Clinical Nuclear Medicine最新文献

Epithelioid sarcoma (ES) is an ultra-rare and aggressive soft tissue malignancy, predominantly affecting the extremities. Scalp involvement in ES is exceedingly uncommon. This case report describes a 25-year-old man diagnosed with a scalp mass confirmed to be ES. Despite undergoing surgical resection and adjuvant chemoradiation, the tumor recurred, causing significant pain and erosion of adjacent bony structures. A multidisciplinary team recommended 99m Tc-FAPI-46 scintigraphy, which demonstrated high uptake in the tumor masses. The patient was subsequently treated with 177 Lu-FAPI-2286 in 4 cycles. Initial cycles showed promising treatment responses; however, disease progression was observed in the final cycle.

Primary renal NUT carcinoma is exceptionally rare. Herein, we report 68 Ga-FAPI-04 PET/CT findings in a 10-year-old girl with this malignancy. The 68 Ga-FAPI-04 PET/CT imaging revealed a right renal mass with intense FAPI uptake, accompanied by FAPI-avid retroperitoneal lymphadenopathy and pulmonary metastases. This case highlights the potential of 68 Ga-FAPI-04 PET/CT for precise staging of renal NUT carcinoma.

Unilateral breast infiltration caused by T-cell acute lymphoblastic leukemia (T-ALL) is a rare occurrence. This report presents the 18 F-FDG PET/CT findings of unilateral breast relapse in a male patient diagnosed with T-ALL. After systematic therapy, a follow-up PET/CT scan revealed no evidence of FDG-avid lesions. This case highlights the critical role of PET/CT in detecting and characterizing extramedullary disease involvement.

We report the multimodal PET/MR imaging findings in a 31-year-old woman with a novel presenilin 1 (PSEN1) missense mutation (c.699G>A, p.M233I) who developed progressive cognitive decline and parkinsonian features. Multimodal imaging, including glucose metabolism, dopamine transporter function, amyloid-β pathology, and tau protein PET imaging, combined with structural MRI, revealed widespread abnormalities concordant with her clinical manifestations. Findings included glucose hypometabolism, dopaminergic dysfunction, amyloid and tau deposition, and cerebellar atrophy. This case highlights the diagnostic value of multiprobe PET/MR imaging in characterizing complex neurodegenerative phenotypes and expands the genotypic and phenotypic spectrum of PSEN1 -associated early-onset Alzheimer's disease (EOAD) with parkinsonism.

Background: Glioblastoma (GBM) is the most common primary malignant tumor of the brain with high morbidity and mortality without an effective therapeutic option currently. This study aimed to evaluate the feasibility and safety of [ 177 Lu] Lu-prostate-specific membrane antigen (PSMA) therapy in patients with progressive/persistent refractory glioblastoma.

Patients and methods: This is a prospective single-arm pilot clinical trial with inclusion of 10 patients with progressive/persistent GBM on standard of care therapy. After evaluation of eligibility by [ 99m Tc] Tc-PSMA single-photon emission computed tomography (SPECT)/ low-dose CT, the patients received 2-6 cycles of 100-150 mCi with 4-5 weeks interval, and toxicity was assessed with regular hematologic and renal function tests as well as clinical history and examination. The response to therapy was also evaluated with magnetic resonance imaging (MRI).

Results: Among 23 patients who were referred for this trial, 10 patients finally were included and received 3-6 cycles [ 177 Lu] Lu-PSMA therapy. No hematologic or renal toxicity was noted. Clinical improvement or stability was seen in 9/10 patients. The comparison of MRI before and after therapy revealed 3 patients with partial response, 4 patients with stable disease and 3 patients with progressive disease. Six-month and 1-year survival rates were 100% and 80% after first dose of [ 177 Lu] Lu-PSMA therapy.

Conclusions: This study demonstrated that [ 177 Lu] Lu-PSMA therapy could be a safe and potentially effective salvage therapy in the progressive/persistent GBM and should be more evaluated with further dedicated study to assess more precise selection criteria and therapeutic protocol and timing.

Gallbladder neuroendocrine tumors (GB-NETs) are rare, accounting for <0.5% of all NETs, and little is known about somatostatin receptor expression (SSTR) and its response to SSTR-targeted treatment such as Lutetium-177 ( 177 Lu) DOTATATE. 68 Ga DOTATATE PET/CT is a valuable imaging modality for SSTR expression and 177 Lu DOTATATE treatment planning. We present a case of a 74-year-old man with recurrent WHO grade 3 GB-NET. 177 Lu DOTATATE failed to control hepatic metastases despite high DOTATATE uptake, which led to treatment discontinuation. This case highlights the fact that positive SSTR imaging in GB-NETs does not always lead to a favorable response to 177 Lu DOTATATE.

Tracheal inflammatory myofibroblastic tumors are exceedingly uncommon. This report presents the findings from an FDG PET/CT scan in a case involving an intratracheal inflammatory myofibroblastic tumor. Bronchoscopy revealed a neoplastic growth on the left lateral wall of the mid-trachea. The subsequent FDG PET/CT scan demonstrated intense radiotracer uptake within the lesion, with a maximum standardized uptake value (SUVmax) of 8.0. Post-surgical resection, immunohistochemical analysis corroborated the diagnosis of a tracheal inflammatory myofibroblastic tumor.

An increasing interest in radiopharmaceutical therapy (RPT), especially in reference to the theranostic framework incorporating both diagnostic and therapeutic components have been reported. Typically, this "theranostic approach" consists of a "matching pair" of radiopharmaceuticals, comprising a diagnostic partner labelled with positron or gamma-emitting radionuclides and a therapeutic partner labelled with beta or alpha-emitting radionuclides. Due to variability in the biodistribution, uptake, and retention, the therapeutic effectiveness of established and newer radiopharmaceutical therapies may show interpatient and intrapatient variability. As RPT requires the systemic administration of radiopharmaceuticals to patients, their normal organ biodistribution, as well as uptake in tumor tissues, can be mapped using molecular imaging (SPECT and PET) techniques. This allows for the quantification of the fraction of the administered radioactivity (MBq) that reaches the tumor, as well as the normal organs. The administered radioactivity can be modified based upon a patient's body habitus and laboratory parameters to achieve the optimal and desired tumor effect and normal tissue sparing, thereby permitting delivery of an individualized theranostics. This review discusses the RPT and dosimetry practices that are in clinical use, along with other cutting-edge radiopharmaceutical therapies that have shown promising therapeutic efficacies in advanced-stage human malignancies.

A 57-year-old woman with a history of right breast cancer surgery 22 years prior presented with CT findings of gastric and intestinal wall thickening, accompanied by mild-to-moderate FDG uptake on 18F-FDG PET/CT. Pathological results showed lobular breast cancer metastasis. The lesions showed significantly higher uptake on 18FAl-NOTA-FAPI PET/CT, and an additional sternal metastasis was identified.

Benign prostatic hyperplasia can show low-grade PSMA uptake, but rarely shows high-grade PSMA uptake. We describe 18 F-PSMA-1007 PET/CT and PET/MRI findings in a case of large benign prostatic hyperplasia with chronic inflammatory infiltrates and a high level of serum total prostate-specific antigen (32.6 ng/mL). The large benign prostatic hyperplasia of the transition zone showed heterogeneous signal intensity on the T2-weighted image and heterogeneous intense PSMA uptake with SUV max of 19. This case indicates that benign prostatic hyperplasia with chronic inflammation can show high-grade PSMA uptake mimicking or masking prostate cancer of the central gland.