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OBJECTIVES: Somatostatin receptor positron emission tomography/computed tomography (SSTR-PET/CT) using [68Ga]-labeled tracers is a widely used imaging modality for neuroendocrine tumors (NET). Recently, [18F]SiTATE, a SiFAlin tagged [Tyr3]-octreotate (TATE) PET tracer, has shown great potential due to favorable clinical characteristics. We aimed to evaluate the reproducibility of Somatostatin Receptor-Reporting and Data System 1.0 (SSTR-RADS 1.0) for structured interpretation and treatment planning of NET using [18F]SiTATE. METHODS: Four readers assessed [18F]SiTATE-PET/CT of 95 patients according to the SSTR-RADS 1.0 criteria at two different time points. Each reader evaluated up to five target lesions per scan. The overall scan score and the decision on peptide receptor radionuclide therapy (PRRT) were considered. Inter- and intra-reader agreement was determined using the intraclass correlation coefficient (ICC). RESULTS: The ICC analysis on the inter-reader agreement using SSTR-RADS 1.0 for identical target lesions (ICC ≥ 85%), overall scan score (ICC ≥ 90%), and the decision to recommend PRRT (ICC ≥ 85%) showed excellent agreement. However, significant differences were observed in recommending PRRT among experienced readers (ER) (p = 0.020) and inexperienced readers (IR) (p = 0.004). Compartment-based analysis demonstrated good to excellent inter-reader agreement for most organs (ICC ≥ 74%), except for lymph nodes (ICC ≥ 53%). CONCLUSION: SSTR-RADS 1.0 represents a highly reproducible and consistent framework system for stratifying SSTR-targeted PET/CT scans, even using the novel SSTR-ligand [18F]SiTATE. Some inter-reader variability was observed regarding the evaluation of uptake intensity prior to PRRT as well as compartment scoring of lymph nodes, indicating that those categories require special attention during further clinical validation and might be refined in a future SSTR-RADS version 1.1. CLINICAL RELEVANCE STATEMENT: SSTR-RADS 1.0 is a consistent framework for categorizing somatostatin receptor-targeted PET/CT scans when using [18F]SiTATE. The framework serves as a valuable tool for facilitating and improving the management of patients with NET. KEY POINTS: SSTR-RADS 1.0 is a valuable tool for managing patients with NET. SSTR-RADS 1.0 categorizes patients with showing strong agreement across diverse reader expertise. As an alternative to [68Ga]-labeled PET/CT in neuroendocrine tumor imaging, SSTR-RADS 1.0 reliably classifies [18F]SiTATE-PET/CT.

Objectives: This study aimed to evaluate the diagnostic utility of [68Ga]Ga-DOTA-Siglec-9 positron emission tomography-computed tomography (PET/CT) in assessing disease activity in a patient experiencing a relapse of giant cell arteritis (GCA). Case presentation: A 90-year-old male patient with GCA, diagnosed in 2018, was enrolled. Demographic data, disease history, and laboratory parameters, including soluble VAP-1 (sVAP-1) levels, were recorded. The patient underwent a [68Ga]Ga-DOTA-Siglec-9 PET/CT scan. Additional imaging assessments included vascular ultrasound of the superficial temporal arteries, their branches, and the facial, axillary, subclavian, carotid, and vertebral arteries, along with magnetic resonance imaging (MRI) of the aorta. The patient's sVAP-1 level was 284 ng/ml compared to 123 ng/ml in the control group (SD ± 55). The [68Ga]Ga-DOTA-Siglec-9 PET/CT scan revealed increased tracer uptake (SUVmax) in the subclavian artery (2.5), aortic arch (2.9), and heart (2.9). Notably, the increased uptake in the descending aorta (3.5) abruptly diminished to 2.2 when passing the diaphragm, with no changes in vessel caliber observed in CT. The injection of [68Ga]Ga-DOTA-Siglec-9 was well tolerated. Aortic MRI revealed no signs of inflammatory involvement. Conclusions: This study introduces the first application of [68Ga]Ga-DOTA-Siglec-9 PET/CT in a patient with GCA experiencing a relapse, revealing enhanced tracer uptake in the subclavian artery and aortic arch with a localized and abrupt reduction, absent in conventional imaging. These findings suggest that [68Ga]Ga-DOTA-Siglec-9 PET/CT has significant potential for precise, inflammation-specific detection of affected vascular tissue in GCA during relapse. [ABSTRACT FROM AUTHOR]

Objective: This investigation aimed to elucidate alterations in metabolic brain network connectivity in drug-resistant mesial temporal lobe epilepsy (DR-MTLE) patients, relating these changes to varying surgical outcomes. Methods: A retrospective cohort of 87 DR-MTLE patients who underwent selective amygdalohippocampectomy was analyzed. Patients were categorized based on Engel surgical outcome classification into seizure-free (SF) or non-seizure-free (NSF) groups. Additionally, 38 healthy individuals constituted a control group (HC). Employing effect size (ES) methodology, we constructed individualized metabolic brain networks and compared metabolic connectivity matrices across these groups using the DPABINet toolbox. Results: Compared to HCs, both SF and NSF groups exhibited diminished metabolic connectivity, with the NSF group showing pronounced reductions across the whole brain. Notably, the NSF group demonstrated weaker metabolic links between key networks, including the default mode network (DMN), frontoparietal network (FPN), and visual network (VN), in comparison to the SF group. Conclusion: Individual metabolic brain networks, constructed via ES methodology, revealed significant disruptions in DR-MTLE patients, predominantly in the NSF group. These alterations, particularly between limbic structures and cognitive networks like the DMN, suggested impaired and inefficient information processing across the brain's networks. This study identified abnormal brain networks associated with DR-MTLE and, importantly, contributed novel insights into the mechanisms underlying poor postoperative seizure control, and offered potential implications for refining preoperative assessments. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the diagnostic utility of [68Ga]Ga-DOTA-Siglec-9 positron emission tomography-computed tomography (PET/CT) in assessing disease activity in a patient experiencing a relapse of giant cell arteritis (GCA). Case presentation: A 90-year-old male patient with GCA, diagnosed in 2018, was enrolled. Demographic data, disease history, and laboratory parameters, including soluble VAP-1 (sVAP-1) levels, were recorded. The patient underwent a [68Ga]Ga-DOTA-Siglec-9 PET/CT scan. Additional imaging assessments included vascular ultrasound of the superficial temporal arteries, their branches, and the facial, axillary, subclavian, carotid, and vertebral arteries, along with magnetic resonance imaging (MRI) of the aorta. The patient's sVAP-1 level was 284 ng/ml compared to 123 ng/ml in the control group (SD ± 55). The [68Ga]Ga-DOTA-Siglec-9 PET/CT scan revealed increased tracer uptake (SUVmax) in the subclavian artery (2.5), aortic arch (2.9), and heart (2.9). Notably, the increased uptake in the descending aorta (3.5) abruptly diminished to 2.2 when passing the diaphragm, with no changes in vessel caliber observed in CT. The injection of [68Ga]Ga-DOTA-Siglec-9 was well tolerated. Aortic MRI revealed no signs of inflammatory involvement. Conclusions: This study introduces the first application of [68Ga]Ga-DOTA-Siglec-9 PET/CT in a patient with GCA experiencing a relapse, revealing enhanced tracer uptake in the subclavian artery and aortic arch with a localized and abrupt reduction, absent in conventional imaging. These findings suggest that [68Ga]Ga-DOTA-Siglec-9 PET/CT has significant potential for precise, inflammation-specific detection of affected vascular tissue in GCA during relapse. [ABSTRACT FROM AUTHOR]

