Molecular Imaging and Radionuclide Therapy最新文献

Follicular lymphoma (FL) is clinically classified as a common type of indolent non-Hodgkin's lymphoma. FL is generally indolent and has good prognosis, it can involve a variety of extranodal sites, including the gastrointestinal tract, bone marrow, spleen, liver, skin, and other organs. Secondary involvement of pancreas in FL is rare. We report the case of a patient with FL whose initial fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) revealed subdiaphragmatic involvement with isolated diffuse pancreatic hypermetabolism. Uncovering such rare site highlights the role of FDG-PET/CT in staging of lymphomas.

Herein, we describe a rare case of multicentric Castleman disease with multiple lymph node and skin involvement. Ultrasonography of a 38-year-old patient with weakness and fever revealed multiple lymphadenopathies in both inguinal regions. Diagnosed via lymph node biopsy was Castleman's disease, a plasma cell variant. He was diagnosed with prurigo nodularis, lymphocytic vasculitis, and stasis dermatitis in the biopsies of skin lesions located in different regions. ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography showed multiple hypermetabolic lymph nodes in the axilla, abdomen, pelvis, and both popliteal areas, multiple hypermetabolic skin thickenings, and skin lesions in both arms, legs, and feet.

We present a case of a 40-year-old male with refractory multiple myeloma, assessed using ⁶⁸Gallium-PENTIXAFOR positron emission tomography/computed tomography (⁶⁸Ga-PENTIXAFOR PET/CT), revealing widespread and intense C-X-C motif chemokine receptor 4 (CXCR4) expression in multiple osteolytic lesions across axial and appendicular skeletons, including bone marrow deposits. Despite undergoing autologous hematopoietic stem cell transplantation and multiple lines of maintenance therapy, the patient experienced disease relapse and progression. The term "superscan" typically refers to diffuse skeletal uptake in conventional bone scans, primarily seen in advanced metastatic cancers or metabolic bone diseases. CXCR4, crucial for tumor growth and metastasis, binds C-X-C motif chemokine 12 (CXCL12) to promote cancer progression. PENTIXAFOR, a CXCR4-targeted PET agent, facilitates imaging of such malignancies. While superscans using PET/CT are rare, our case underscores the utility of ⁶⁸Ga-PENTIXAFOR PET/CT in evaluating CXCR4 expression in multiple myeloma, highlighting its potential as a diagnostic and prognostic tool in refractory disease management.

Integrins play crucial roles in the migration of tumor cells during angiogenesis and metastasis. Consequently, αvβ6-integrin-targeted positron emission tomography (PET) radiopharmaceuticals have been developed and tested in humans, with clinical trials highlighting their applications in idiopathic pulmonary fibrosis and carcinomas. However, data on integrins are limited, and the role of [⁶⁸Ga]Ga-Trivehexin tomography/computed tomography (CT) PET/CT is not well-established. Some studies have suggested that [⁶⁸Ga]Ga-Trivehexin PET/CT is more specific than ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET/CT, which can yield false-positive results. It has been shown to be more efficient in evaluating pancreatic lesions and head and neck tumors. The role of [⁶⁸Ga]Ga Trivehexin PET/CT in neuroendocrine tumors is not yet clearly defined. In our case, integrin was negative in the pancreatic neuroendocrine tumor but positive in the breast lobular tumor. Additionally, we observed that the lobular carcinoma lesion in the right breast is somatostatin receptor+positive on [⁶⁸Ga]Ga-DOTATATE PET/CT.

Meningiomas express the somatostatin receptor (SSTR). The utilization of SSTR ligands, specifically Gallium-68 (⁶⁸Ga) isotope, a radioactive isotope (⁶⁸Ga)-DOTA-labeled peptides, has demonstrated exceptional diagnostic precision for the detection of meningiomas, primarily due to the absence of normal brain and bone activity. We report a case of a 48-year-old woman with sphenoid wing meningioma who underwent ⁶⁸Ga-DOTA TOC positron emission tomography (PET) for tumor delineation. ⁶⁸Ga-DOTA TOC PET shows SSTR-avid meningioma in the right sphenoid/anterior temporal region with significant hyperostosis with high expression of SSTR in the bone. ⁶⁸Ga-DOTA TOC uptake in the hyperostosis signifies bone infiltration rather than reactive changes. ⁶⁸Ga-DOTA PET provides a better assessment of osseous involvement and provides additional information in terms of meningioma extent and planning for further management.

