Although prior studies showed that patients with cirrhosis have a lower risk of developing liver metastases, appropriate workup of incidental liver masses in cirrhotic liver is important for a correct diagnosis. Here we present a case of newly diagnosed liver cirrhosis with multifocal hepatic lesions, which was initially categorized as a LI-RADS (Liver Imaging Reporting and Data System) 5 lesions. Scintigraphy with 111In-pentetreotide (Octreoscan) indicated a suspected thyroid nodule, later confirmed to represent medullary thyroid carcinoma lesion. The most relevant imaging finding of this rare form of thyroid malignancy is reviewed in this presentation.
{"title":"Hepatic Lesions in a Cirrhotic Liver: Primary or Metastases?","authors":"L. Mannelli, S. Monti, V. Grieco, M. Matesan","doi":"10.2967/jnmt.116.183228","DOIUrl":"https://doi.org/10.2967/jnmt.116.183228","url":null,"abstract":"Although prior studies showed that patients with cirrhosis have a lower risk of developing liver metastases, appropriate workup of incidental liver masses in cirrhotic liver is important for a correct diagnosis. Here we present a case of newly diagnosed liver cirrhosis with multifocal hepatic lesions, which was initially categorized as a LI-RADS (Liver Imaging Reporting and Data System) 5 lesions. Scintigraphy with 111In-pentetreotide (Octreoscan) indicated a suspected thyroid nodule, later confirmed to represent medullary thyroid carcinoma lesion. The most relevant imaging finding of this rare form of thyroid malignancy is reviewed in this presentation.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"1 1","pages":"50 - 52"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79844808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Survey on the Use of Nuclear Renal Imaging in the United States","authors":"R. Halkar, Andrew T. Taylor","doi":"10.2967/jnmt.116.188664","DOIUrl":"https://doi.org/10.2967/jnmt.116.188664","url":null,"abstract":"","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"10 1","pages":"65 - 65"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82788314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Bauer, Alaina Lathrum, O. Raslan, P. Kelly, Yihua Zhou, Debra Hewing, C. Botkin, James Turner, M. Osman
Gadolinium is toxic and to avoid its deposition in tissues, it must be chemically bonded with nonmetal ions to facilitate its excretion by the kidneys. High signal intensity in the dentate nucleus (DN) and globus pallidus (GP) on unenhanced T1-weighted MR images has been both morphologically and pathologically linked to gadolinium-based contrast agent (GBCA) retention in the brain. The purpose of this study was to determine whether repeated administrations of GBCA would affect the uptake of 18F-FDG in the DN and GP on PET/CT. Methods: Three hundred seventy-six patients who underwent both contrast-enhanced MR (CE MR) of the brain and PET/CT from January 2004 to October 2015 were identified. Patients with a history of brain irradiation or hepatic or renal disease were excluded. The SUVmax was measured in the DN and GP on the PET/CT scan in patients who had 3–6 successive CE MR brain studies. The SUVmax of the corresponding areas in the control group of patients who had not undergone previous CE MR and who had a normal, unenhanced MR finding of the brain was also measured. A Wilcoxon 2-sample test was used for statistical analysis. Results: Fifteen of 376 (4%) patients (mean age ± SD, 54 ± 18 y; 10 men and 5 women) were included in the subject group, and 15 patients (mean age ± SD, 36 ± 9 y; 11 men and 4 women) were included in the control group. The median DN SUVmax was significantly lower in the subject group than in the control group (5.4 vs. 6.4, respectively; P = 0.021). Similarly, the median GP SUVmax was significantly lower in the subject group than in the control group (8.8 vs. 12.1, respectively; P = 0.003). Conclusion: The median SUVmax in the DN and GP was 16% and 27% lower, respectively, in patients who received GBCAs than in those who had not received GBCAs, possibly related to gadolinium deposition in these areas.
