Molecular Imaging and Radionuclide Therapy最新文献

Serous psammocarcinoma of the ovary is a rare variant of ovarian serous carcinoma characterized by the presence of calcified peritoneal lesions, known as psammoma bodies. These calcified lesions may usually be considered benign on computed tomography but may show avidity for ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG), which can be helpful in the diagnosis of this rare ovarian tumor. We present a rare case of serous psammocarcinoma of the ovary detected during the diagnostic work-up of lobular breast cancer using ¹⁸F-FDG positron emission tomography/computed tomography.

Objectives: This study aimed to evaluate the impact of Radioactive iodine 131 (RAI 131) therapy on the quality of life (QoL) of patients with hyperthyroidism using the Thyroid Patient-Reported Outcome (ThyPRO) questionnaire and to quantify the extent of these improvements.

Methods: This two-year, prospective, single-center study was conducted at the University Medical Faculty Hospital. Eighty-four patients (39 males and 45 females) diagnosed with hyperthyroidism due to Graves' disease, toxic multinodular goiter, or toxic adenoma received RAI 131 therapy at doses of 10, 15, 20, or 30 mCi. The ThyPRO questionnaire, consisting of 84 questions across 12 domains, was administered before treatment and six months post-treatment to assess QoL. The primary outcome was the change in ThyPRO scores.

Results: Significant improvements in all post-treatment QoL measures were observed in both males and females (p<0.001). The average age of the patients was 58.33±12.45 years. QoL improvements were consistent across all age groups (<50, 50-60, >60 years) and at all levels of hyperthyroidism severity (mild, moderate, and severe). All RAI 131 dose groups (10, 15, 20, and 30mCi) showed significant improvements in QoL, with no significant differences between dose groups. The correlation analysis revealed that age had a weak negative correlation with QoL improvement (r=-0.20, p=0.05), whereas thyroid hormone levels were significantly correlated with QoL improvement. Multiple regression analysis identified initial ThyPRO score and age as significant predictors of QoL improvement, whereas sex and RAI 131 dose were not significant predictors.

Conclusion: RAI therapy significantly enhanced the QoL of hyperthyroid patients according to demographic and disease severity. These findings support the use of RAI 131 as a primary treatment for hyperthyroidism, highlighting the importance of personalized treatment approaches for optimizing patient outcomes. Future research should focus on long-term QoL outcomes and refine therapeutic strategies.

Neoplastic infiltration of the omentum is mostly caused by metastatic ovarian, gastric, colon, or pancreatic cancer. Lymphomatous infiltration of the omentum is rare because the omentum lacks a lymphoid component. To date, lymphomatous involvement of the omentum has only been reported in patients with non-Hodgkin lymphoma. Peritoneal lymphomatosis remains a rare presentation of malignant lymphoma characterized by diffuse peritoneal lesions and is frequently accompanied by ascites and mesenteric lesions. In this review, we aimed to illustrate the case of a 72 year old mal patient diagnosed with aggressive large B-cell lymphoma, adressed for initial extension assessment in whom ¹⁸F-fluorodeoxyglucose positron emission tomograph/computed tomography found unusual omental and mesenteric involvement.

Primary liposarcoma of the lung is extremely rare. To date, only 24 cases have been reported in the English literature. Herein, we present a case of well-differentiated pulmonary liposarcoma that was misdiagnosed as teratoma on positron emission tomography/computed tomography (CT) and contrast-enhanced CT. Radical surgery with left superior lobectomy and mediastinal lymph node dissection were performed. The patient experienced recurrence and distant metastases 33 months after surgery. He was alive at the time of writing this report (36 months postoperatively). To our knowledge, this is the first case report of pulmonary well-differentiated liposarcoma.

A Chemoport is frequently utilized in oncological patients for administering chemotherapy. However, inadequate care can lead to various infectious and non-infectious complications. Infection commonly presents as a local infection that can lead to life-threatening septicemia. Early diagnosis and intervention are necessary to reduce morbidity and mortality. We report a patient with breast cancer who underwent ¹⁸F-fluorodeoxyglucose positron (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) due to suspicion of metastatic disease. ¹⁸F-FDG-PET/CT revealed pyomyositis involving multiple skeletal muscles and septic emboli in the lungs and identified the chemoport as a possible source of infection. The infection source was confirmed and the patient responded to anti-microbiological therapy.

Objectives: This study aimed to evaluate the potential efficacy of ⁶⁸Ga-fibroblast activation protein inhibitor (FAPi) positron emission tomography/computed tomography (PET/CT) for detecting, staging, and restaging digestive system malignancies that are ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) negative or show equivocal ¹⁸F-FDG uptake.

Methods: We conducted a prospective analysis of 30 patients with pathologically confirmed primary tumors or metastases of the digestive system. Participants underwent ⁶⁸Ga-FAPi PET/CT and ¹⁸F-FDG PET/CT imaging for staging or restaging purposes within the same week. The efficacy of ⁶⁸Ga-FAPi PET/CT was assessed by comparing its ability to detect lesions and influence disease staging with that of ¹⁸F-FDG PET/CT.

