Clinical Nuclear Medicine最新文献

We report the imaging findings of a 33-year-old woman with polymorphous adenocarcinoma of the parotid gland. To evaluate bone metastases, she underwent a PET/CT scan using 68Ga-labeled DOTA-ibandronic acid (68Ga-DOTA-IBA). The examination revealed increased 68Ga-DOTA-IBA uptake in multiple bone metastases. Unexpectedly, 68Ga-DOTA-IBA uptake was also observed in the primary parotid polymorphous adenocarcinoma (PAC).

An 82-year-old man on active surveillance for low-risk prostate cancer underwent 18 F-DCFPyL PET/CT PET/CT for rising PSA. Imaging revealed interval progression of known intraprostatic malignancy. Interestingly, intracranial uptake was seen along the right frontoparietal convexity, corresponding to a known chronic subdural hematoma (cSDH) in this patient who had previously undergone middle meningeal artery embolization. This case highlights prostate-specific membrane antigen (PSMA) expression associated with cSDH, likely reflecting inflammation-driven neoangiogenesis. Recognition of such uptake is essential to avoid misinterpretation as metastatic disease and may provide novel insights into cSDH pathophysiology and potential therapeutic targets.

A 78-year-old man with prostate cancer underwent 68Ga-Gozetotide PSMA-targeted PET/CT. PET/CT images demonstrated avid primary prostate cancer and a focus of increased uptake in the right upper abdomen that initially appeared suspicious for metastasis. On axial PET/CT images, this focus localized to a horseshoe-shaped structure in the thorax. It showed a subtle communication with the right kidney through a Bochdalek hernia. The possibility of an anomaly rather than a metastatic lesion was raised. Further correlation with prior diagnostic contrast-enhanced CT scans confirmed the finding of a herniated ureter containing radioactive urine. This rare anomaly is a previously unreported pitfall in PSMA-targeted PET imaging.

Hepatocellular carcinoma involving the solitary zygomatic bone is quite rare. Here we present FDG PET/CT findings of the right zygomatic bone metastasis from hepatocellular carcinoma in a patient after transarterial chemoembolization 2 years ago. 18F-FDG PET/CT showed increased 18F-FDG uptake in the right zygomatic bone with SUVmax of 3.9. Finally, the diagnosis of solitary zygomatic bone metastasis was confirmed by pathologic examination.

We reported a 52-year-old man with thymus nonkeratinized squamous carcinoma presenting with acute superior vena cava syndrome (SVCS) who received 177Lu-FAP-2286 treatment and followed by low-dose chemotherapy. 68Ga-FAP-2286 PET/CT revealed significantly less intensity of the mediastinal mass comparing to pretherapy scan, as well as significant relief of SVCS. No adverse effects were observed.

We present the case of a 60-year-old woman with metastatic breast cancer who underwent 18 F-FDG PET/CT for treatment response assessment. Beyond oncologic findings, the scan revealed abnormal gastric retention, gallbladder, colonic, and renal uptake patterns suggestive of Semaglutide-induced gastroparesis, cholecystitis, colitis, and possible acute kidney injury secondary to dehydration. Suspicions were confirmed by clinical evaluation. Symptoms resolved after supportive therapy and withholding of semaglutide. To our knowledge, this is the first report of multi-organ side effects seen on 18 F-FDG PET/CT following a single semaglutide dose administration, emphasizing the need for nuclear medicine physicians to recognize glucagon-like peptide-1 receptor agonist medication-related side effects and their imaging manifestations.

Hypertrophic pachymeningitis is an uncommon disorder characterized by chronic inflammation and thickening of the dura mater, which can be idiopathic or secondary to autoimmune or infectious causes such as sarcoidosis, IgG4-related disease, tuberculosis, or syphilis. We report the case of a patient with a preliminary diagnosis of pachymeningitis in whom 68Ga-DOTA-TATE PET/CT demonstrated intense radiotracer uptake corresponding to dural thickening on MRI. The findings suggest the potential role of somatostatin receptor imaging in assessing disease extent and activity, and in differentiating inflammatory pachymeningitis from neoplastic or infectious mimics.

In adults, fibroblast activation protein inhibitor (FAPI) PET/CT scan has been employed for detecting recurrent and metastatic thyroid cancer in patients with thyroglobulin elevation and negative iodine scintigraphy (TENIS) syndrome. A 7-year-old boy with TENIS syndrome underwent 18F-FAPI PET/CT scan, which showed intense 18F-FAPI activity in metastatic lymph node in the right neck and pulmonary metastases. Meanwhile, intense uptake was noted on the region of the right ischiopubic synchondrosis. This case sheds light on the use of FAPI PET/CT scan in pediatric patients with TENIS. The need for caution is also highlighted for false-positive FAPI PET/CT findings in pediatric patients.

A 44-year-old man with a history of ulcerative colitis and primary sclerosing cholangitis presented with fecaluria and was found to have rectal and cecal masses, later histologically confirmed as mucinous adenocarcinomas forming rectovesical fistulas. Despite chemotherapy reducing the primary tumor size, elevated serum CEA levels prompted further imaging. An 18F-FDG PET/CT scan showed no new lesions, but a subsequent 99mTc-FAPI-46 scintigraphy revealed diffuse peritoneal involvement. During surgery for bowel obstruction, multiple metastatic deposits were identified. This case underscores the superior detection capability of 99mTc-FAPI-46 SPECT/CT in assessing peritoneal carcinomatosis in colorectal mucinous adenocarcinomas compared with 18F-FDG PET/CT.

Purpose: To evaluate the radioactive distribution patterns of [68Ga]Ga-FAPI-04 in primary hepatocellular carcinoma (HCC).

Methods: Twenty-three primary HCC patients (26 lesions) from a prospective trial (ChiCTR2000039099) underwent both [18F]FDG and [68Ga]Ga-FAPI-04 PET/CT within 1 week. Uptake at tumor margins versus centers was compared.

Results: FAPI-04 uptake was significantly higher at tumor margins than centers (SUVmax, P<0.001; SUVmean, P<0.01). As SUVmax thresholds increased, FAPI volume of interest concentrated at the margins and decreased sharply in the centers.

Conclusions: [68Ga]Ga-FAPI-04 PET/CT demonstrated higher marginal uptake and pronounced central heterogeneity (low-SUV centers) in HCC. Strong peripheral uptake supports the use of FAP-targeted fluorescence-guided surgery and targeted treatment of marginal residual/recurrent disease, while low central uptake may limit FAP-targeted therapy.