Clinical Nuclear Medicine最新文献

Background: This study aims to evaluate the diagnostic value of 18F-FAPI-42 PET in differentiating glioma recurrence from treatment-related changes, with comparative analyses against 11C-MET PET and contrast-enhanced MRI (CE-MRI).

Patients and methods: In this prospective study, patients with suspected glioma recurrence underwent concurrent 18F-FAPI-42 PET/MRI, 11C-MET PET/MRI, and CE-MRI examinations. Diagnostic performance for differentiating tumor recurrence was evaluated and compared across imaging modalities using McNemar test. Wilcoxon rank-sum tests were used to assess differences in SUVmax and tumor-to-background ratios (TBR) between glioma recurrence and treatment-related changes. Receiver operating characteristic curve analysis was performed to determine optimal cutoff values and compare the diagnostic efficacy of SUVmax and TBR through area under the curve (AUC) metrics.

Results: Among the 76 suspected glioma recurrence patients, 59 were diagnosed with recurrence and 17 had treatment-related changes. When distinguishing between recurrence and treatment-related changes, the accuracy and sensitivity of 18F-FAPI-42 PET were comparable to those of 11C-MET PET and CE-MRI (accuracy: 80.26% vs 86.84% vs 78.95%, respectively, all P > 0.05; sensitivity: 89.83% vs 93.22% vs 98.31%, respectively, all P > 0.05), but the specificity of 18F-FAPI-42 PET was significantly higher than that of CE-MRI (47.06% vs 11.76%, P = 0.031). The semiquantitative analysis of PET parameters showed that SUVmax and TBR of 18F-FAPI-42 PET and 11C-MET PET in glioma recurrence were significantly higher than treatment-related changes (all P < 0.05). The diagnostic performance of 18F-FAPI-42 PET TBR is outstanding (AUC: 0.940), higher than 11C-MET SUVmax and TBR (AUC: 0.842 and 0.851, P = 0.099 and 0.080), and significantly better than 18F-FAPI-42 SUVmax (AUC: 0.668, P < 0.001).

Conclusions: The diagnostic efficacy of 18F-FAPI-42 PET for glioma recurrence is comparable to 11C-MET PET, and its specificity superior to CE-MRI. 18F-FAPI-42 PET has a high TBR and advantages in delineating glioma boundaries, which may provide valuable information for therapeutic decision-making.

A 66-year-old man with a pathology-confirmed gastric mucosa-associated lymphoid tissue (MALT) lymphoma underwent imaging with both 68 Ga-pentixafor and 18 F-FDG PET/CT. The 18 F-FDG PET/CT demonstrated intense FDG uptake in the gastric lesion, whereas the 68 Ga-pentixafor PET/CT showed only minimal tracer uptake. Subsequent histopathologic evaluation confirmed a transformation into aggressive diffuse large B-cell lymphoma (DLBCL). This case underscores the importance of recognizing atypical imaging patterns to identify histologic transformation and guide timely clinical intervention.

A 23-year-old woman presented with prolonged menstruation for 10 days. Pelvic ultrasound showed multiple masses in the uterus, suspicious for leiomyomas. Pelvic MRI showed an irregular multinodular uterine mass involving the cervix, and bilateral enlarged extrailiac lymph nodes, suggesting uterine malignancy with lymph node metastases. FDG PET/CT showed heterogeneous activity of the uterine mass and multiple FDG-avid lymph nodes in the bilateral pelvic and retroperitoneal regions, suggesting uterine malignancy with multiple lymph node metastases. Hysterectomy, bilateral salpingo-oophorectomy, and pelvic and retroperitoneal lymph node dissection revealed EWSR1-rearranged Ewing sarcoma of the uterus and no malignancy in the resected lymph nodes.

A 46-year-old woman with right breast invasive ductal carcinoma and sternalgia underwent Tc-99m methylene diphosphonate (MDP) whole-body bone scintigraphy, on which a scallop-shaped photopenic region in the urinary bladder area was found, besides increased radioactivity in the sternum region and both breasts. By reviewing a previous CT scan, a pelvic mass oppressing the right wall of the urinary bladder was noted, which was confirmed to be a rare uterine cervical leiomyoma by biopsy.

