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1.
Indian J Urol ; 36(3): 191-199, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33082634

RESUMEN

INTRODUCTION: Radical prostatectomy (RP) and radical radiotherapy (RT) are well established primary curative options for localized prostate cancer. Despite technical improvements, prostate-specific antigen (PSA)-recurrence after RP and RT is a common clinical scenario. We aimed to assess the role of 68Gallium (68Ga) prostate-specific membrane antigen positron emission tomography computed tomography (PSMA PET/CT) in patients with biochemical recurrence of prostate cancer after RP or RT for the detection and localization recurrent and metastatic disease. MATERIALS AND METHODS: We ambispectively (70 retrospective and 100 prospective) analyzed the data of men with biochemical recurrence post-RP and post-RT who were evaluated by 68Ga PSMA PET/CT at our institute. We aimed to assess the relationship between serum PSA levels and the probability of having a positive scan in patients with recurrent prostate cancer. RESULTS: The study included 170 men, all had adenocarcinoma of the prostate, 124/170 had previous RP and 46/170 had prior RT. The median serum PSA in the RP group was 1.8 ng/ml and 5.2 ng/ml in the RT group. In the post-RP cohort, the detection rate of 68Ga PSMA PET/CT was 39.3% for PSA 0.2 to <0.5 ng/ml, 47.3% for PSA 0.5 to <1 ng/ml, 68.4% for PSA 1 to <2 ng/ml and 93.1% for PSA ≥2 ng/ml. In the post-RT group, the detection rate was 88.8% for PSA 2 to <4 ng/ml and 100% for PSA ≥4 ng/ml. CONCLUSIONS: 68Ga PSMA PET/CT provides a novel imaging modality for the detection of prostate cancer recurrence and metastases at low posttreatment PSA levels, which may help in directing appropriate salvage treatments.

2.
Clin Nucl Med ; 49(6): e307-e311, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38557407

RESUMEN

ABSTRACT: Both the central and peripheral nervous systems can be affected in COVID-19. Although MRI is the primary investigative tool for neurological imaging, FDG PET may show additional areas of involvement in the brain in the form of regional hypometabolism or hypermetabolism, secondary to synaptic dysfunction and electrical or glial activation. We present a case series of 4 patients who had neurological symptoms attributable to COVID-19 infection with abnormalities in the brain FDG PET scan.


Asunto(s)
COVID-19 , Fluorodesoxiglucosa F18 , Enfermedades del Sistema Nervioso , Tomografía de Emisión de Positrones , Humanos , Encéfalo/diagnóstico por imagen , COVID-19/diagnóstico por imagen , COVID-19/complicaciones , Enfermedades del Sistema Nervioso/diagnóstico por imagen , SARS-CoV-2
3.
Clin Nucl Med ; 49(1): e31-e32, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38015722

RESUMEN

ABSTRACT: An osteoid osteoma (OO) is a benign bone neoplasm, characterized by significant nocturnal pain that usually responds to nonsteroidal anti-inflammatory drugs. It occurs most commonly in the lower extremities and vertebrae. Here, we present a case of carcinoma prostate, who was referred to our department for 68 Ga-PSMA PET/CT scan, and we incidentally found out PSMA-avid OO involving frontal bone of skull, which is a rare finding. To the best of our knowledge, this is the second case in which high PSMA uptake is found in the OO, suggesting a possible PSMA expression related to osteoblastic activity.


