NUCLEAR MEDICINE REVIEW最新文献

A 75-year-old man underwent a positron emission tomography/computed tomography (PET/CT) scan with fluorine-18-prostate specific membrane antigen ([¹⁸F]F-PSMA-1007) for initial staging of prostate adenocarcinoma. The scan showed lung infiltrates predominantly in both lower lobes with moderate uptake, in addition to a bilateral pulmonary hilar lymph node uptake. CT images revealed ground-glass opacities and a reticular pattern, suggesting COVID-19 pneumonia, which was confirmed by reverse transcription polymerase chain reaction (RT-PCR). Similar incidental findings have been reported in patients undergoing PET/CT scans with other radiotracers. In this case, the probable lung angiogenesis linked to COVID-19 infection can be potencially demonstrated by [¹⁸F]F-PSMA-1007, which helps ensure timely diagnosis and appropriate care for cancer patients.

The aim of the report is to present the current state of equipment, radiopharmacy, dosimetry, and selected clinical applications, together with proposed new solutions and expected directions of development of classic nuclear medicine and positron emission tomography (PET). The statement presents the individual points of view of the members of the Commission for Nuclear Medicine of the Committee of Medical Physics, Radiobiology and Diagnostic Imaging of the Polish Academy of Sciences in the 2020-2023 term.

Background: In radioembolization therapy for hepatic malignancies, the accurate estimation of lung shunt fraction (LSF) is crucial to minimize the risk of radiation-induced pneumonitis and fibrosis due to hepatopulmonary shunting of yttrium-90 (90Y)-microspheres. This study aimed to compare the accuracy and precision of LSF estimation using technetium-99m macroaggregated albumin single photon emission computed tomography ([99mTc]Tc-MAA SPECT) LSF, [99mTc]Tc-MAA planar LSF, and 90Y PET LSF in patients undergoing 90Y-radioembolization.

Material and methods: A retrospective study was conducted involving 15 patients diagnosed with hepatocellular carcinoma (HCC) or liver metastases and planned to undergo transarterial radioembolization with 90Y SirSpheres after multidisplinary team discussion. LSF values were calculated using [99mTc]Tc-MAA SPECT LSF, [99mTc]Tc-MAA planar LSF, and 90Y PET LSF. The accuracy of these methods was assessed through paired t-tests and correlation analysis.

Results: The paired t-test revealed a statistically significant difference between SPECT LSF and planar LSF (t-statistic = -4.81, p-value = 0.0003), indicating that planar imaging tends to overestimate LSF values. However, no significant difference was observed between [99mTc]Tc-MAA SPECT LSF and 90Y PET LSF (t-statistic = -0.98, p-value = 0.343), suggesting a high degree of agreement between these two methods. Correlation analysis showed a very strong positive correlation between [99mTc]Tc-MAA SPECT LSF and 90Y PET LSF (r = 0.999), while strong correlations were also found between SPECT LSF and planar LSF, and between planar LSF and 90Y PET LSF (r = 0.841).

Conclusions: The findings suggest that 90Y PET LSF aligns closely with [99mTc]Tc-MAA SPECT LSF, making them both reliable for LSF estimation in radioembolization therapy. In contrast, planar imaging tends to overestimate LSF, potentially leading to inaccurate dosimetric planning. Incorporating [99mTc]Tc-MAA SPECT/CT and 90Y PET/CT into routine clinical practice could enhance the accuracy of LSF estimation, thereby improving patient outcomes. Further research with larger cohorts is recommended to validate these findings.

Carcinoid crisis (CC) is a rare but potentially life-threatening complication that may occur in patients with neuroendocrine tumor (NET). The pathophysiology of CC involves the sudden, massive release of vasoactive substances. This article presents a unique case study of a patient with a disseminated NET of the pancreas, who developed CC after radioligand therapy (RLT). Despite its rarity, awareness of CC as a potential severe complication of RLT is essential for timely and effective management and better prognosis for affected patients.

A 61-year-old woman with diffuse large B-cell lymphoma received a fluorine-18-deoxyglucose positron emission tomography/computed tomography ([¹⁸F]FDG PET/CT) for staging. Because of the obvious uptake of [¹⁸F]FDG in the spinal cord and brain, a positron emission tomography/magnetic resonance imaging (PET/MRI) was performed after the positron emission tomography/computed tomography (PET/CT). The images showed diffuse [¹⁸F]FDG uptake of the spinal cord and increased T2 signal intensity on MRI, which was suspected to be lymphoma involvement. The patient was diagnosed with diffuse large B-cell lymphoma involving the right maxillofacial region, right cervical lymph nodes, cervix, brain and spinal cord (stage IV of non-germinal center B-cell origin). After chemotherapy, the spinal [¹⁸F]FDG uptake level decreased significantly, which was considered to be a partial metabolic response. Our case was different from prior, which indicated the pattern of spinal cord involvement by lymphoma was focal.

Glucagonoma is a rare pancreatic neuroendocrine tumor (panNET) that can be characterized by increased secretion of glucagon and distinguishing symptoms - glucagonoma syndrome with a typical dermatosis, necrolytic migratory erythema, being its most common manifestation. While surgery and somatostatin analogs remain first-line therapeutic options in panNETs, radioligand therapy with [177Lu]Lu-DOTA-TATE is a recommended second-line palliative treatment in advanced, metastatic cases. However, its prospects and efficacy are still not vastly researched in less frequent neuroendocrine neoplasms. Here, we present an extraordinary case of a metastatic glucagonoma treated with [177Lu]Lu-DOTA-TATE used as a second-line treatment in progressive disease.

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.

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: 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.

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.