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ABSTRACT: We presented a patient with abnormal focal accumulation of Ga in the left upper abdomen. After drinking water, we successfully identified the abnormal radioactivity that was from the stomach. Subsequent endoscopic examination did not reveal gastric pathological condition. Gastric accumulation of Ga may relate to pathological conditions or physiological uptake, confounding interpretation of Ga scintigraphy. Simple water ingestion method can rapidly identify gastric Ga uptake, and the shape of distended stomach can also help to differentiate pathological conditions from physiological uptake, which is especially helpful for a busy nuclear medicine department and for places where the SPECT/CT systems are not available.
Clinical nuclear medicine 05/2013; · 3.92 Impact Factor
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ABSTRACT: Tc TRODAT-1, a selective dopamine transporter SPECT imaging agent, has demonstrated its efficacy in identifying patients with Parkinson disease. Primary or metastatic brain neoplasm uptake of TRODAT-1 is rarely reported in literatures. A 51-year-old female patient underwent TRODAT-1 study for bradykinesia and altered cognitive function; the images showed abnormal extrastriatal uptake in the right frontal lobe subsequent to operation, and pathological examination confirmed anaplastic oligodendroglioma. Care should be taken in interpreting TRODAT-1 image; any focus on abnormal accumulation of radiotracer should not be overlooked because it can be brain neoplasm as demonstrated in this case.
Clinical nuclear medicine 04/2013; · 3.92 Impact Factor
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JACC. Cardiovascular imaging 04/2013; 6(4):512-4. · 14.29 Impact Factor
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ABSTRACT: BACKGROUND: The current study aimed to evaluate whether therapy-related changes occurred in brain metabolism at an earlier stage during the course of anticancer therapy. METHODS: We recruited 14 non-diabetic male patients with newly diagnosed pharyngeal squamous cell carcinoma. We analyzed the patients' serial brain FDG PET/CT scans by SPM8 to establish whether any therapy-related changes had occurred in brain FDG metabolism, either during or after the course of therapy. RESULTS: Decreased metabolism was noted during the anticancer therapy, displaying a symmetric pattern involving bilateral basal ganglia and bilateral occipital lobes. The decrease in FDG metabolism in these regions persisted after the anticancer therapy had terminated. However, relative recovery of the metabolism was noted in the bilateral occipital lobes, whereas further deterioration was noted in bilateral basal ganglia. CONCLUSIONS: The current study revealed that unappreciable changes in brain metabolism can occur during the early course of anticancer therapy, and persist even after therapy has terminated. Although the exact mechanism remains unclear, these changes may be related to the systemic effects of chemotherapy or radiotherapy as well as subclinical cancer-related depressive or adjustment mood disorder.
Journal of neuroimaging: official journal of the American Society of Neuroimaging 01/2013; · 1.72 Impact Factor
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The American Journal of the Medical Sciences 11/2012; · 1.39 Impact Factor
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ABSTRACT: A 25-year-old woman had carcinosarcoma of uterine cervix after definitive treatment. One year later, local recurrent disease was found in the right posterior pelvis on FDG PET/CT. FDG PET/CT also disclosed an incidental intramural hypermetabolic lesion in the rectum, which seemed separate from the right pelvic lesion on contrast-enhanced CT. The rectal lesion was confirmed as metastatic carcinosarcoma from uterine cervix after endoscopic biopsy.
Clinical nuclear medicine 11/2012; · 3.92 Impact Factor
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The American Journal of the Medical Sciences 11/2012; 344(5):406. · 1.39 Impact Factor
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ABSTRACT: A 55-year-old man was diagnosed with squamous cell carcinoma in the middle thoracic esophagus. The FDG PET/CT revealed an incidental strong FDG-avid finding (SUVmax, 11) in the right parotid gland, which was subsequently confirmed as metastasis from the squamous cell carcinoma of esophagus via surgery. The current case adds another differential diagnosis of parotid FDG-avid lesion to the existing literature.
