Molecular Imaging and Radionuclide Therapy

A 70-year-old man with newly diagnosed rectum adenocarcinoma was referred to 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) for staging, and 68 Ga-fibroblast activation protein inhibitor (FAPI)-04 PET/CT for ongoing trial. Both 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT showed intense uptake in the primary rectal tumor, and also in nodular areas in the right lung. Due to intense 68 Ga-FAPI-04 and 18 F-FDG uptake, the lung lesions were considered as metastases. However the lesions were reduced in size on CT after 20 days antibiotherapy and diagnosed as pneumonia...

A 70-year-old man underwent right upper lobectomy for lung adenocarcinoma. During the operation, hemostatic matrix (as known Floseal® ) was used to prevent pulmonary laceration-associated bleeding. When 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography was performed for staging after surgery, intense 18 F-FDG uptake was observed in the cicatricial fibrotic tissue in the operation area, and no significant change was observed in that area during the 4-year follow-up. Because it remained stable for several years without treatment, this finding was thought to be due to a foreign body reaction caused by the homeostatic material...

OBJECTIVES: This study aimed to evaluate the stability, safety, and efficacy of alpha-targeted therapy with [225 Ac]Ac-DOTATATE in patients with grade 1/2 metastatic neuroendocrine tumors (NETs). METHODS: This retrospective cohort included patients (n=11) with metastatic NETs from different primary sites (bronchial, pancreatic, nonpancreatic gastroenteropancreatic NETs, paraganglioma, and unknown primary site) treated with [225 Ac]Ac-DOTATATE with a mean activity of 8...

OBJECTIVES: The aim of this study was to evaluate the correlation between clinical histopathologic features and micropapillary (MP) ratio with the maximum standardized uptake value (SUVmax ) derived from 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) in treatment naïve breast cancer. METHODS: Twenty-nine patients diagnosed with breast cancer with a MP component who underwent PET/CT imaging before any local and/or systemic treatment were included in this retrospective study...

OBJECTIVES: To investigate the amount of effective dose (ED) due to the computed tomography (CT) component of lung perfusion-single-photon emission computed tomography (Q-SPECT)/CT. METHODS: In this single-center retrospective study, imaging data were collected from the clinic database for the period 2016-2022. The 327 patients identified were aged between 20 and 94 years. Tube voltage, tube current, pitch, gantry rotation time, volume CT dose index, and dose-length product (DLP) were recorded...

OBJECTIVES: The aim of this study was to analyze the systolic part of the left ventricular (LV) volume curve obtained by gated myocardial perfusion imaging with the formula used in exponential decay and to investigate the clinical value of the results. METHODS: One hundred fifty eight patients were retrospectively enrolled in the study. The study group was divided into three groups as normal, ischemia, and infarct. The systolic portion of the LV volume curve was also analyzed using the exponential decay formula...

OBJECTIVES: The aim of this study was to evaluate the relationship between the types of distant metastatic spread, histopathological features, and imaging features of primary tumor on positron emission tomography/magnetic resonance imaging (PET/MRI) for primary staging in newly diagnosed breast invasive ductal carcinoma (IDC) patients. METHODS: Data from 289 female patients were retrospectively evaluated. Maximum standardized uptake value, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and minimum apparent diffusion coefficient (ADCmin ) values of primary tumors were obtained from PET/MRI...

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Fibrous dysplasia (FD) is a rare congenital benign bone disease that manifests as a defect in the bone remodeling process, affecting the function, differentiation, and maturation of osteoblasts. This process is located in the bone marrow, where the normal marrow tissue is replaced with immature bone islands and fibrous stroma. The etiology is unclear so far, but it is known to be connected with a point mutation of the gene that encodes Gs α protein at the time of embryogenesis, and because of that, all of the affected somatic cells become dysplastic...

A 42-year-old female patient diagnosed with invasive ductal breast ca underwent 18 F-fluorodeoxyglucose (FDG) positron emission tomography/ computed tomography (PET/CT) scan for staging, 1.5 cm diameter hypermetabolic lesion was observed in the lower inner quadrant of the right breast that was compatible with primary tumor [maximum standardized uptake value (SUVmax ): 10.5]. No pathological 18 F-FDG uptake was observed in lymph nodes whose fatty hilum was seen in the right axilla. However, in the left axilla and left deep axilla, hypermetabolic lymph nodes with a maksimum diameter of 19 mm and fatty hilum were observed (SUVmax : 8...

Intravenous tumor extension is a well-recognized phenomenon occurring in various malignancies but is a relatively rare entity in thyroid carcinoma. In patients with poorly differentiated thyroid cancer (pDTC), I-131 avid superior vena cava tumor (SVC) thrombus at initial presentation is infrequent and potential life threatening. Tumor thrombus can form either due to direct vascular extension of the primary mass or by hematogenous spread. Hybrid nuclear imaging can differentiate the two entities, which can impact the treatment plan of the patient...

