Clinical Nuclear Medicine最新文献

Abstract: Idiopathic hypereosinophilic syndrome is a group of unexplained diseases characterized by a persistent increase in eosinophils with multiple organs damage. Herein, we describe the 68Ga-FAPI PET/CT findings of idiopathic hypereosinophilic syndrome in a 56-year-old woman. 68Ga-FAPI PET/CT showed multiple aneurysms with increased FAPI uptake. In addition, myocardial uptake of FAPI was observed.

Abstract: Multiple-pinhole collimators provide considerable improvement of SPECT system count sensitivity. This case report suggests that SPECT with brain-specific multiple-pinhole collimators enables cerebral perfusion imaging with diagnostic quality by an early 12 minutes scan immediately after injection of a standard dose of the dopamine transporter ligand 123I-FP-CIT. Thus, 123I-FP-CIT SPECT with multiple-pinhole collimators could assess nigrostriatal degeneration (late image) and extrastriatal involvement (early perfusion image) during the same imaging session. The early image may serve as an alternative to FDG PET in patients with suspicion of an atypical neurodegenerative parkinsonian syndrome. This could streamline diagnostic workflows by reducing the need for additional imaging modalities.

Abstract: McCune-Albright syndrome is characterized by a triad of café au lait macules, polyostotic fibrous dysplasia (FD), and endocrine abnormalities. Bilateral and extensive presentation of FD is rarely reported. We report an interesting case of 24-year-old woman presenting with multiple episodes of slip and fall, sustaining multiple fractures with history of precocious puberty and skin complaints. On evaluation with 99mTc-MDP bone scan, all the long bones, ribs, pelvic bones, frontal bone, and maxilla showed deformities and increased osteoblastic activity, suggesting extensive polyostotic FD. Thus emphasizing the crucial role of 99mTc-MDP bone scan in the diagnosis of extensive FD and guides in understanding of the polyostotic involvement.

Abstract: Primary prostatic urothelial carcinoma is a very rare aggressive tumor with poor prognosis. We describe FDG PET/CT findings in 2 patients with primary prostatic urothelial carcinoma. In 1 patient, FDG PET/CT showed intense activity of the prostate tumor with extraprostatic invasion. In the other patient, FDG PET/CT showed heterogeneous intense activity of the primary tumor and multiple hypermetabolic metastases in the regional lymph nodes, bone, and lung. Both patients had normal serum total prostate-specific antigen levels. These cases highlight the usefulness of FDG PET/CT in detecting and staging of primary prostatic urothelial carcinoma due to high FDG avidity.

Abstract: Scrotal edema is a complication in continuous ambulatory peritoneal dialysis patients, and its etiology can be challenging to determine. We performed peritoneal scintigraphy in a case of a patient who developed pronounced scrotal edema following peritoneal dialysis. The imaging revealed clear visualization of the right inguinal canal and right scrotum, suggesting the usefulness of peritoneal scintigraphy in identifying the etiology of scrotal edema in continuous ambulatory peritoneal dialysis patients.

Abstract: Cutaneous manifestations of multiple myeloma are rare but, as with other extramedullary manifestations, carry a worse prognosis. We present the case of a 65-year-old man with immunoglobulin G κ multiple myeloma and prior autologous stem cell transplant. On subsequent therapy, he presented with multiple new cutaneous and subcutaneous left hip masses. Biopsy of these lesions revealed plasma cell neoplasm with anaplastic morphology, confirming progression of disease. He subsequently underwent radiation to these lesions with plans for chimeric antigen receptor T-cell therapy due to refractory disease.

Abstract: Mantle cell lymphoma (MCL) is a rare type of B-cell non-Hodgkin lymphoma that commonly presents with constitutional symptoms, lymphadenopathy, and laboratory abnormalities. Although less common, extranodal involvement of MCL may be seen at initial presentation and most commonly occurs in the spleen, liver, bone marrow, and gastrointestinal tract. Adrenal involvement in MCL is extremely rare, and only a few cases have been reported in the literature. Herein, we present 18 F-FDG PET/CT and 68 Ga-DOTATATE PET/CT findings of a unique case of primary extranodal MCL with gastric and adrenal involvement.

Purpose: The aim of this study was to evaluate the efficacy and safety of 177Lu-DOTA-IBA for pain palliation in participants with bone metastases and confirm its potential for treating bone metastasis.

