Aftab Hasan Nazar

Gallium-68-DOTA-NOC PET/CT of Patients With Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Single-Center Study

OBJECTIVE The objective of this study was to evaluate the role of (68)Ga-labeled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI(3)-octreotide (DOTA-NOC) PET/CT in the diagnosis and management of gastroenteropancreatic neuroendocrine tumors (NETs). SUBJECTS AND METHODS One hundred nine patients (median age, 50 years) with gastroenteropancreatic NETs underwent (68)Ga-DOTA-NOC PET/CT. PET/CT was performed after injection of 132-222 MBq (4-6 mCi) of (68)Ga-DOTA-NOC. Images were evaluated by two experienced nuclear medicine physicians both qualitatively as well as quantitatively (maximum standardized uptake value [SUV(max)]). Results of PET/CT were compared with the results of conventional imaging. Histopathology results, when available, and follow-up PET/CT or conventional imaging with biochemical markers were considered to be the reference standards. RESULTS Gallium-68-DOTA-NOC PET/CT showed sensitivity and specificity of 78.3% and 92.5%, respectively, for primary tumor and 97.4% and 100% for metastases. It was better than a conventional imaging modality for the detection of both primary tumor (p < 0.001) and metastases (p < 0.0001). It changed the management strategy in 21 patients (19%) and supported management decisions in 32 patients (29%). CONCLUSION Gallium-68-DOTA-NOC PET/CT appears to be a highly sensitive and specific modality for the detection of gastroenteropancreatic NET. It is better than conventional imaging for the evaluation of gastroenteropancreatic NETs and can have a significant impact on patient management.

Spectrum of 18F-FDG PET/CT Findings in Patients Presenting With Fever of Unknown Origin

OBJECTIVE The objective of this article is to provide an illustrative tutorial highlighting the clinical utility of (18)F-FDG PET/CT for imaging patients presenting with fever of unknown origin (FUO). CONCLUSION FDG PET/CT is a powerful tool in localizing an inciting source in patients with FUO. The high sensitivity of FDG PET/CT for diagnosing infective, inflammatory, and neoplastic processes can be exploited in this setting because these processes are often the common causes of FUO.

SPECT-CT for characterization of extraosseous uptake of 99mTc-methylene diphosphonate on bone scintigraphy.

Bone scintigraphy is a sensitive and popular method for imaging a wide array of benign or malignant skeletal abnormalities. However, the uptake of tracers used for bone scintigraphy may be observed in various extraosseous sites, thereby limiting its specificity. It is difficult to correctly localize such sites of uptake on planar bone scintigraphy alone. The addition of hybrid single-photon emission computed tomography-computed tomography (SPECT-CT) under such circumstances is very useful. The present essay illustrates the commonly encountered extraosseous uptake of 99mTc-methylene diphosphonate (MDP) and the usefulness of hybrid SPECT-CT in clarifying 99mTc-MDP uptake.

Schmorl's node mimicking metastasis in a patient with breast cancer: diagnosis with 99mTC methylene diphosphonate SPECT-CT.

Schmorls node (SN) is a common entity characterized by protrusion of intervertebral disc material through a break in the subchondral end plate of a vertebral body. They can show increased 99mTC methylene diphosphonate uptake on bone scintigraphy mimicking metastasis and can be symptomatic. Differentiation of SN from metastasis is essential for appropriate patient management. Here, we present a case where increased 99mTC methylene diphosphonate uptake in a dorsal vertebra was found to be because of SN by using single-photon emission computed tomography-computed tomography.

Primary pulmonary lymphoma-role of fluoro-deoxy-glucose positron emission tomography-computed tomography in the initial staging and evaluating response to treatment - case reports and review of literature

Primary pulmonary lymphoma (PPL) is an uncommon entity of non-Hodgkin lymphoma, which accounts for <1% of all cases of lymphoma. We present two rare cases of PPL of diffuse large B-cell lymphoma, which underwent 18fluorine fluoro-deoxy-glucose positron emission tomography-computed tomography for initial staging and response evaluation after chemotherapy.

18 F-FDG PET/CT for initial assessment and response monitoring in a case of high grade primary lymphoma of the thyroid gland: A case report and review of literature

Thyroid lymphoma is a rare disease entity of elderly females. Chronic lymphocytic thyroiditis is said to be the precursor of thyroid lymphoma, suggesting a role of chronic antigen stimulation in the development of the disease. We present a case of male with lymphocytic thyroiditis who presented with painless progressive neck enlargement and pathology revealed features of high grade lymphoma. Staging and posttreatment 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was performed. This report reemphasizes the role of 18F-FDG PET/CT in the diagnosis, staging, and assessment of therapy response in patients with extranodal lymphoma, including the primary thyroid lymphoma.

Contrast Media in PET/Computed Tomography Imaging

Is there a need for the contrast-enhanced PET/computed tomography (CT) scan or is the low-dose, non-contrast-enhanced PET/CT scan sufficient? The topic has been debated time and again. Although low-dose noncontrast CT serves the purpose of simple anatomic correlation and attenuation correction of PET images, many times patients have to undergo additional contrast-enhanced diagnostic imaging modalities, which may lead to a delay in decision-making. In this review, the authors have addressed various such issues related to the use of contrast agents and special techniques of clinical interest based on their utility in dual-modality PET/CT.

Asymmetrical F-18 Flurorodeoxyglucose uptake in the breasts: A dilemma solved by patient history

The present case highlights the importance of history taking in solving the dilemmas of variant F-18 FDG uptake on PET/CT. Asymmetrically increased, abnormal looking, FDG uptake in the right breast of our patient was related to her breast feeding practice. Because of personal preference the patient suckled her child from the right breast only. This resulted in asymmetry of size, increase in glandular breast parenchyma and FDG uptake in the breast that was suckled.

99mTc-pertechnetate SPECT/CT for detecting recurrent foregut duplication cyst in a case with negative planar scintigraphy.

Recurrence can occur after incomplete surgical excision of foregut duplication cysts. We here present (99m)Tc-pertechnetate SPECT/CT images of a 3-year-old girl with recurrence of foregut duplication cyst. (99m)Planar Tc-pertechnetate scintigraphy was negative in this case.

Ectopic thoracic kidney: evaluation using 99mTc dimercaptosuccinic acid SPECT-CT.

Ectopic thoracic kidney is a very rare congenital defect and is usually diagnosed incidentally. 99mTc-dimercaptosuccinic acid SPECT-CT images of a 7-year-old boy with left ectopic thoracic kidney are presented here.