NUCLEAR MEDICINE REVIEW最新文献

Optic nerve sheath meningiomas are rare and difficult to diagnose accurately due to the high risk of visual loss associated with histologic confirmation. Currently, the primary imaging techniques used for diagnosis are contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI). However, these methods may not always provide a definitive diagnosis, necessitating alternative approaches. This case study is one of the few that reports the use of a [99mTc]Tc-Tektrotyd single-photon emission computed tomography (SPECT/CT) scan for the non-invasive diagnosis of an orbital space-occupying tumor. This radiopharmaceutical can bind with high affinity to somatostatin receptor subtype 2, which is expressed in meningiomas.

Background: This study aimed to evaluate the diagnostic accuracy of [18F]FDG PET/MR versus [18F]FDG PET/CT in the thoracic staging of patients with non-small cell lung cancer (NSCLS).

Material and methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) were followed in conducting the present study. All available research was collected through Embase (Elsevier), PubMed, as well as Cochrane Library databases up to June 2021. Only studies covering both [18F]FDG PET/MRI and [18F]FDG PET/CT techniques in the same group were included. Statistical analysis was done using Stata v.12.

Results: The overall accuracy of [18F]FDG PET/CT in T and N staging was 92% (95% CI: 89-95 , I2 : 93.4%) and 78% (95% CI: 74-82 , I2 : 98.5%) respectively. While, the corresponding rates for [18F]FDG PET/MRI were 91% (95% CI: 88-94 , I2 : 96.5%) and 89% (95% CI: 84-94 , I2 : 88.1%) respectively.

Conclusions: The present meta-analysis showed that [18F]FDG PET/CT and [18F]FDG PET/MRI exhibit relatively the same performance in detecting N and T stages in patients with NSCLC. Thus, [18F]FDG PET/MRI can be a worthy alternative for [18F]FDG PET/CT in the diagnosis of advanced of NSCLC in the chest area, more specifically in N-staging, since it provides higher soft-tissue contrast. There is a need for more reliable research for comparing the diagnostic performance of these imaging techniques and various optimized [18F]FDG PET/MRI protocols.

A case involving a 64-year-old woman with ovarian carcinoma on maintenance therapy who underwent 18-fluorodeoxyglucose positron emission tomography with computed tomography ([18F]FDG PET/CT) restaging due to rapid cancer antigen 125 (Ca-125) rise. This revealed recurrent disease within the pelvis and large volume, peritoneal carcinomatosis including an avid umbilical deposit, consistent with the rarely seen Sister Mary Joseph nodule (SMJN). This case elegantly demonstrates not only the anatomy of the peritoneal surfaces through avid disease deposition but also highlights the sensitive depiction of disease burden in peritoneal carcinomatosis, including the detection of rare manifestations such as SMJN.

Background: The purpose of the study was to present the cardiological procedures performed and scintigraphic devices used in Poland in 2019-2021 - based on the results of a nationwide survey.

Material and methods: Forty-three (100%) institutions performing scintigraphic cardiology tests responded to the survey: 29 classic nuclear medicine centers (NM), 4 PET centers, and 10 institutions performing NM and PET examinations.

Results: In 2021, 51 SPECT devices (including 5 dedicated cardiocentric semiconductor cameras, 12 SPECT gamma cameras, and 39 hybrid SPECT/CT devices) and 15 PET devices (14 PET/CT and 1 PET/MR) were used for cardiological examinations. The total number of cardiological SPECT and PET examinations has reached 33,107; PET shares 0.8%. The most frequently performed NM cardiological examination in 2019-2021 was myocardial perfusion scintigraphy (98-99% of all tests). NM cardiac amyloidosis studies accounted for less than 1% of all studies, and diagnostics of inflammation in the chest using labeled leukocytes - for less than 0.5%. The most frequently performed cardiological heart examination using the PET technique was the diagnostics of inflammation in the chest (166 of 269 examinations, i.e. 61.7%, in 2021), followed by the assessment of cardiac viability (46 examinations, i.e. 17.1%).

Conclusions: In Poland, in 2021, cardiac scintigraphy was performed in 39 classic nuclear medicine centers and 14 PET centers, using modern equipment, in approximately 1/1000 inhabitants per year. Polish nuclear cardiology is based on classical nuclear medicine. Almost 99% of the tests are stress and rest myocardial perfusion studies. PET has limited practical use (< 1% of cardiac studies).

The radioiodine scan is a non-invasive imaging modality that allows for the visualization of functional thyroid tissue, as well as the detection of thyroid cancer remnants and metastases. However, it is important to note that radioiodine uptake is not exclusive to thyroid tissue and can lead to false-positive results if unexpected uptake occurs in non-thyroidal tissue. Herein, we present a case of a patient diagnosed with thyroid carcinoma, whose radioiodine scan demonstrated increased uptake in the thorax, corresponding to a lung carcinoma.