Objectives: We aimed to evaluate the relationship of ¹⁸Fluorine-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) parameters with diagnostic efficacy, disease management and prognosis in patients with cholangiocarcinoma (CCA). The prognostic value of the spleen/liver ¹⁸F-FDG uptake ratio was also investigated.

Methods: The clinical and imaging findings of 39 patients who met the diagnostic criteria and underwent ¹⁸F-FDG PET/CT imaging for staging between 2013 and 2023 were retrospectively analysed.

Results: The tumour was intrahepatic in 34 patients and extrahepatic in 5 patients. PET/CT detected nodal involvement in 21 patients (53.8%) and distant metastases in 35 patients (89.7%). Fourteen cases (35.9%) had regional-distant metastases detected by PET/CT but not by magnetic resonance imaging/CT, and the stage of the disease changed accordingly. SUV_max, SUV_mean, metabolic tumor volume, tumour lesion glycolysis, tumor-to-liver ratio (tumour/liver parenchyma SUV_max), tumor-to-background ratio (tumour/blood pool SUV_max), tumor-stroma ratio (tumour/spleen parenchyma SUV_max), and standardized liver ratio (SLR) (spleen/liver SUV_max) did not differ based on tumour location. Recurrence occurred in 14 patients (35.9%), and 2 patients survived. When the cut-off values for the parameters were determined by the Youden index, progression-free survival (PFS) was significantly shorter in patients with an SLR value of less than 0.94 compared to the others (p=0.04). Nodal involvement, metastatic location, and other PET/CT parameters had no significant effect on PFS and overall survival.

Conclusion: Our results highlight the efficacy of ¹⁸F-FDG PET/CT in staging nodal and distant metastases, similar to several studies in patients with CCA. Although SLR was found to have significant efficacy in PFS among the parameters we analysed, it is appropriate to evaluate the prognostic significance of these parameters in larger patient groups.

Neurolymphomatosis (NL) is a rare clinical condition characterized by the infiltration of malignant lymphocytes into the cranial or peripheral nerves, nerve roots, or plexus. Diagnosis can be clinically challenging due to its variable presentation. It usually occurs in B cell lymphoma; however, a few cases of extranodal killer/T cell lymphoma. Most cases present at a secondary site in patients with primary site in remission. ¹⁸Fluorine fluorodeoxyglucose positron emission tomography/computed tomography plays an important role in the early detection of NL, resulting in timely treatment. We present a case of a 24-year-old male with nasal natural killer T cell lymphoma who initially responded to treatment but relapsed with NL based on clinical and radiological findings.

Objectives: In patients with ipsilateral breast tumor recurrence (IBTR), lymphatic drainage may be altered due to factors such as prior axillary surgery and radiotherapy, thereby increasing the likelihood of sentinel lymph nodes (SLNs) in atypical locations. This study aimed to evaluate patients who underwent surgery for IBTR with lymphoscintigraphy for repeat SLN biopsy (re-SLNB), and to investigate the role of lymphoscintigraphy in re-SLNB in this patient group.

Methods: Patients diagnosed with IBTR who were evaluated using preoperative lymphoscintigraphy and subsequently underwent surgery were included in the study. Patients with systemic or nodal metastases, as well as those who did not undergo lymphoscintigraphy, were excluded. Demographic, clinical, and pathological data of the included patients were analyzed.

Results: A total of 16 patients were evaluated, with a median age of 56 years (range 30-73), all of whom were female. Lymphoscintigraphy successfully localized the SLN in 81.3% of the patients. In eight patients, the SLN was located in the ipsilateral axilla, while in five patients, it was found in the contralateral axilla. Axillary lymph node dissection (ALND) was performed in three patients (all in the contralateral axilla) due to metastatic involvement in the SLN. ALND during first surgery was associated with an increased likelihood of SLN detection in the contralateral axilla or Re-SLNB failure (p=0.043).

Conclusion: In patients undergoing surgery for IBTR, the likelihood of the SLN being in atypical locations is high. Lymphoscintigraphy may enhance the success of Re--SLNB in this patient group.

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.