In differentiated thyroid cancer, radioiodine therapy and whole body scans (WBS) are integral part of disease management. We present the case of a 33-year-old woman with multifocal thyroid carcinoma who was treated with radioiodine. Post-treatment WBS scintigraphy showed focal increased I-131 uptake in the spleen, although stimulated thyroglobulin level was not suggestive of distant metastasis. Dynamic magnetic resonance imaging performed later revealed that the finding was an incidental splenic cyst. Radioiodine uptake is not specific to the thyroid tissue...

Bone scintigraphy with Tc-99m-diphosphonate analogs are widely used in staging, restaging, and monitoring the therapy effectiveness of various cancer types. Bone-seeking agents are excreted through urination, resulting in the visualization of either anatomical abnormalities or pathological conditions of the kidneys and bladder. We present a case of a 63-year-old man with urinary bladder carcinoma depicted on whole body planar and single-photon emission computed tomography/computed tomography images.

The fever of unknown origin (FUO) represents a complex diagnostic challenge due to the wide range of etiologies that could cause it, including neoplastic, infectious, rheumatic/inflammatory, and miscellaneous disorders. Several nuclear medicine techniques have proven to be valuable tools for guiding etiologic diagnosis in the setting of FUO. One of these is technetium-99m (Tc-99m)-hexamethylpropylene amine oxime (HMPAO)-labeled leukocyte scintigraphy, which is a diagnosis method that allows in most cases the localization and evaluation of the extension of an occult infection...

Meningiomas constitute 37% of primary central nervous system tumors and are more common in women. Also may occur with other primary malignancies, which can cause confusion with the metastasis in whole body bone scan (WBBS) imaging. A 58-year-old woman diagnosed with breast cancer was referred to the WBBS for the investigation of possible bone metastases. In the planar images, radiotracer uptake at multiple sites was detected on the anterior side of the skull base and the posterior side of the vertex of the cranium...

A 69-year-old male was admitted to our hospital because of left facial trauma with bone fractures, including the maxillary sinus, zygomatic arch, and ethmoid and sphenoid bones. Brain computed tomography was unremarkable but regional cerebral blood flow with hexamethyl-propylene-amine oxime single-photon emission computed tomography (SPECT) showed hypoperfusion of the left hemisphere, which was reversible since a repeat SPECT 4 months later was substantially improved. Brain perfusion SPECT may provide information on cerebrovascular status in some cases of facial injury...

Ovarian cancer is one of the deadliest tumors among women. It mostly metastasizes to the liver, pleura, lungs, and bones. We present a sixty-six-year-old patient with skin lesions. The patient who underwent biopsy due to skin lesions was diagnosed with ovarian cancer. 18 F-fluorodeoxyglucose (FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) performed for metastasis search shows widespread skin involvement, especially in the lower abdomen and legs. Skin involvement it ovarian cancer can be rarely seen, and in this article we would like to share 18 F-FDG PET/MRI of skin involvement in ovarian cancer...

Neuroendocrine tumors are slow-growing tumors originating from neuroendocrine cells and capable of metastasis. Most of them are found in the gastrointestinal tract; however, they can also be rarely seen in other organs. Testicular neuroendocrine tumors account for less than 1% of all testicular neoplasms. They may present as primary testicular or secondary tumors from extratesticular sources. Jejunal neuroendocrine tumor metastasis to the testis is extremely rare. We present the case of a 61-year-old man with a jejunal neuroendocrine tumor and metastases to bilateral testicles revealed on Gallium-68-DOTATATE positron emission tomography/computed tomography...

Rectal neuroendocrine carcinomas constitute <1% of all neuroendocrine carcinomas and <1% of all gastrointestinal tract malignancies. Cutaneous metastases of rectal neuroendocrine carcinoma are rarer than visceral metastases. We represent a 71-year-old man who was diagnosed with neuroendocrine tumor grade 3 originating from the rectum 1 year ago. He was referred for 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography for restaging after 6 cycles of chemotherapy and radiotherapy...

Prostate cancer is one of the most prevalent cancers in the world. After radical prostatectomy, prostate-specific antigen (PSA) levels are usually used as a marker of recurrence for prostate cancer. In the case of increased PSA levels, 68 Ga-prostate-specific membrane antigen (PSMA) or 18 F-PSMA, a new alternative, can be performed for the detection of recurrent disease. We report a case of a 49-year-old male patient with increasing PSA levels who was previously operated 8 years ago. Although no obvious pathological uptake was detected in 68 Ga-PSMA positron emission tomography/computed tomography (PET/CT), 18 F-PSMA PET/CT revealed a lesion with pathological uptake on the urinary bladder wall...