascular tumours, and it accounts for less than 1% of sarcomas. This case of PAB, diagnosed thanks to FDG-PET/CT guided biopsy, is a paradigm of how powerful are clinical informations that can be derived by a F-FDG PET/CT, in view of negative or inconclusive imaging of conventional radiology, starting from the metabolic characterization of an equivocal finding, the possibility to drive the biopsy towards the most active site, the accurate total body staging, the stratification of prognosis and early therapy assessment...
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215412/serial-fdg-pet-ct-imaging-in-the-management-of-cardiac-sarcoidosis
#11
William Bremer, Nadera J Sweiss, Yang Lu
A 60-year-old woman with biopsy-proven cardiac sarcoidosis status post implantable cardioverter defibrillator placement presented with periodic dizziness and dyspnea on exertion. Myocardial perfusion scan demonstrated a moderate sized, fixed perfusion defect along the mid to proximal anteroseptal wall of the left ventricle, with better perfusion on stress images. FDG-PET/CT demonstrated corresponding focal FDG avidity of the mid to proximal anteroseptal wall, suggestive of active cardiac sarcoidosis. Because of severe side effects, mycophenolate mofetil was discontinued, and the patient received low-dose steroid therapy...
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215411/a-novel-technique-to-measure-the-intensity-of-abnormality-on-gi-bleeding-scans-development-initial-implementation-and-correlation-with-conventional-angiography
#12
Rami Farhat, Derek T Kim, T Dustin French, Dov Bechhofer, Anca-Oana Kranz, Jason C Hoffmann
PURPOSE: Develop a technique to quantify intensity of lower gastrointestinal bleeding (LGIB) on Tc-labeled red blood cell (RBC) scintigraphy, correlate with angiography, and determine the tool's predictive value. MATERIALS AND METHODS: An IRB-approved, single institution database query of GI bleeding scans performed between January 2013 and December 2015. Reports from all studies and imaging from all positive studies were reviewed. A technique was developed for scan analysis, allowing for calculation of percent increase of activity in the region of interest (ROI, area of bleeding) and ROI in the aorta and liver (controls)...
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215410/isolated-multinodular-soft-tissue-rosai-dorfman-disease-on-fdg-pet-ct
#13
Darko Pucar, William B Laskin, Lawrence Saperstein
Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) is a rare systemic histiocytic disorder of unknown etiology characterized by the accumulation of enlarged non-Langerhans histiocytes within lymph nodes and extranodal sites. The histiocytes display characteristic emperipolesis (nondestructive engulfment of inflammatory cells) and are CD68 and S100 positive and CD1a negative. Although extranodal disease frequently occurs with nodal involvement, isolated extranodal disease is uncommon. We report a case of isolated localized subcutaneous multinodular disease on FDG PET/CT...
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215409/imaging-of-acquired-demyelinating-syndrome-with-18f-fdg-pet-ct
#14
Caroline Malo-Pion, Raymond Lambert, Jean-Claude Décarie, Sophie Turpin
Acquired demyelinating syndromes include acute disseminated encephalomyelitis, transverse myelitis and may progress to multiple sclerosis (MS). Acute disseminated encephalomyelitis is characterized by impairment of level of consciousness and multifocal neurological deficits and transverse myelitis by back pain, weakness and sphincter dysfunction. Only a few cases of acquired demyelinating syndrome have been imaged with F-FDG PET/CT. We present two such cases.
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215408/18f-fdg-pet-ct-findings-of-mesenchymal-chondrosarcoma-of-the-orbit
#15
Mitsuteru Tsuchiya, Takayuki Masui, Yoshiro Otsuki, Harumi Sakahara
Mesenchymal chondrosarcoma of the orbit is an extremely rare and aggressive tumor. We report image findings of F-fluorodeoxyglucose (FDG) positron emission/computed tomography (PET/CT) in 2 cases, one primary case and one recurrent case. The F-FDG PET/CT images revealed high uptake with an SUVmax of 6.7 and 11.7, respectively. In both cases, the HEY1-CoA2 gene fusion was positive. The high uptake of F-FDG in mesenchymal chondrosarcoma of the orbit well suggests the malignancy of this tumor.