Results: ⁶⁸Ga-FAPi PET/CT imaging was performed in 30 patients with ¹⁸F-FDG-negative or indeterminate lesions. Of the 30 patients, 23 had gastric cancer and 7 had colorectal cancer. Among all patients, histopathological diagnosis of signet ring cell carcinoma was present in 15 (50%) patients. Primary tumor or local recurrence was detected in 19 (63%) patients, lymph node metastasis in 8 (27%) patients, visceral metastasis in 4 (13%) patients, peritoneal metastasis in 14 (47%) patients, and bone metastasis in 3 (10%) patients on ⁶⁸Ga-FAPi PET/CT images. All patients underwent histopathological confirmation on ⁶⁸Ga-FAPi PET/CT images. The disease stage was upgraded in 20 patients (67%) after ⁶⁸Ga-FAPi PET/CT imaging. Of the 20 patients, 12 had no evidence of recurrence or metastasis on ¹⁸F-FDG PET/CT.

Conclusion: Based on our study, ⁶⁸Ga-FAPi PET/CT alters the disease stage in the majority of gastrointestinal malignancies with negative or equivocal ¹⁸F-FDG PET/CT findings. ⁶⁸Ga-FAPi PET/CT appears to be effective in both staging and restaging of gastrointestinal malignancies, such as signet-ring cell carcinomas of the stomach that frequently show low ¹⁸F-FDG -avidity.

A 39-year-old woman presented with left neck masses for 4 months and epiphora of the left eye for 3 weeks. Ultrasonography revealed a mass in the left parotid gland and multiple cervical lymph nodes. Biopsy of the mass in the left parotid gland revealed infiltrating ductal carcinoma. ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography scan was undertaken, which showed a mass in the left parotid gland and multiple cervical lymph nodes with high metabolism. A nodule in the left nasolacrimal duct with high metabolism was observed. The nodule was surgically removed and pathologically confirmed as metastatic parotid ductal carcinoma.

Objectives: Positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) are widely used in the diagnosis and follow-up of liver metastases. Both modalities provide anatomical and functional information and have advantages and disadvantages. The objective of this study was to investigate the correlation between apparent diffusion coefficient (ADC) and standardized uptake value (SUV) values in metastatic liver lesions.

Methods: Abdominal magnetic resonance (MR) scans performed between April 2021 and 2024 using the 3T MR scanner were retrospectively evaluated. Thirty-three patients with liver metastases, less than one month between magnetic resonance imaging (MRI) and PET/CT, no treatment during this period, and lesions larger than 1 cm were included in the study. In each MRI scan, an index lesion was selected for ADC measurement. The radiologist and nuclear medicine specialist measured the same index lesion without the patient being informed of the results.

Results: The mean age of the 33 patients was 59±12 years, with 17 (51%) men and 16 (49%) women. The mean size of the index lesions was 27±9 mm. In MRI, mean ADC_min: (0.54±0.2) ×10^-3mm²/s; ADC_mean: (1.02±0.2) ×10^-3mm²/s; ADC_max: (1.48±0.44) ×10^-3mm²/s; and region of interest area was calculated as 6±4.6 cm². In PET/CT, mean SUV_mean: 5.8±3.3; SUV_peak: 6.8±4.3; SUV_max: 10.7±5.6; and metabolic tumor volume: 12.1 (7.4-20.7) cm³. No statistically significant correlation was found between ADC and SUV values.

Conclusion: There was no correlation between ADC and SUV values in liver metastases. Prospective studies with a large patient group are needed.

Objectives: This study aimed to evaluate the relationship between the degree of bone marrow involvement, hematological parameters, and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG)-positron emission tomography/computed tomography (PET/CT) data in patients diagnosed with multiple myeloma.

Methods: A total of 71 patients [19 females, 52 males, mean age 67 (36-83) years] who were diagnosed with multiple myeloma between 2014 and 2021, had not received any treatment yet, and underwent ¹⁸F-FDG-PET/CT for staging were included in the study.

Results: No significant correlation was observed between bone marrow standardized uptake value (SUV)_max and plasma cell infiltration (p=0.07). However, we found that patients with visually increased bone marrow counts also had higher plasma cell infiltration rates (p=0.037). No significant correlation was found between plasma cell infiltration rates and bone marrow SUV_max and systemic inflammatory index (SII) (p=0.187 and p=0.446, respectively). However, there was a significant correlation between the SUV_max of lytic lesions showing increased ¹⁸F-FDG uptake in bone and SII (p=0.025, r=0.330).

Conclusion: We believe that ¹⁸F-FDG PET/CT may be an advantage over bone marrow biopsy in the diagnosis and evaluation of multiple myeloma recurrence and may prevent repeated bone marrow biopsies.

A 57-year-old man diagnosed with a metastatic bladder tumor was initiated on pembrolizumab treatment. ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) imaging performed to evaluate treatment response showed numerical-dimensional and metabolic increase in the metastatic lesions. In the ¹⁸F-FDG PET/CT imaging performed 8 weeks later due to suspicion of pseudoprogression, a significant regression of the lesions was observed, and the patient was diagnosed with pseudoprogression. Pseudoprogression should be kept in mind when ¹⁸F-FDG PET/CT is performed after the use of immunotherapy, and evaluation with follow-up PET/CT is recommended to confirm that the patient has hyperprogression or pseudoprogression.