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Τρίτη 16 Φεβρουαρίου 2021

18F-FDG PET/CT Imaging of Metastatic Testicular Choriocarcinoma Mimicking Gastric Cancer which Initial Symptom is Melena

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18F-FDG PET/CT Imaging of Metastatic Testicular Choriocarcinoma Mimicking Gastric Cancer which Initial Symptom is Melena

Mol Imaging Radionucl Ther. 2021 02 09;30(1):47-49

Authors: Göksel S, Akın S, Akdoğan RA, Rakıcı S, Abdioğlu GY, Ayvaz MA

Abstract
Gastric metastasis of choriocarcinoma is rarely reported in the literature. This case report presents the case of multiple metastatic testicular choriocarcinoma mimicking gastric cancer, with melena as the initial symptom. In this case, 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) showed that the testis was the primary focus. The contribution of PET/CT is significant to primary focus detection in metastatic diseases of unknown primary origin that presented gastrointestinal bleeding. In addition to its use in staging of testicular carcinoma, PET/CT provides significant benefit in evaluating patients with increased levels of tumor markers and in detecting recurrence.

PMID: 33586408 [PubMed]

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Somatostatin Receptor Scintigraphy in a Patient with Myocarditis

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Somatostatin Receptor Scintigraphy in a Patient with Myocarditis

Mol Imaging Radionucl Ther. 2021 02 09;30(1):50-53

Authors: Amini A, Dehdar F, Jafari E, Gholamrezanezhad A, Assadi M

Abstract
We report a case of myocarditis imaged with technetium-99m octreotide cardiac single-photon emission computed tomography which showed diffuse uptake in the myocardium, indicating inflammatory reaction to myocardial damage. Somatostatin receptor scintigraphy of the heart could be considered in patients with suspected cardiac inflammation. This could facilitate early diagnosis and guide appropriate treatment.

PMID: 33586409 [PubMed]

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Small-angle Compton Scatter Artifact in Tc-99m-IDA Hepatobiliary Scintigraphy Resulting in the Breast Overlying the Liver in Planar Dynamic Imaging.

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Small-angle Compton Scatter Artifact in Tc-99m-IDA Hepatobiliary Scintigraphy Resulting in the Breast Overlying the Liver in Planar Dynamic Imaging.

Mol Imaging Radionucl Ther. 2021 Feb 09;30(1):54-56

Authors: Qutbi M

Abstract
Compton scatter photons are generally considered problematic in nuclear medicine imaging. Therefore, efforts are being made to minimize the involvement of these photons by employing some special strategies in daily practice. Basically, photons scattering at a small angle and traveling in the proper direction stand a chance of getting recorded and thereby participate in the image formation. These photons may create artifactual hot spots in the vicinity of a region with high concentration of radioactivity. The present study focuses on the negative impact of such photons during routine imaging in clinical setting, through an artifact detected in technetium-99m-IDA hepatobiliary scintigraphy, with the purpose of highlighting this issue to the nuclear medicine practitioners.

PMID: 33586410 [PubMed]

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Active Giant Cell Vasculitis Diagnosis with 68Ga PSMA PET/CT Imaging.

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Active Giant Cell Vasculitis Diagnosis with 68Ga PSMA PET/CT Imaging.

Mol Imaging Radionucl Ther. 2021 Feb 09;30(1):57-59

Authors: Sağer MS, Bilgiç S, Uslu L, Asa S, Sağer G, Sönmezoğlu K

Abstract
Vasculitis is a multisystem disease characterized by inflammation with infiltration of leukocytes into the blood vessels. Giant cell arteritis (GCA) is the most common form of vasculitis that mostly affects medium- and large-sized arteries. 18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is increasingly used to diagnose inflammation of large arteries in GCA. Galium-68 prostate-specific membrane antigen (PSMA) PET/CT has a vital role in the assessment of patients with prostate cancer for recurrence and metastasis of the disease. Various benign and non-prostate malignant conditions may give rise to increased PSMA uptake. Herein, we demonstrate that PSMA uptake can be seen in GCA.

PMID: 33586411 [PubMed]

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Unexpected Detection of Abscessualized Lung Carcinoma on Tc-99m-HMPAO-labeled Leukocytes Scintigraphy Misdiagnosed on Chest Computed Tomography.

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Unexpected Detection of Abscessualized Lung Carcinoma on Tc-99m-HMPAO-labeled Leukocytes Scintigraphy Misdiagnosed on Chest Computed Tomography.