Solitary fibrous tumors (SFTs) are classified as fibroblastic/myofibroblastic tumors that originate from CD34-positive dendritic cells and usually occur in the pleura. In this paper, we describe a case of SFT within the joint cavity of the left knee. A 60-year-old man was admitted to hospital due to swelling in the left knee for the past 8 months without relevant trauma history. X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography–computed tomography (PET-CT) presented a large, ill-circumscribed, hypervascular, and highly enhanced mass with eccentric calcification and peripheral, intra-lesional vessels. Subsequently, the patient underwent surgical resection. Postoperative pathology confirmed the neoplastic cells to be positive for CD34, Bcl-2, and SATA6, therefore was finally diagnosed as malignant SFT. The patient developed bone metastases within 1 year after surgery. SFT in the joint cavity is rare, and it is difficult to make a preoperative diagnosis. [ABSTRACT FROM AUTHOR]

We present the imaging findings of a 44-year-old female patient who was diagnosed with nasopharyngeal carcinoma (NPC) extending from the nasopharynx to the external auditory canal (EAC) through the Eustachian tube (ET). The patient presented with a left neck submandibular lump on initial presentation that showed NPC upon fine needle aspiration, leading to chemoradiotherapy. Despite treatment, the patient experienced multiple relapses and later presented with aural symptoms, including left ear pain, foul-smelling drainage, and trismus on recurrence, and was subsequently diagnosed through biopsy. CT, MRI, and PET-CT scans revealed an extensive infiltrative nasopharyngeal mass extending into the left ET, involving the EAC. This rare case highlights the importance of considering the extension of NPC into the EAC as a potential etiology in patients who present with aural symptoms.

Abstract Introduction Preoperative evaluation of inferior vena cava (IVC) wall invasion is very important to improve outcomes of patients with renal cell carcinoma (RCC), and may allow surgical urologists to treat the IVC more effectively. The objective of this study was to evaluate preoperative 18F-FDG PET/CT in patients with RCC and IVC tumor thrombus (IVCTT) for the diagnosis of IVC wall invasion. Methods This retrospective case-control study evaluated 68 patients with RCC with level I-IV tumor thrombus. According to the histopathologic examination result, the patients were divided into IVC wall invasion group and non-invasion group. The 18F-FDG PET/CT features between two groups were analyzed. Furthermore, a logistic regression model was used to determine if there was an association between PET/CT features and IVC wall invasion. Results Sixty-eight patients were evaluated, and 55.9% (38/68) had IVC wall invasion. Compared with non-invasion group, invasion group had higher SUVmax of RCC, higher SURmax (tumor to tumor thrombus ratio, Tu/Th), higher IVCTT coronal diameter, and longer IVCTT craniocaudal extent (all p

Abstract Purpose Identifying primary hepatic angiosarcoma (PHA) preoperatively is challenging, often relying on postoperative pathology. Invasive biopsy increases bleeding risk, emphasizing the importance of early PHA diagnosis through imaging. However, comprehensive summaries of ultrasound, abdominal computed tomography (CT), magnetic resonance imaging (MRI), and whole- body positron emission tomography-CT (PET-CT) in this context are lacking. This study aimed to investigate the comprehensive imaging characteristics of PHA. Patients and methods Imaging data were collected from 7 patients diagnosed with PHA via pathology between January 2000 and December 2019 in two provincial grade III hospitals. All patients underwent routine color ultrasound examinations before surgery, with 3 patients receiving contrast-enhanced ultrasound (CEUS).CT scans, both plain and enhanced, were performed on 5 patients, and whole-body PET-CT examinations were conducted on 2 patients. Results Among the 7 patients with PHA, 4 presented with a single solid intrahepatic mass (2 of which were large), 1 with a single exophytic macroblock type, 1 with a mixed type featuring multiple masses and nodules, and 1 with a multiple nodule type. Conventional ultrasound of PHA showed uneven echoes within the tumor, potentially accompanied by septal zone echoes, and a blood flow grade of 0-I. CEUS displayed early-stage circular high enhancement, a central non-enhancement area, and a "vascular sign" around the tumor. CT scans revealed low-density shadows in the plain scan stage, high peripheral ring enhancement, and punctate nodular enhancement in the arterial phase, with varying intensities and the presence of a "vascular sign." During the portal vein stage, the interior of the tumor was consistently unfilled and exhibited structural disorder. PET-CT showed low-density lesions in the liver and low fluorodeoxyglucose metabolism. Conclusions Imaging diagnosis plays a crucial role in PHA diagnosis. When liver tumor imaging matches the above characteristics, consider PHA.

Introduction: Preoperative evaluation of inferior vena cava (IVC) wall invasion is very important to improve outcomes of patients with renal cell carcinoma (RCC), and may allow surgical urologists to treat the IVC more effectively. The objective of this study was to evaluate preoperative 18F-FDG PET/CT in patients with RCC and IVC tumor thrombus (IVCTT) for the diagnosis of IVC wall invasion. Methods: This retrospective case-control study evaluated 68 patients with RCC with level I-IV tumor thrombus. According to the histopathologic examination result, the patients were divided into IVC wall invasion group and non-invasion group. The 18F-FDG PET/CT features between two groups were analyzed. Furthermore, a logistic regression model was used to determine if there was an association between PET/CT features and IVC wall invasion. Results: Sixty-eight patients were evaluated, and 55.9% (38/68) had IVC wall invasion. Compared with non-invasion group, invasion group had higher SUVmax of RCC, higher SURmax (tumor to tumor thrombus ratio, Tu/Th), higher IVCTT coronal diameter, and longer IVCTT craniocaudal extent (all p < 0.05). Multivariate analysis showed that SURmax (Tu/Th) (OR 8.760 [95%CI, 1.019–75.310]; p = 0.048) and the maximum coronal diameter of IVCTT (OR 1.143 [95%CI, 1.029–1.269]; p = 0.028) were predictors of IVC wall invasion. A model combining SURmax (Tu/Th) and the maximum coronal diameter of IVCTT achieved an AUC of 0.855 (95%CI, 0.757–0.954). The specificity and sensitivity for assessing IVC wall invasion was 92.1% and 76.7%, respectively. Conclusions: Increases in SURmax (Tu/Th) and the maximum coronal diameter of IVCTT are associated with a higher probability of IVC wall invasion. Preoperative 18F-FDG PET/CT imaging may be used to assess IVC wall invasion. [ABSTRACT FROM AUTHOR]

Purpose: Identifying primary hepatic angiosarcoma (PHA) preoperatively is challenging, often relying on postoperative pathology. Invasive biopsy increases bleeding risk, emphasizing the importance of early PHA diagnosis through imaging. However, comprehensive summaries of ultrasound, abdominal computed tomography (CT), magnetic resonance imaging (MRI), and whole- body positron emission tomography-CT (PET-CT) in this context are lacking. This study aimed to investigate the comprehensive imaging characteristics of PHA. Patients and methods: Imaging data were collected from 7 patients diagnosed with PHA via pathology between January 2000 and December 2019 in two provincial grade III hospitals. All patients underwent routine color ultrasound examinations before surgery, with 3 patients receiving contrast-enhanced ultrasound (CEUS).CT scans, both plain and enhanced, were performed on 5 patients, and whole-body PET-CT examinations were conducted on 2 patients. Results: Among the 7 patients with PHA, 4 presented with a single solid intrahepatic mass (2 of which were large), 1 with a single exophytic macroblock type, 1 with a mixed type featuring multiple masses and nodules, and 1 with a multiple nodule type. Conventional ultrasound of PHA showed uneven echoes within the tumor, potentially accompanied by septal zone echoes, and a blood flow grade of 0-I. CEUS displayed early-stage circular high enhancement, a central non-enhancement area, and a "vascular sign" around the tumor. CT scans revealed low-density shadows in the plain scan stage, high peripheral ring enhancement, and punctate nodular enhancement in the arterial phase, with varying intensities and the presence of a "vascular sign." During the portal vein stage, the interior of the tumor was consistently unfilled and exhibited structural disorder. PET-CT showed low-density lesions in the liver and low fluorodeoxyglucose metabolism. Conclusions: Imaging diagnosis plays a crucial role in PHA diagnosis. When liver tumor imaging matches the above characteristics, consider PHA. [ABSTRACT FROM AUTHOR]

