Askin's Tumor in an Adult: Case Report and Findings on 18F-FDG PET/CT

Primitive neuroectodermal tumor (PNET) of the chest wall or Askin's tumor is a rare neoplasm of chest wall. It most often affects children and adolescents and is a very rare tumor in adults. In this case report, we present an Askin's tumor occurred in a 73-year-old male. The patient was admitted with a history of 3-month lower back pain and cough. In computed tomography, there was a lesion with dimensions of 70 × 40 × 65 mm in the superior segment of the lower lobe of the left lung. Positron emission tomography/computed tomography with 18F-flourodeoxyglucose revealed a pleural-based tumor in the left lung with a maximum standardized uptake value of 4.36. No distant or lymph node metastases were present. The patient had gone through surgery, and wedge resection of the superior segment of left lobe and partial resection of the ipsilateral ribs were performed. Pathology report with immunocytochemistry was consistent with PNET and the patient received chemotherapy after that

Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging of a Patient with Squamous Cell Carcinoma of Prostate

Primary squamous cell carcinoma is an uncommon tumor of the prostate gland. We report a 77-year-old male patient with urinary frequency and constipation. Fine needle biopsy from prostate was suspicious of squamous cell carcinoma of the prostate. Whole body positron emission tomography/computed tomography scan revealed high fluorodeoxyglucose uptake in prostate gland. Transurethral resection confirmed the diagnosis. In contrast to prostatic adenocarcinoma, high fluorodeoxyglucose accumulation was observed in the primary tumor of the prostate gland

The Appearances of Brain Metastases of Small Cell Lung Cancer on 18F-FDG PET/CT

Purpose: We evaluate the appearances of the brain metastases (BMs) detected by brain magnetic resonance imaging (MRI) of small cell lung cancer (SCLC) on 18Fluor-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). Patients and methods: SCLC patients who had an 18F-FDG PET/CT scan and a brain MRI within 30 days for initial staging were included. MRI was used to detect BMs. The imaging results of BMs on 18F-FDG PET/CT were assessed. On the 18F-FDG PET/CT study, the BMs were classified as undetectable, hypometabolic, hypermetabolic, or mixed patterns (lesions with both hypermetabolic and hypometabolic parts). Results: A total of 51 patients [48 (94.1%) of whom were male and 3 (5.9%) female, with an average age of 62.57 ± 9.64] were included in this study. Fifteen patients (29.4%) were in the limited stage, whereas 36 patients (69.6%) were in the extensive stage. In 11 individuals, MRI indicated 28 BMs. On 18F-FDG PET/CT, 13 of the 28 metastases were visible. The following were the BMs appearances on 18F-FDG PET/CT: hypometabolic (n: 4), hypermetabolic (n: 6), and mixed (n: 3). While the mean diameter of BMs detected in 18F-FDG PET/CT was 16mm; the mean diameter of undetected ones was 4.3 mm. Conclusion: On 18F-FDG PET/CT, BMs can have a variety of appearances, including hypometabolic, hypermetabolic, and mixed patterns. On the other hand, failure to detect millimetric size BMs in 18F-FDG PET/CT prevents proper staging