Asunto(s)
Neoplasias Óseas , Osteoma Osteoide , Neoplasias de la Próstata , Masculino , Humanos , Tomografía Computarizada por Tomografía de Emisión de Positrones , Osteoma Osteoide/diagnóstico por imagen , Radioisótopos de Galio , Neoplasias de la Próstata/patología , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/metabolismo , Cráneo/metabolismo , Ácido Edético/metabolismo
4.
Clin Nucl Med ; 48(1): e9-e11, 2023 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-36469073

RESUMEN

ABSTRACT: Renal cell carcinoma (RCC) is an aggressive carcinoma with hematogenous spread commonly to lungs, liver, and bones. However, few cases of isolated urinary bladder metastasis have also been reported. Here we report a case of 63-year-old man, a known case of left RCC (clear cell type), post left nephrectomy, who was on regular clinicoradiological follow-up. He presented with complaints of painless hematuria; on further evaluation, 18F-FDG PET/CT revealed few FDG-avid intramural nodular lesions along the walls of urinary bladder. He underwent TURBT, and the tissue was sent for histopathological examination, which was diagnostic of metastatic RCC.


Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Masculino , Humanos , Persona de Mediana Edad , Carcinoma de Células Renales/patología , Fluorodesoxiglucosa F18 , Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/patología , Vejiga Urinaria/patología
5.
Ann Indian Acad Neurol ; 25(5): 880-889, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36561021

RESUMEN

Aim: The aim of this study is to elucidate the patterns of characteristic hypometabolism on 18F-Fluoro Deoxy-glucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) in the variants of Progressive supranuclear palsy (PSP) and its correlation with their core clinical features. Material and Methods: A retrospective analysis of 88 subjects with clinically suspected PSP was done. An institutional informed consent to participate in the study was taken from all the subjects. All the subjects had undergone a prior 99mTechnetium labeled Tropane derivative of dopamine transporter Single Photon Emission Computed Tomography (99mTc TRODAT-1 SPECT) study and had abnormal scans to confirm degenerative parkinsonism. The subjects were clinically examined by the neurologists using the Progressive Supranuclear Palsy Rating Scale proposed by the Movement Disorder Society and were further clinically segregated into eight subtypes. All the included subjects further underwent a detailed clinical analysis to obtain their individual Schwab and England activities of daily living scale and Modified Hoehn and Yahr staging by a neurologist. All the subjects underwent 18F-FDG PET/CT scan after adequate preparation. The scans were analyzed both qualitatively (visually) and quantitatively using Statistical Parametric Mapping. Results: The frontal, limbic, and sensorimotor cortices represented the common areas of hypometabolism among all the subtypes of PSP. The subcortical regions showing the most significant hypometabolism were the thalami, mid-brain, nucleus accumbens, caudate, globus pallidus, and putamen in descending order. Multiple cortical and subcortical regions of hypometabolism were identified in different subtypes of PSP. Conclusion: The characteristic patterns of hypometabolism observed in the different subgroups were more apparent on quantification and based on visual analysis alone, it may not be possible to differentiate the different subtypes of PSP. A good correlation was seen between some of the core clinical features and hypometabolic clusters.

6.
Indian J Nucl Med ; 37(1): 94-96, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35478670

RESUMEN

We present a case of Anti-IgLON 5 encephalitis with Lewy body dementia. 18F fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan and 99 mTc-TRODAT-1 SPECT/CT scan were done. 99 mTc-TRODAT-1 scan findings revealed severely reduced concentration of dopamine transporter in bilateral basal ganglia, suggestive of a degenerative parkinsonian disorder. 18F-FDG PET scan findings were suggestive of moderate-to-severe hypometabolism in the bilateral parieto-temporal and bilateral occipital cortices including the primary visual cortices, supporting Lewy body spectrum disease with associated hypermetabolism in the bilateral sensorimotor cortices, bilateral basal ganglia, thalami, brain stem, and bilateral cerebellar hemispheres suggestive of inflammatory pathology.

7.
Indian J Nucl Med ; 36(1): 39-42, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34040294

RESUMEN

Metastatic lesions to thyroid cartilage are very rare and can be often missed on conventional imaging. Anatomical and functional fused positron emission tomography/computed tomography (PET/CT) imaging has higher sensitivity as compared to conventional CT imaging and can thus identify such atypical sites of metastasis. Here, we present four cases of thyroid cartilage metastases detected on 18fluorodeoxyglucose PET/CT scan from carcinoma lung, breast, stomach and urinary bladder.

