Purpose of the Report In vivo tau PET imaging could help clarify the spatial distribution of tau deposition in Alzheimer disease (AD) and aid in the differential diagnosis of tauopathies. To date, there have been no in vivo 18F-APN1607 tau PET studies in patients with AD. Methods We applied tau tracer in 12 normal controls (NCs) and 10 patients in the mild to moderate stage of probable AD. Detailed clinical information, cognitive measurements, and disease severity were documented. Regional...
Fri Jul 17, 2020 03:00
The assessment of tumor parameters derived from 18F-FDG PET/CT in oncology provides valuable information in non–small cell lung cancer. A proper segmentation should delineate tumor with high accuracy, being the most important step to measure metabolic parameters. However, there is still no consensus about the optimal methodology. Additionally, some clinical conditions inherently tied to tumor and imaging can limit the proper tumor delineation. We present some practical cases that represent different...
Fri Jul 17, 2020 03:00
Dopamine transporter SPECT with 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropane (123I-ioflupane) aids in the diagnosis of parkinsonian syndrome by demonstrating loss of striatal dopamine transporters, proportional to nigrostriatal dopaminergic neuronal loss. Quantitative software analysis (QSA) is a helpful adjunct to visual interpretation. An atlas of pearls and pitfalls of QSA is presented. Examples include correction for head tilt/orientation, scaling artifacts, and detection...
Fri Jul 17, 2020 03:00
A 68-year-old woman with a history of multiple myeloma on regular hematological follow-up and with no previous relevant gynecological diseases was found to have an incidental focal uptake by the right ovary at 11C-methionine PET/CT (C-MET). Transvaginal ultrasound was then performed showing a 2-cm solid right ovarian mass with irregular borders and moderate vascularization at color Doppler examination. Therefore, the patient underwent bilateral salpingectomy, and the final histological results revealed...
Fri Jul 17, 2020 03:00
Rosai-Dorfman disease, or sinus histiocytosis with massive lymphadenopathy, is an uncommon histiocytic disorder, which is rare and typically occurs in lymph nodes. However, one third of the cases manifest as extranodal disease. The cardiac involvement of this disease is extremely rare. We reported here the FDG PET/CT findings of a pathologically confirmed Rosai-Dorfman disease occurring in the right atrium in a 60-year-old man. Received for publication February 9, 2020; revision accepted May...
Fri Jul 17, 2020 03:00
Constrictive pericarditis refers to focal or global thickening of pericardium causing impedance to diastolic filling and increased systemic venous pressure. We discuss a case of thymic carcinoma presenting as constrictive pericarditis. A 70-year-old man experiencing shortness of breath underwent Doppler echocardiography for further evaluation. Echocardiography was suggestive of thickened nodular pericardium with minimal pericardial effusion, and Doppler features were suggestive of constrictive pericarditis....
Fri Jul 17, 2020 03:00
Paget bone disease is a chronic benign bone disease characterized by excessive and abnormal bone remodeling. The scintigraphic and bone SPECT/CT hybrid imaging appearances of the affected bone(s) depend on the stage of the disease. We report the case of a patient newly diagnosed with prostate cancer who was found to have multiple osseous metastases, with coexisting Paget disease in the left hemipelvis diagnosed because of typical scintigraphic and SPECT/CT appearance. 68Ga–prostate-specific membrane...
Fri Jul 17, 2020 03:00
Pediatric solitary plasmacytomas are extremely rare, with only 14 cases previously reported. None of these reports included PET imaging findings. We present PET/CT and PET/MRI imaging findings in a 15-year-old boy with what was initially thought to be a solitary plasmacytoma, which later developed into multiple myeloma. The initial PET/CT of solitary plasmacytoma, as well as postradiotherapy PET/MRI findings with the new lesions suggestive of multiple myeloma, are presented. Received for publication...
Fri Jul 17, 2020 03:00
Graft-versus-host disease (GVHD) is a major complication of bone marrow transplantation. Polymyositis with myonecrosis is a rare manifestation of GVHD. Here, we report the case of a 32-year-old man with acute myeloid leukemia who developed GVHD after transplant. He subsequently developed polymyositis, which was diagnosed on PET/CT and confirmed on pathology. Treatment with corticosteroids resulted in the resolution of the symptoms. Abnormal muscular FDG uptake resolved on the follow-up PET/CT. ...