The Comparasion of Bone Mineral Density Between Male Smokers and Non-Smokers

INTRODUCTION[|]Osteoporosis is one of the health issues caused by smoking. Osteoporosis is the most commonly seen bone disease and becoming a major public health issue due to rise of death age.Studies on detection of smoking related osteoporosis in males are limited in our country. Therefore we intended to assess the effects smoking on bone mineral density in middle age male patients alongside with related factors.[¤]METHODS[|]Our study is a case control type analytical research. We included 144 male 30-60 aged smoker patient and 100 male never smoked. BMD of the patients' lumbar vertebrae (L1-3 and L2-4) and proximal femur (femur total, femur trochanter and wards triangle) regions of the individuals were measured anteroposteriorly by using dual energy x-ray absorptiometer (DXA) method. Serum Ca, P, ALP, PTH and total vitamin D levels of the samples were studied.[¤]RESULTS[|]L1-L4 lumbar spine bone mineral density mean, femoral neck bone mineral density mean, femoral trochanter bone mineral density mean and total femoral bone mineral density mean were significantly lower in case group than control group, according to DXA measurements (p=0,017 p=0,047 p=0,005 p=0,009). There was slightly strong correlation and negative statistically significant difference between femoral trochanter BMD and both cigarette consumption (per-day) and packets.year (r: -0,153, p=0,017 r: -0,142, p=0,027).Mean serum calcium levels were significantly higher in case group than control group (p=0,018).[¤]DISCUSSION AND CONCLUSION[|]We can conclude that bone mineral density decreasing effects of smoking.[¤

Influence of single photon emission computed tomography (SPECT) reconstruction algorithm on diagnostic accuracy of parathyroid scintigraphy: Comparison of iterative reconstruction with filtered backprojection

Background & objectives: Preoperative localization of parathyroid lesions is essential for improving the results in patients with primary hyperparathyroidism. The purpose of this study was to evaluate retrospectively the value of technetium-99m (Tc-99m) methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) and to compare the diagnostic accuracy of iterative reconstruction (IR) and filtered backprojection (FBP) reconstruction algorithms about localization of parathyroid lesions. Methods: Forty four patients with primary hyperparathyroidism, in whom histopathological correlation could be performed, were included in the study. Dual-phase Tc-99m parathyroid scintigraphy was performed 20 and 120 min after injection of 740 MBq Tc-99m MIBI in all patients. Tomographic images were acquired 120 min after the administration of radiopharmaceutical. The SPECT data were evaluated using an IR as well as a FBP algorithm. In 23 of 44 patients, SPECT acquisitions were performed in 64×64 matrix; in the remaining 21 patients, tomographic data were collected in 128×128 matrix. The imaging results were compared with pathological findings and sensitivities of both reconstruction algorithms, and planar views were calculated. Results: Using planar MIBI scans, abnormal parathyroid glands were correctly localized in 75 per cent of the cases. Sensitivity increased to 77 per cent using SPECT with FBP and to 84 per cent with IR. When the sensitivities were calculated according to the acquisition matrix, these were 95 per cent (20/21) and 85 per cent (18/21) for IR and FBP, respectively in patients in whom 128×128 matrix was used. The sensitivities were lower in patients who were imaged with 64×64 matrix; these were calculated as 74 per cent (17/23) and 70 per cent (16/23) with IR and FBP, respectively. Interpretation & conclusions: Our findings showed that compared to planar scintigraphy, Tc-99m MIBI SPECT was more sensitive diagnostic modality in the detection of abnormal parathyroid tissues. Image quality and sensitivity may be improved further when larger matrices with IR are used instead of FBP algorithm

Nefrotoksik Kemoterapiye İkincil Böbrek Yetmezliği Gelişen Bir Olguda FDG PET/BT’de Böbrek Bulguları

Küçük hücreli akciğer kanseri tanısı almış 60 yaşındaki erkek hasta yeniden evrelenmek üzere FDG PET/BT istemiyle bölümümüze yönlendirildi. Kontrastlı toraks tomografisinde küçük hücreli akciğer kanserinin kitle etkisine bağlı olarak vena kava süperior sendromu geliştiği görülmekteydi. FDG PET/BT’de sağ akciğer üst lobda artmış FDG tutulumu gösteren kitle lezyonu, kemik yapılarda belirgin olmak üzere tüm vücutta metabolik aktivite artışı gösteren lezyonlar, her iki böbrek boyutunda artış ve böbrek parankimlerinde diffüz artmış FDG tutulumu saptandı. Hastanın öyküsünden 450 mg/m2 dozunda karboplatin aldığı, PET/BT çekimi sırasında serum üre ve kreatinin seviyelerinin sırasıyla 81 mg/dl (n:17-43 mg/dl) ve 1.78 mg/dl (n: 0.7-1.2 mg/dl) olduğu öğrenildi. Tetkik esnasında günlük idrar miktarı 350cc/gün idi. Hastanın takibinde, serum üre ve kreatinin düzeylerinin 48 mg/dl ve 1.1 mg/dl’ye düştüğü ve günlük idrar miktarının normale döndüğü görüldü. Böbreklerdeki artmış FDG tutulumunun karboplatin toksisitesine ikincil gelişen akut tübüler nekroza bağlı oldu- ğu düşünüldü. Takip sırasında renal fonksiyonların normale dönmesi de bu tezi desteklemekteydi. Bu sunumda küçük hücreli akciğer kanserli bir hastada karboplatin tedavisine bağlı nefrotoksisitenin FDG-PET/BT bulgularını sunuyoruz

