Zaid Al-faham

Use of SPECT/CT with 99mTc-MDP Bone Scintigraphy to Diagnose Symptomatic Os Acromiale

Os acromiale is an anatomic variant that in rare cases can cause pain. 99mTc-methylene diphosphonate bone scintigraphy with SPECT/CT can play an important role in diagnosing this clinical entity. We present a male football player with shoulder pain secondary to a symptomatic os acromiale, and we demonstrate the findings on bone scanning with limited SPECT/CT that diagnosed this important clinical abnormality.

The Evaluation of Cardiac Sarcoidosis with 18F-FDG PET

Cardiac involvement in sarcoidosis is associated with poor prognosis. 18F-FDG PET can detect the presence of cardiac sarcoidosis, assess disease activity, and serve as a means to monitor treatment response in patients with cardiac sarcoidosis.

The Evaluation of Lupus Myocarditis with 13N-Ammonia and 18F-FDG PET

Although the use of 13N-ammonia and 18F-FDG PET shows great promise as a tool for diagnosing heart involvement in inflammatory diseases, it can be equally powerful for following disease progression and treatment outcome. We describe a case in which 18F-FDG PET was effective in following up the treatment outcome of lupus myocarditis.

The Appearance of Congenitally Corrected Transposition of the Great Arteries on Myocardial Perfusion Imaging

We present a case of incidentally discovered congenitally corrected transposition of the great arteries (ccTGA), initially seen on stress–rest myocardial perfusion imaging (MPI). ccTGA has a characteristic appearance on MPI, which reflects the functional alterations associated with this condition.

Lumbosacral Transitional Vertebra Diagnosed on 99mTc-Methylene Diphosphonate SPECT/CT

Lumbosacral transitional vertebra (LSTV) is a congenital anomaly of the lumbosacral junction. The association between back pain and LSTV is controversial; however, in our patient the symptoms localized to a hemisacralized left transverse process of L5. LSTV should be included in the differential diagnosis in young patients with lower back pain, and scintigraphic imaging should be considered for diagnostic purposes.

Evaluation of a Case of Inflammatory Breast Cancer with 18F-FDG PET/CT

Inflammatory breast cancer is a rare and aggressive form of cancer characterized by dermal lymphatic invasion and tumor embolization resulting in erythema and edema. In many cases, by the time of diagnosis there is already distant metastasis. Mammography, sonography, CT, and MRI are usually performed for initial staging; however, PET/CT can also be used for initial staging as it offers additional diagnostic information.

18F-FDG PET Assessment of Lewy Body Dementia with Cerebellar Diaschisis

Alzheimer disease and Lewy body dementia are the 2 most common causes of dementia. Each disease has distinctive regional metabolic reduction patterns on 18F-FDG PET. In this report, we present a rare case of an elderly man with dementia whereby 18F-FDG PET clearly showed Lewy body disease with crossed cerebellar diaschisis.

Mediastinal masses in nuclear medicine studies: A diagnostic algorithm.

There are multiple reasons for an anterior mediastinal mass. In this case, we discuss possible etiologies and offer an algorithm to narrow the differential diagnosis. When the mass cannot be diagnosed radiographically, the next step in imaging is a physiologic assessment with radionuclide modalities.

Appearance of Meningioma on 99mTc-HMPAO SPECT: Correlation with MRI

On brain perfusion SPECT, a primary brain lesion presents as a localized defect that corresponds to the mass lesion. 99mTc-HMPAO images generally show a focal defect in the region of abnormality, whether containing necrotic tissue, recurrent tumor, or both. Further characterization with MR imaging is needed to confirm the diagnosis, as demonstrated in this case report.

Optimizing 18F-FDG Uptake Time Before Imaging Improves the Accuracy of PET/CT in Liver Lesions

18F-FDG PET/CT has emerged as one of the fastest-growing imaging modalities. A shorter protocol results in a lower target-to-background ratio, which can increase the challenge of identifying mildly 18F-FDG–avid lesions and differentiating inflammatory or physiologic activity from malignant activity. The purpose of this study was to determine the delay between radiotracer injection and imaging that optimizes target-to-background ratio while maintaining counts high enough to ensure scan sensitivity. Methods: The study included 140 patients (66 male and 74 female; age range, 42–95 y) with suspected hepatic lesions as seen on an 18F-FDG PET scan. SUV was determined as region-of-interest activity/(dose/total body weight). Results: The mean injected dose was 610 ± 66.6 MBq (16.5 ±1.8 mCi), with a mean glucose level of 107 ± 26.6 mg/dL (standardized to 90 mg/dL). The uptake time before imaging ranged from 61 to 158 min, with a mean of 108.8 ± 24.8 min. The P values for the correlation of SUV to time were 0.004, 0.003, and 0.0001 for malignant lesions, benign lesions, and background hepatic tissue, respectively. Conclusion: An approximately 90-min time window from 18F-FDG injection to PET imaging would significantly improve target-to-background ratio and, thus, quantitation and visual interpretation. This benefit outweighs the minimal loss in patient throughput.