Differentiated thyroid carcinoma (DTC) metastasizing to the adrenal glands is very infrequent. We present three cases of DTC with adrenal metastasis in their follow-up, in which two were from follicular thyroid carcinoma and one from papillary thyroid carcinoma along with review of literature to emphasize the role of cross-sectional and correlative imaging in DTC with adrenal metastasis. [ABSTRACT FROM AUTHOR]

Detection of adrenal lesions either incidentally, or in symptomatic cases and/or during staging/restaging of oncological cases, it is very crucial to know the adrenal lesion is benign or malignant. Fluorodeoxyglucose positron emission tomography–computed tomography (FDG PET/CT) helps in this comprehensive evaluating process. Here, we present the most frequently facing adrenal lesions in routine oncological PET/CT scans. The aim of this presentation is to know the FDG uptake spectrum of various adrenal lesions on PET/CT scan so that increase the diagnostic accuracy and spectrum of differential diagnosis. [ABSTRACT FROM AUTHOR]

ObjectiveThis investigation aimed to elucidate alterations in metabolic brain network connectivity in drug-resistant mesial temporal lobe epilepsy (DR-MTLE) patients, relating these changes to varying surgical outcomes.MethodsA retrospective cohort of 87 DR-MTLE patients who underwent selective amygdalohippocampectomy was analyzed. Patients were categorized based on Engel surgical outcome classification into seizure-free (SF) or non-seizure-free (NSF) groups. Additionally, 38 healthy individuals constituted a control group (HC). Employing effect size (ES) methodology, we constructed individualized metabolic brain networks and compared metabolic connectivity matrices across these groups using the DPABINet toolbox.ResultsCompared to HCs, both SF and NSF groups exhibited diminished metabolic connectivity, with the NSF group showing pronounced reductions across the whole brain. Notably, the NSF group demonstrated weaker metabolic links between key networks, including the default mode network (DMN), frontoparietal network (FPN), and visual network (VN), in comparison to the SF group.ConclusionIndividual metabolic brain networks, constructed via ES methodology, revealed significant disruptions in DR-MTLE patients, predominantly in the NSF group. These alterations, particularly between limbic structures and cognitive networks like the DMN, suggested impaired and inefficient information processing across the brain’s networks. This study identified abnormal brain networks associated with DR-MTLE and, importantly, contributed novel insights into the mechanisms underlying poor postoperative seizure control, and offered potential implications for refining preoperative assessments.

ObjectivesThis study aimed to evaluate the diagnostic utility of [68Ga]Ga-DOTA-Siglec-9 positron emission tomography-computed tomography (PET/CT) in assessing disease activity in a patient experiencing a relapse of giant cell arteritis (GCA).Case presentationA 90-year-old male patient with GCA, diagnosed in 2018, was enrolled. Demographic data, disease history, and laboratory parameters, including soluble VAP-1 (sVAP-1) levels, were recorded. The patient underwent a [68Ga]Ga-DOTA-Siglec-9 PET/CT scan. Additional imaging assessments included vascular ultrasound of the superficial temporal arteries, their branches, and the facial, axillary, subclavian, carotid, and vertebral arteries, along with magnetic resonance imaging (MRI) of the aorta.The patient’s sVAP-1 level was 284 ng/ml compared to 123 ng/ml in the control group (SD ± 55). The [68Ga]Ga-DOTA-Siglec-9 PET/CT scan revealed increased tracer uptake (SUVmax) in the subclavian artery (2.5), aortic arch (2.9), and heart (2.9). Notably, the increased uptake in the descending aorta (3.5) abruptly diminished to 2.2 when passing the diaphragm, with no changes in vessel caliber observed in CT. The injection of [68Ga]Ga-DOTA-Siglec-9 was well tolerated. Aortic MRI revealed no signs of inflammatory involvement.ConclusionsThis study introduces the first application of [68Ga]Ga-DOTA-Siglec-9 PET/CT in a patient with GCA experiencing a relapse, revealing enhanced tracer uptake in the subclavian artery and aortic arch with a localized and abrupt reduction, absent in conventional imaging. These findings suggest that [68Ga]Ga-DOTA-Siglec-9 PET/CT has significant potential for precise, inflammation-specific detection of affected vascular tissue in GCA during relapse.

This case report details a rare instance of rapid iris metastasis from esophageal cancer in a 59-year-old man. A literature review was conducted to explore recent advances in detecting, diagnosing, and treating intraocular metastatic malignancies. Positron emission tomography-computed tomography played a crucial role in identifying primary sites and systemic metastases. Local treatment combined with systemic therapy effectively reduced tumor size, preserved useful vision, and improved the patient's survival rate. A comparison was made of the characteristics of iris metastases from esophageal cancer and lung cancer, including age, gender, tumor characteristics, and treatment. The challenges associated with diagnosis and treatment are discussed, highlighting the implications for clinical practice.

Abstract Prostate-specific membrane antigen (PSMA) targeted tracers show increased uptake in several malignancies, indicating a potential for peptide radioligand therapy. Intra-arterial injection of radiotracers can increase the therapeutic window. This study aimed to evaluate the feasibility of intra-arterial injection of [68Ga]Ga-PSMA-11 for intrahepatic cholangiocarcinoma and compare tracer uptake after intrahepatic arterial injection and intravenous injection. Three patients with intrahepatic cholangiocarcinoma received [68Ga]Ga-PSMA-11 through a hepatic arterial infusion pump, followed by positron emission tomography/computed tomography (PET/CT). Two-three days later, patients underwent PET/CT after intravenous [68Ga]Ga-PSMA-11 injection. All tumours showed higher uptake on the intra-arterial scan compared with the intravenous scan: the intra-arterial / intravenous standardised uptake value normalised by lean body mass ratios were 1.40, 1.46, and 1.54. Local intra-arterial PSMA injection is possible in patients with intrahepatic cholangiocarcinoma. Local injection increases tumour-to-normal tissue ratios, increasing the therapeutic window for theranostic applications. Relevance statement Intra-arterial Prostate specific membrane antigen (PSMA) injection increases the therapeutic window for potential theranostic application in intrahepatic cholangiocarcinoma. Key Points Three patients with intrahepatic cholangiocarcinoma underwent PET/CT after intra-arterial and intravenous injection of [68Ga]Ga-PSMA-11. Intra-arterial injection showed higher uptake than intravenous injection. PSMA-targeted imaging could be valuable for a subset of intrahepatic cholangiocarcinoma patients. Graphical Abstract

Simple Summary: Despite multiple standardized interpretation criteria (SICs) for imaging response assessment in patients with head and neck squamous cell carcinoma (HNSCC), these systems remain relatively underutilized. This underutilization may in part relate to the fact that the relevant information has been published in disparate journals over multiple decades. This paper aims to review the SICs available for use in interpreting post-treatment FDG PET/CT in patients with HNSCC. We evaluate each SIC in the context of eight desired traits. Selecting a SIC that best matches the needs of one's practice is expected to facilitate multidisciplinary buy-in and maximize the likelihood of successful implementation. Introduction: There is growing interest in the development and application of standardized imaging criteria (SIC), to minimize variability and improve the reproducibility of image interpretation in head and neck squamous cell carcinoma (HNSCC). Methods: "Squamous cell carcinoma" AND "standardized interpretation criteria" OR "radiographic response assessment" were searched using PubMed and Google Scholar for articles published between 2009 and 2024, returning 56 publications. After abstract review, 18 were selected for further evaluation, and 6 different SICs (i.e., PERCIST, Porceddu, Hopkins, NI-RADS, modified Deauville, and Cuneo) were included in this review. Each SIC is evaluated in the context of 8 desired traits of a standardized reporting system. Results: Two SICs have societal endorsements (i.e., PERCIST, NI-RADS); four can be used in the evaluation of locoregional and systemic disease (i.e., PERCIST, Hopkins, NI-RADS, Cuneo), and four have specific categories for equivocal imaging results (i.e., Porceddu, NI-RADS, modified Deauville, and Cuneo). All demonstrated areas for future improvement in the context of the 8 desired traits. Conclusion: Multiple SICs have been developed for and demonstrated value in HNSCC post-treatment imaging; however, these systems remain underutilized. Selecting an SIC with features that best match the needs of one's practice is expected to maximize the likelihood of successful implementation. [ABSTRACT FROM AUTHOR]