钆是有毒的，为了避免其在组织中沉积，它必须与非金属离子化学结合，以促进其由肾脏排出。在未增强的t1加权MR图像上，齿状核(DN)和苍白球(GP)的高信号强度与钆基造影剂(GBCA)在大脑中的滞留在形态学和病理学上都有联系。本研究的目的是确定反复给药GBCA是否会影响PET/CT上DN和GP对18F-FDG的摄取。方法:选取2004年1月至2015年10月期间接受脑造影增强MR (CE MR)和PET/CT检查的376例患者。排除有脑照射史或肝脏或肾脏疾病的患者。在连续进行3-6次CE MR脑研究的患者中，通过PET/CT扫描的DN和GP测量SUVmax。对照组患者的相应区域的SUVmax也被测量，对照组患者之前没有接受过CE MR，并且他们的大脑有一个正常的，未增强的MR发现。采用Wilcoxon 2-样本检验进行统计分析。结果:376例患者中15例(4%)(平均年龄±SD, 54±18 y;试验组纳入10例男性，5例女性，15例患者(平均年龄±SD, 36±9y;11名男性和4名女性被纳入对照组。受试者组的中位DN SUVmax显著低于对照组(分别为5.4 vs 6.4;P = 0.021)。同样，受试者组的中位GP SUVmax显著低于对照组(分别为8.8 vs 12.1;P = 0.003)。结论:与未接受GBCAs治疗的患者相比，接受GBCAs治疗的患者DN和GP的中位SUVmax分别低16%和27%，可能与这些区域的钆沉积有关。
{"title":"Do Gadolinium-Based Contrast Agents Affect 18F-FDG PET/CT Uptake in the Dentate Nucleus and the Globus Pallidus? A Pilot Study","authors":"K. Bauer, Alaina Lathrum, O. Raslan, P. Kelly, Yihua Zhou, Debra Hewing, C. Botkin, James Turner, M. Osman","doi":"10.2967/jnmt.116.180844","DOIUrl":"https://doi.org/10.2967/jnmt.116.180844","url":null,"abstract":"Gadolinium is toxic and to avoid its deposition in tissues, it must be chemically bonded with nonmetal ions to facilitate its excretion by the kidneys. High signal intensity in the dentate nucleus (DN) and globus pallidus (GP) on unenhanced T1-weighted MR images has been both morphologically and pathologically linked to gadolinium-based contrast agent (GBCA) retention in the brain. The purpose of this study was to determine whether repeated administrations of GBCA would affect the uptake of 18F-FDG in the DN and GP on PET/CT. Methods: Three hundred seventy-six patients who underwent both contrast-enhanced MR (CE MR) of the brain and PET/CT from January 2004 to October 2015 were identified. Patients with a history of brain irradiation or hepatic or renal disease were excluded. The SUVmax was measured in the DN and GP on the PET/CT scan in patients who had 3–6 successive CE MR brain studies. The SUVmax of the corresponding areas in the control group of patients who had not undergone previous CE MR and who had a normal, unenhanced MR finding of the brain was also measured. A Wilcoxon 2-sample test was used for statistical analysis. Results: Fifteen of 376 (4%) patients (mean age ± SD, 54 ± 18 y; 10 men and 5 women) were included in the subject group, and 15 patients (mean age ± SD, 36 ± 9 y; 11 men and 4 women) were included in the control group. The median DN SUVmax was significantly lower in the subject group than in the control group (5.4 vs. 6.4, respectively; P = 0.021). Similarly, the median GP SUVmax was significantly lower in the subject group than in the control group (8.8 vs. 12.1, respectively; P = 0.003). Conclusion: The median SUVmax in the DN and GP was 16% and 27% lower, respectively, in patients who received GBCAs than in those who had not received GBCAs, possibly related to gadolinium deposition in these areas.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"7 1","pages":"30 - 33"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78568975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Our aim was to comparatively assess dual-tracer PET/CT (68Ga-DOTATATE and 18F-FDG) and multimodality anatomic imaging in studying metastatic neuroendocrine tumors (NETs) of unknown primary (CUP-NETs) scheduled for peptide receptor radionuclide therapy for divergence of tracer uptake on dual-tracer PET/CT, detection of primary, and overall lesion detection vis-a-vis tumor proliferation index (MIB-1/Ki-67). Methods: Fifty-one patients with CUP-NETs (25 men, 26 women; age, 22–74 y), histopathologically proven and thoroughly investigated with conventional imaging modalities (ultrasonography, CT/contrast-enhanced CT, MRI, and endoscopic ultrasound, wherever applicable), were retrospectively analyzed. Patients were primarily referred for deciding on feasibility of peptide receptor radionuclide therapy (except 2 patients), and all had undergone 68Ga-DOTATATE and 18F-FDG PET/CT as part of pretreatment workup. The sites of metastases included