Extinction of Lipomatous Hypertrophy of the Interatrial Septum FDG Uptake With Propranolol Premedication.

ABSTRACT: Lipomatous hypertrophy of the interatrial septum is a rare lesion of the heart. CT and cardiac MR are often sufficient to determine the benign lipomatous nature of the tumor and can avoid the need for histological confirmation. Lipomatous hypertrophy of the interatrial septum contains variable amounts of brown adipose tissue, resulting in different degrees of 18 F-FDG uptake in PET. We report the case of a patient with an interatrial lesion suspected of malignancy, discovered on CT and failing cardiac MR, with initial 18 F-FDG uptake. Final characterization was made thanks to 18 F-FDG PET with ß-blocker premedication, avoiding an invasive procedure.

18 F-FDG Muscular Uptake in Statin-Associated Symptoms Without Myositis : How Long to Stop Treatment for Image Quality Improvement?

ABSTRACT: Statin-associated muscle symptoms are a frequent adverse effect of statin treatment and can lead to a statin-associated myopathy characterized by a significant serum creatine kinase increase. We report the case of an 80-year-old man who presented an increased muscular 18 F-FDG uptake in a statin-associated muscle symptom without creatine kinase abnormality or inflammation. Statin treatment was discontinued for 6 hours, 3 days, and 7 days on consecutive follow-up examinations. The 1-week window clearly enhanced image quality. This case illustrates the possibility of diffuse muscular 18 F-FDG uptake without myositis and the need for a minimal 1-week statin discontinuation to reduce muscular uptake.

Case Report: Potential Applications of Using a 3D-Ring CZT SPECT for Lymphoscintigraphic Exploration of Lower Limb Edema.

Lymphoscintigraphy is still considered the gold standard imaging modality for diagnosing lymphedema, due to ineffective lymphatic transport resulting in edema and skin damage. However, protocol variability and poor image resolution can make the interpretation challenging. Up to now, 99 mTc-labeled colloid lymphatic travel is monitored with dual-head cameras, but single-photon emission CT (SPECT) has proved its interest. Here, we present the case of a 59-year-old-man with bilateral asymmetric lower limb edema which was explored using dual-head and new 3D-ring cadmium -zinc-telluride (CZT) SPECT cameras, confirming bilateral lower limb lymphatic dysfunction. In line with other recently published reports, this case report promotes the use of SPECT/CT in the lymphoscintigraphic exploration of lower limb edema. The recognition of the clinicopathologic features of lower limb edema is required to prevent missed diagnoses, such as compressive disease, tumors, etc., as well as to better influence the management of patients.

18F-FDG PET imaging in a patient with late omental infarction after treatment of pancreatic adenocarcinoma.

We report a case of late omental infarction visualized by F-FDG PET/CT during follow-up for pancreatic adenocarcinoma. The 65-year-old patient was referred for imaging 8 months after pancreaticoduodenectomy and 2 months after completion of a course of chemotherapy. PET/CT showed an FDG-avid omental lesion that suggested peritoneal carcinomatosis. The appearance and evolution at follow-up studies confirmed the diagnosis of omental infarction, a rare complication of pancreatic surgery. This case revealed the possibility of late FDG uptake in omental infarction.

18F-FDG PET/CT superscan in prostate cancer.

F-FDG PET/CT of a patient with inflammatory lower back pain reveals diffuse bony metastases, similar to the "superscan" found on a Tc-methylene diphosphonate scintigraphy, and also demonstrates a prostatic lesion which appears to be a poorly differentiated prostate adenocarcinoma.