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215407/dilated-internal-thoracic-vertebral-venous-plexus-simulating-bone-metastases-on-fdg-pet-ct
#16
Nir Hod, Reut Anconina, Daniel Levin, Dina Ezroh Kazap, Sophie Lantsberg
A 42-year-old woman with a newly diagnosed malignant thymoma underwent FDG PET/CT, which demonstrated an increased uptake in anterior mediastinal tumor and several pleural masses in the right hemithorax, compatible with "drop metastases." In addition, contrast-enhanced CT images showed hyperdense abnormality in T2 vertebral body, congruent with intensely increased FDG uptake, raising suspicion of skeletal metastasis. This is a rare but important potential pitfall either in CT and FDG PET/CT-a "false-positive" bony lesion not attributed to skeletal metastasis but to dilated internal thoracic vertebral venous plexus associated with collateral circulation due to superior vena cava syndrome...
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215406/focal-18f-dopa-uptake-in-brain-parenchyma-surrounding-developmental-venous-anomalies
#17
Lee Condon, John Blazak
We report the finding of increased F-DOPA uptake within parenchyma surrounding a developmental venous anomaly, found incidentally in a 64-year-old woman undergoing PET scan to assess for Parkinson's disease. Not identified on previous T1/T2 MRI, susceptibility-weighted imaging MRI performed post-PET scan demonstrated the presence of developmental venous anomaly within the left cerebellar hemisphere. Focal uptake of F-DOPA may suggest the presence of a brain tumor and prompt invasive diagnostic investigations...
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215405/123i-fp-cit-spect-accurately-distinguishes-parkinsonian-from-cerebellar-variant-of-multiple-system-atrophy
#18
Nicolas Nicastro, Valentina Garibotto, Pierre R Burkhard
PURPOSE: Dopamine transporter SPECT imaging is a valuable tool to estimate the integrity of presynaptic dopaminergic pathways in degenerative parkinsonisms. Evidence about SPECT differential pattern between parkinsonian and cerebellar forms of multiple system atrophy (MSA-P and MSA-C) is lacking. We aimed at assessing whether MSA-P and MSA-C variants have a distinct semiquantitative I-FP-CIT SPECT pattern. METHODS: We studied a unicentric 13-year (2003-2016) retrospective cohort of subjects with possible or probable MSA and scanned with the same acquisition and reconstruction SPECT protocol...
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215404/quality-and-safety-in-health-care-part-xxxiv-coronary-artery-disease-secondary-prevention-medications
#19
Jay A Harolds
There is an important opportunity for improvement in the care of cardiology outpatients by having greater compliance with published guidelines, and the PINNACLE (Practice Innovation and Clinical Excellence) Registry seeks to do that. One of the major areas studied by this registry is the use of secondary prevention medications for patients with coronary artery disease. Appropriate use of these medications decreases later myocardial infarctions and death from a cardiac cause.
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29215403/suv-as-a-possible-predictor-of-disease-extent-and-therapy-duration-in-complex-tuberculosis
#20
David Lang, Helmut Huber, Bernhard Kaiser, Irene Virgolini, Bernd Lamprecht, Michael Gabriel
OBJECTIVE: F-FDG PET/CT provides information on disease extension and activity in neoplastic and inflammatory conditions. So far, little is known about whether SUVmax of a reference lesion can allow a prognosis to be given regarding patient-specific outcome parameters in complex cases of tuberculosis (TB). METHODS: We retrospectively identified 37 patients (21 men, 16 women; mean age, 50.4 years) who underwent F-FDG PET/CT for the evaluation of active TB before treatment initiation...
December 5, 2017: Clinical Nuclear Medicine
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