Molecular Imaging and Radionuclide Therapy最新文献

Identifying osseous metastases by imaging is essential and may be challenging in patients with lobular breast cancer. We present a case of a 66-year-old woman with lobular breast cancer who underwent ¹⁸F- fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for staging purposes. ¹⁸F-FDG PET/CT reveals minimal FDG uptake in the primary tumor cells. Prominent sclerotic lesions with low FDG avidity are seen in the spinal and pelvic bones. The subsequent Tc-99m methylene diphosphonate bone scan is unremarkable. The magnetic resonance imaging (MRI) reveals bone metastases. MRI may be beneficial in invasive lobular carcinoma. MRI facilitates improved metastatic evaluation, especially in bone-only and bone-predominant metastatic malignancies, when assessment with ¹⁸F-FDG PET/CT may be difficult and constrained.

This systematic review aimed to explore the currently reported false positive findings of Gallium-68 (⁶⁸Ga)-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid Tyr3-octreotide (⁶⁸Ga-DOTATOC). PubMed, Web of Science, and Scopus databases were used to conduct a systematic search and were updated until March 4, 2024. Three authors independently screened the titles and abstracts of the retrieved articles and selected the articles based on the inclusion and exclusion criteria. In a qualitative analysis of 42 included research articles involving 601 patients, 219 false positive findings were identified and categorized. Non-oncologic etiologies predominated, constituting 50.2% of pitfalls, followed by benign oncologic (27.4%) and malignant neoplasms (22.4%). Anatomically, the abdomen was the most common site for pitfalls (30.6%), followed by the musculoskeletal (22.4%), head and neck (20.5%), and pelvic (14.6%) regions. Chest region findings were least frequent, accounting for only 11.9%. This study elucidates potential false positive findings, predominantly occurring in the abdominal and head-neck regions-primary sites for meningiomas and neuroendocrine tumors (NETs). Understanding these false-positive findings is crucial for accurate diagnosis. Furthermore, recognizing these pitfalls may lead to novel applications of ⁶⁸Ga-DOTATOC beyond its conventional use in evaluating NETs and meningiomas, potentially expanding its current utility.

Objectives: Prostate-specific membrane antigen-positron emission tomography (PSMA-PET) has significantly improved sensitivity and specificity for detecting metastatic disease in prostate cancer compared to traditional computed tomography and bone scans. It is now recommended by the European Association of Urology for staging intermediate and high-risk disease, however, there are no recommendations on its incorporation into practice due to lack of long-term survival data. We aimed to identify the current use of PSMA-PET in high-volume prostate cancer centres to see whether there is standardisation in its use and interpretation prior to robotic-assisted laparoscopic prostatectomy (RALP).

Methods: An anonymised SurveyMonkey^® was sent to multiple high-volume surgeons across the United Kingdom (UK), with all questions optional. Participants were asked about their personal practices for PSMA-PET staging, for both intermediate and high-risk disease, and how it would change their management if considering RALP.

Results: Thirty-one participants responded across 17 different UK centres. 11/31 (35%) used PSMA-PET a lone as primary staging for high-risk prostate cancer, with 6/30 (20%) using it for intermediate staging as well. Of the 23 surgeons that routinely perform lymph node dissection (LND) in high-risk cases, 13/23 (57%) would obviate performing it if the PSMA was negative. If a patient was found to have positive nodes on PSMA-PET, 12/31 (39%) surgeons will still offer RALP. Individual answers also varied within same centres.

Conclusion: The current interpretation of PSMA-PET for staging and treatment before RALP varies widely amongst surgeons, particularly regarding LND. A national consensus statement is needed to help standardise treatment practice for patients until robust long-term survival data exists.

Although extrapulmonary Coccidioides infection is rare, it has been shown to disseminate to the skin and musculoskeletal system, with a strong affinity for bone. We present a case of disseminated Coccidioides infection with bone scintigraphy indicating diffuse fungemia despite equivocal serum assay, leading to appropriate antifungal therapy and a full recovery.