liver, lung/mediastinum, skeleton, abdominal nodes, and other soft-tissue sites. Patients were divided into 5 groups on the basis of MIB-1/Ki-67 index on a 5-point scale: group I (1%–5%) (n = 35), group II (6%–10%) (n = 8), group III (11%–15%) (n = 4), group IV (16%–20%) (n = 2), and group V (>20%) (n = 2). Semiquantitative analysis of tracer uptake was undertaken by SUVmax of metastatic lesions and the primary (when detected). The SUVmax values were studied over increasing MIB-1/Ki-67 index. The detection sensitivity of 68Ga-DOTATATE for primary and metastatic lesions was assessed and compared with other imaging modalities including 18F-FDG PET/CT. Results: Unknown primary was detected on 68Ga-DOTATATE in 31 of 51 patients, resulting in sensitivity of 60.78% whereas overall lesion detection sensitivity was 96.87%. The overall lesion detection sensitivities (individual groupwise from group I to group V) were 97.75%, 87.5%, 100%, 100%, and 66.67%, respectively. As MIB-1/Ki-67 index increased, 68Ga-DOTATATE uptake decreased in metastatic and primary lesions (mean SUVmax, 43.5 and 22.68 g/dL in group I to 22.54 and 16.83 g/dL in group V, respectively), whereas 18F-FDG uptake showed a gradual rise (mean SUVmax, 3.66 and 2.86 g/dL in group I to 7.53 and 9.58 g/dL in group V, respectively). There was a corresponding decrease in the 68Ga-DOTATATE–to–18F-FDG uptake ratio with increasing MIB-1/Ki-67 index (from 11.89 in group I to 2.99 in group V). Conclusion: In CUP-NETs, the pattern of uptake on dual-tracer PET (68Ga-DOTATATE and 18F-FDG) correlates well with tumor proliferation index with a few outliers; combined dual-tracer PET/CT with MIB-1/Ki-67 index would aid in better whole-body assessment of tumor biology in CUP-NETs.
{"title":"MIB-1 Index–Stratified Assessment of Dual-Tracer PET/CT with 68Ga-DOTATATE and 18F-FDG and Multimodality Anatomic Imaging in Metastatic Neuroendocrine Tumors of Unknown Primary in a PRRT Workup Setting","authors":"N. Sampathirao, S. Basu","doi":"10.2967/jnmt.116.185777","DOIUrl":"https://doi.org/10.2967/jnmt.116.185777","url":null,"abstract":"Our aim was to comparatively assess dual-tracer PET/CT (68Ga-DOTATATE and 18F-FDG) and multimodality anatomic imaging in studying metastatic neuroendocrine tumors (NETs) of unknown primary (CUP-NETs) scheduled for peptide receptor radionuclide therapy for divergence of tracer uptake on dual-tracer PET/CT, detection of primary, and overall lesion detection vis-a-vis tumor proliferation index (MIB-1/Ki-67). Methods: Fifty-one patients with CUP-NETs (25 men, 26 women; age, 22–74 y), histopathologically proven and thoroughly investigated with conventional imaging modalities (ultrasonography, CT/contrast-enhanced CT, MRI, and endoscopic ultrasound, wherever applicable), were retrospectively analyzed. Patients were primarily referred for deciding on feasibility of peptide receptor radionuclide therapy (except 2 patients), and all had undergone 68Ga-DOTATATE and 18F-FDG PET/CT as part of pretreatment workup. The sites of metastases included liver, lung/mediastinum, skeleton, abdominal nodes, and other soft-tissue sites. Patients were divided into 5 groups on the basis of MIB-1/Ki-67 index on a 5-point scale: group I (1%–5%) (n = 35), group II (6%–10%) (n = 8), group III (11%–15%) (n = 4), group IV (16%–20%) (n = 2), and group V (>20%) (n = 2). Semiquantitative analysis of tracer uptake was undertaken by SUVmax of metastatic lesions and the primary (when detected). The SUVmax values were studied over increasing MIB-1/Ki-67 index. The detection sensitivity of 68Ga-DOTATATE for primary and metastatic lesions was assessed and compared with other imaging modalities including 18F-FDG PET/CT. Results: Unknown primary was detected on 68Ga-DOTATATE in 31 of 51 patients, resulting in sensitivity of 60.78% whereas overall lesion detection sensitivity was 96.87%. The overall lesion detection sensitivities (individual groupwise from group I to group V) were 97.75%, 87.5%, 