Clinical Nuclear Medicine最新文献

Abstract: A 59-year-old man presented with a mass and pain in the left side of his back for 6 months. 18 F-FDG PET/CT demonstrated increased FDG uptake in the inferior aspect of his left scapula and the left hepatic lobe, highly suggesting the possibility of hepatic malignancy with solitary scapula metastasis. Finally, solitary scapula metastasis from intrahepatic cholangiocarcinoma was confirmed.

Abstract: An 85-year-old non-smoking woman with right back pain for 1 month underwent a chest CT, which showed a mass with a maximum diameter of 12.2 cm in the upper lobe of right lung. The lesion demonstrated heterogeneous uptake on FDG PET scanning. The final pathology of the lung mass was a high-grade fetal adenocarcinoma of the lung, which was a rare histological form of malignant lung neoplasm. This case revealed the glucose avidity of the rare lung cancer.

Purpose: The purpose of this study was to evaluate the benefit of dual-time point 68 Ga-FAPI-04 PET/CT in staging head and neck squamous cell carcinoma (HNSCC).

Patients and methods: Sixty-nine treatment-naive patients with HNSCC were enrolled. Each patient underwent whole-body 68 Ga-FAPI-04 PET/CT at approximately 30 minutes postinjection and a delayed scan in head and neck region at 2 hours. Radiotracer uptake (SUV max ), tumor-to-background ratio, change in SUV max (∆SUV max ), retention index, diagnostic performance, and staging were explored. Histopathology was the reference standard.

Results: Primary tumors showed similar average SUV max between early (17.89) and delayed scans (17.86, P = 0.241). However, the tumor-to-background ratios of delayed imaging were all significantly higher than those of early imaging (all P < 0.001). In 38 patients who underwent neck dissection, metastatic lymph nodes showed higher mean SUV max on delayed imaging than on early imaging (early 10.53 ± 5.98 vs delayed 11.71 ± 6.36, P < 0.001), whereas nonmetastatic lymph nodes showed the opposite result (early 3.51 ± 0.51 vs delayed 2.58 ± 0.63, P = 0.002). The mean ∆SUV max and retention index of metastatic and nonmetastatic lymph nodes were 1.19 versus -0.93 and 12.79% versus -26.55%, respectively. N staging was correctly altered in 3 (3/38) patients based on delayed images.

Conclusions: Delayed 68 Ga-FAPI-04 PET/CT can effectively acquire high-contrast images, better tumor delineation, and detect hidden lesions near or within the tissues influenced by physiological uptake for HNSCC. In addition, dual-time point imaging adds diagnostic value for the differentiation of metastatic from nonmetastatic lymph nodes.

Abstract: 177 Lu-PSMA-617 radioligand therapy has been US Food and Drug Administration-approved safe and effective treatment modality for metastatic castration-resistant prostate cancer, usually administered in 4 to 6 cycles at 6 to 8 weeks apart. Many patients achieve partial response or stable disease with biochemical response after treatment. However, these effects are usually short-lived, and patients ultimately show disease progression after a median period of 6 to 9 months. Rechallenge therapy appears to be safe and effective treatment modality in such patients. We show the clinical efficacy and safety of re-rechallenge 177 Lu-PSMA radioligand therapy in a 64-year-old man with metastatic castration-resistant prostate cancer with disease progression on multiple lines of hormonal and chemotherapy treatment.

Abstract: We present a case of 12-year-old boy evaluated in view of refractory ascites in whom 18 F-FDG PET/CT incidentally revealed hypermetabolism in the medulla that was proven to be hypertrophic olivary degeneration on MRI.

Abstract: We present a case with systemic amyloidosis secondary to immunoglobulin light-chain amyloidosis (AL amyloidosis), which 18 F-FDG PET/CT and 99m Tc-PYP scintigraphy revealed amyloid deposition in the peritoneum, omentum, and mesentery. AL amyloidosis is characterized by the proliferation of clonal plasma cells and increased production and extracellular accumulation of immunoglobulin light chains, leading to organ malfunction. Even though AL amyloidosis can affect the gastrointestinal system, peritoneal involvement is rarely observed. PET/CT and SPECT/CT images showed moderate to slightly increased tracer uptake in affected organs.

Abstract: Oral squamous cell carcinoma (OSCC) is one of the most common malignancies worldwide. Locoregional nodal involvement by OSCC is commonly encountered. Current conventional and functional imaging modalities have limited diagnostic accuracy in nodal assessment, particularly in head and neck cancer. Thus, definitive management of head and neck malignancies customarily addresses the locoregional nodes along with the primary malignancy. However, OSCC, particularly tongue cancer, shows erratic lymphatic drainage and thus commonly requires extensive bilateral neck dissection, leading to significant morbidity. Cancer integrin imaging with 68 Ga-trivehexin PET-CT can offer highly specific result and thus has the potential for effective tailored management.

Abstract: A 7-year-old boy with high-risk neuroblastoma underwent 123 I-MIBG SPECT/CT to evaluate the therapy response. The scan revealed abnormal 123 I-MIBG uptake in the left basal ganglion, indicating the possibility of brain metastasis. Subsequent contrast-enhanced brain MRI, however, did not show any abnormal signal intensity in the left basal ganglion. Follow-up 123 I-MIBG SPECT/CT scans at 3-month and 9-month also did not show abnormal MIBG uptake in the same area. The case highlights the possibility of false-positive uptake of 123 I-MIBG in the basal ganglion.

Abstract: A 75-year-old man with a previous history of left nephrectomy for clear cell renal cell carcinoma in remission was underwent 68 Ga-DOTATATE PET/CT imaging for evaluation of pancreatic body lesion. It showed a mass with intense 68 Ga-DOTATATE uptake in the pancreatic corpus. During the follow-up of the patient who did not want to undergo surgery, 18 F-FDG PET/CT scan was performed due to the increase in the size of the mass, and mild FDG uptake was detected in the pancreatic corpus lesion, and histopathological examination was confirmed as renal cell carcinoma metastasis.

Abstract: We report the case of a 62-year-old man with metastatic castration-resistant prostate cancer with subcutaneous involvement being treated with 177 Lu-prostate-specific membrane antigen (PSMA). Before treatment, he was diagnosed with 2 subcutaneous nodules in the chest wall and soft tissue edema in the pubic and inguinal regions showing PSMA avidity. Biopsy and immunohistochemistry assessment confirmed cutaneous metastases from prostate cancer. He received 3 cycles of 177 Lu-PSMA, resulting in a decline in PSA levels and resolution of symptoms. This case underscores the challenging diagnosis of cutaneous metastasis from prostate cancer, especially in atypical presentations. We also reviewed all causes of PSMA-avid lesions in the skin and subcutaneous tissues.