A 59-year-old man admitted to the hospital complained of left arm and neck pain. Magnetic resonance imaging was performed for possible cervical discopathy. It revealed that in the C7 vertebral body, lesions with surrounding bone marrow edema were observed, which were compatible with metastasis that caused cervical stenosis. Cervical stenosis surgery was performed, and the lesion was pathologically diagnosed as a metastasis of thyroid carcinoma. ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) scan was ordered for further evaluation. The PET/CT images showed an increased ¹⁸F-FDG uptake from the left internal jugular vein to the right atrium. It was considered a malignant thrombus.

A 62-year-old male patient, with bladder carcinoma, was referred to our institution for Technetium-99m methylene diphosphonate bone scintigraphy to assess for bone metastasis. While the bone scan showed no abnormal uptake, extraosseous uptake was detected in the left perirenal and pelvic regions on the whole body scan. Computed tomography showed fornix rupture and demonstrated tracer pooling in the perirenal collection. Our diagnosis was very consistent, and oriented the therapeutic attitude towards a percutaneous drainage for the perinephric urinary leak.

Gout is an inflammatory arthropathy that develops due to the accumulation of monosodium urate crystals in the joints in adults. In approximately half of the cases, it presents as monoarthritis with an acute attack involving the first metatarsophalangeal joint. The first attack is rarely polyarticular. Herein, we present a male patient who presented with swelling and acute pain in the 5^th toe but ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography showed symmetric polyarticular involvement which was mimicking arthritis.

Objective: The aim of this study was to evaluate the relationship between Galium-68 prostate-specific membrane antigen positron emission tomography combined with computed tomography (⁶⁸Ga-PSMA PET/CT) quantitative parameters and patient obesity, prostate-specific antigen (PSA) levels, and metastasis type in prostate cancer.

Methods: In the present study, we included 112 patients diagnosed with prostate cancer between 2020 and 2024. These patients underwent ⁶⁸8Ga-PSMA PET/CT imaging for staging purposes, with locoregional or distant metastasis detected in the imaging results.

Results: No significant correlation was observed between body mass index (BMI) classification and prostate gland maximum standard uptake values (SUV_max), metabolic tumor volume (MTV), total lesion glycolysis (TLG), standardized uptake value lean (SUL), or SUV_mean values. A weak inverse correlation was found between BMI and PSA levels (p=0.08, r=-0.248), with PSA values decreasing as patient weight increased. The presence of locoregional disease or distant metastasis was not significantly associated with prostate gland SUV_max, MTV, TLG, SUV_mean, or SUL values (p=0.25; 0.667; 0.667; 0.244; 0.126, respectively). However, a significant association was detected between PSA levels and distant metastases or locoregional disease (p=0.02), with higher PSA values observed in patients with distant metastases compared to those with locoregional disease. Additionally, significant correlations were found between the D'Amico risk classification and the prostate gland SUV_max, TLG, SUL, and SUV_mean values (p=0.035, 0.037, 0.012, 0.028, respectively).

Conclusion: PSA levels may assist in estimating whether metastases are local or distant. However, due to the weak inverse correlation between BMI and PSA, it is important that low PSA levels may not necessarily indicate localized disease during clinical evaluation.

Galium-68 prostate-specific membrane antigen positron emission tomography combined with computed tomography (⁶⁸Ga PSMA PET-CT) is receptor specific imaging, which has increasingly been used in the staging and restaging of prostate carcinoma (PCa). PSMA is type II transmembrane glycoprotein expressed in cytosol of normal prostatic tissue with 100-1000-fold over expression in PCa. It is also expressed in the endothelium of tumor-associated neo vasculature of non-prostatic solid tumor such as transitional cell and renal cell carcinoma, hepatocellular, thyroid, and brain cancers. We hereby present a case where PSMA PET scan showed three tumors proved on follow up imaging.