Clinical Nuclear Medicine最新文献

Purpose: The aim of this study was to compare Al18F-NOTA-HER2-BCH and 18F-FDG for detecting nodal metastases in patients with HER2-positive breast cancer on PET/CT.

Patients and methods: In this retrospective study, 62 participants with HER2-positive breast cancer underwent both Al18F-NOTA-HER2-BCH and 18F-FDG PET/CT. Participants were pathologically confirmed as HER2-positive (IHC 3+ or IHC 2+ with gene amplification on FISH). Three independent readers visually assessed uptake of tracers on imaging. Furthermore, the diagnostic accuracy of nodal metastases was assessed using c-statistics. The lesion uptakes were quantified by SUVmax and target-to-background ratio (TBR) and compared using the general linear mixed model.

Results: The findings showed nodal metastases in 33 (53%) participants, including 45% only with regional nodal metastasis and 55% with nonregional nodal metastasis. On per-patient level, the sensitivity and specificity of Al18F-NOTA-HER2-BCH and 18F-FDG based on the majority reads were 0.97, 0.97, and 0.85, 0.77, respectively. Five participants were visualized only on Al18F-NOTA-HER2-BCH. Seven participants with high uptake only on 18F-FDG PET/CT were confirmed to be inflammatory uptake by pathological results and later imaging follow-up. On per-lesion level, Al18F-NOTA-HER2-BCH PET/CT detected more axillary (98.8% vs 70.2%), extra-axillary (100% vs 61.7%), and nonregional (99.1% vs 67.0%) lymph nodal metastases than 18F-FDG PET/CT. Additionally, Al18F-NOTA-HER2-BCH PET/CT detected more nodal metastases small than 10 mm than 18F-FDG PET/CT (198 vs 125, 99.5% vs 62.8%). The median SUVmax and TBR of regional or nonregional nodal metastases at Al18F-NOTA-HER2-BCH were all higher than those on 18F-FDG (range of median SUVmax, 8.0-11.4 vs 2.3-5.6; P range, <0.001-0.007; range of median TBR, 7.3-16.3 vs 2.9-5.3; P range, <0.001). No adverse reactions related to imaging agents were observed in all participants.

Conclusions: Al18F-NOTA-HER2-BCH PET/CT detected more regional and nonregional lymph nodal metastases in patients with HER2-positive breast cancer than on 18F-FDG PET/CT, especially for lesions small than 10 mm.

Abstract: Typical Meckel diverticulum on 99mTcO4- scintigraphy usually appears early in the dynamic imaging in the right lower quadrant of the abdomen, without change of location during the study. We report a case of pathology-proven Meckel diverticulum a 7-year-old boy, which appeared only on the later part of the 99mTcO4- study in the midline upper pelvis which gradually changed location during the study.

Abstract: Solitary axillary lymph node metastasis from ovarian cancer is rare. A 74-year-old woman who had undergone hysterectomy and bilateral salpingo-oophorectomy for ovarian cancer 2 years ago presented to our hospital with enlarged axillary lymph node. 18F-FDG PET/CT revealed left axillary lymphadenopathy with an SUVmax of 8.92. The postbiopsy pathology confirmed metastasis of poorly differentiated ovarian adenocarcinoma. This case highlights the need to consider ovarian cancer metastasis in cases of solitary axillary lymphadenopathy with intense FDG uptake, especially in patients with a recent history of ovarian cancer.

Abstract: We present the case of a 60-year-old man admitted to the hospital presenting with high FUO (fever of unknown origin), strong headache, face erythematous-desquamative cutaneous lesions, long history of abdominal pain, and diffuse myalgia. He was also previously treated with immunosuppressants and currently managed with corticosteroids for a seronegative rheumatic disease. Given the immunocompromised state, an infective etiology was suspected. The patient was referred, as part of standard clinical practice, to perform an 18F-FDG PET/CT to identify potential causes of FUO.

Abstract: Subcutaneous nodules and masses as the primary manifestation of diffuse large B-cell lymphoma are exceedingly rare. We present 18F-FDG PET/CT findings of multiple hypermetabolic nodules and masses distributed throughout the body, creating a characteristic "leopard man" appearance on the MIP image, in a 65-year-old man. An excisional biopsy of the right thigh mass confirmed the diagnosis of diffuse large B-cell lymphoma.

Abstract: A 57-year-old man with a 3-month history of lower abdominal pain and rectal bleeding with black stools underwent urgent abdominal CT, which revealed an ovoid hyperdense lesion in the ileum in the right iliac fossa. The prime differential was a midgut neuroendocrine tumor. Thus, the patient was referred for a 68Ga-DOTATATE PET/CT scan, which demonstrated intense activity in this lesion with no evidence of somatostatin receptor expression elsewhere. Surgical small bowel resection later revealed a small bowel leiomyoma, which was confirmed on immunohistochemistry analysis. This case demonstrates that leiomyomas can express somatostatin receptors and can be a false-positive on 68Ga-DOTATATE PET/CT scan.

Abstract: We present a case of 37-year-old man with multiple masses in the abdominal and pelvic cavity who underwent 18F-AlF-NOTA-octreotide PET/CT. The masses demonstrated heterogeneously increased uptake on 18F-AlF-NOTA-octreotide PET/CT and were suggestive of neuroendocrine tumor. However, the histopathological examinations confirmed the masses to be peritoneal mesothelioma. This case indicated that peritoneal mesothelioma should be kept in mind as one of the differential diagnoses for 18F-AlF-NOTA-octreotide-avid tumors.

Abstract: A 13-year-old girl presented with dysphagia underwent contrast-enhanced CT and endoscopy. The CT revealed cervical esophageal wall thickening with heterogeneous enhancement. Microscopic examination of the biopsy specimen suggested a possible mesenchymal tumor. She underwent an 18F-FDG PET/CT scan for staging. The scan showed local thickening of the cervical esophageal wall with heterogeneous and significantly elevated FDG activity. Subsequent immunohistochemical staining and fluorescence in situ hybridization confirmed the diagnosis of esophageal inflammatory myofibroblastic tumor.

Abstract: We present 18F-FDG PET/CT findings of fallopian tube with Walthard cell nests. The images revealed a thickening of the bilateral fallopian tubes with increased FDG uptake. Malignant tumor or tuberculosis of the fallopian tube was suspected. Histopathology suggested fallopian tube with Walthard cell nests.

Abstract: Uterine carcinosarcoma is a rare type of endometrial carcinoma with poor prognosis. A bone metastasis to the skull base is extremely scarce in uterine carcinosarcoma. A 54-year-old woman with uterine carcinosarcoma complained of right ear otorrhea and otalgia. 18F-FDG PET/CT presented an increased FDG uptake at the right middle ear involving the mastoid process and external acoustic meatus. Primary carcinoma of the middle ear was considered according to clinical symptoms and PET manifestation. However, the skull base metastasis from uterine carcinosarcoma was pathologically confirmed. The rare metastasis from uterine carcinosarcoma should be differentiated from primary carcinoma of the middle ear.