100%, 100%, and 66.67%, respectively. As MIB-1/Ki-67 index increased, 68Ga-DOTATATE uptake decreased in metastatic and primary lesions (mean SUVmax, 43.5 and 22.68 g/dL in group I to 22.54 and 16.83 g/dL in group V, respectively), whereas 18F-FDG uptake showed a gradual rise (mean SUVmax, 3.66 and 2.86 g/dL in group I to 7.53 and 9.58 g/dL in group V, respectively). There was a corresponding decrease in the 68Ga-DOTATATE–to–18F-FDG uptake ratio with increasing MIB-1/Ki-67 index (from 11.89 in group I to 2.99 in group V). Conclusion: In CUP-NETs, the pattern of uptake on dual-tracer PET (68Ga-DOTATATE and 18F-FDG) correlates well with tumor proliferation index with a few outliers; combined dual-tracer PET/CT with MIB-1/Ki-67 index would aid in better whole-body assessment of tumor biology in CUP-NETs.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"54 1","pages":"34 - 41"},"PeriodicalIF":0.0,"publicationDate":"2017-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90100616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Kulshrestha, S. Vinjamuri, A. England, J. Nightingale, P. Hogg
We describe the role of 18F-sodium fluoride (18F-NaF) PET/CT bone scanning in the staging of breast and prostate cancer. 18F-NaF PET was initially utilized as a bone scanning agent in the 1960s and early 1970s, however, its use was restricted by the then-available γ-cameras. The advent of hybrid PET/CT cameras in the late 1990s has shown a resurgence of interest in its use and role. After a brief introduction, this paper describes the radiopharmaceutical properties, dosimetry, pharmacokinetics, and mechanism of uptake of 18F-NaF. The performance of 18F-NaF PET/CT is then compared with that of conventional bone scintigraphy using current evidence from the literature. Strengths and weaknesses of 18F-NaF PET/CT imaging are highlighted. Clinical examples of improved accuracy of diagnosis and impact on patient management are illustrated. Limitations of 18F-NaF PET/CT imaging are outlined.
{"title":"The Role of 18F-Sodium Fluoride PET/CT Bone Scans in the Diagnosis of Metastatic Bone Disease from Breast and Prostate Cancer","authors":"R. Kulshrestha, S. Vinjamuri, A. England, J. Nightingale, P. Hogg","doi":"10.2967/jnmt.116.176859","DOIUrl":"https://doi.org/10.2967/jnmt.116.176859","url":null,"abstract":"We describe the role of 18F-sodium fluoride (18F-NaF) PET/CT bone scanning in the staging of breast and prostate cancer. 18F-NaF PET was initially utilized as a bone scanning agent in the 1960s and early 1970s, however, its use was restricted by the then-available γ-cameras. The advent of hybrid PET/CT cameras in the late 1990s has shown a resurgence of interest in its use and role. After a brief introduction, this paper describes the radiopharmaceutical properties, dosimetry, pharmacokinetics, and mechanism of uptake of 18F-NaF. The performance of 18F-NaF PET/CT is then compared with that of conventional bone scintigraphy using current evidence from the literature. Strengths and weaknesses of 18F-NaF PET/CT imaging are highlighted. Clinical examples of improved accuracy of diagnosis and impact on patient management are illustrated. Limitations of 18F-NaF PET/CT imaging are outlined.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"39 1","pages":"217 - 222"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73191702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Fakhri, Aun Hussain, Abbas Taiyebi, Amena Fatima Fakhri
We present a case study of a 56-y-old man who was admitted with acute abdominal pain and was found to have retroperitoneal hematoma from a ruptured duodenal aneurysm. 99mTc-diisopropyliminodiacetic acid cholescintigraphy showed incidental absent transit of radiotracer into the distal duodenum and severe enterogastric reflux, thought to be secondary to duodenal obstruction from the hematoma. Findings were confirmed on esophagogastroduodenoscopy, and the patient improved after subsequent gastrojejunostomy.