Clinical nuclear medicine 10/2012; 37(10):1001-2. · 3.92 Impact Factor
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The American Journal of the Medical Sciences 09/2012; · 1.39 Impact Factor
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Yao-Ching Wang, Te-Chun Hsieh,
Chun-Yen Yu,
Kuo-Yang Yen,
Shang-Wen Chen,
Shih-Neng Yang,
Chun-Ru Chien,
Shih-Ming Hsu,
Tinsu Pan,
Chia-Hung Kao,
Ji-An Liang
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ABSTRACT: A combination of four-dimensional computed tomography with (18)F-fluorodeoxyglucose positron emission tomography (4D CT-FDG PET) was used to delineate gross tumor volume (GTV) in esophageal cancer (EC). Eighteen patients with EC were prospectively enrolled. Using 4D images taken during the respiratory cycle, the average CT image phase was fused with the average FDG PET phase in order to analyze the optimal standardized uptake values (SUV) or threshold. PET-based GTV (GTV(PET)) was determined with eight different threshold methods using the auto-contouring function on the PET workstation. The difference in volume ratio (VR) and conformality index (CI) between GTV(PET) and CT-based GTV (GTV(CT)) was investigated. The image sets via automatic co-registrations of 4D CT-FDG PET were available for 12 patients with 13 GTV(CT) values. The decision coefficient (R(2)) of tumor length difference at the threshold levels of SUV 2.5, SUV 20% and SUV 25% were 0.79, 0.65 and 0.54, respectively. The mean volume of GTV(CT) was 29.41 ± 19.14 ml. The mean VR ranged from 0.30 to 1.48. The optimal VR of 0.98, close to 1, was at SUV 20% or SUV 2.5. The mean CI ranged from 0.28 to 0.58. The best CI was at SUV 20% (0.58) or SUV 2.5 (0.57). The auto-contouring function of the SUV threshold has the potential to assist in contouring the GTV. The SUV threshold setting of SUV 20% or SUV 2.5 achieves the optimal correlation of tumor length, VR, and CI using 4D-PET/CT images.
Journal of Radiation Research 07/2012; 53(4):594-600. · 1.68 Impact Factor
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ABSTRACT: We reported 3 male patients with hepatocellular carcinoma who underwent FDG PET/CT for systemic survey before liver transplantation. All of their scans demonstrated obvious FDG uptake in bilateral breasts. These uptakes might be owing to gynecomastia caused by an increase in free estrogen related to the cirrhotic liver.
Clinical nuclear medicine 05/2012; 37(5):520-1. · 3.92 Impact Factor
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ABSTRACT: A 38-year-old pregnant woman at 26-week gestation with left breast cancer requested an FDG PET/CT scan for more detailed staging of her breast cancer before treatment. After discussing the potential radiation-related risk and estimating possible absorbed dose to fetus, she consented for examination. By using a low-radiation-dose CT protocol and administration of routine 370-MBq FDG without diuresis, the resultant calculated (using existing models to predict fetal radiation exposure) fetal dose from CT and FDG would be 3.60 mGy and 6.29 mGy, respectively. In contrast to the existing few literatures, our case also demonstrated previously unreported uptake in the fetal kidneys.
Clinical nuclear medicine 05/2012; 37(5):489-91. · 3.92 Impact Factor
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ABSTRACT: The aim of the study was to investigate the predictive role of pretreatment metabolic volume (MTV) in pharyngeal cancer (PC) patients treated with definitive (chemo) radiotherapy.
This retrospective analysis enrolled 64 patients with PC treated with (chemo) radiotherapy. All patients received pretreatment fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT. Four PET segmentation methods were used, namely applying an isocontour at a standardized uptake value (SUV) of either 2.5 or 3.0 (MTV2.5 and MTV3.0) or using fixed thresholds of either 40 or 50 % (MTV40 %, MTV50 %) of the maximum intratumoural FDG activity. Disease-free survival (DFS) and primary relapse-free survival (PRFS) were examined according to cutoffs of the median values for each MTV and the gross tumour volume (GTVp). Independent prognosticators were identified by Cox regression analysis.
With a median follow-up of 24 months, 19 patients died, and 26 patients experienced tumour relapse at primary sites. Multivariate analysis of the DFS showed that MTV2.5 > 13.6 ml was the only predictor of relapse [p = 0.011, hazard ratio = 2.69, 95 % confidence interval (CI) 1.25-5.76]. The independent predictor for PRFS was MTV2.5 > 13.6 ml (p = 0.003, hazard ratio = 3.76, 95 % CI 1.57-8.92), whereas GTVp > 15.5 ml had a marginal impact on PRFS (p = 0.06, hazard ratio = 3.54, 95 % CI 0.97-11.85). Patients having tumours with MTV2.5 > 13.6 ml had a significantly inferior 2-year PRFS compared with patients who had lower MTV2.5 tumours (39 vs 72 %, respectively, p = 0.001).
For PC patients treated with definitive (chemo)radiotherapy, pretreatment MTV2.5 volume achieved the best predictive value for primary recurrence, and the same value was also a prognosticator for DFS.