Prostate-specific membrane antigen (PSMA) targeted tracers show increased uptake in several malignancies, indicating a potential for peptide radioligand therapy. Intra-arterial injection of radiotracers can increase the therapeutic window. This study aimed to evaluate the feasibility of intra-arterial injection of [68Ga]Ga-PSMA-11 for intrahepatic cholangiocarcinoma and compare tracer uptake after intrahepatic arterial injection and intravenous injection. Three patients with intrahepatic cholangiocarcinoma received [68Ga]Ga-PSMA-11 through a hepatic arterial infusion pump, followed by positron emission tomography/computed tomography (PET/CT). Two-three days later, patients underwent PET/CT after intravenous [68Ga]Ga-PSMA-11 injection. All tumours showed higher uptake on the intra-arterial scan compared with the intravenous scan: the intra-arterial / intravenous standardised uptake value normalised by lean body mass ratios were 1.40, 1.46, and 1.54. Local intra-arterial PSMA injection is possible in patients with intrahepatic cholangiocarcinoma. Local injection increases tumour-to-normal tissue ratios, increasing the therapeutic window for theranostic applications. Relevance statement: Intra-arterial Prostate specific membrane antigen (PSMA) injection increases the therapeutic window for potential theranostic application in intrahepatic cholangiocarcinoma. Key Points: Three patients with intrahepatic cholangiocarcinoma underwent PET/CT after intra-arterial and intravenous injection of [68Ga]Ga-PSMA-11. Intra-arterial injection showed higher uptake than intravenous injection. PSMA-targeted imaging could be valuable for a subset of intrahepatic cholangiocarcinoma patients. [ABSTRACT FROM AUTHOR]

Background: The introduction of positron emission tomography/computed tomography (PET/CT) has significantly advanced medical imaging. In oncology, 18F-fluorodeoxyglucose (18F-FDG) PET/CT is particularly crucial for staging, evaluating treatment response, monitoring follow-up, and planning radiotherapy. However, in resource limiting hospitals, the availability of fluorine-labeled 18F-FDG limits optimal scan acquisition. This study aims to determine the optimal dosage and acquisition time to maximize patient throughput during shortages. Aim and Objective: To optimize lowdose 18F-FDG scan protocols while maintaining high image quality despite radiotracer availability challenges. Materials and Methods: PET/CT scans were performed using GE's Discovery IQ 5-ring, 16-slice system within 40-60 minutes of intravenous 18F-FDG injection. The protocol was adjusted to a low-dose (0.05 mCi/kg of 18F-FDG), and the PET data acquisition time was increased to 3 min per bed position to ensure image quality. Results: Notable differences were observed in image quality scores based on varying acquisition times, with the extended acquisition time helping maintain diagnostic standards despite reduced tracer doses. Conclusion: The high sensitivity and long axial length of the PET/CT system (with five rings spanning 26 cm AFOV) can significantly alleviate the challenges faced by cyclotron-dependent centers. By leveraging the increased sensitivity, we successfully reduced the injected activity rather than the scan time to address the tracer shortage at our institute. This approach proved to be effective in maintaining image quality and patient care standards. [ABSTRACT FROM AUTHOR]

Solitary fibrous tumors (SFTs) are classified as fibroblastic/myofibroblastic tumors that originate from CD34-positive dendritic cells and usually occur in the pleura. In this paper, we describe a case of SFT within the joint cavity of the left knee. A 60-year-old man was admitted to hospital due to swelling in the left knee for the past 8 months without relevant trauma history. X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography–computed tomography (PET-CT) presented a large, ill-circumscribed, hypervascular, and highly enhanced mass with eccentric calcification and peripheral, intra-lesional vessels. Subsequently, the patient underwent surgical resection. Postoperative pathology confirmed the neoplastic cells to be positive for CD34, Bcl-2, and SATA6, therefore was finally diagnosed as malignant SFT. The patient developed bone metastases within 1 year after surgery. SFT in the joint cavity is rare, and it is difficult to make a preoperative diagnosis.

AIM: To explore the role of positron emission tomography-computed tomography (PET-CT) examination in the diagnosis and treatment of ocular adnexal mucosa associated lymphoid tissue lymphoma (OAML). METHODS: The general clinical data, postoperative PET-CT results, treatment regimens, and the prognosis of 21 histopathologically confirmed OAML patients between October 2017 and September 2021 were collected. Among the 21 patients, five patients underwent surgical treatment alone, 13 patients underwent surgical treatment combined with radiotherapy, and three patients underwent surgical treatment combined with chemotherapy. RESULTS: The follow-up period ranged from 8 to 79mo, with four cases of recurrence and no deaths. Through PET-CT examination, two patients exhibited both local ocular metabolic elevation and systemic metastasis, and one of these patients had cervical lymph node metastasis, while the other had submandibular and parotid gland metastasis. Nine patients showed only local ocular metabolic elevation, while 10 patients had no abnormal metabolic activity locally. CONCLUSION: PET-CT examination plays a crucial role in detecting residual lesions and recurrence following tumor resection, aiding in precise disease staging, and facilitating the development of personalized treatment plans, ultimately improving patient prognosis.

Objective (1): To develop and validate a machine learning (ML) model using radiomic features (RFs) extracted from [18F]FDG PET-CT to predict abdominal aortic aneurysm (AAA) growth rate. Methods (2): This retrospective study included 98 internal and 55 external AAA patients undergoing [18F]FDG PET-CT. RFs were extracted from manual segmentations of AAAs using PyRadiomics. Recursive feature elimination (RFE) reduced features for model optimisation. A multi-layer perceptron (MLP) was developed for AAA growth prediction and compared against Random Forest (RF), XGBoost, and Support Vector Machine (SVM). Accuracy was evaluated via cross-validation, with uncertainty quantified using dropout (MLP), standard deviation (RF), and 95% prediction intervals (XGBoost). External validation used independent data from two centres. Ground truth growth rates were calculated from serial ultrasound (US) measurements or CT volumes. Results (3): From 93 initial RFs, 29 remained after RFE. The MLP model achieved an MAE ± SEM of 1.35 ± 3.2e−4 mm/year with the full feature set and 1.35 ± 2.5e−4 mm/year with RFE. External validation yielded 1.8 ± 8.9e−8 mm/year. RF, XGBoost, and SVM models produced comparable accuracies internally (1.4–1.5 mm/year) but showed higher errors during external validation (1.9–1.97 mm/year). The MLP model demonstrated reduced uncertainty with the full feature set across all datasets. Conclusions (4): An MLP model leveraging [18F]FDG PET-CT radiomics accurately predicted AAA growth rates and generalised well to external data. In the future, more sophisticated stratification could guide individualised patient care, facilitating risk-tailored management of AAAs.

