Clinical Nuclear Medicine

Re: Hepatocellular Carcinoma Mimicking Neuroendocrine Tumor Metastasis on 68Ga-DOTATATE PET/CT No abstract available

Esthesioneuroblastoma on 68Ga DOTANOC PET/CT Esthesioneuroblastoma is a rare neoplasm arising from the neural crest cells of olfactory epithelium mostly in the nasal vault. We describe the 68Ga DOTANOC PET/CT findings of a 44-year-old woman who was operated for right nasal mass diagnosed as paraganglioma in the past and then develop a mass in the right nasal cavity after 2 years which upon surgery diagnosed to be esthesioneuroblastoma on histopathology. Received for publication January 17, 2019; revision accepted April 22, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Dr Shamim Ahmed Shamim, MD, Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, India. E-mail: sashamim2002@yahoo.co.in. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Parathyroid Glands Hyperplasias Mimicking Medullary Thyroid Carcinoma Metastatic Lymph Nodes on 18F-DOPA PET/CT A pre operatory assessment by neck US, 18F-DOPA and 18F-choline PET/CT was performed in a 43-year-old MEN 2A woman affected by hyperparathyroidism and medullary thyroid carcinoma (MTC). On 18F-DOPA, two thyroid uptakes were analyzed as multifocal MTC and two others in the central neck compartment as MTC metastatic lymph nodes. After surgery, multifocal intra thyroidal MTC and two parathyroid glands hyperplasias were proved without MTC adenopathies. We report a case of rare false positive uptake on 18F-DOPA. In case of several endocrine diseases coexistence as in MEN 2A, 18F-DOPA should be carefully analyzed. Received for publication February 14, 2019; revision accepted April 19, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Marie Terroir, MD, 114 rue Edouard vaillant, 94805 Villejuif, France. E-mail: marie.terroir-cassou-mounat@gustaveroussy.fr. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

18F-Fluorocholine Uptake by a Head and Neck Meningeal Inflammatory Pseudotumor 18F-Fluoro-ethyl-choline (18F-FCH) PET/CT is widely used to study patients affected by prostate cancer. However, 18F-FCH may be taken-up by other neoplastic diseases, infections, and non-infective inflammatory processes. While this behavior may be an opportunity to study different diseases, on the other hand, this condition brings with it the source of error in the evaluation of the images. Here we present the case of a meningeal inflammatory pseudotumor evidenced by 18F-FCH. Received for publication January 15, 2019; revision accepted April 22, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Giordano Savelli, MD, Nuclear Medicine Division, Fondazione Poliambulanza Istituto Ospedaliero, via L. Bissolati, 57, 25124 Brescia, Italy. E-mail: giordano.savelli@poliambulanza.it. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Re: Concordance Between Intracervical and Fundal Injections for Sentinel Node Mapping in Patients With Endometrial Cancer? A Study Using Intracervical Radiotracer and Fundal Blue Dye Injections No abstract available

Alveolar Sarcoidosis With Intense FDG Uptake, Mimicking Multi-focal Pneumonia and Infiltrative Lung Malignancy Alveolar sarcoidosis is an uncommon radiologic manifestation of pulmonary sarcoidosis which appears as infiltrative or mass-like opacities mimicking multifocal pneumonia or infiltrative lung malignancies such as multi-focal adenocarcinoma or pulmonary lymphoma. It has correlation with a more acute and symptomatic phase of thoracic sarcoidosis and therefore expected to show a more severely increased metabolic activity on FDG PET. Alveolar sarcoidosis shows a relatively rapid radiological improvement after initiation of corticosteroid therapy. Tissue diagnosis might be needed in some cases to exclude malignancy. Received for publication January 7, 2019; revision accepted April 22, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Kianoush Ansari-Gilani, MD, Radiology Department, University Hospital Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44124. E-mail: kianoush.ansarigilani@uhhospitals.org. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Radionuclide Therapy With 177Lu-PSMA in a Case of Metastatic Adenoid Cystic Carcinoma of the Parotid In vivo prostate-specific membrane antigen (PSMA) overexpression creates an opportunity for PSMA-directed theranostic approach in adenoid cystic carcinoma of the parotid. Herein, we illustrate a patient with metastatic PSMA-directed theranostic approach in adenoid cystic carcinoma of the parotid who had intense PSMA uptake on metastatic lesions, followed by radionuclide therapy with 177Lu-PSMA. Received for publication March 14, 2019; revision accepted April 20, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Duygu Has Simsek, MD, Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, 34093 Fatih/İstanbul, Turkey. E-mail: dr.duyguhas@hotmail.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

A Comparison of Angiogenesis and Glycolytic Imaging in Patients With Clinical Suspected Locally Advanced Breast Cancer 18F-FDG PET/CT imaging is an important diagnostic tool for accurate staging and assessment of response to neoadjuvant chemotherapy (NACT) in patients with locally advanced breast carcinoma (LABC). However, 18F-FDG being non-specific marker, it also accumulates in inflammatory conditions, leading to false positive results. Angiogenesis, an essential characteristic for tumor development, intrusion and metastasis can be imaged using 68Ga-labeled RGD tripeptide. We here depict a series of clinically staged LABC patients who underwent both 68Ga-DOTA-RGD2 and 18F-FDG PET/CT imaging for staging and illustrate the similarities and significant differences between the two tracers. Received for publication January 14, 2019; revision accepted April 22, 2019. Conflicts of interest and sources of fundings: none declared. Correspondence to: Bhagwant Rai Mittal, Department of Nuclear Medicine and PET, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. E-mail: brmittal@yahoo.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

99mTc-MIBI Embolus in the Late Phase of a Parathyroid Scan We report a case of a transient focal MIBI uptake in the late, 90 minutes postinjection phase of a parathyroid scintigraphy in which SPECT/CT imaging proved valuable in delineating the nature of this incidental finding. Received for publication January 8, 2019; revision accepted April 13, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Christos Savvopoulos, MD, PhD, Department of Radiology, Örebro University Hospital, 701 85 Örebro, Sweden. E-mail: christos.savvopoulos@regionorebrolan.se. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

EBV-Associated T-Cell Lymphoproliferative Disorders Demonstrated on FDG PET/CT in a Patient With Hemophagocytic Lymphohistiocytosis FDG PET/CT was performed in a 20-year-old woman to find the underlying cause of hemophagocytic lymphohistiocytosis. The images revealed hypermetabolic activity in multiple lymph nodes and in the spleen. Lymphoma was suspected. However, the pathology of bone marrow, lymph nodes, and the spleen demonstrated chronic active Epstein-Barr virus–associated T-cell lymphoproliferative disorders. Received for publication April 1, 2019; revision accepted April 23, 2019. Conflicts of interest and sources of funding: J.Y. was supported by Beijing Natural Science Foundation (No. 7192041), National Key Research and Development Plan (No. 2017YFC0114003) and National Natural Science Foundation of China (No. 81771860). None declared to all other authors. Correspondence to: Jigang Yang, MD, PhD, Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China 100050. E-mail: 13681221974@163.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Alexandros Sfakianakis
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