Contribution of SPECT-CT to planar imaging in post-ablation imaging in different thyroid cancers, the clinical significance of the differential diagnosis of neck and thorax uptakes

Background: The aim of this study is to demonstrate the superiority of Single Photon Emission Computed Tomography-Computed Tomography (SPECT-CT) over planar imaging in distinguishing benign from malignant foci and patient management after 131I ablation therapy in patients with differentiated thyroid cancer (DTC). Material and Methods: Planar and SPECT-CT imaging findings were retrospectively analyzed in 80 patients who received I-131 therapy for thyroid cancer. Possible foci in whole body scanning (WBS), neck, and thorax were compared with SPECT-CT. Anatomical localization of the foci and differential diagnosis of the benign and malignant lesion was made with SPECT-CT. Those without anatomical counterparts were recorded as equivocal foci. According to the 2015 American Thyroid Association (ATA) guidelines, patients were divided into three groups: High, intermediate, low-risk groups. Interpretation changes between both scannings were recorded as downstage and upstage. Results: There were 53 female and 27 male patients. The patients' age ranged from 21 to 88 years with a mean age of 47 ±14.2. In 80 patients, 139 foci were detected in planar images and SPECT-CT images (neck: 118, thorax: 21). SPECT-CT revealed that 50% of the lateral neck foci were compatible with pathologies in malignant nature and 50% with pathologies in benign nature. Foci in the middle part of the neck were found to be not only thyroid remnant (56%), but also thyroglossal duct remnant (40%) foci at a significant rate It was determined that 66% of the foci in the thorax region were lung metastases and 34% were bone metastases. It was proved that 33% of the foci in the mediastinal region were lymph nodes. Although only one of the remaining patients had a pathological diagnosis, it was thought that all of them might have thymus pathologies. SPECT-CT images changed the interpretation of 18 patients (22.5%), of which 5 (6.25%) were upstage and 13 (16.25%) were downstage. Conclusions: The use of SPECT-CT will be very effective, facilitating patient management and avoiding unnecessary procedures, especially in moderate/high-risk patients with suspicious focal lesions. The presence of benign iodine avid foci (thyroglossal duct residue, etc.) in the neck showing iodine uptake other than the thyroid remnant may be effective in making ablation decisions in low-risk patients

Pulmoner Sarkoidozlu Bir Hastanın F-18 FDG PET/BT Görüntülemesi

Son yıllarda, PET/BT malignite düşünülen pulmoner ve mediastinal lezyonların tanısında sıklıkla kullanılmaktadır. Ancak artmış F-18 FDG tutulumu gösteren, SUVmaks değerinin 2.5’ten fazla olduğu aspergilloz, tuberküloz, Wegener granulomatozu, ve sarkoidoz gibi inflamatuar ve granulomatoz hastalıklar yanlış pozitif sonuçlara neden olabilmektedir. Bu çalışmada malignite şüphesi ile araştırılan pulmoner sarkoidozlu bir hastanın ilginç F-18 FDG PET/BT görüntüleme bulguları sunulmuştur