{"title":"Duodenal Obstruction on 99mTc-DISIDA Cholescintigraphy: A Noninvasive Approach to Bowel Obstruction Diagnosis","authors":"A. Fakhri, Aun Hussain, Abbas Taiyebi, Amena Fatima Fakhri","doi":"10.2967/jnmt.116.183822","DOIUrl":"https://doi.org/10.2967/jnmt.116.183822","url":null,"abstract":"We present a case study of a 56-y-old man who was admitted with acute abdominal pain and was found to have retroperitoneal hematoma from a ruptured duodenal aneurysm. 99mTc-diisopropyliminodiacetic acid cholescintigraphy showed incidental absent transit of radiotracer into the distal duodenum and severe enterogastric reflux, thought to be secondary to duodenal obstruction from the hematoma. Findings were confirmed on esophagogastroduodenoscopy, and the patient improved after subsequent gastrojejunostomy.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"120 1","pages":"265 - 266"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79430523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Maurer, Rahul Parupalli, Perry Orthey, H. Parkman
The Society of Nuclear Medicine and Molecular Imaging and European Association of Nuclear Medicine procedure guide on gastrointestinal transit currently indicates that the mean of total abdominal counts of 7 time points (0–360 min) is used to define the total abdominal counts for bowel transit studies. The purpose of this study was to investigate the variability of total abdominal counts during the initial 6 h of bowel transit and to determine whether a simplified, single-time-point measurement can be used. Methods: Thirty consecutive bowel transit studies were retrospectively analyzed. Patients received an oral dose of 4.6 MBq (125 μCi) of 111In-DTPA in 300 cc of water together with a standard egg white solid-phase, gastric-emptying meal to measure small bowel and colon transit. 111In-DTPA geometric mean and decay-corrected total abdominal counts obtained at 0, 30, 60, 120, 180, 240, 300, and 360 min after meal ingestion were analyzed. The coefficient of variation was used to determine the variability of the mean total abdominal counts. Slope of the regression line, Student t test, and a Pearson product-moment correlation coefficient (PCC) were also calculated to determine the correlation of total abdominal counts at each time point compared with the mean of all time points. Results: The mean coefficient of variation of total abdominal counts of each patient was 3.3%, with a range of 1.1%–6.3%. The mean of the slope of the regression line of the total abdominal counts of the patients was −0.001 ± 0.003. There was no significant difference between the measured slope of the regression line compared with a line with a slope of 0 (P > 0.05). When the counts at each time were compared with the mean counts, there was no significant difference (P > 0.05). The PCC of each of the counts showed a significant and strong correlation between each interval and the mean total abdominal counts (P < 0.01). Conclusion: There is no significant variability in geometric mean 111In-DTPA total abdominal counts during the initial 6 h of bowel transit studies. This can permit a more simplified analysis using the total abdominal counts from only a single time point.
{"title":"Validation of a Single-Time-Point Measurement of Total Abdominal Counts to Simplify Small Bowel and Colon Transit Analyses","authors":"A. Maurer, Rahul Parupalli, Perry Orthey, H. Parkman","doi":"10.2967/jnmt.116.183368","DOIUrl":"https://doi.org/10.2967/jnmt.116.183368","url":null,"abstract":"The Society of Nuclear Medicine and Molecular Imaging and European Association of Nuclear Medicine procedure guide on gastrointestinal transit currently indicates that the mean of total abdominal counts of 7 time points (0–360 min) is used to define the total abdominal counts for bowel transit studies. The purpose of this study was to investigate the variability of total abdominal counts during the initial 6 h of bowel transit and to determine whether a simplified, single-time-point measurement can be used. Methods: Thirty consecutive bowel transit studies were retrospectively analyzed. Patients received an oral dose of 4.6 MBq (125 μCi) of 111In-DTPA in 300 cc of water together with a standard egg white solid-phase, gastric-emptying meal to measure small bowel and colon transit. 111In-DTPA geometric mean and decay-corrected total abdominal counts obtained at 0, 30, 60, 120, 180, 240, 300, and 360 min after meal ingestion were analyzed. The coefficient of variation was used to determine the variability of the mean total abdominal counts. Slope of the regression line, Student t test, and a Pearson product-moment correlation coefficient (PCC) were also calculated to determine the correlation of total abdominal counts at each time point compared with the mean of all time points. Results: The mean coefficient of variation of total abdominal counts of each patient was 3.3%, with a range of 1.1%–6.3%. The mean of the slope of the regression line of the total abdominal counts of the patients was −0.001 ± 0.003. There was no significant difference between the measured slope of the regression line compared with a line with a slope of 0 (P > 0.05). When the counts at each time were compared with the mean counts, there was no significant difference (P > 0.05). The PCC of each of the counts showed a significant and strong correlation between each interval and the mean total abdominal counts (P < 0.01). Conclusion: There is no significant variability in geometric mean 111In-DTPA total abdominal counts during the initial 6 h of bowel transit studies. This can permit a more simplified analysis using the total abdominal counts from only a single time point.