FDG-Avid Periprosthetic Particle Disease Mimicking Osteosarcoma Recurrence.

ABSTRACT: A 24-year-old man with a history of osteosarcoma presented with swelling in his right thigh for more than 1 year. 18 F-FDG PET/CT demonstrated increased FDG uptake in multiple juxtacortical masses around the prosthesis, which highly suggested the possibility of osteosarcoma recurrence. A biopsy was performed, and the pathology confirmed the diagnosis of particle disease. The current case indicates that particle disease should be considered when interpreting the PET/CT images with high FDG uptake around the prosthesis.

The value of FT4/TSH ratio in the differential diagnosis of Graves' disease and subacute thyroiditis.

Objective: To explore the value of the FT4/TSH ratio in the etiological diagnosis of newly diagnosed patients with thyrotoxicosis. Methods: The retrospective study was conducted on 287 patients with thyrotoxicosis (122 patients with subacute thyroiditis and 165 patients with Graves' disease) and 415 healthy people on their first visit to our hospital. All patients underwent thyroid function tests including the measurement of T3, T4, FT3, FT4, TSH, T3/TSH, and T4/TSH. The receiver operating characteristic (ROC) curve was employed to evaluate the value of FT4/TSH in the differential diagnosis of Graves' disease and subacute thyroiditis, and compared with other related indicators. Results: The area under the curve of FT4/TSH for diagnosing Graves' disease and thyroiditis was 0.846, which was significantly larger than the area under the curve of T3/T4 ratio (P< 0.05) and FT3/FT4 ratio (P< 0.05). When the cut-off value of the FT4/TSH ratio was 5731.286 pmol/mIU, the sensitivity was 71.52%, the specificity was 90.16%, the positive predictive value was 90.77% and the negative predictive value was 70.06%. The diagnostic accuracy was 79.44%. Conclusion: FT4/TSH ratio can be used as a new reference index for the differential diagnosis of thyrotoxicosis.

Intravascular Large B-Cell Lymphoma Identified by PET/CT.

ABSTRACT: Intravascular large B-cell lymphoma is a rare subtype of extranodal invasive non-Hodgkin lymphoma, and the diagnosis is challenging. Here we report findings of 18 F-FDG PET/CT study in a case of intravascular large B-cell lymphoma invading bilateral lungs and kidneys in a 63-year-old woman. The PET/CT images showed diffuse increased FDG uptake in bilateral lungs and kidneys. Unexpectedly, there was no abnormal density on the CT images. The 18 F-FDG PET/CT seems to be valuable and sensitive in the diagnosis of intravascular large B-cell lymphoma.

Trends in incidence and survival in patients with gastrointestinal neuroendocrine tumors: A SEER database analysis, 1977-2016.

Objectives: We aimed to determine trends in incidence and survival in patients with gastrointestinal neuroendocrine tumors (GI-NETs) from 1977 to 2016, and then analyze the potential risk factors including sex, age, race, grade, Socioeconomic status (SES), site, and stage. Methods: Data were obtained from Surveillance, Epidemiology, and End Results Program (SEER) database. Kaplan-Meier survival analysis, relative survival rates (RSRs), and Cox proportional risk regression model were used to evaluate the relationship between these factors and prognosis. Results: Compared with other sites, the small intestine and rectum have the highest incidence, and the appendix and rectum had the highest survival rate. The incidence was higher in males than in females, and the survival rate in males was close to females. Blacks had a higher incidence rate than whites, but similar survival rates. Incidence and survival rates were lower for G3&4 than for G1 and G2. Age, stage, and grade are risk factors. Conclusions: This study described changes in the incidence and survival rates of GI-NETs from 1977 to 2016 and performed risk factor analyses related to GI-NETs.

Primary Aortic Epithelioid Angiosarcomas With Metastatic Disease Detected by 18F-FDG PET/CT.

ABSTRACT: Epithelioid angiosarcoma in the aortic arch with metastatic disease is extremely rare. We report a case of 63-year-old man with suspected bone metastases who underwent 18F-FDG PET/CT for seeking the potential primary tumor. PET/CT demonstrated intense FDG uptake in the aortic arch with multiple FDG-avid lesions involving the lung, lymph nodes, and bones. Finally, the diagnosis of primary aortic epithelioid angiosarcomas with metastatic disease was confirmed.

Hyperparathyroidism Caused by Coexisting Parathyroid Hyperplasia and Unilateral Bifocal Parathyroid Carcinoma.

ABSTRACT: The coexistence of parathyroid hyperplasia and carcinoma is uncommon. Here we report findings of 99m Tc-sestamibi SPECT/CT study in a case of unilateral bifocal parathyroid carcinoma coexisting with parathyroid hyperplasia in a 49-year-old man. The images showed 4 foci of elevated activity around the thyroid. Histopathology confirmed the 2 lesions of the left side as parathyroid hyperplasia and the other 2 lesions of the right side as parathyroid carcinoma.

The Xiangya equation could not replace the Asian modified CKD-EPI equation in estimating glomerular filtration rate in Chinese patients with chronic kidney disease.

BACKGROUND: To evaluate the clinical practicability of the Xiangya equation in estimating glomerular filtration rate (GFR) and compare with the Asian modified Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation, assessing whether the Xiangya equation could replace the Asian modified CKD-EPI equation as the preferred method for predicting GFR in the Chinese CKD patients in an external validation study. METHODS: The GFR was determined simultaneously by two methods: (a) the Asian modified CKD-EPI equation (GFRCKD-EPI); (b) the Xiangya equation (GFRXiangya); diagnostic performance of the two models was compared by the regression analysis, the Bland-Altman plot, bias, precision and P30 under the background of 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) dual plasma sample clearance method as reference method for GFR measurement (mGFR). RESULTS: A total of 158 Chinese CKD patients were included in our external study. The GFRXiangya was highly related with mGFR, with the correlation coefficient of 0.92. The regression equation was GFRXiangya = 0.55*mGFR + 28.25, where the regression coefficient was far away from one and the intercept was wide. Compared with the Asian modified CKD-EPI equation, the performance of the Xiangya equation demonstrated a poorer bias (9.5 vs - 3.3 ml/min/1.73 m2, P < 0.001), an inferior precision (23.9 vs 13.0 ml/min/1.73 m2, P < 0.001), a lower P30 (51.3% vs 73.4%, P < 0.001) and a wider 95% limit of agreement in Bland-Altman analysis (65.0 vs 44.9 ml/min/1.73 m2). CONCLUSION: Due to relatively inferior performance, the Xiangya equation could not replace the Asian modified CKD-EPI equation in estimating GFR in Chinese patients with chronic kidney disease in our external cohort.