Extramedullary plasmacytoma involving multiple lymph nodes is extremely rare. We report FDG PET/CT findings of multiple extramedullary plasmacytomas involving lymph nodes in a 71-year-old man. A chest CT scan revealed multiple enlarged lymph nodes in the right supraclavicular region, hilum, and mediastinum, merging into several soft tissue masses suggestive of lymphoma. On FDG PET/CT, these masses demonstrated intense 18 F-FDG uptake, mimicking aggressive lymphoma. No other abnormal tracer uptake was identified. Biopsy of the right supraclavicular lymph node confirmed the diagnosis of plasmacytoma.

Prostate cancer commonly metastasizes to the skeleton, with multiple bones typically affected. Solitary metastasis in the appendicular skeleton, particularly in the scapula, is exceedingly rare. We present the case of a 75-year-old man with prostate adenocarcinoma, who initially presented with scapular bone metastasis detected using Ga-68 PSMA PET/CT. Imaging revealed intense uptake in a sclerotic lesion in the left scapula, suggesting a solitary metastasis.

Purpose: The aims of this study were to determine the publication pressure perceived by nuclear medicine scientists and to identify associated determinants.

Patients and methods: Corresponding authors who published in Clinical Nuclear Medicine , Journal of Nuclear Medicine , or European Journal of Nuclear Medicine and Molecular Imaging between 2021 and 2023 were invited to participate in this survey study. Publication pressure was assessed using the revised Publication Pressure Questionnaire in the domains of "publication stress" (stress due to perceived pressure to publish), "publication attitude" (attitude regarding current publication culture), and "publication resources" (resources when working on publications or experiencing stress when working on publishing), with 5-point Likert scales.

Results: A total of 181 individuals participated. Median Publication Pressure Questionnaire scores in the domains "publication stress," "publication attitude," and "publication resources" were 3.33, 3.33, and 2.17, respectively. None of the researchers' characteristics were significantly associated with publication stress. Age >65 years was significantly associated with a more positive view on the publication climate (β coefficient of -0.552, P =0.007). Several variables were significantly associated with a perception of fewer factors available to alleviate publication pressure: age 45-54 years (β coefficient of 0.249, P =0.030), age 55-64 years (β coefficient of 0.421, P =0.002), associate professor position (β coefficient of 0.398, P <0.001), fellow/resident position (β coefficient of 0.355, P =0.007), <5 years of research experience (β coefficient of 0.410, P =0.026), and 5-10 years of research experience (β coefficient of 0.361, P =0.003).

Conclusions: Publication pressure among nuclear medicine scientists is appreciable. Several researcher characteristics appear to be associated with vulnerability to publication pressure.

Endometriosis is a benign condition characterized by chronic inflammation and fibrosis. We report the findings of endometriosis at the rectouterine pouch on 68 Ga-FAPI-04 PET/CT scan in a 25-year-old woman. The finding was initially thought as peritoneal metastasis from her newly diagnosed gastric cancer. However, subsequent pathologic examination confirmed that it was endometriosis.

We present a case involving a 77-year-old man with prostate cancer who underwent radical prostatectomy with negative surgical margins. After 10 years without follow-up, his serum prostate-specific antigen level increased to 2.76 ng/mL, suggesting disease recurrence. Due to limited access to 68 Ga-PSMA PET/CT, a 99m Tc-HYNIC-PSMA SPECT/CT was conducted, which identified PSMA uptake in the bilateral vas deferens, a rare site for recurrence. While recurrence in the vas deferens has been previously reported using 68 Ga-PSMA PET/CT or PET/MR, this novel experience with 99m Tc-PSMA SPECT/CT highlights its potential utility in detecting such recurrences. This is particularly relevant in low-income countries where access to PET/CT may be limited.

We describe a 51-year-old man with cholangiocarcinoma of the common bile duct. Initially deemed nonmetastatic, he was a candidate for curative surgery and liver transplantation. However, during laparotomy, peritoneal seeding was discovered, necessitating omentectomy and lesion resection. Following chemotherapy, the patient underwent 18 F-FDG PET/CT for re-staging, revealing uptake in the primary tumor and a right iliac bone metastasis. Subsequently, FAPI-based scintigraphy using 99m Tc-FAPI-46 as a novel conventional imaging agent demonstrated comparable uptake in both lesions. This case highlights the diagnostic potential of 99m Tc-FAPI-46 SPECT/CT as an alternative to 18 F-FDG PET/CT and 68 Ga-FAPI in cholangiocarcinoma, particularly in resource-limited settings.