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"14 1","pages":"239 - 242"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87130447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The potential of peptide receptor radionuclide therapy (PRRT) is described in a case of recurrent inoperable phosphaturic mesenchymal tumor causing osteomalacia in the left basiocciput, for which the patient had undergone surgery twice previously. After one cycle of PRRT, there was good symptomatic improvement, with a modest reduction in uptake on both 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT suggesting a favorable response. Hence, treatment with a second cycle was considered. Being somatostatin receptor–avid, this rare group of tumors when inoperable or recurrent may potentially be targeted with PRRT. Well-tolerated and noninvasive, PRRT could evolve as a promising targeted treatment approach in this clinical setting. In summary, tumor-induced osteomalacia with 68Ga-DOTATATE–avid inoperable or recurrent tumor can be considered a potential clinical application for PRRT beyond neuroendocrine tumors.
{"title":"177Lu-DOTATATE PRRT in Recurrent Skull-Base Phosphaturic Mesenchymal Tumor Causing Osteomalacia: A Potential Application of PRRT Beyond Neuroendocrine Tumors","authors":"S. Basu, Preeti Fargose","doi":"10.2967/jnmt.116.177873","DOIUrl":"https://doi.org/10.2967/jnmt.116.177873","url":null,"abstract":"The potential of peptide receptor radionuclide therapy (PRRT) is described in a case of recurrent inoperable phosphaturic mesenchymal tumor causing osteomalacia in the left basiocciput, for which the patient had undergone surgery twice previously. After one cycle of PRRT, there was good symptomatic improvement, with a modest reduction in uptake on both 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT suggesting a favorable response. Hence, treatment with a second cycle was considered. Being somatostatin receptor–avid, this rare group of tumors when inoperable or recurrent may potentially be targeted with PRRT. Well-tolerated and noninvasive, PRRT could evolve as a promising targeted treatment approach in this clinical setting. In summary, tumor-induced osteomalacia with 68Ga-DOTATATE–avid inoperable or recurrent tumor can be considered a potential clinical application for PRRT beyond neuroendocrine tumors.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"60 1","pages":"248 - 250"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82698578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Gelfand, Jennifer M. Harris, A. Rich, Chelsea S. Kist
This study was designed to evaluate the effectiveness of video goggles in distracting children undergoing PET/CT and to determine whether the goggles create CT and PET artifacts. Methods: Video goggles with small amounts of internal radioopaque material were used. During whole-body PET/CT imaging, 30 nonsedated patients aged 4–13 y watched videos of their choice using the goggles. Fifteen of the PET/CT studies were performed on a scanner installed in 2006, and the other 15 were performed on a scanner installed in 2013. The fused scans were reviewed for evidence of head movement, and the individual PET and CT scans of the head were reviewed for the presence and severity of streak artifact. The CT exposure settings were recorded for each scan at the anatomic level at which the goggles were worn. Results: Only one of the 30 scans had evidence of significant head motion. Two of the 30 had minor coregistration problems due to motion, and 27 of the 30 had very good to excellent coregistration. For the 2006 scanner, 2 of the 14 evaluable localization CT scans of the head demonstrated no streak artifact in brain tissue, 6 of the 14 had mild streak artifact in brain tissue, and 6 of the 14 had moderate streak artifact in brain tissue. Mild streak artifact in bone was noted in 2 of the 14 studies. For the 2013 scanner, 7 of 15 studies had mild streak artifact in brain tissue and 8 of 15 had no streak artifact in brain tissue, whereas none of the 15 had streak artifact in bone. There were no artifacts attributable to the goggles on the 18F-FDG PET brain images of any of the 29 evaluable studies. The average CT exposure parameters at the level of the orbits were 36% lower on the 2013 scanner than on the 2006 scanner. Conclusion: Video goggles may be used successfully to distract children undergoing PET with localization CT. The goggles cause no significant degradation of the PET brain images or the CT skull images. The degree of artifact on brain tissue images varies from none to moderate and depends on the CT equipment used.