Secondary anemia in hemoglobinopathies like thalassemia can cause expansion of the bone marrow cavities because of compensatory marrow hyperplasia. This case demonstrates spontaneous osteonecrosis of the distal left femur in a patient with β-thalassemia that may be secondary to ischemic infarction secondary to occlusion of the microvasculature within the expanded cancellous bone. This subject was referred to Hazrat Rasool Akram Hospital because of fever, cough, and bone pain. In the CT scan she had scattered peripheral CGO in both lungs due to COVID-19 with two paravertebral masses due to extramedullary hematopoiesis. The patient had also generalized bone pain so the physician asked for a whole-body bone scan and incidentally, we found a cold lesion with a rim of increased uptake in the distal left femur that with bone biopsy it was consistent with osteonecrosis. This case illustrates the importance of performing a whole-body bone scan in β-thalassemia for the management of patients and diagnosis of occult osteonecrosis.

Background: The exact role of positron emission tomography with fluorine-18-deoxyglucose ([18F]FDG PET/CT) in an early diagnosis of relapsed ovarian cancer is not clearly defined. The aim of the study was to assess the value of [18F]FDG PET/CT in the detection and differentiation of recurrent ovarian cancer.

Material and methods: Eighty-four patients with suspected recurrent ovarian cancer underwent [18F]FDG PET/CT examination. Results of PET/CT were analyzed taking into account clinical data of the patients, histological diagnosis, and 6-month follow-up.

Results: The [18F]FDG PET/CT examinations showed abnormal findings in 67 patients (79.76%). There were 63 true positive results (75.00%), 14 true negative (16.67%), 4 false positive (4.76%), and 3 false negative (3.57%) results. Sensitivity, specificity, positive and negative predictive values of [18F]FDG PET/CT were 95%, 78%, 94%, and 82%, respectively. In patients with elevated serum Ca 125 concentration (n = 43), sensitivity and specificity of [18F]FDG PET/CT was 95.00% and 66.67%, respectively. Recurrence was confirmed in 22 (88.00%) of 25 patients referred for [18F]FDG PET/CT due to suspected relapse in imaging tests.

Conclusions: A high frequency of recurrent ovarian cancer detected in the [18F]FDG PET/CT examinations due to increased Ca 125 concentration in patients without clinical symptoms and without changes in other imaging tests confirmed the usefulness of [18F]FDG PET/CT in such cases. In patients with suspected recurrent ovarian cancer implied in radiological findings, [18F]FDG PET/CT results in most cases differed from the original results of imaging examination. Our results showed high accuracy of [18F]FDG PET/CT in the evaluation of recurrent ovarian cancer and presented this diagnostic method as a useful tool in detecting and differentiating suspected lesions in this group of patients.

Brown tumours are rare bone lesions occurring in patients with severe hyperparathyroidism (HPT) because of increased osteoclastic activity due to high levels of parathyroid hormone (PTH). We report the case of 30-year-old woman with secondary hyperparathyroidism due to severe chronic kidney diseases who underwent [18F]F-choline PET/CT scan for localization of the hyperfunctioning parathyroid gland before surgical treatment. [18F]F-choline PET/CT scan showed increased choline uptake in the lower left parathyroid gland and in multiple bone lytic lesions. Multiple focal choline uptake in bone corresponded to brown tumours - fibrous osteitis cystica.

A 65 years old man with high-risk prostate adenocarcinoma underwent bone scintigraphy with 99mTc-methylene diphosphate ([99mTc]Tc-MDP). The scan revealed a focus of radiotracer uptake in the left pubic region, which was suspicious for metastatic involvement. Additional imaging with single photon emission computed tomography (SPECT/CT) confined the uptake to be extra-osseous and contributed to the calcified zone in the prostate bed. Prostatic bed calcification with [99mTc]Tc-MDP uptake mimics metastasis and can be easily missed on planar images.

Introduction: Nuclear medicine (NM) methods play an important role in the evaluation of renal function in a wide range of clinical indications. The aim of our study was to evaluate the correlation between measured GFR (mGFR) obtained by the three-plasma sample slope-intercept NM method (TPSM) - reference method vs. estimated GFR (eGFR) using Fleming's single plasma sample method (SPSM) at 120 min, 180 min, and 240 min and correlation of reference method with eGFR with camera-based Gates' protocol.

Material and methods: A total of 82 subjects (33 male/49 female) with a mean age of 54.87 ± 15.65 years were included and mGFR value was obtained by the three-plasma sample slope-intercept NM method and eGFR was obtained with Fleming's single sample method. eGFR was also quantified with the camera-based Gates' protocol after i.v. application of [99mTc]Tc-DTPA.

Results: Our study revealed a very strong positive significant correlation between all three SPSMs with the TPSM as the reference method. Between the Gates' method and the TPSM in the group of patients with mGFR ≥ 61-84 mL/min/1.73 m2 and mGFR ≥ 84 mL/min/1.73 m2, a moderate positive statistically significant correlation was obtained.

Conclusions: The SPSM method shows a very strong correlation with the reference and low bias in all three groups of patients and can be routinely used for GFR estimation.