Clinical Nuclear Medicine最新文献

In primary hyperparathyroidism (PHPT), exact preoperative localization of parathyroid adenomas is essential for best surgical planning. While new PET tracers like 18 F-fluorocholine and 68 Ga-Trivehexin show promise, traditional imaging consists of 99m Tc-Sestamibi scintigraphy, SPECT/CT, and 4DCT. Herein, we report the potential new application of another angiogenesis imaging agent, 68 Ga-NODAGA-RGD PET/CT, illustrated in a 12-year-old girl with PHPT. The scan revealed diffuse skeletal tracer uptake (superscan) in addition to localizing right inferior parathyroid adenoma, thereby indicating systemic effects. This case underscores 68 Ga-RGD PET/CT as a possible instrument for parathyroid imaging and systemic evaluation, justifying more research to define its diagnostic value and role in treatment response evaluation.

A 53-year-old man presented with right upper abdominal pain for more than 3 weeks without an apparent cause. Multiple sequences of MR imaging detected multiple liver nodules with irregular peripheral enhancement. 18 F-FDG and 68 Ga-FAPI PET showed multiple elevated tracer uptake, which mimicked multiple liver metastases of unknown primary focus. Finally, the pathology of ultrasound-guided biopsy confirmed the diagnosis of hepatic eosinophilic granuloma (HEG).

Gilal fibrillary acidic protein (GFAP) meningomyelitis is a rare autoimmune inflammatory disorder of the central nervous system, typically presenting with subacute encephalopathy, ataxia, optic neuritis, and cerebrospinal fluid (CSF) pleocytosis. It is characterized by the presence of GFAP-specific autoantibodies, which target astrocytes and cause widespread neuroinflammation. 18 F-FDG PET/CT plays a critical role in the early diagnosis of autoimmune encephalitides, particularly in cases where conventional MRI findings may be subtle or nonspecific. Here, we present a case of 21-year-old woman who presented with early morning occipital headache with fever, followed by progressive drowsiness and acute urinary retention. On clinical examination, meningeal signs were positive. MRI brain was suggestive of leptomeningeal enhancement involving the brain and spinal cord, and 18 F-FDG PET/CT was done for further evaluation.

Technetium-99m Technegas SPECT/CT is a promising tool for the localization of postoperative air leaks in thoracic surgery patients. We report a case of successful leak detection in a mechanically ventilated patient following thoracoscopic surgery and revision. Radioventilation was performed by connecting the TechnegasPlus (Cyclomedica Pty Ltd.) generator's administration set to the patient's endotracheal tube and gently inflating the lungs with a disposable respirator through the generator's assist valve. Intense pleural Technegas accumulation was observed as a correlate of the air leak. Characteristic changes of ventilation distribution secondary to mechanical ventilation are discussed.

[ 18 F]FDG PET/CT is widely used in the diagnosis and treatment monitoring of lung cancer, yet its ability to differentiate histologic heterogeneity remains limited. In this case, a 75-year-old man presented with a large pulmonary mass adjacent to a small satellite lesion. Bronchoscopic biopsy of the main lesion revealed small-cell lung cancer (SCLC). After first-line chemotherapy, the primary lesion showed partial response, while the smaller nodule remained stable. Posttreatment [ 18 F]FDG and [ 68 Ga]Ga-DOTA-3P-TATE-RGD PET/CT demonstrated divergent uptake patterns. Rebiopsy of the nodule with discordant tracer uptake confirmed squamous cell carcinoma, indicating synchronous double primary lung cancers. The dual-targeted tracer PET/CT guided precise biopsy and individualized therapy.

A 72-year-old man underwent 18 F-DCFPyL PSMA PET/CT imaging for the localization of biochemical recurrence (BCR) of prostate cancer. The scan revealed no definite findings, with only a vague uptake of uncertain significance in the bladder neck region. An additional PET/CT scan using a 64 Cu-labeled trimeric PSMA ligand demonstrated astonishing distinct uptake in the former prostate bed, unequivocally confirming the presence of a small local recurrence and allowing for targeted local therapy. This intriguing case highlights the potential of PET/CT using 64 Cu-labeled trimeric PSMA ligands, especially when conventional PSMA PET/CT scans yield ambiguous results.

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.