Key Clinical Message: Sarcomatoid carcinoma, a rare and aggressive subtype of bladder cancer, accounting for 0.3% of cases, is more aggressive than urothelial carcinomas. Accurate diagnosis, crucial for treatment, can be challenging. We present a characterized case of sarcomatoid carcinoma of the urinary bladder using multimodal imaging and pathology. [ABSTRACT FROM AUTHOR]

Introduction: The goal of this study is to compare the prognostic performance of NETPET scores, based on gallium-68 DOTANOC (68Ga-DOTANOC) and fluorine-18 fluorodeoxyglucose (18F-FDG) Positron Emission Tomography-Computed Tomography (PET-CT), and PET-CT metabolic parameters in metastatic gastrointestinal neuroendocrine tumors (GI-NET), while constructing and validating a nomogram derived from dual-scan PET-CT. Methods: In this retrospective study, G1–G3 GI-NET patients who underwent 68Ga-DOTANOC and 18F-FDG PET scans were enrolled and divided into training and internal validation cohorts. Three grading systems were constructed based on NETPET scores and standardized uptake value maximum (SUVmax). LASSO regression selected variables for a multivariable Cox model, and nomograms predicting progression-free survival (PFS) and overall survival (OS) were created. The prognostic performance of these systems was assessed using time-dependent receiver-operating characteristic (ROC) curves, concordance index (C-index), and other methods. Nomogram evaluation involved calibration curves, decision curve analysis (DCA), and the aforementioned methods in both cohorts. Results: In this study, 223 patients (130 males; mean age ±  SD: 52.6 ± 12 years) were divided into training (148) and internal validation (75) cohorts. Dual scans were classified based on NETPET scores (D1–D3). Single 68Ga-DOTANOC and 18F-FDG PET-CT scans were stratified into S1-S3 and F1-F3 based on SUVmax. The NETPET score-based grading system demonstrated the best OS and PFS prediction (C-index, 0.763 vs. 0.727 vs. 0.566). Nomograms for OS and PFS exhibited superior prognostic performance in both cohorts (all AUCs > 0.8). Conclusions: New classification based on NETPET score predicts patient OS/PFS best. PET-CT-based nomograms show accurate OS/PFS forecasts. [ABSTRACT FROM AUTHOR]

Pyomyositis is an acute pyogenic infection of the muscles and tissues which results in localized pus collections and abscess formation. This entity at times becomes difficult to diagnose due to lack of specific signs and atypical or nonspecific manifestations. This condition is a mimic for a wide range of differential diagnoses due to which the patient often receives many unwarranted antibiotics. Furthermore, the deep location of the muscles makes the clinical signs in apparent leading to misdiagnosis as rarer entities such as inflammatory myositis. In the last 1 year, four such interesting cases were admitted in this tertiary care center with different clinical presentations. All these cases were healthy, immunocompetent individuals who presented to smaller hospitals with clinical presentation of muscle and joint pain with fever. The muscle groups affected were different in all these cases. All four patients were transferred to this hospital due to the diagnostic dilemma between inflammatory and infective myositis. After a thorough workup including imaging and tissue diagnostics, they were labeled pyomyositis. This further stresses the need for physicians to become acquainted with this potentially life-threatening yet curable infective disease entity. The patients were managed with antibiotics for a minimum duration of 3 weeks and a maximum duration of 8 weeks for complete recovery. Pyomyositis in immunocompetent hosts was related to factors affecting the muscles without any strenuous exercise or direct trauma. Comprehensive evaluation of the muscles is facilitated by assessment of fluorodeoxyglucose uptake on positron emission tomography–computed tomography scan. The initial therapy consisting of cephalosporin and teicoplanin was found effective in our patients. The minimum length of in-hospital treatment was 4 weeks. This series further reinforces the fact that tropical pyomyositis is not exclusive to immunocompromised persons.

Abstract Identification of patients with idiopathic normal pressure hydrocephalus (iNPH) in a collective with suspected neurodegenerative disease is essential. This study aimed to determine the metabolic spatial covariance pattern of iNPH on FDG PET using an established technique based on scaled subprofile model principal components analysis (SSM-PCA). We identified 11 patients with definite iNPH. By applying SSM-PCA to the FDG PET data, they were compared to 48 age-matched healthy controls to determine the whole-brain voxel-wise metabolic spatial covariance pattern of definite iNPH (iNPH-related pattern, iNPHRP). The iNPHRP score was compared between groups of patients with definite iNPH, possible iNPH (N = 34), Alzheimer’s (AD, N = 38), and Parkinson’s disease (PD, N = 35) applying pairwise Mann–Whitney U tests and correction for multiple comparisons. SSM-PCA of FDG PET revealed an iNPHRP that is characterized by relative negative voxel weights at the vicinity of the lateral ventricles and relative positive weights in the paracentral midline region. The iNPHRP scores of patients with definite iNPH were substantially higher than in patients with AD and PD (both p

This study aimed to evaluate the predictive and monitoring role of somatostatin receptor (SSTR) positron emission tomography-computed tomography (PET/CT) and clinical parameters in patients with neuroendocrine liver metastases (NELM) from pancreatic neuroendocrine tumors (pNET) receiving capecitabine and temozolomide (CAPTEM).

Artifacts in nuclear medicine imaging are not uncommon. We are aware of some of these, for which we follow necessary protocols to avoid them. However, there are some unusual and unavoidable artifacts that we come across in daily imaging, which may be of concern and need to be detected and corrected on time. Hence, sharing a few such unusual artifacts we encountered while performing routine studies on positron emission tomography-computed tomography and gamma cameras, evaluating the cause and possible precautions. [ABSTRACT FROM AUTHOR]

BackgroundAlthough many patients with follicular lymphoma (FL) undergo routine radiographic surveillance during their first remission, no consensus exists on the modality, duration, frequency, or need for routine imaging studies. The authors retrospectively examined the effect of surveillance imaging on relapse detection and overall survival (OS) in patients with FL.MethodsPatients with newly diagnosed FL who had a response to induction therapy were identified from the Lymphoid Malignancies Enterprise Architecture Database (LEAD) at Emory University and from the Molecular Epidemiology Resource (MER) of the University of Iowa/Mayo Clinic. Patients were evaluated for both relapse and method of relapse detection (ie, clinical concerns vs radiologic detection through surveillance imaging in an asymptomatic patient).ResultsOf 148 patients in the LEAD cohort, 55 (37%) relapsed, and the majority (n = 35; 64%) of relapses were detected clinically. In the MER cohort, 63 of 177 relapses (54%) were detected clinically. There was no significant difference in OS from the date of diagnosis between the 2 methods of relapse detection in the LEAD (hazard ratio [HR], 0.61; 95% CI, 0.13-2.94; P = .54) and MER (HR, 1.02; 95% CI, 0.47-2.21; P = .96) cohorts. Similarly, there was no significant difference in OS from the date of relapse between the 2 methods of relapse detection in the LEAD (HR, 0.47; 95% CI, 0.10-2.27; P = .35) and MER (HR, 1.02; 95% CI, 0.47-2.21; P = .96) cohorts.ConclusionsThese findings suggest a limited role for routine surveillance imaging in patients with FL who complete front-line therapy. Future studies should evaluate which patients may benefit from a more aggressive surveillance approach and should explore novel methods of relapse detection.