8.
Indian J Nucl Med ; 36(2): 183-188, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34385791

RESUMEN

Prostate cancer usually metastasizes to regional lymph nodes and bone. Laryngeal cartilage metastases are very rare and only few cases have been published so far describing thyroid cartilage metastatic lesions from prostate cancer. Here, we describe 5 cases of carcinoma prostate, 3 staging and 2 follow-up, where 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (PET/CT) scan revealed multiple skeletal lesions along with thyroid cartilage metastasis. Initially, laryngeal cartilage metastases remain asymptomatic and in later stages patients present with symptoms. These metastatic lesions to thyroid cartilage are rare entities and can often easily be missed on conventional imaging. PET-CT imaging has overcome this diagnostic problem due to its ability to provide for both anatomical and functional imaging.

9.
Ann Indian Acad Neurol ; 24(4): 490-494, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34728939

RESUMEN

AIM: To elucidate the patterns of characteristic hypometabolism on 18F- fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in multisystem atrophy (MSA) and their correlation with the patterns of uptake on dopamine transporter imaging with 99mTc TRODAT-1 SPECT. MATERIAL AND METHODS: A retrospective analysis of 67 patients with clinically diagnosed MSA was performed. All the subjects underwent 99mTc TRODAT-1 SPECT and 18F-FDG PET/CT scanning on two separate days. The 99mTc-TRODAT-1 scans were analyzed visually for asymmetry and rostro-caudal gradient. The FDG uptake patterns were recorded, and areas of hypometabolism that were two standard deviations from the mean were considered abnormal. RESULTS: All the subjects had an abnormal pattern of FDG uptake on PET scan, both on a visual inspection and semiquantitative analysis. In MSA-P subjects (n = 29), diffuse predominant hypometabolism of the globus pallidus-putamen complex was noted, with relative sparing of the caudate nuclei. In MSA-C subjects (n = 25), characteristic hypometabolism was noted in the cerebellum and brainstem. In mixed subtypes (n = 13), variable involvement of the basal ganglia, cerebellum, and brainstem was noted with frontoparietal hypometabolism. A statistically significant difference between MSA-P and MSA-C for gradient reduction and asymmetry with gradient reduction was observed. CONCLUSION: Dopamine transporter imaging with 99mTc TRODAT-1 SPECT not only helps in confirmation of parkinsonian disorders but also demonstrates varying patterns of distribution in different subtypes of MSA. Characteristic patterns of hypometabolism in 18F-FDG PET may help in the differentiation of the subtypes of MSA in the presence of clinically overlapping symptoms.

10.
World J Nucl Med ; 20(1): 93-95, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33850495

RESUMEN

The abnormal thickening of the gallbladder (GB) wall can be caused by a malignant condition like gallbladder carcinoma or by benign lesions such as chronic cholecystitis or xanthogranulomatous cholecystitis (XGC). Mural thickening is a common finding between them as fluorodeoxyglucose (FDG) can be taken up by inflammatory cells also. Here, we present a patient with irregular thickening of the GB wall which was suspected to of GB carcinoma since FDG positron emission tomography/computed tomography scan showed increased tracer uptake in the lesion. However, after surgery the histopathological report was suggestive of XGC.

11.
Indian J Nucl Med ; 36(2): 168-172, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34385788

RESUMEN

Melanomas are the malignancies that can affect any anatomic region where melanocytes exist (such as the epidermis, eyes, nasal cavity, and anus). Anorectal melanoma is a rare mucosal melanocytic malignancy, comprising 0.8% of all anorectal malignancies. Here, we report a case series of three patients of anorectal melanoma and role of positron emission tomography/computed tomography in diagnosis and follow-up to evaluate the local recurrence and distant metastases. Of three patients, two presented with rectal bleeding and one with obstruction. One patient had recurrence after 10 months, other after 24 months, and third remained disease free post surgery till 9 months.