{"title":"Use of Video Goggles to Distract Patients During PET/CT Studies of School-Aged Children","authors":"M. Gelfand, Jennifer M. Harris, A. Rich, Chelsea S. Kist","doi":"10.2967/jnmt.116.179473","DOIUrl":"https://doi.org/10.2967/jnmt.116.179473","url":null,"abstract":"This study was designed to evaluate the effectiveness of video goggles in distracting children undergoing PET/CT and to determine whether the goggles create CT and PET artifacts. Methods: Video goggles with small amounts of internal radioopaque material were used. During whole-body PET/CT imaging, 30 nonsedated patients aged 4–13 y watched videos of their choice using the goggles. Fifteen of the PET/CT studies were performed on a scanner installed in 2006, and the other 15 were performed on a scanner installed in 2013. The fused scans were reviewed for evidence of head movement, and the individual PET and CT scans of the head were reviewed for the presence and severity of streak artifact. The CT exposure settings were recorded for each scan at the anatomic level at which the goggles were worn. Results: Only one of the 30 scans had evidence of significant head motion. Two of the 30 had minor coregistration problems due to motion, and 27 of the 30 had very good to excellent coregistration. For the 2006 scanner, 2 of the 14 evaluable localization CT scans of the head demonstrated no streak artifact in brain tissue, 6 of the 14 had mild streak artifact in brain tissue, and 6 of the 14 had moderate streak artifact in brain tissue. Mild streak artifact in bone was noted in 2 of the 14 studies. For the 2013 scanner, 7 of 15 studies had mild streak artifact in brain tissue and 8 of 15 had no streak artifact in brain tissue, whereas none of the 15 had streak artifact in bone. There were no artifacts attributable to the goggles on the 18F-FDG PET brain images of any of the 29 evaluable studies. The average CT exposure parameters at the level of the orbits were 36% lower on the 2013 scanner than on the 2006 scanner. Conclusion: Video goggles may be used successfully to distract children undergoing PET with localization CT. The goggles cause no significant degradation of the PET brain images or the CT skull images. The degree of artifact on brain tissue images varies from none to moderate and depends on the CT equipment used.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"72 1","pages":"227 - 229"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84549912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paragangliomas associated with mutations of the SDHD gene can occasionally result in distant metastasis. Diagnosis can be difficult, and nuclear imaging is used to evaluate the case further. Not all tumors are alike; nuclear avidity may differ. We present a case in which metastatic paraganglioma caused by mutations of the SDHD gene was negative on 123I-metaiodobenzylguanidine scintigraphy and positive on 111In-labeled octreotide scintigraphy. This situation presents an opportunity for a novel therapeutic approach toward metastatic paraganglioma using targeted peptide receptor radionuclide therapy.
{"title":"Nuclear Imaging in Metastatic Paraganglioma","authors":"Rohit Kedia, Neil J. Hansen, W. Goldner","doi":"10.2967/jnmt.116.180067","DOIUrl":"https://doi.org/10.2967/jnmt.116.180067","url":null,"abstract":"Paragangliomas associated with mutations of the SDHD gene can occasionally result in distant metastasis. Diagnosis can be difficult, and nuclear imaging is used to evaluate the case further. Not all tumors are alike; nuclear avidity may differ. We present a case in which metastatic paraganglioma caused by mutations of the SDHD gene was negative on 123I-metaiodobenzylguanidine scintigraphy and positive on 111In-labeled octreotide scintigraphy. This situation presents an opportunity for a novel therapeutic approach toward metastatic paraganglioma using targeted peptide receptor radionuclide therapy.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"50 1","pages":"251 - 252"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80512867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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