Fri Jul 17, 2020 03:00
A 76-year-old man, who experienced prostate cancer biochemical relapse after 12 years from radical prostatectomy, underwent abdominal CT scan for restaging purposes, negative for metastases, and then 11C-choline PET/CT. The only finding was an area of focal uptake of radiotracer between the intestinal loops and the abdominal wall; after resection, the lesion demonstrated to be a metastasis from hepatocellular carcinoma (HCC), for which the patient had undergone liver resection 2 years earlier. This...
Fri Jul 17, 2020 03:00
177Lu-DOTATATE is an effective treatment for inoperable metastatic well-differentiated pancreatic neuroendocrine tumors. There are no guidelines for patients with terminal renal failure. We present the case of a 74-year-old woman who received different lines of treatment: analogs of somatostatin, chemotherapy, a first series of peptide receptor radionuclide therapy (PRRT), and finally chemoembolization. Because of persistent hepatic progression, a safe and successful administration of 4 cycles of...
Fri Jul 17, 2020 03:00
We review recent technological advances and new clinical indications for sentinel node (SN) and radioguided surgery in order to delineate future tendencies of interventional nuclear medicine in this field. A literature research was performed in PubMed to select relevant articles to be used as key references for analysis of the current approaches and tendencies in SN and radioguided surgery, as well as the evolving contribution of nuclear medicine intervention techniques to the various clinical applications....
Fri Jul 17, 2020 03:00
A 69-year-old man underwent FDG PET/CT to evaluate a right upper abdominal mass. The images showed peripherally increased activity with central photopenic region in the head of the pancreas, which was consistent with pancreatic malignancy. Histopathologic findings showed characteristic findings of diffuse large B-cell lymphoma. The activity was diminished on follow-up PET/CT after 8 courses of chemotherapy. Received for publication May 28, 2020; revision accepted May 29, 2020. Conflicts of...
Fri Jul 17, 2020 03:00
Adenoid cystic carcinoma is a rare cancer that arises from secretory glands. Metastases are mainly seen in the lungs and bones. Cardiac metastases are extremely rare; only 1 case has previously been described. In this patient, cardiac metastases were suspected based on CT imaging. Tumor imaging by 68Ga–prostate-specific membrane antigen (PSMA)-11 PET is mainly used in prostate cancer patients but is also of interest in adenoid cystic carcinoma patients because of high PSMA-ligand uptake in salivary...
Fri Jul 17, 2020 03:00
Progression of prostate cancer and prostate-specific antigen (PSA) elevation are closely associated. In fewer than 1% of all cases, disease progression may occur despite low or undetectable PSA levels. In these conditions, androgen deprivation therapy is relatively ineffective, and the prostate cancer progresses very quickly. We present a 65-year-old man with non–PSA-secreting prostate cancer and widespread metastases with rather fair response to 177Lu-prostate-specific membrane antigen radioligand...
Fri Jul 17, 2020 03:00
An 85-year-old man with biochemical recurrence of prostate cancer after prostatectomy was imaged with 18F-fluciclovine PET/CT. Images incidentally revealed 18F-fluciclovine uptake in a dilated appendix with associated fat stranding, suggestive of acute appendicitis. The patient was then questioned about abdominal symptoms, and he reported severe right lower quadrant pain. He then underwent laparoscopic appendectomy with pathology confirming acute appendicitis. Received for publication February...
Fri Jul 17, 2020 03:00
An 18-year-old woman presented to the emergency department for bloody stools. A CT scan of the abdomen ruled out intussusception. Meckel’s scan was ordered to rule for Meckel’s diverticulum before upper endoscopy and colonoscopy. After proper pretreatment with H2 blocker, 99mTc-pertechnetate Meckel’s scan was performed. Dynamic planar imaging revealed a focus of gradual increase in uptake in midabdomen suggestive of Meckel’s diverticulum. A SPECT/CT was done to localize the focus of uptake. Surprisingly,...
Fri Jul 17, 2020 03:00
18F-fluciclovine is a PET radiotracer approved for detection of recurrent prostate cancer, with utility in other malignancies being investigated. We present the case of a 71-year-old man with high-risk primary prostate cancer (Gleason score 9, prostate-specific antigen 34 ng/mL) and newly diagnosed lung adenocarcinoma. As part of a clinical trial (NCT03081884), preoperative 18F-fluciclovine PET/CT showed localized abnormal uptake in the prostate gland with extracapsular extension. Additionally, an...