The metastatic lesions to pancreas are reported in various malignancies. However, pancreatic metastasis from breast cancer is rare and difficult to diagnose due to nonspecific symptoms and imaging findings. At the time of diagnosis, there may already be an associated widespread metastasis. In this case report, a woman in her forties with a history of breast cancer was found to have widespread metastases, including in the pancreas. The patient was treated with chemotherapy and hormonal therapy. [ABSTRACT FROM AUTHOR]

Identification of patients with idiopathic normal pressure hydrocephalus (iNPH) in a collective with suspected neurodegenerative disease is essential. This study aimed to determine the metabolic spatial covariance pattern of iNPH on FDG PET using an established technique based on scaled subprofile model principal components analysis (SSM-PCA). We identified 11 patients with definite iNPH. By applying SSM-PCA to the FDG PET data, they were compared to 48 age-matched healthy controls to determine the whole-brain voxel-wise metabolic spatial covariance pattern of definite iNPH (iNPH-related pattern, iNPHRP). The iNPHRP score was compared between groups of patients with definite iNPH, possible iNPH (N = 34), Alzheimer's (AD, N = 38), and Parkinson's disease (PD, N = 35) applying pairwise Mann–Whitney U tests and correction for multiple comparisons. SSM-PCA of FDG PET revealed an iNPHRP that is characterized by relative negative voxel weights at the vicinity of the lateral ventricles and relative positive weights in the paracentral midline region. The iNPHRP scores of patients with definite iNPH were substantially higher than in patients with AD and PD (both p < 0.05) and non-significantly higher than those of patients with possible iNPH. Subject scores of the iNPHRP discriminated definite iNPH from AD and PD with 96% and 100% accuracy and possible iNPH from AD and PD with 83% and 86% accuracy. We defined a novel metabolic spatial covariance pattern of iNPH that might facilitate the differential diagnosis of iNPH versus other neurodegenerative disorders. The knowledge of iNPH-associated alterations in the cerebral glucose metabolism is of high relevance as iNPH constitutes an important differential diagnosis to dementia and movement disorders. Key points: • Subprofile model principal components analysis revealed a distinct metabolic spatial covariance pattern of definite idiopathic normal pressure hydrocephalus (iNPH). • This iNPH-related pattern delineates patients with definite iNPH from patients with Alzheimer's or Parkinson's disease. • The iNPH-related pattern expression was higher in definite than in probable iNPH. [ABSTRACT FROM AUTHOR]

Novel coronavirus-19 (COVID-19) variants continue to spread worldwide with the development of highly transmissible strains. Several guidelines addressing management of cancer patients during the COVID-19 pandemic have been published, primarily based upon expert opinion. The COVID-19 pandemic has affected all aspects of breast cancer care including screening, diagnosis, treatment, and long-term follow-up. Recent reports indicate that mRNA COVID-19 vaccines can provoke lymphadenopathy in both cancer patients and healthy individuals. Unilateral axillary lymphadenopathy (UAL) post-COVID-19 vaccination is a challenging presentation for cancer patients because of the potential for misinterpretation as malignancy. The World Health Organization’s target to vaccinate 70% of the world’s population by mid-2023 is likely to increase the incidence of post-COVID-19 vaccination UAL. In this article, we review the published evidence regarding UAL post-COVID-19 vaccination and present diverse cases of breast cancer patients where false-positive UAL post-COVID-19 vaccination proved to be a therapeutic challenge. The United Arab Emirates (UAE) vaccination program is well ahead of other countries in the world, having accomplished the target of 100% vaccination of the population with at least one dose. Therefore, an increasing number of recently vaccinated patients are likely to present with UAL, detected by surveillance imaging, post-vaccination. We have therefore made recommendations regarding the management of cancer patients with UAL post-COVID-19 vaccination in order to avoid misdiagnosis and unnecessary imaging or invasive biopsy procedures.

Abstract A 45‐year‐old male with cardiac sarcoidosis verified by cardiac biopsy presented with multiple coexisting arrhythmias, including ventricular tachycardia of more than 1000 episodes per 24 h, paroxysmal atrial fibrillation, and third‐degree atrioventricular block. He did not respond to corticosteroids dose of 20–60 mg once daily and mycophenolate mofetil dose of 1 g twice daily for 6 months. Cardiac magnetic resonance (CMR) demonstrated inflammation and late gadolinium enhancement on right ventricular wall and interventricular septum. Positron emission tomography‐computed tomography (PET‐CT) showed multifocal 18F‐fluorodeoxyglucose uptake in the heart. We replaced mycophenolate mofetil with adalimumab, a tumour necrosis factor‐α inhibitor. After 3 months, his arrhythmias improved significantly, manifesting as premature ventricular contractions of only 500 beats per 24 h and first‐degree atrioventricular block. CMR showed a significant reduction in inflammation and late gadolinium enhancement, and PET‐CT showed a complete resolution of fluorodeoxyglucose uptake.

To provide an overview of the current available data about FAPI PET in breast cancer patients, with a perspective point of view. A literature search for studies about FAPI PET in the last 5 years (from 2017 to January 2023) was carried out on MEDLINE databases, such as PubMed, EMBASE, Web of Science and Google Scholar using the following keywords: "PET" AND "FAPI" AND "Breast Cancer" AND "Fibroblast imaging". The Critical Appraisal Skills Program (CASP) checklist for diagnostic test studies was used for testing the quality of selected papers. 13 articles were selected, including 172 patients affected by breast cancer who underwent FAPI-based PET images. CASP checklist was used in 5/13 papers, demonstrating a general low quality. Different types of FAPI-based tracers were used. No difference in terms of FAPI uptake was reported based on the histopathological characteristics, such as immunohistochemistry and grading of breast cancer. FAPI demonstrated more lesions and yielded much higher tumor-to-background ratios than 2-[18F]FDG. Preliminary experiences with FAPI PET in breast cancer showed some advantages than the current available 2-[18F]FDG, although prospective trials are needed to further evaluate its diagnostic utility in clinical practice. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate the role of 18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) scan in the detection of axillary lymph node (ALN) involvement and comparison with sentinel lymph node biopsy (SLNB) in operable early-stage breast cancer (EBC). Settings and Design: It is a retrospective analysis of staging PET-CT scan of EBC. Methods: A total of 128 patients with histopathologically proven breast cancer (BC) were included in the study. Preoperative mammography supplemented with ultrasonography and staging 18F-FDG PET-CT scan was done for all patients. Surgery was done within 30 (mean ± standard deviation = 13.8 ± 10.5) days of staging. SLNB was performed in patients without PET-positive ALNs. All patients with positive sentinel nodes and PET-positive ALNs underwent axillary lymph node dissection (ALND). Statistical Analysis Used: The comparison between categorical variables was made by Chi-square/Fisher's exact test as applicable. For continuous variables comparisons, Student's t-test and one-way analysis of variance tests were used. Results: Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PET-CT scan for detection of ALN involvement were 41.7%, 93.2%, 92.1%, and 45.6%, respectively. Sensitivity, specificity, PPV, and NPV of mammography were 84.5%, 54.5%, 78.0%, and 68.6%, respectively. Sixteen out of 46 (34.7%) patients with negative ALNs in PET-CT scan finally showed involvement in histopathology report after SLNB resulting in upstage of the disease. The size of tumor deposits in sentinel nodes was significantly smaller than PET-positive ALNs (P = 0.01). Our observations correlate with the results of earlier studies published in the literature. Conclusions: 18F-FDG PET-CT scan cannot substitute SLNB for ALN screening in EBC. The limitations are most marked in smaller and micrometastatic tumor deposits in ALNs and may be attributed to limitations of PET resolution. However, PET-positive nodes showed good specificity for disease involvement in our study. Therefore, ALND can safely be performed by omitting SLNB in such cases. [ABSTRACT FROM AUTHOR]

We evaluated the effects of obesity and osteocalcin on glucose metabolism in the brain. A total of 179 healthy men were enrolled in this study. After preprocessing positron emission tomography images, including by performing coregistration, spatial normalization, and smoothing, regression analysis was conducted to identify the correlation between body mass index, osteocalcin, and brain glucose metabolism. Body mass index was positively correlated with brain glucose metabolism in the anterior lobe of the right cerebellum, the anterior and posterior lobes of the left cerebellum, the right middle frontal gyrus (Brodmann area 9), the right cingulate gyrus (Brodmann area 32), the right anterior cingulate (Brodmann area 32), the left middle frontal gyrus (Brodmann area 10), and the subgyral area of the left frontal lobe. Osteocalcin was negatively correlated with glucose metabolism in the anterior lobe of the left cerebellum. Body mass index was positively correlated with brain glucose metabolism in the prefrontal cortex and cerebellum. Osteocalcin levels were negatively correlated with brain glucose metabolism in the left cerebellum. [ABSTRACT FROM AUTHOR]

