Molecular Imaging and Radionuclide Therapy最新文献

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.

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.