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Neurologic manifestations are now being increasingly encountered in patients who are admitted for respiratory symptoms of COVID-19. A 67-year-old male with a recent history of Wernicke's aphasia was referred to the nuclear medicine department for risk stratification of malignancy in pulmonary nodule by 18F-FDG PET-CT scan. PET-CT revealed decreased metabolic activity in the left temporoparietal lobe of the brain consistent with recent CVA and excluded malignancy in the pulmonary nodule with low-grade metabolic activity. Incidentally noted, new bilateral pulmonary hypermetabolic ground glass opacities rising suspicious for covid-19 infection which was confirmed by PCR of nasopharyngeal mucosa sample. These findings highlight the value of 18FFDG PET-CT in the assessment of COVID-19 infection especially in non-pulmonary presentations like early neurologic manifestation.
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Prostate-specific membrane antigen (PSMA)-targeted imaging is now an effective tool for the evaluation of prostate cancer patients. Although salivary glands take up 68Ga-PSMA avidly, pathologies of these glands may be readily noticeable. Herein, we present a case of prostate cancer referred for 68Ga-PSMA positron emission tomography-computed tomography in whom an isolated aplasia of the submandibular salivary gland was incidentally found.
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A 65-year-old patient with acute lymphoblastic leukemia presented for an 18fluoro-2-deoxy-d-glucose positron emission tomography computed tomography (18FDG PET) after several courses of chemotherapy for metastatic evaluation. Unexpectedly, on 18FDG PET scan, no discernible uptake was observed in the visceral organs, but instead, the skeleton/bone marrow showed homogenously intense metabolic activity. The distribution of 18FDG observed on the scan was remarkably similar to that on the NaF PET scan, indicating a superscan appearance.
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INTRODUCTION: PET/CT scan has an emerging role in head and neck oncology with a few well-established indications, including: detection of unknown primary tumor site, tumor staging, radiotherapy planning, treatment response assessment and detection of recurrent disease. The purpose of this study is reporting PET/CT findings in head and neck cancer patients to emphasize its role in head and neck oncology. MATERIALS AND METHODS: In a retrospective study, we reviewed our PET/CT database and found 94 patients with primary head and neck cancer. This is a descriptive report of PET/CT scan findings in head and neck cancer patients referred to Masih Daneshvari hospital, Tehran, Iran between 2013 and 2016. RESULTS: The most common primary tumor sites were oral cavity (27%) and nasopharynx (22%). The most common indication for referral was tumor restaging (76%) including treatment response evaluation and differentiation between recurrence and post-treatment fibrosis. In 60% of patients with negative primary tumor site, PET/CT was able to detect evidence of regional or distant metastasis. PET/CT was able to localize the primary tumor site in 66% of patients with unknown primary tumor site. We also had 19 patients with primary head and neck cancer referred for initial staging, demonstrating evidence of metastasis in 66% of all cases. CONCLUSION: Most patients are referred for restaging and demonstrate evidence of regional or distant metastasis with significant value for further treatment planning. Providing insurance coverage and familiarizing referring physicians about correct indications of this relatively new diagnostic modality will be to the best interest of head and neck cancer patients in the long run.