12.
Int Cancer Conf J ; 10(4): 312-317, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34567944

RESUMEN

Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare subtype of dendritic cell tumour. The solitary lymph node disease is most commonly seen, but may occasionally present extranodally in skin, intestines, soft tissue, liver or spleen. Here we present a case of IDCS in pleura in 53-year-old man, who presented with loss of appetite and chest pain. The initial biopsy was inconclusive. The patient was started on anti-tubercular treatment considering the higher prevalence of the disease in this part of the world. However, the symptoms worsened after 2 months and repeat PET-CT scan revealed extensive FDG avid lesions in the multiple sites in the body. Repeat PET guided biopsy confirmed this rare IDCS neoplasm. Diagnostic challenges of this rare tumour are discussed.

13.
World J Nucl Med ; 20(4): 382-385, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-35018156

RESUMEN

Multiple primary malignancies in a cancer patient are not a rare occurrence. The most common presentation of multiple primary malignancies is dual malignancies. The usefulness of different positron emission tomography (PET)/computed tomography (CT) tracers in the evaluation of dual synchronous primary malignancies is not well documented. Here, we present a case series, where two patients, referred for PET/CT, after being diagnosed with one primary malignancy were found to be having a second primary malignancy, diagnosed incidentally in PET/CT, further validated by PET/CT with another tracer.

14.
Clin Nucl Med ; 46(1): e27-e28, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32910055

RESUMEN

Autoimmune encephalitis is a diverse group of neuropsychiatric disorders, which are difficult to diagnose clinically. The disorder presents acutely or subacutely with alteration of consciousness, cognitive decline, seizures, and abnormal movements. Autoantibodies are directed against intracellular antigens or extracellular domains of cell surface proteins, critical for neuronal excitability. F-FDG PET/CT has been used to diagnose the metabolic derangement in the brain due to various antibodies. Here we describe a case where acute and subacute phase of disease was visualized on serial F-FDG PET/CT.


Asunto(s)
Enfermedades Autoinmunes/diagnóstico por imagen , Enfermedades Autoinmunes/metabolismo , Fluorodesoxiglucosa F18 , Encefalitis Límbica/diagnóstico por imagen , Encefalitis Límbica/metabolismo , Tomografía Computarizada por Tomografía de Emisión de Positrones , Enfermedad Aguda , Autoanticuerpos/metabolismo , Enfermedades Autoinmunes/inmunología , Femenino , Humanos , Encefalitis Límbica/inmunología
15.
Clin Nucl Med ; 46(1): e63-e64, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33181746

RESUMEN

We report a case of 34-year-old woman presenting with complaints of abnormal posturing of hand and tonic-clonic seizures of few days' duration, which soon progressed to psychotic episodes and injuries secondary to fall/abnormal movements. She underwent F-FDG PET for a suspicion of encephalitis, which revealed increased FDG uptake in the bilateral parietotemporal lobes (right more than left), anterior cingulate cortex, bilateral basal ganglia, thalami, and cerebellum. This atypical pattern did not conform to any known pattern of encephalitis, which was later attributed to the presence of both anti-NMDAr and anti-GAD antibodies in blood and cerebrospinal fluid.


Asunto(s)
Encefalitis Antirreceptor N-Metil-D-Aspartato/diagnóstico por imagen , Encefalitis Antirreceptor N-Metil-D-Aspartato/terapia , Encefalitis/diagnóstico por imagen , Encefalitis/terapia , Fluorodesoxiglucosa F18 , Enfermedad de Hashimoto/diagnóstico por imagen , Enfermedad de Hashimoto/terapia , Tomografía Computarizada por Tomografía de Emisión de Positrones , Adulto , Femenino , Humanos , Resultado del Tratamiento
16.
Indian J Nucl Med ; 36(1): 100-102, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34040315

RESUMEN

18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scan is the imaging modality of choice in the management of lymphoma. However, 18F-FDG is a nonspecific tracer for tumoral metabolic activity and infective pathology, thus posing a challenge in accurate response assessment. Here, we present a case of Hodgkin's lymphoma, referred for staging PET/CT scan which showed FDG-avid disease in the mediastinum, and on interim 18F-FDG PET/CT in addition to the mediastinal mass lesion, a FDG-avid lesion was also noted in the spleen suggestive of disease progression. The biopsy report of the lesion was tuberculosis, which was masquerading as disease progression on interim 18F-FDG PET/CT.

