Clinical Nuclear Medicine最新文献

Abstract: A 46-year-old woman underwent 131 I radiotherapy following thyroidectomy for papillary thyroid carcinoma. Posttherapeutic 131 I scintigraphy was performed 4 days later. Both attenuation-corrected and non-attenuation-corrected 131 I tomography images elucidated an intrauterine device with avid 131 I uptake in her uterus. This case illustrated that an intrauterine device should be considered as a potential cause of false-positive results in posttherapeutic 131 I scintigraphy, highlighting the need for accurate image interpretation to avoid unnecessary treatment.

Abstract: Cutaneous T-cell lymphomas (CTCLs) characterized by infiltration of the skin of T-cell lymphocytes represent an uncommon and rare subset of extranodal non-Hodgkin lymphomas. Primary CTCL, not otherwise specified, is among the most important subtypes of CTCLs characterized by rapid cutaneous dissemination and systemic involvement. Herein, we present a case of primary CTCL, not otherwise specified, diagnosed via 18 F-FDG PET/CT after initial misdiagnosis of cutaneous leishmaniasis.

Abstract: This case highlights the effectiveness of 177 Lu-PSMA therapy in a 70-year-old man with castration-resistant prostate cancer who has extensive skeletal metastases in posttherapeutic whole-body imaging. A 70-year-old man with extensive skeletal metastases underwent 4 cycles of 177 Lu-PSMA-617 therapy. A whole-body 177 Lu-PSMA scan after the first cycle showed diffuse skeletal lesions, with minimal PSMA uptake in the kidneys and salivary glands. A whole-body scan after the fourth cycle of 177 Lu-PSMA showed a complete response of skeletal metastases with normal PSMA uptake in the kidneys and salivary glands. According to RECİP 1.0, the patient was considered a complete response.

Abstract: A 47-year-old woman, a diagnosed case of syndrome of inappropriate secretion of antidiuretic hormone, underwent 18 F-FDG PET/CT to detect occult malignancy for suspected paraneoplastic etiology. Abnormal FDG uptake was noted in the right lower chest region, which was correlated on corresponding CT images to be colonic activity interposed between the liver and elevated diaphragm, also known as Chilaiditi sign. Even though rare, Chilaiditi sign should be considered as a differential diagnosis of hypermetabolic activity in the right lower chest region on 18 F-FDG PET/CT scan that is done to look for occult tumor as shown in this case.

Abstract: Acute cholecystitis typically exhibits intense FDG uptake of the gallbladder wall. Radiolabeled fibroblast activation protein inhibitor (FAPI) is considered as a potential alternative agent for tumor-specific imaging. We report 18 F-FDG and 68 Ga-FAPI-04 PET/MR findings in a 44-year-old woman with acute exacerbation of chronic cholecystitis. The lesions show negative 18 F-FDG uptake but intense 68 Ga-FAPI-04 uptake in PET/MR. This case highlights the imperative for nuclear medicine clinicians to exercise vigilance when evaluating gallbladder lesions exhibiting intense 68 Ga-FAPI-04 but negative 18 F-FDG uptake.

Abstract: We describe a rare case of metastatic prostate carcinoma to the heel. Bone scintigraphy revealed high uptake simulating fractures. Standard PSMA PET/CT was negative. As PSA elevated, extended field-of-view PET/CT revealed ankle uptake with virtually identical spatial distribution and intensity of both tracers. Histopathology confirmed ankle metastases of prostate carcinoma, which retrospectively was the inaugural manifestation of the metastatic skeletal disease. This case highlights the need to consider peripheral limb bone metastases in patients with biochemical recurrence. In case of focal symptoms or unexplained bone scan findings, the PSMA acquisition coverage should be extended to include the respective body part.

Abstract: We present the case of a 58-year-old man with metastatic medullary thyroid carcinoma refractory to conventional therapies, including peptide receptor radionuclide therapy. Despite multiple interventions, serum calcitonin and carcinoembryonic antigen levels continued to rise. Subsequent evaluation with 99m Tc-FAPI-46 revealed remarkable uptake in metastatic lesions, suggesting a potential role for FAPI-labeled radioisotopes in the management of medullary thyroid carcinoma. This case underscores the emerging utility of FAPI-targeted radiotracers in oncologic nuclear medicine and highlights the need for further research in this promising area.

Abstract: The central nervous system (CNS) tumor with embryonal tumors type is a rare type of CNS tumor with lack of unifying genetic alterations or diagnostic markers. The CNS tumor-embryonal tumors (CETs) have limited therapeutic options with high probability of adverse events associated with conventional treatment. Identification of somatostatin receptor expression and/or prostate-specific membrane antigen expression in CET patients by using PET/CT imaging may be helpful for deciding therapeutic approaches in these patients as theranostics. We present a 56-year-old woman who complained of headache, diminution of vision, and diagnosed CET and demonstrated high SSTR expression on PET/CT imaging, indicating peptide receptor radionuclide therapy could be effective therapeutic option in this case.

Abstract: We present a case of a 65-year-old woman with a history of melanoma of the left foot who underwent tumor resection with inguinal lymph nodes dissection and received external beam radiation therapy. After some time, she developed nodular lesions in the same region that were confirmed to be due to involvement of the dermis. She was selected as a candidate for isolated limb perfusion procedure. The isolated limb perfusion was performed with the aid of radioguided monitoring of systemic leakage by injecting 99m Tc-labeled macroaggregated albumin, and whole-body acquisition was also performed, which confirmed compartmental localization of the tracer. Our case is the first one in which 99m Tc-labeled macroaggregated albumin injection has been used.

Abstract: Neuroblastoma is the most common malignancy in infants and the most common extracranial solid tumor accounting for approximately 6% of pediatric cancer. Although surgical intervention serves as the primary treatment for early-stage disease, advanced-stage cases necessitate a variety of oncologic therapeutic approaches, including 131 I-MIBG and peptide receptor radionuclide therapy. Herein we report incidental pineal gland activity, represented in 68 Ga-DOTATATE PET/CT (SSTR-PET) in 3 pediatric patients diagnosed with stage 4 neuroblastoma, related to the physiological distribution of radiopharmaceuticals.