Diagnosis of cardiac infections, which includes infective endocarditis (IE) and cardiac device infections, despite having a high death rate, is still challenging. Frequently used modalities such as echocardiography, computed tomography (CT), and magnetic resonance imaging cannot confirm the presence of an active infection or extracardiac findings. Taking these things to consideration, newer guidelines have suggested the inclusion of 18F fluorodeoxyglucose positron emission tomography/ CT (18F FDG PET/CT) in the workup of patients with suspected prosthetic valve IE. In this pictorial essay, we are demonstrating the utility of 18F-FDG PET/CT in varied cases of IE, cardiac implantable electronic devices, and coronary stent infection and how they helped in solving diagnostic dilemmas. [ABSTRACT FROM AUTHOR]

Multiple myeloma is a clonal B-lymphocyte tumor of terminally differentiated plasma cells. 18F-FDG PET/CT can provide valuable data for the diagnosis, restaging, and evaluate prognosis of multiple myeloma (MM). This meta-analysis aimed to evaluate the prognostic value of pre-treatment 18F-FDG PET/CT at diagnosis in MM patients. Related researches came from Embase, PubMed, and Cochrane Library databases through a systematic search, and the last one was updated on April 26, 2021. Cochran Q test and I-squared statistics were used to test for heterogeneity among the studies analyzed. The fixed model and random model were used to combine results when appropriate. Stata 12.0 was used to perform statistical analysis, and p < 0.05 was considered statistically significant. A total of 16 articles with 2589 patients were included in this study. Our results indicated PET/CT has an excellent prognostic role in MM, that higher SUVmax, more FL and EMD were associated with poor OS and PFS. SUVmax: OS (HR 1.89, 95% CI 1.47–2.44), PFS (HR 1.34, 95% CI 1.18–1.51); Fl: OS (HR 2.65, 95% CI 1.83–3.79), PFS (HR 1.61, 95% CI 1.40–1.86); EMD: OS (HR 2.11, 95% CI 1.41–3.16), PFS (HR 2.18, 95% CI 1.69–2.81). Furthermore, similar results were observed in most subgroup analyzes. Conclusion Pre-treatment 18F-FDG PET/CT examination has prognostic value for myeloma patients and has guiding significance for clinical treatment. [ABSTRACT FROM AUTHOR]

Novel coronavirus-19 (COVID-19) variants continue to spread worldwide with the development of highly transmissible strains. Several guidelines addressing management of cancer patients during the COVID-19 pandemic have been published, primarily based upon expert opinion. The COVID-19 pandemic has affected all aspects of breast cancer care including screening, diagnosis, treatment, and long-term follow-up. Recent reports indicate that mRNA COVID-19 vaccines can provoke lymphadenopathy in both cancer patients and healthy individuals. Unilateral axillary lymphadenopathy (UAL) post-COVID-19 vaccination is a challenging presentation for cancer patients because of the potential for misinterpretation as malignancy. The World Health Organization's target to vaccinate 70% of the world's population by mid-2023 is likely to increase the incidence of post-COVID-19 vaccination UAL. In this article, we review the published evidence regarding UAL post-COVID-19 vaccination and present diverse cases of breast cancer patients where false-positive UAL post-COVID-19 vaccination proved to be a therapeutic challenge. The United Arab Emirates (UAE) vaccination program is well ahead of other countries in the world, having accomplished the target of 100% vaccination of the population with at least one dose. Therefore, an increasing number of recently vaccinated patients are likely to present with UAL, detected by surveillance imaging, post-vaccination. We have therefore made recommendations regarding the management of cancer patients with UAL post-COVID-19 vaccination in order to avoid misdiagnosis and unnecessary imaging or invasive biopsy procedures. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES We recently reported a high rate of nontherapeutic thymectomy. Mediastinal lymphomas (MLs) are the malignancies most likely to be confused with thymic epithelial tumours (TETs). This study aimed to establish a predictive model by evaluating clinical variables and positron emission tomography to distinguish those diseases. METHODS From 2018 to 2021, consecutive patients who were pathologically diagnosed with TETs or MLs were retrospectively reviewed. Univariable and multivariable analyses were used to identify association factors. The Akaike information criterion was used to select variables. A nomogram was developed and validated to differentiate MLs from TETs. RESULTS A total of 198 patients were included. Compared with TETs, patients with MLs were more likely to be younger with higher metabolic tumour volume (154.1 vs 74.6 cm3), total lesion glycolysis (1388.8 vs 315.2 g/ml cm3), SUVmean (9.2 vs 4.8), SUVpeak (12.9 vs 6.3) and SUVmax (14.8 vs 7.5). A nomogram was established based on the stepwise regression results and the final model containing age and SUVmax had minimal Akaike information criterion value of 72.28. Receiver operating characteristic analyses indicated that the area under the curve of predictive nomogram in differentiating MLs from TETs was 0.842 (95% CI: 0.754–0.907). The internal bootstrap resampling and calibration plots demonstrated good consistence between the prediction and the observation. CONCLUSIONS Combination of age and SUVmax appears to be a useful tool to differentiate MLs from TETs. The novel predictive model prevents more patients from receiving nontherapeutic thymectomy. [ABSTRACT FROM AUTHOR]

A 45‐year‐old male with cardiac sarcoidosis verified by cardiac biopsy presented with multiple coexisting arrhythmias, including ventricular tachycardia of more than 1000 episodes per 24 h, paroxysmal atrial fibrillation, and third‐degree atrioventricular block. He did not respond to corticosteroids dose of 20–60 mg once daily and mycophenolate mofetil dose of 1 g twice daily for 6 months. Cardiac magnetic resonance (CMR) demonstrated inflammation and late gadolinium enhancement on right ventricular wall and interventricular septum. Positron emission tomography‐computed tomography (PET‐CT) showed multifocal 18F‐fluorodeoxyglucose uptake in the heart. We replaced mycophenolate mofetil with adalimumab, a tumour necrosis factor‐α inhibitor. After 3 months, his arrhythmias improved significantly, manifesting as premature ventricular contractions of only 500 beats per 24 h and first‐degree atrioventricular block. CMR showed a significant reduction in inflammation and late gadolinium enhancement, and PET‐CT showed a complete resolution of fluorodeoxyglucose uptake. [ABSTRACT FROM AUTHOR]