Patients and methods: Overall, 69 participants with bone metastases were included. 68Ga-DOTA-IBA PET/CT was performed within 1 week before treatment. Vital signs, blood markers, electrocardiogram, Karnofsky Performance Status (KPS), and pain scores were evaluated within 7 days before treatment. Postadministration of 177Lu-DOTA-IBA, participants' vital signs and general conditions were monitored. Follow-up evaluations of KPS, pain scores, and blood biomarkers were performed within 8 weeks. 68Ga-DOTA-IBA PET/CT was repeated to evaluate imaging responses at 8 weeks. Imaging responses were defined as complete response, partial response, stable disease, and disease progression. Subsequent treatments were administered based on participants' agreement and clinical conditions.

Results: Sixty-nine participants received at least 1 dose of 177Lu-DOTA-IBA treatment; 22 received 38 reinjected doses, totaling 107 treatments. The median injection dose of 177Lu-DOTA-IBA was 1110 MBq. The pain remission rates after first treatment, retreatment, and total treatment were 82.5%, 72.4%, and 79.3%, respectively. The improvement rates in KPS for first treatment, retreatment, and total treatment were 81.3%, 60.6%, and 74.2%, respectively. The total incidence of the pain flare reaction (temporary aggravation of pain intensity after treatment) was 16.8%. Comparative analysis of 68Ga-DOTA-IBA PET/CT showed a 27.1% rate of partial response imaging response. The total incidence of adverse hematological events was 15%.

Conclusions: 177Lu-DOTA-IBA is a promising bone-seeking radiopharmaceutical with a considerable pain relief rate and safety. It also can benefit some participants with bone metastases in imaging response.

Abstract: We report a case of a woman with SAPHO syndrome who exhibited increased tracer uptake in the sternal angle on a 99m Tc-MDP bone scan. This patient was enrolled in a 68 Ga-pentixafor PET/CT trial for inflammatory diseases. The PET/CT showed no abnormal tracer uptake in the sternal angle. Unexpectedly, diffuse uptake of 68 Ga-pentixafor was observed in both breasts, which might be due to hormonal stimulation because the woman underwent the 68 Ga-pentixafor PET/CT scan during the ovulatory phase.

Propose: The aim of this study was to evaluate the clinical application value of 18 F-FGln PET/CT in glioma.

Patients and methods: Patients with suspected gliomas by MRI were included in this study. Static and/or dynamic brain 18 F-FGln PET/CT was performed. The PET parameters SUV max , SUV mean , MTV, and TLG were evaluated.

Results: Twenty-three patients were included in the analysis. Nineteen of 23 patients were positive for 18 F-FGln PET. The SUV max of high- and low-grade gliomas were 4.75 ± 2.21 and 1.00 ± 0.66 ( P < 0.001), respectively. FGln-PET SUV max , SUV mean , and TLG all showed statistically significant correlations with glioma grade, with correlation coefficients ( r ) of 0.667 ( P < 0.001), 0.693 ( P < 0.001), and 0.487 ( P = 0.021), respectively. Additionally, the SUV max , SUV mean , and TLG exhibited higher distinguishing performance for glioma grade by receiver operating characteristic curve analysis. The areas under the receiver operating characteristic curve of SUV max , SUV mean , and TLG were 0.976 (95% confidence interval [CI], 0.918-1) ( P = 0.002), 0.976 (95% CI, 0.918-1) ( P = 0.002), and 0.835 (95% CI, 0.628-1.000) ( P = 0.026), respectively. For glioma isocitrate dehydrogenase (IDH) mutation status, the SUV max of IDH wildtype and mutant glioma were 2.95 ± 1.99 and 6.13 ± 2.16 ( P = 0.005), respectively. The SUV mean and SUV max had good-to-satisfactory performance for IDH status with the area under the receiver operating characteristic curve of SUV max and SUV mean of 0.885 (95% CI, 0.734-1.000) ( P = 0.009) and 0.942 (95% CI, 0.828-1) ( P = 0.002).

Conclusions: Although we do not assert that 18 F-FGln PET/CT imaging is satisfactory in the differential diagnosis of glioma, we revealed its potential for identifying the stage of gliomas and the IDH mutation status and propose that glutamine-based PET imaging enables the assessment of metabolic nutrient uptake of gliomas to assist clinical diagnosis and treatment of patients.