17.
World J Nucl Med ; 20(4): 401-404, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-35018162

RESUMEN

18F-2-fluoro-2-deoxy-D-glucose ([18F]-FDG) positron emission tomography (PET) CT has proven useful in the evaluation of high-grade glioma and is also useful as a predictor of the degree of malignancy in newly diagnosed brain tumors. It is commonly accepted that high-grade gliomas are characterized by increased FDG uptake, whereas the low-grade glioma demonstrates reduced or absent FDG uptake. [18F]-FDOPA is an amino acid PET tracer which is a marker of the proliferative activity of brain tumors and demonstrates positive uptake in all grades of brain tumors; however, the degree of tracer uptake is significantly higher in high-grade tumors as compared to low-grade tumors. Here, we discuss a case where both FDG and DOPA PET/CT scans raised suspicion of low-grade glioma; however, the final histopathology report confirmed WHO grade IV Glioblastoma.

18.
Indian J Nucl Med ; 35(2): 172-173, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32351277

RESUMEN

Inguinal hernia is a common pathology seen in the general population. However, the presence of herniated urinary bladder in the inguinal canal is a rare condition. Most cases are asymptomatic and are detected incidentally either during surgery or on imaging. Here, we present a report, where a patient, diagnosed case of carcinoma esophagus, was referred for staging 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) scan and revealed FDG uptake in the right inguinal canal, other than primary and metastatic lesions and corresponding CT and fused PET/CT images revealed herniated urinary bladder in the inguinal canal.

19.
Clin Nucl Med ; 45(9): 692-693, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32604120

RESUMEN

A 64-year-old man with recently diagnosed prostate adenocarcinoma with a total prostate-specific antigen level of 3.32 ng/mL and Gleason score 4 (3 + 4) was referred for Ga-prostate-specific membrane antigen PET/CT scan for pretreatment staging. Prostate-specific membrane antigen-avid lesion was noted in the right lobe of the prostate gland, corresponding to the known primary lesion. Note was made of another prostate-specific membrane antigen-avid lesion in the right parietal lobe of brain, likely meningioma. MRI scan performed later confirmed the brain lesion to be meningioma.


Asunto(s)
Antígenos de Superficie/metabolismo , Glutamato Carboxipeptidasa II/metabolismo , Glicoproteínas de Membrana , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/metabolismo , Meningioma/diagnóstico por imagen , Meningioma/metabolismo , Compuestos Organometálicos , Tomografía Computarizada por Tomografía de Emisión de Positrones , Isótopos de Galio , Radioisótopos de Galio , Humanos , Imagen por Resonancia Magnética , Masculino , Neoplasias Meníngeas/patología , Meningioma/patología , Persona de Mediana Edad , Clasificación del Tumor
20.
Indian J Nucl Med ; 35(3): 244-247, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33082685

RESUMEN

New onset refractory status epilepticus (NORSE), is a rare, neurological condition characterised by prolonged periods of refractory epileptic seizure with no readily identifiable cause in otherwise healthy individuals. Anatomical imaging like MRI and serology is usually unremarkable. In patients who have underlying etiology as auto-immune encephalitis without any evidence of auto-antibodies FDG PET may help in early diagnosis and treatment response as it tends to accumulate in the neuronal tissue whenever there is increased blood flow, metabolic demand or increased electrical activity which reverts back with clinical recovery.

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