Clinical Nuclear Medicine最新文献

Abstract: A 25-year-old woman experiencing dysphagia for 2 years underwent 18 F-FDG and Al 18 F-FAPI-74 PET/CT. The scans showed local thickening of the cervical and upper thoracic esophageal wall with several calcifications, accompanied by increased and heterogeneous FDG uptake and more intense FAPI activity. Histopathological analysis following thoracoscopic esophagectomy confirmed the diagnosis of esophageal inflammatory pseudotumor.

Abstract: A 63-year-old man was remitted for a 68 Ga-PSMA-11 PET/CT scan due to biochemical recurrence with a PSA of 0.32 ng/mL 1 year after radical prostatectomy of locally advanced Gleason 6 (3 + 3) ISUP 2 pT3a pN0 prostate cancer. 68 Ga-PSMA-11 PET/CT showed multiple cutaneous and subcutaneous uptake foci in the upper body. Physical examination revealed numerous dome-shaped, ruby-red papules. These were consistent with a previous diagnosis of cutaneous hemangiomas. Cherry hemangiomas (also known as Campbell de Morgan spots) are the most common type of benign vascular proliferation of the skin. Due to the nonspecific 68 Ga-PSMA-11 uptake of vascular lesions, careful interpretation should be considered in order to avoid a potential pitfall in nonmalignant conditions.

Abstract: A 61-year-old woman, referred for recurrent pneumonia over a period of 3 months with insufficient response to antibiotic treatment, presented with coughing and intense right-sided chest pain. Previously, she underwent right upper lobectomy for locally advanced non-small cell lung cancer (squamous cell carcinoma) followed by adjuvant chemotherapy and subsequent partial chest wall resection with polytetrafluoroethylene net insert due to a pleurocutaneous fistula. 18 FDG plus a 68 Ga-labeled fibroblast activation protein inhibitor ( 68 Ga-FAPI) PET/CT scans were performed to rule out non-small cell lung cancer recurrence. Pathological workup with bronchoscopy and endobronchial ultrasound-guided transbronchial fine-needle aspiration of the lymph nodes showed no evidence of malignancy, but microbiology confirmed Aspergillus fumigatus infection of the middle lobe. Thus, the patient transitioned from antibiotic to antifungal therapy; no second-line oncologic treatment was initiated.

Abstract: A 43-year-old man with chronic hepatitis B and elevated alpha-fetoprotein levels showed no malignant evidence on 18 F-FDG PET/CT. However, subsequent assessment using 68 Ga-FAPI-04 PET/MR identified a lesion with increased FAPI uptake in the liver, coupled with detailed enhancement patterns on MRI, leading to a diagnosis of hepatocellular carcinoma, later confirmed by pathology. This case highlights the pivotal role of integrated 68 Ga-FAPI-04 PET and enhanced MRI in refining hepatocellular carcinoma diagnostics, advancing a more nuanced imaging approach over conventional modalities for comprehensive evaluation of hepatic lesions.

Abstract: A 59-year-old woman underwent radical surgery and chemotherapy for gastric adenocarcinoma. After the personalized antigen peptide tumor vaccine, a new nodular lesion, in the upper abdomen, was discovered during 68 Ga-FAPI-04 PET/MRI follow-up. To determine possible pseudoprogression, 68 Ga-FAPI-04 PET/MRI was repeated 39 days later, referring to immune PET response criteria in solid tumors. The lesion showed increased 68 Ga-FAPI-04 uptake, whereas uptake in vaccine injection sites decreased, and was ultimately diagnosed as a postoperative spindle cell nodule.

Abstract: A 53-year-old woman presented with signs of Cushing syndrome with challenges in diagnosis and localization. A novel somatostatin receptor (SSTR)-targeted PET/CT with 68 Ga-DOTA-LM3, an SSTR antagonist, revealed a suspicious focal finding in the pancreatic head, proven to be ectopic Cushing syndrome after surgical resection. This interesting image clearly shows the potential of PET imaging with SSTR antagonists as 68 Ga-DOTA-LM3 in the diagnosis of ectopic Cushing syndrome.

Abstract: A 2-and-a-half-year-old boy with a previous history of Langerhans cell histiocytosis reached remission as assessed by 18 F-FDG PET/CT. Routine follow-up 18 F-FDG PET/CT revealed the appearance of new bone lesions in the right scapula and right ischium with abnormal FDG activity 3 months after the end of treatment, and Langerhans cell histiocytosis recurrence was considered. Meanwhile, these lesions also showed increased FAPI uptake. After adjusting the chemotherapy regimen, both FDG and FAPI uptake almost disappeared in these lesions.

Abstract: Pheochromocytomas (PHEOs) are neural crest-derived tumors originating from the chromaffin cells of the adrenal medulla and were recognized as one of the subtypes of paragangliomas by the World Health Organization in 2022. 68 Ga-labeled somatostatin analog ( 68 Ga-DOTA-NOC, 68 Ga-DOTA-TOC, and 68 Ga-DOTA-TATE) PET imaging has shown significant performance compared with 123 MIBG scintigraphy in the diagnosis of paragangliomas. It is now known that fibroblast activation protein (FAP) is overexpressed by various cancer-associated fibroblasts, including PHEOs. We would like to present the findings of 68 Ga-DOTA-FAPI-46 PET/CT and 68 Ga-DOTA-TATE PET/CT imaging performed for restaging on a 42-year-old man diagnosed with metastatic PHEO.

Abstract: Ischemic colitis is the most common form of ischemic bowel disease; identification of ischemic colitis with PET/CT is rare. We present a case of unexplained ischemic colitis in a 66-year-old man who underwent 18 F-FDG PET/CT to exclude intestinal malignancy and was subsequently recruited in a clinical trial regarding 68 Ga-FAPI. 18 F-FDG PET/CT showed intense activity in the intestinal lumen where mucosa had chronic inflammation. Conversely, 68 Ga-FAPI PET/CT revealed high tracer uptake in the intestinal wall and adjacent mesentery. Our case showed the different distribution pattern of 18 F-FDG and 68 Ga-FAPI in ischemic colitis.