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ABSTRACT: After a total or near total thyroidectomy and radioiodine ablation therapy for differential thyroid cancer (DTC), routine follow-up methods are I or I whole-body scanning (WBS) as well as serum thyroglobulin (Tg) and anti-thyroglobulin (anti-Tg) levels. We describe a case of a 41-year-old woman with follicular thyroid cancer. Although serum Tg level and I WBS were negative after radioiodine ablation therapy, she had pain around her left medial clavicle. FDG PET/CT was performed for any undetected metastases. FDG PET/CT showed hypermetabolic bone metastases in the left medial clavicle. Biopsy confirmed metastases of the thyroid follicular carcinoma.
Clinical nuclear medicine 03/2013; 38(3):226-7. · 3.92 Impact Factor
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Internal Medicine 01/2013; 52(9):1009-10. · 0.94 Impact Factor
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ABSTRACT: A 53-year-old man with recent diagnosis of urinary bladder carcinoma was referred to our PET/CT unit. There was no sign and symptom other than hematuria. Urinary ultrasound showed a mass lesion at the right wall of the urinary bladder. FDG PET/CT was performed for initial staging. One-hour whole-body PET/CT images were normal, whereas delayed pelvic images with "diluted and filled bladder" demonstrated that intense hypermetabolic lesion at the right lateral wall of the urinary bladder.
Clinical nuclear medicine 08/2012; 37(8):778-80. · 3.92 Impact Factor
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European Journal of Nuclear Medicine 06/2012; 39(10):1660-1. · 4.53 Impact Factor
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ABSTRACT: Vasculitis is defined as inflammation and necrosis with leukocytic infiltration of the blood vessel wall. Takayasu arteritis is a chronic inflammatory arteritis that primarily involves the aorta and its main branches. A 64-year-old female patient with a 2-month history of fever of unknown origin was presented to our clinic for F-18 FDG PET/CT imaging. Baseline PET/CT images demonstrated intense F-18 FDG uptake in the aorta, bilateral subclavian and brachiocephalic arteries consistent with Takayasu arteritis. After 2 months of immunosuppressive therapy, she was asymptomatic and follow-up FDG PET/CT scan showed almost complete disappearance of large vessels' F-18 FDG uptake. FDG PET/CT is a sensitive technique for assessing presence of large-vessel vasculitis such as Takayasu arteritis, extent of large-vessel inflammation and disease activity after therapy. Conflict of interest:None declared.
Molecular imaging and radionuclide therapy. 04/2012; 21(1):32-4.
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ABSTRACT: A 53-year-old man with a diagnosis of gastric non-Hodgkin lymphoma (NHL) underwent PET/CT scans both prior to starting chemotherapy and immediately following completion of chemotherapy to evaluate the response to therapy. Pre-therapy PET/CT images showed intense FDG uptake in the antral region of the stomach. Biodistribution of FDG was otherwise unremarkable. The patient was started on metformin in the middle of his therapy period to provide glycemic control. Post-therapy PET/CT study performed after 6 courses of chemotherapy showed complete resolution of the disease with no evidence of residual FDG uptake. However, intense and diffuse FDG accumulation is observed in the bowel, which was interpreted as physiological and most probably due to metformin administration. It should be borne in mind that there are a number of physiological variants of FDG biodistribution seen on PET/CT imaging. Recognizing physiologic bowel activity is crucial for the accuracy of PET image interpretation. Conflict of interest:None declared.
Molecular imaging and radionuclide therapy. 12/2011; 20(3):114-6.