Background: To investigate the current knowledge and attitudes towards [ 18 F]fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) among non-radiologist medical staff in China., Methods: This cross-sectional study was conducted between November 18, 2022, and December 6, 2022, at the First Affiliated Hospital (Southwest Hospital) of the Army Medical University (Third Military Medical University) among non-radiologist staff (medical, nursing, and others). The questionnaire survey (Cronbach's α = 0.887) included 28 items: 10 on demographics, 11 on knowledge (maximum score of 22), and seven on attitudes (maximum score of 35). The factors influencing knowledge and attitudes were identified using multivariable logistic regression analysis., Results: This study analyzed 631 valid questionnaires. The mean knowledge score was 7.16 ± 6.48 (32.55%), indicating poor knowledge. The mean attitude score was 22.859 ± 2.36 (65.29%), indicating positive attitudes. Nursing (OR = 0.301, 95%CI: 0.159-0.571), other occupations (OR = 0.426, 95%CI: 0.200-0.905), departments with high volumes of PET/CT prescriptions (OR = 0.419, 95%CI: 0.269-0.652), radioprotection training (OR = 2.520, 95%CI: 1.576-4.030), underwent (or a relative) a PET/CT (OR = 1.713, 95%CI: 1.063-2.761), and contact with 1-10 (OR = 2.429, 95%CI: 1.627-3.627) or > 10 (OR = 3.575, 95%CI: 1.762-7.252) patients per month were independently associated with higher knowledge scores. Only the knowledge scores (OR = 1.063, 95%CI: 1.032-1.094) were independently associated with higher attitude scores., Conclusion: Non-radiologist medical staff members in China have poor knowledge but positive attitudes toward PET/CT. This study identified knowledge areas worth improving in future training interventions. Radioprotection training appears particularly useful in improving the knowledge of PET/CT, which should translate into more favorable attitudes., Trial Registration: Not applicable., Competing Interests: Declarations. Ethics approval and consent to participate: The study was exempted from the Ethics Committee of the First Affiliated Hospital of Army Medical University, PLA. Informed consent was obtained from the participants before completing the survey. I confirm that all methods were performed in accordance with the relevant guidelines. All procedures were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Introduction: Tuberculosis (TB) is a leading cause of spinal infections, frequently presenting as spondylodiscitis. However, its clinical and radiological features can resemble those of Hodgkin's Lymphoma (HL). While Gene X-pert MTB/Rif Ultra and computed tomography (CT)-guided biopsies are common diagnostic tools for TB, they may sometimes be inconclusive. In such cases, HL should be considered as a differential diagnosis. Positron emission tomography-CT (PET-CT) scans are useful in assessing whether the disease is metabolically active. Accurate and timely diagnosis is essential for effective treatment, especially when initial tests suggest an infectious cause., Case Report: A 16-year-old male presented with lower back pain radiating to the lower limbs and difficulty walking. Magnetic resonance imaging revealed vertebral body destruction suggestive of spondylodiscitis. Despite anti-tubercular therapy, his condition worsened. Gene X-pert MTB/Rif Ultra and multiple CT-guided biopsies initially suggested a granulomatous lesion but did not confirm TB. Subsequent imaging revealed systemic nodular lesions, raising the suspicion of malignancy. Immunohistochemical studies confirmed HL with positivity for CD15 and CD30. The patient responded positively to chemotherapy and has been in remission for 1 year., Conclusion: This case underscores the diagnostic challenges of distinguishing between spinal TB and HL. Initial tests such as Gene X-pert MTB/Rif Ultra and CT-guided biopsies can sometimes produce false negatives, leading to delays in accurate diagnosis and appropriate treatment. The use of PET-CT and detailed immune-histochemical analysis proved crucial in this case, emphasizing the importance of a comprehensive diagnostic approach when conventional treatments fail. This case contributes to the orthopedic literature by highlighting the need to consider HL in differential diagnoses and the role of advanced imaging and biopsies in ensuring timely and accurate diagnosis., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)

One of the leading causes of cancer-related death is gastrointestinal cancer, which has a significant morbidity and mortality rate. Although preoperative risk assessment is essential for directing patient care, its biological behavior cannot be accurately predicted by conventional imaging investigations. Potential pathophysiological information in anatomical imaging that cannot be visually identified can now be converted into high-dimensional quantitative image features thanks to the developing discipline of molecular imaging. In order to enable molecular tissue profile in vivo , molecular imaging has most recently been utilized to phenotype the expression of single receptors and targets of biological therapy. It is expected that molecular imaging will become increasingly important in the near future, driven by the expanding range of biological therapies for cancer. With this live molecular fingerprinting, molecular imaging can be utilized to drive expression-tailored customized therapy. The technical aspects of molecular imaging are first briefly discussed in this review, followed by an examination of the most recent research on the diagnosis, prognosis, and potential future clinical methods of molecular imaging for GI tract malignancies., Competing Interests: Conflict-of-interest statement: The authors had no conflict of interests., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Hodgkin's lymphoma (HL) is a malignant disease of the lymphoid tissue originating from the germinal center and postgerminal center B-cells comprising 10% of all lymphomas and 0.6% among all cancers. Here, we report a case of a 22-year-old male with a chief complaint of painless swelling in the right submandibular region for the past 6 months with no contributory medical history. Correlating the history and clinical examination, a clinical diagnosis of benign sialadenoma was made. Benign sialadenoma was confirmed on radiographic investigations such as ultrasonography and magnetic resonance imaging. Furthermore, excisional biopsy and immunohistochemistry performed revealed a case of classical HL (lymphocyte-rich type). The positron-emission tomography–computed tomography revealed metastasis to the inguinal and cervical lymph nodes.

Esophageal neuroendocrine neoplasms (NENs) are uncommon type of esophageal malignancies. We describe the clinical course and molecular imaging features of the relatively rare esophageal malignancy (an aggressive poorly differentiated NEN) that was widely metastatic at the initial presentation. The patient underwent multiple cycles of chemotherapeutic regimens, employing cisplatin-etoposide and nanopaclitaxel-carboplatin and later on rechallenge with cisplatin-etoposide. There was observation of fluctuating disease course and differential characteristics of tumor lesions in terms of treatment response and recurrences with multiple cycles of chemotherapy. In view of the histopathology of high Mib-1 labeling index and dual tracer positron emission tomography-computed tomography (PET-CT) (flurodeoxyglucose [FDG] and 68Ga-DOTATATE) features, the patient was not a suitable candidate for 177Lu-DOTATATE PRRT and FDG PET-CT was the preferred imaging modality for both treatment response assessment and disease monitoring in this patient. The varying response among metastatic lesions in the same individual (with one lesion showing partial response and the other one demonstrating disease progression) was an additional noteworthy feature of the case.

Introduction: F-18 fluorodeoxyglucose (F18-FDG) positron emission tomography-computed tomography (PET/CT) is a valuable functional imaging modality for the clinical diagnosis which provides physiological information based on the altered tissue metabolism. Aim: This study aims to investigate the effectiveness of F-18 fluorodeoxyglucose (F18-FDG) positron emission tomographycomputed tomography (PET/CT) in preoperative staging and postoperative local recurrence and distant metastases in patients with rectal cancer. Material and methods: The imaging of 726 patients with rectal cancer who were operated on at Istanbul University, Istanbul School of Medicine and had F18-FDG PET/CT, CT, and magnetic resonance imaging (MRI) scans between September 2005 and October 2016 were retrospectively analyzed. Of these patients, 170 who had pre- and postoperative PET/CT scans, had their CT scans included in the study. The sensitivity and specificity of PET/CT in preoperative staging and detection of postoperative local recurrence and distant metastases were analyzed. Results: Of the patients, 101 were males and 69 were females with a median age of 62.27 (range, 31 to 89) years. The sensitivity and specificity of preoperative PET/CT in detecting liver metastases were 100% (confidence interval [CI]: 66.37-100%) and 94.2% (CI: 89.72-100%), respectively (Cohen's kappa [1]: 1.00; P < 0.001). The sensitivity and specificity of postoperative PET / CT in diagnosing liver metastases were 100% (CI: 88.06-100%) and 98% (CI: 9-100%), respectively (Cohen's: 1.00; P < 0.001). The sensitivity and specificity of preoperative PET/CT in detecting lung metastases were 100% (CI: 66.37-100%) and 91.8% (CI: 89.72-100%), respectively (Cohen's: 1.00; P < 0.001). The sensitivity and specificity of postoperative PET/CT in detecting lung metastases were 100% (CI: 91.4-100%) and 96% (CI: 95.8-100%), respectively (Cohen's: 1.00; P < 0.001). The sensitivity and specificity of PET/CT in preoperative staging of pathological pelvic lymph nodes were 100% (CI: 63.06-100%) and 94.29% (CI: 80.84-99.3%), respectively (Cohen's: 0.860; P < 0.001). The sensitivity and specificity of postoperative PET/CT in detecting local recurrences were 100% (CI: 78.2-100%) and 76.74% (CI: 61.37-88.24%), respectively (Cohen's: 0.219; P < 0.08). Results: Given the fact that PET/CT can detect all primary rectal cancer in preoperative staging, it can be effectively used in selected cases, particularly in those suspected of local and advanced disease and with metastases (T3N0, T3N1, and/or T4N1). Due to a relatively low specificity in detecting local recurrences postoperatively, PET/CT can be combined with further modalities. [ABSTRACT FROM AUTHOR]