Clinical Nuclear Medicine最新文献

Abstract: A 70-year-old woman presented with left ovarian mass and thickened peritoneum. 18 F-FDG PET/CT showed no significant FDG-avid in the whole body. 68 Ga-FAPI-04 demonstrated abnormally high FAPI uptake in the ileocecal region, left ovarian lesion, and thickened peritoneum. The postoperative pathology confirmed the appendiceal goblet cell adenocarcinoma. This case highlights the superior and innovative diagnostic role of 68 Ga-FAPI-04 in appendiceal goblet cell adenocarcinoma and its metastases.

Abstract: We herein report a case of an elderly woman in whom brown adipose tissue (BAT) was visible on 18 F-FDG PET imaging performed in the summer. In this patient, none of the well-known factors that induce BAT activation in adults, including cold exposure, catecholamine-producing tumors, or β3-adrenergic receptor agonists administration, were present. Daily inhalation of a long-acting β2-adrenergic agonist for treatment of her bronchial asthma was considered the cause of her BAT visualization. This case suggests the need to consider β2-adrenergic receptor agonists as a cause of BAT visualization.

Abstract: A 67-year-old woman presented with a palpable breast mass. A biopsy was taken, and the diagnosis was squamous cell carcinoma. Primary squamous cell carcinoma of breast is an extremely rare subtype of invasive breast cancer. The diagnosis requires ruling out metastasis of other sites and that is not skin origin. The patient was referred to 18 F-FDG PET/CT for diagnosis and staging. In this report, we present PET/CT and postsurgical pathology findings.

Abstract: A 67-year-old woman presented with a 12 × 20 × 24-cm adnexal tumor. Ultrasonography revealed an irregular, multilocular tumor, with increased flow in the solid components, and ascites-features that are consistent with ovarian cancer. The patient underwent 18 F-FDG PET/CT and 68 Ga-FAPI-46 PET/CT, both of which showed low uptake values. Histopathology confirmed ovarian clear cell adenocarcinoma (OCCC), a less common subtype that is underrepresented in FAPI PET/CT studies so far. Low 18 F-FDG uptake is a known feature of OCCC and has been previously reported; however, this case identifies OCCC as a potential pitfall in 68 Ga-FAPI-46 PET/CT.

Abstract: A patient with left upper quadrant breast cancer who had 18 F-FDG PET/CT imaging underwent 68 Ga-Trivehexin PET/CT. 68 Ga-Trivehexin PET/CT showed higher radiotracer accumulation in the primary tumor, left internal mammary lymph nodes, and axillary lymph nodes compared with 18 F-FDG PET/CT. However, Trivehexin uptake was not observed in FDG-positive lymph nodes in the mediastinum and left hilar region. Benign cytological findings were noted in the biopsy of the subcarinal lymph node. This case demonstrates that the use of 68 Ga-Trivehexin PET/CT in suspicious lymph nodes in areas difficult to biopsy in breast cancer cases can contribute to accurate staging.

Purpose: Neurological symptoms often prominent in post-acute sequelae of COVID-19 (PASC) necessitate deeper understanding. Our objective was to investigate brain metabolism in PASC and examine correlations with neurological symptoms during both the acute and chronic stages.

Methods: Eighty-seven adults experiencing PASC with neurocognitive symptoms were recruited in the PERSICOR prospective study and examined using brain [ 18 F]FDG PET/CT. Comprehensive clinical variables including neurocognitive symptoms were evaluated. PET images were compared voxel-wise with SPM12 software ( P < 0.05, false discovery rate corrected) and volume-of-interest basis (BrainVisa software) with those of 55 healthy controls recruited before COVID-19 pandemic. We also investigated differences in brain metabolism according to the time interval after acute COVID-19. The correlation between brain metabolism and neurocognitive symptoms was assessed.

Results: Frequently reported neurological symptoms included concentration difficulties (79%) and immediate/working memory impairments (66%). Significant hypometabolism was identified in regions previously identified in PASC: left fusiform gyrus (33% of patients), amygdala (23% on left, 28% on right), parahippocampal area (25% left, 24% right), and vermis (22%). The most substantial metabolism decreases were observed in the pons (5.5% decrease in the whole patient group vs controls) and right amygdala (-4.2%). Concentration and memory impairments correlated with decreased metabolism in prefrontal and mesial/inferior temporal areas, respectively ( P < 0.01 for both). A shorter interval between PET imaging and the acute phase of COVID-19 correlated with reduced glucose metabolism in the brainstem, thalamus, mesiotemporal lobe, frontobasal cortex, and olfactory bulb ( P < 10 -3 ).

Conclusions: This study underscores the links between neurological symptoms and cerebral hypometabolism in specific regions in PASC. These findings illuminate the complex neuropathophysiological mechanisms of PASC and pave the way for potential therapeutic interventions.

Abstract: A 78-year-old woman diagnosed with left breast invasive lobular carcinoma with left axillary nodal metastasis underwent 18 F-fluoroestradiol (FES) PET/CT imaging for further evaluation of indeterminate right axillary lymph nodes seen on staging 18 F-FDG PET/CT. 18 F-FES PET/CT revealed abnormal 18 F-FES-avid right axillary and bilateral cervical nodes, subsequently biopsy-proven metastases, upstaging the patient from stage II to IV and greatly changing patient management. This case demonstrates the value of 18 F-FES PET/CT in accurately staging metastatic invasive lobular carcinoma at diagnosis, an indication for which 18 F-FES PET/CT "may be appropriate" per current Society of Nuclear Medicine and Molecular Imaging guidelines.

Abstract: Breast metastasis from sigmoid carcinoma is rare. A 32-year-old woman, who had a history of sigmoid carcinoma, was found a hypermetabolic soft tissue mass in the left breast and a lymph node with moderate uptake on FDG PET/CT. Final pathology supported that the breast mass and lymph node were both metastases from the sigmoid carcinoma.

Abstract: A 60-year-old man underwent an extended cholecystectomy with regional lymphadenectomy for T2N0M0 gallbladder cancer (GBC), which showed significant FDG uptake (SUV max = 6.5). However, CT scan at 24 months postsurgery revealed multiple hepatic masses. Unlike the primary GBC, the hepatic masses showed limited FDG uptake (SUV max = 3.7). A tumor biopsy revealed the diagnosis of a grade 3 neuroendocrine tumor. Furthermore, the hepatic masses showed significant uptake on somatostatin receptor scintigraphy. Upon reevaluation, the primary resected specimen was found to include approximately 10% of neuroendocrine tumor components. This case suggests that different FDG uptake between primary and metastatic cancer may necessitate differential diagnosis.

Abstract: Myoepithelial carcinoma of bone is uncommon. We presented the imaging features of myoepithelial carcinoma of the left femur in a 61-year-old man on 18 F-FDG PET/CT. Lytic bone destruction and the formation of a slightly low-density soft tissue mass extending to adjacent muscles with intense and circular FDG uptake were found on 18 F-FDG PET/CT. Postoperative pathology confirmed the diagnosis of myoepithelial carcinoma.