Fri Jul 17, 2020 03:00
A 64-year-old man with anal cancer underwent follow-up 18F-FDG PET/CT to evaluate chemoradiation therapy response 5 months after an initial PET/CT. The follow-up 18F-FDG PET/CT demonstrated new FDG-avid curvilinear soft tissue adjacent to the abdominal aorta, interpreted as an aortic dissection. Despite lack of clinical symptoms, the patient was directed to an emergency room the same day, where a contrast-enhanced CT confirmed an aortic aneurysm with dissection. The patient underwent endovascular...
Fri Jul 17, 2020 03:00
Purpose The aim of this study was to investigate the value of dual-phase 99mTc-MIBI SPECT/CT in the differential diagnosis between benign and malignant enhancing solid renal tumors. Patients and Methods Totally, 180 patients were imaged with dual-phase 99mTc-MIBI SPECT/CT, which was performed 30 minutes and 90 minutes after 99mTc-MIBI administration. Among them, 147 patients with 148 histologically proved solid renal tumors met the selection criteria and were included for the final...
Fri Jul 17, 2020 03:00
Cutaneous leiomyomas are rare, sporadic, or inherited benign tumors arising from smooth muscle cells of the skin associated with various disorders. We present a case of multiple cutaneous leiomyomas showing increased FDG uptake with SUVmax of 19.9. This case indicates cutaneous leiomyoma should be considered as a rare differential diagnosis in patients with hypermetabolic cutaneous lesions. Careful correlation with clinical history is needed to avoid misdiagnosis. Received for publication May...
Fri Jul 17, 2020 03:00
A 66-year-old man with a history of non–small cell lung cancer treated with nivolumab underwent contrast-enhanced CT and FDG PET/CT. No recurrence was demonstrated; however, soft-tissue thickening that showed delayed contrast enhancement and FDG uptake was detected around an abdominal aortic aneurysm. After discontinuation of nivolumab, the periaortic lesion disappeared within 2 months, indicating nivolumab-induced periaortitis. Immune checkpoint inhibitors such as nivolumab can cause vasculitis...
Fri Jul 17, 2020 03:00
A 76-year-old man with a prior medical history of resected malignant melanoma of the skull underwent 68Ga–prostate-specific membrane antigen (PSMA) PET/CT due to rising tumor markers of a known prostate carcinoma. Unexpected high 68Ga-PSMA brain uptake was encountered around the surgical cavity in the skull with initially no specific structural changes on anatomical imaging. Successive CT and MRI eventually revealed local melanoma brain recurrence at this site. This interesting case demonstrates...
Fri Jul 17, 2020 03:00
99mTc-leukocyte scintigraphy was performed on a 40-year-old woman with spiking fevers. A focus of intense uptake in the right upper thorax was identified, concerning for infection along the central line in the superior vena cava. Additionally, heterogeneously increased uptake in both lungs was noted, which suggested pulmonary infection. CT images of the chest showed patchy ground-glass changes in both lungs and a large consolidation in the right lower lobe, which were consistent with changes for...
Fri Jul 17, 2020 03:00
A 71-year-old man underwent 18F-FDG and 68Ga-FAPI-46 PET/CT for initial staging prior to surgery of a squamous cell carcinoma of the lower esophagus under the prospective study NCT04147494. Both scans showed increased uptake in the mid and distal esophagus without evidence of metastatic disease. A soft tissue right infrascapular mass with mild 18F-FDG and moderate 68Ga-FAPI-46 uptake was incidentally found. The patient underwent robotic-assisted Ivor-Lewis esophagectomy and excision of the right...
Fri Jul 17, 2020 03:00
Os sustentaculi is a rare accessory bone of the foot located along the posterior end of sustentaculum tali. It is a component type of extra-articular talocalcaneal coalition. We report the case of a 17-year-old boy with symptomatic os sustentaculum with talocalcaneal coalition diagnosed on 99mTc-HDP SPECT/CT. We wish to emphasize on the use of SPECT/CT in not only characterizing the ossicle morphologically, but also for evaluation of this anatomical variant as an active source of pain in the absence...
Fri Jul 17, 2020 03:00
Prostate cancer (Pca) is the most common cancer and the second leading cause of death among men. Although conventional bone scans and abdominal CT are preferred in most of the guidelines and clinical trials, PET/CT has already started to become the inevitable part of Pca management because of its higher sensitivity and specificity. Radiotracers used for PET imaging show different molecular aspects of the disease process. Although 68Ga–prostate-specific membrane antigen offers the highest sensitivity...
Fri Jul 17, 2020 03:00
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