Mol Imaging Radionucl Ther. 2021 Feb 09;30(1):60-62

Authors: Cosma L, Frantellizzi V, Pontico M, De Vincentis G

Abstract
Technetium-99m (Tc-99m)-hexamethylpropylene amine oxime (HMPAO)-labeled leukocytes scintigraphy is well established for investigating and diagnosing infections in bone and soft tissue, as well as for the detection of occult infection. A 71-year-old female who was recently diagnosed with bronchopulmonary neuroendocrine tumor of the right lung was referred for an intermittent fever of unknown origin associated with chill at night for the last month. Chest computed tomography (CT) scan showed a thrombotic widespread of the superior vena cava and a solid pathological tissue in the superior segment of the inferior lobe of the right lung with consensual atelectasis. Being a carrier of port-a-cath, an infection of this device was suspected. Therefore, Tc-99m-HMPAO-labeled leukocytes single-photon emission computed tomography (SPECT) was performed, and matching pairs of CT scan and Tc-99m-HMPAO-labeled white blood cell SPECT images were fused. Through this means, it was found that th e area of the radiotracer increased uptake corresponded with the soft tissue density mass detected by CT scan localized at the inferior lobe of the right lung. The hybrid SPECT/CT fused imaging was crucial for diagnosis of the presence of a lung abscess localized in correspondence with the known lung cancer region.

PMID: 33586412 [PubMed]

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68Ga PSMA Uptake at Roux-en-Y Eso-jejunostomy Junction Mimicking the Recurrence of Gastric Carcinoma in PET/CT.

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68Ga PSMA Uptake at Roux-en-Y Eso-jejunostomy Junction Mimicking the Recurrence of Gastric Carcinoma in PET/CT.

Mol Imaging Radionucl Ther. 2021 Feb 09;30(1):63-66

Authors: Arslan E, Aksoy T, Cin M, Çakır C, Can Trabulus FD, Çermik TF

Abstract
A 67-year-old male patient had undergone total gastrectomy and Roux-en-Y eso-jejunostomy 3 years ago for the treatment of tubular adenocarcinoma located at the corpus of the stomach. The patient was diagnosed with Gleason score 8 (4+4) metastatic prostate cancer during the follow-up period and received hormone therapy. Owing to his elevated prostate-specific antigen levels (77 ng/mL), his clinician referred him gallium-68 (68Ga) prostate-specific membrane antigen 11 (PSMA) positron emission tomography/computed tomography (PET/CT) for restaging. PET/CT showed multiple 68Ga PSMA receptor-positive skeletal lesions and linear PSMA activity at the eso-jejunostomy junction. He was then referred to undergo 18fluorine-fluorodeoxyglucose (18F-FDG) PET/CT to screen for gastric carcinoma recurrence. PET/CT images demonstrated no 18F-FDG avid lesion. However, endoscopy and biopsy performed with samples from the eso-jejunostomy junction revealed superficial benign squamous epithelial frag ments.

PMID: 33586413 [PubMed]

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Δευτέρα 15 Φεβρουαρίου 2021

Long‐term Impact of Middle Ear Effusion in Pediatric Tympanostomy Tubes

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Objectives/Hypothesis

Bilateral myringotomy and tympanostomy tube placement (BMT) is the most common pediatric surgery in the United States. Intraoperative middle ear effusion (MEE) is a risk factor for future BMTs in children with recurrent acute otitis media (RAOM). However, the impact of the type of MEE is unknown. Here, we assess otologic outcomes based on intraoperative MEE type and indication for surgery.

Study Design

Case series chart review.

Methods

After institutional review board approval, we performed a review of children undergoing BMTs between 2008 and 2009. Included patients had their first BMT, preoperative visit, and an operative report. Patients with cleft palate or Down syndrome were excluded. Indications for surgery included RAOM and chronic otitis media with effusion (COME). Other variables evaluated were future BMT, acquired cholesteatoma, and otorrhea. Logistic regression was used for statistical analysis.

Results

Out of 1,045 patients reviewed, 680 were included and underwent their first BMT. There were 619 patients who had RAOM. Serous effusions were present in 22.2%, mucoid in 31.3%, purulent in 12.9%, undocumented or bloody in 2.3% of patients, and 31.2% of patients had dry middle ears. Moreover, 22.7% of patients underwent future BMTs. In RAOM patients, serous effusions decreased odds of perforation (odds ratio [OR]: 0.195, 95% confidence interval [CI]: 0.0438‐0.867, P = .032), and purulent effusions increased the odds of in‐office otorrhea suctioning (OR: 2.13, 95% CI: 1.20‐3.77, P = .010) compared to dry. Mucoid effusions had no significant effect on outcomes in COME or RAOM patients.

Conclusions

Intraoperative MEEs were noted in 68.7% of cases; purulent effusions increase the odds of in‐office suctioning in RAOM patients.

Level of Evidence

4 Laryngoscope, 131:E993–E997, 2021

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