Clinical Nuclear Medicine最新文献

Xanthogranulomatous inflammatory disease is a rare and benign condition that affects various organs. Due to their aggressive nature, the clinical and radiological findings of xanthogranulomatous inflammatory diseases are often misdiagnosed as malignant neoplasms. Prostate cancer metastases are most prevalent in lymph nodes and bones, with less common locations including the lung, liver, and brain. However, widespread liver metastasis is rare without metastatic dissemination to other sites. Herein, we present a case in which these 2 rare conditions were seen together on 68Ga-PSMA PET/CT.

We present the case of a young 38-year-old woman with metastatic progressive pancreatic neuroendocrine neoplasm (NEN) exhibiting an unusual metastasis to the parotid gland. After previous treatments, including radionuclide therapy with the somatostatin-receptor agonist DOTATOC and parotid metastasectomy, failed, she was referred to TANDEM peptide receptor radionuclide therapy (PRRT) using the somatostatin-receptor antagonist DOTA-LM3 labeled with Actinium-225 and Lutetium-177. Following 2 cycles of TANDEM-PRRT, she achieved partial remission in all metastatic sites, notably in the parotid gland and liver. This is the first reported case of metastatic pancreatic NEN with parotid involvement treated with TANDEM-PRRT.

Capillary hemangiomas are commonly encountered superficially in the cutaneous, subcutaneous, or mucosal tissues during childhood and early adulthood, but retroperitoneal capillary hemangioma is a rare occurrence. We present a case of a 61-year-old woman with incidentally detected capillary hemangioma in the retroperitoneum initially presumed to be paraganglioma based on 18F-AlF-NOTA-Octreotide PET/CT findings. Contrast-enhanced MRI revealed a hypervascular mass in the retroperitoneum. 18F-AlF-NOTA-Octreotide PET/CT performed for suspicion of paraganglioma showed intense uptake. Histopathologic examination of the retroperitoneal mass after surgical resection confirmed the diagnosis of capillary hemangioma rather than paraganglioma.

A 69-year-old man, with a known case of metastatic castration-resistant prostate cancer (mCRPC) underwent 68Ga-PSMA PET/CT and 99mTc-PSMA for evaluation of disease burden and response assessment to 177Lu-PSMA therapy. 99mTc-PSMA provided a mirror image of 68Ga-PSMA. This suggests the potential of 99mTc-PSMA SPECT/CT for disease evaluation and response assessment to PSMA-based radioligand therapies in advanced-stage mCRPC patients, especially when 68Ga-PSMA PET/CT is not available.

Meningioma is typically a benign tumor that may incidentally be found on imaging. This case demonstrates the utility of 18F-flutemetamol (FMM) PET/CT in an 80-year-old woman evaluated for memory decline. Although the scan was performed for dementia assessment, it revealed an incidental mass in the frontal region. Early-phase PET showed relatively low uptake, while delayed-phase imaging displayed intense uptake of 18F-FMM. Magnetic resonance imaging and surgical pathology confirmed the lesion as a meningioma. This report may aid in interpreting incidental mass lesions on 18F-FMM PET, providing a reference for physicians who may encounter similar findings.

This case report describes a 41-year-old man with a progressively enlarging, painful vegetative lesion in the perianal region, ultimately diagnosed as squamous cell carcinoma (SCC), through a punch biopsy. Sentinel lymph node (SLN) mapping was performed via preoperative lymphoscintigraphy utilizing 99mTc-Phytate. Notably, an SLN was identified in an atypical location, below the anterior superior iliac spine (ASIS) in the subcutaneous tissue, diverging from typical drainage patterns associated with perianal SCC. Surgical excision of the SLNs revealed no evidence of tumoral involvement. This case underscores the importance of personalized assessment with preoperative lymphoscintigraphy in atypical lymphatic drainage patterns for effective staging and treatment of malignancies such as peri-anal SCC.

Tendon xanthoma is very rare. We report FDG PET/CT findings of tendon xanthoma in a 33-year-old man. On FDG PET/CT image, it manifested as multiple symmetric nodules with an SUVmax of 9.37, located in the tendons of both elbows, knees and ankles. The final pathology supported a diagnosis of a tendon xanthoma.

A 69-year-old man with esophageal cancer underwent dual-tracer PET/CT using 18F-FDG and 68Ga-FAPI during his treatment. At baseline, neither scan showed abnormal uptake in the rectum. Three months later, an interim 18F-FDG PET/CT revealed focal uptake in the rectum, while the 68Ga-FAPI PET/CT showed no abnormal findings. Seventeen months later, he received a third dual-tracer PET/CT for surveillance. Both 18F-FDG and 68Ga-FAPI PET/CT detected abnormal activity in the same area of the rectum​​​​​​. The lesion was later confirmed as adenocarcinoma by histopathology after surgery. Our case demonstrated the 18F-FDG PET/CT could identify the rectal malignancy before 68Ga-FAPI PET/CT.

Background: Markedly expressed on hematopoietic stem cells, C-X-C motif chemokine receptor 4 (CXCR4)-directed radioligand therapy (RLT) has been used in relapsed/refractory (r/r) MM to prepare for hematopoietic stem cell transplantation (HSCT). We aimed to determine the myeloablative efficacy of CXCR4 RLT in MM patients and assessed the safety profile of this treatment.

Methods: Thirty-eight patients with r/r MM were treated with 40 cycles of CXCR4-targeting [90Y]Y-PentixaTher or [177Lu]Lu-PentixaTher. Myeloablative dynamics were closely monitored by examining hematologic parameters before the application of RLT (day 1), on day 2, and on the start day of conditioning chemotherapy (CON, median day 10). Laboratory parameters evaluating organ toxicity were collected and categorized following the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Cairo-Bishop classification was also applied to identify patients experiencing laboratory tumor lysis syndrome (TLS) caused by RLT. After CON, we determined the rate of patients receiving hematopoietic stem cell transplantation (HSCT) followed by successful neutrophile engraftment.

Results: Forty cycles of CXCR4-directed RLT were applied. Myeloablative effects resulted in an 81.8% decline in leukocytes and a 69.4% decrease in neutrophil levels till the day of CON (P<0.0001, respectively), followed by platelets (63.1%; P<0.0001) and hemoglobin (9%; P=0.002). We observed 58 AE Events (1/58 [1.7%], ≥ grade 3). CON could be applied successfully after 39/40 (97.5%) cycles. After CON, in 39/39 (100%) of the cycles, HSCT was conducted, and successful neutrophil engraftment was reached after 37/39 (94.9%) of these cycles.

Conclusions: CXCR4-directed RLT exerted relevant myeloablative effects. When performing HSCT after applying additional CON, successful neutrophile engraftment was reached in the vast majority of the cases.

Solid papillary carcinoma of the breast is a rare low-grade tumor of the breast with unique histology and frequent neuroendocrine differentiation. The tumor usually affects older women with a favorable prognosis. We describe FDG PET/CT findings in a patient with unilateral invasive solid papillary carcinoma of the breast with ipsilateral axillary lymph node metastasis. The primary breast tumor showed focal intense activity (SUVmax, 8.8), and the enlarged metastatic axillary lymph node showed higher FDG uptake (SUVmax, 17.8) than the primary tumor. This case indicates that FDG PET/CT may be useful for staging this rare tumor, which needs further investigation.