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ABSTRACT: Preoperative octreotide scintigraphy imaging has opened up a new era to approach recurrent medullary thyroid carcinoma (MTC). We describe the case of a 53-year-old woman who was diagnosed with recurrent MTC and elevated serum calcitonin level >2000 pg/mL. Preoperatively, Tc-99m HYNIC-TATE scintigraphy was used in identifying 2 focal abnormalities in the right upper cervical and left upper mediastinal regions, and a hand-held gamma probe was used intraoperatively to identify the hot areas. Six months after intraoperative dissection, serum calcitonin level and Tc-99m HYNIC-TATE scintigraphy were found normal. This case demonstrates the proper localization for recurrent MTC using Tc-99m HYNIC-TATE and a surgical gamma probe.
Clinical nuclear medicine 09/2011; 36(9):831-3. · 3.92 Impact Factor
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ABSTRACT: A 50-year-old man presented with chest pain symptoms for 7 years. He did not report any other complaints. The diagnostic tests including physical examination, routine laboratory tests, chest x-ray, and electrocardiography were reported as normal. Cardiac MRI, however, revealed a 64 × 66 mm mass lesion in the left myocardium. He was referred to our unit for further tests. A PET/CT was carried out which demonstrated a minimally increased fluorodeoxyglucose uptake at the peripheral margins of the mass, which deemed to be suspicious for malignancy. The patient underwent a thoracotomy and the cardiac mass was excised. Histopathologic examination reported this lesion as a hydatid cyst.
Clinical nuclear medicine 07/2011; 36(7):580-1. · 3.92 Impact Factor
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ABSTRACT: A 40 years old woman with a recent diagnosis of vaginal cancer was referred for PET/CT scans to evaluate extent of the disease. PET/CT demonstrated intense hypermetabolic tumoral lesions at the uterus and vagina as well as multiple intraabdominal lymph nodes which was consistent with primary tumor and metastases. There was also hypermetabolic alveolar consolidation and ground glass opacities in the bilateral lung parenchyma other than subpleural regions suggestive of pulmonary edema. Pulmonary edema can be divided into four main categories on the basis of pathophysiology: (a) increased hydrostatic pressure edema, (b) permeability edema with diffuse alveolar damage (DAD), (c) permeability edema without DAD, and (d) mixed edema due to simultaneous increased hydrostatic pressure and permeability changes. After one day, the patient was admitted to intensive care unit with a diagnosis of acute respiratory distress syndrome (ARDS). Despite whole body (18)F-FDG PET/CT mainly used for evaluation of malignancies, recognizing of incidental benign disease such as ARDS had a crucial importance.Acute lung injury and ARDS represent a process of progressive respiratory failure characterized by the acute onset of dyspnea, decreased arterial oxygen pressure, development of bilateral pulmonary infiltrates on radiographs and absence of clinical evidence of primary left-sided heart failure. The imbalance of proinflammatory and antiinflammatory cytokines results in lung injury. There is increased synthesis of IL-8, a potent neutrophil chemotactic and activating agent, by pulmonary macrophages leading to pulmonary microvascular sequestration and activation of neutrophils which play a key role in the pathogenesis of the ARDS. Recently, PET using glucose analog 2-deoxy-2-[(18)F]fluoro-Dglucose (FDG), a standard tool in oncology, is increasingly used to evaluate metabolic activity of pulmonary inflammatory cells. A possible basis for (18)F-FDG accumulation at sites of inflammation is that activation of inflammatory cells cause increased density of membrane glucose transporters (GLUT) and hexokinase activity resulting in cellular (18)F-FDG uptake. Diffuse lung uptake of (18)F-FDG occurs prior to development of the overt clinical and radiographic manifestations of ARDS in some subjects. Fluorine-18-FDG-PET gives diagnostic information in the progression of ARDS and may serve as a non-invasive imaging technique in the pathogenesis and natural history of ARDS. Although, (18)F-FDG PET/CT is an efficient method for the evaluation of malignancies, incidental benign disease such as ARDS may cause false positive results. In conclusion, diagnosis of ARDS should be born in mind in cases showing diffusely increased lung uptake of (18)F-FDG.
Hellenic journal of nuclear medicine 15(1):72-3. · 0.81 Impact Factor