European Journal of Nuclear Medicine 04/2012; 39(8):1297-305. · 4.53 Impact Factor
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ABSTRACT: A 46-year-old woman was initially diagnosed with rare small-cell neuroendocrine carcinoma of uterine cervix with regional lymph node metastases. She hesitated to undergo the suggested concurrent chemoradiation therapy and was lost to follow-up for 4 months. Then, a FDG PET/CT scan was requested for restaging her disease and disclosed other abnormal findings in the breast and adrenal gland that probably indicated malignancies. The following pathologic examination confirmed the diagnosis of rare breast and adrenal gland metastases from small-cell neuroendocrine carcinoma of uterine cervix.
Clinical nuclear medicine 03/2012; 37(3):280-3. · 3.92 Impact Factor
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ABSTRACT: A 50-year-old man with nasopharyngeal carcinoma was suspected to have progressive malignant disease because of an unexpected FDG-avid finding that was suspected to be neck lymph node metastasis on the follow-up FDG PET/CT after the definite anticancer therapy. However, after carefully correlating with the relevant MRI findings because of the atypical depth of the neck lesion and possible connection with the spinal nerve, the FDG-avid finding was reconsidered to be a tumor that originated from the nerve. The subsequent histologic examination confirmed the diagnosis of neurilemmoma.
Clinical nuclear medicine 12/2011; 36(12):e217-9. · 3.92 Impact Factor
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ABSTRACT: A 55-year-old man was incidentally diagnosed with a superficial squamous cell carcinoma of esophagus. However, the systemic survey with FDG PET/CT revealed a picture of more advanced disease because of the regional lymph node metastases and a suspected distal metastasis in the left renal pelvis, which was somewhat strange for a small superficial esophageal cancer. Subsequently, the renal pelvic lesion was confirmed as squamous cell carcinoma. However, a primary tumor rather than metastasis in the renal pelvis was considered according to the histologic characteristics and radiologic findings.
Clinical nuclear medicine 11/2011; 36(11):e171-4. · 3.92 Impact Factor
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ABSTRACT: A 24-year-old woman presented with progressive pain in the left groin and left buttock for 4 months. The whole-body FDG PET/CT and MRI of the pelvis revealed a left pelvic mass and venous thrombosis in the left common iliac vein, inferior vena cava, and right atrium. Chondrosarcoma with venous tumor invasion of the inferior vena cava to the right atrium was documented surgically.
Clinical nuclear medicine 10/2011; 36(10):e142-5. · 3.92 Impact Factor
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ABSTRACT: A case of an 84-year-old man with suspicious rectal cancer has been reported. The patient underwent FDG PET/CT for whole-body survey. Unexpectedly, FDG PET/CT demonstrated abnormally increased FDG uptake in rectum (SUVmax: 3.33) and prostate (SUVmax: 5.66) simultaneously. Ultimately, biopsies of rectal tumor and prostatic gland confirmed diagnoses of synchronous schwannoma in the rectum and adenocarcinoma in the prostate. To our best knowledge, this is the first case of rectal schwannoma with representative FDG PET/CT scan in the literature.
Clinical nuclear medicine 10/2011; 36(10):948-9. · 3.92 Impact Factor
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ABSTRACT: We report a case of a 25-year-old woman presented with neutropenic fever after chemotherapy for the relapse of acute biphenotypic leukemia. Gallium-67 scintigraphy for the detection of infectious foci demonstrated a unique pattern of numerous foci with intense and varying-sized radioactivity spreading throughout the body. The subsequent skin biopsy and culture proved Pseudomonas infection. Therefore, this unique image, in combination with clinical information, was compatible with cutaneous manifestations of Pseudomonas sepsis. Eventually, the patient died of uncontrolled systemic infection despite the aggressive antibiotic treatment. This case reminded clinicians and nuclear medicine physicians to notice the potentially fatal finding on gallium-67 scan.
Clinical nuclear medicine 08/2011; 36(8):e96-7. · 3.92 Impact Factor
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ABSTRACT: We report on the imaging findings of Tolosa-Hunt syndrome in a 59-year-old patient. Clinical findings included periorbital pain, ptosis, disordered eye movements, and blurred vision. Treatment with intravenous administration of steroid resolved all symptoms. Currently, magnetic resonance imaging plays a key role in the diagnosis of Tolosa-Hunter syndrome for locating the inflammatory tissue and follow-up. This case of Tolosa-Hunter syndrome with representative (FDG PET/CT) images may imply that FDG PET/CT is a useful tool in detecting and monitoring of this disease.
Clinical nuclear medicine 07/2011; 36(7):574-5. · 3.92 Impact Factor
