1.Hot Embolus Artifact Mimicking Disease Progression in Post‑therapy177Lu‑DOTATATE Scan: Incremental Value of SPECT/CT
Piyush AGGARWAL ; Anupriya ANWARIYA ; Anwin Joseph KAVANAL ; Ashwani SOOD ; Santosh Ranjan JENA ; Bhagwant Rai MITTAL
Nuclear Medicine and Molecular Imaging 2023;57(3):159-161
Peptide receptor radionuclide therapy (PRRT) has become an established treatment for patients with inoperable and/or metastatic, well-differentiated neuroendocrine tumors with overexpression of somatostatin receptor type 2 (SSTR-2). The post-therapy 177Lu-DOTATATE whole-body scan not only assesses the biodistribution of the lesions seen on pre-therapy68 Ga-SSTR PET/CT scan but also provides a quick assessment of disease status and dosimetry during treatment. Like any other radionuclide scan, the whole-body 177Lu-DOTATATE scan may also show abnormal radiotracer uptake, which may require further imaging to establish its exact etiology. Though radiotracer emboli mimicking focal pulmonary lesions have been described with 18F-FDG and 68 Ga-DOTANOC PET/CT scans, similar artifacts with post-therapy 177Lu-DOTATATE scans have not been described. Herein, we report two cases of hot emboli in the post-therapy 177Lu-DOTATATE scans.
2.Real Time F-18 FDG PET-CT-Guided Metabolic Biopsy Targeting Differential FDG Avidity in a Pulmonary Blastoma
Tarun Kumar JAIN ; Harmandeep SINGH ; Rajender KUMAR ; Amanjit BAL ; Ashwani SOOD ; Bhagwant Rai MITTAL
Nuclear Medicine and Molecular Imaging 2020;54(5):261-263
Pulmonary blastoma (PB) is a rare thoracic malignancy and preoperative diagnosis is challenging. A young man presented with dyspnea and chest pain for 3–4 months and chest-computed tomography (CT) revealed large mass in the left lung upper lobe and pleural effusion. Repeated CT-guided fine-needle aspiration cytology from the lesion and pleural fluid aspiration was negative for malignancy. F-18-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) revealed heterogeneous tracer avidity in left lung mass with areas of necrosis. Real-time PET-CT-guided biopsy from metabolically active component of the lesion revealed biphasic PB on histopathology.
3.Incidental Muscle Uptake of 177 Lu-DOTATATE in Peripheral Vascular Disease
Piyush AGGARWAL ; Kunal Ramesh CHANDEKAR ; Ashwani SOOD ; Shakti ZERIAL ; Rajender KUMAR ; Anindita SINHA
Nuclear Medicine and Molecular Imaging 2021;55(6):320-322
Somatostatin receptor (SSTR)-based imaging and therapy has emerged as well-established modality in neuroendocrine tumors. However, its role in inflammation imaging is still evolving. We present a 48-year-old male with metastatic neuroendocrine tumor who underwent lutetium-177-based somatostatin receptor-based therapy. The post-therapy scan showed a focal tracer uptake in the left calf muscle in addition to the expected tracer uptake at the primary and metastatic sites. Further, cross-sectional imaging and biochemical investigations revealed peripheral vascular disease (PVD). The incidental tracer uptake in the calf on post-therapy scan potentiates the role of somatostatin receptor scintigraphy in identifying macrophagespecific inflammatory reactions.
4.Sensitive Detection of a Small Parathyroid Adenoma Using Fluorocholine PET/CT: A Case Report
Thanseer N T K PADINHARE-KELOTH ; Sanjay K BHADADA ; Ashwani SOOD ; Rajender KUMAR ; Arunanshu BEHERA ; Bishan D RADOTRA ; Bhagwant R MITTAL
Nuclear Medicine and Molecular Imaging 2017;51(2):186-189
Primary hyperparathyroidism is caused by parathyroid adenoma in the majority of cases and diagnosis is usually made biochemically. Pre-surgical localization of parathyroid adenoma is essential to limit the extent of surgery and avoid missing them at ectopic sites. Anatomical and functional imaging are used for the localization, but may fail to identify the small and ectopic parathyroid adenoma. We present a case of small sized ectopic parathyroid adenoma at unusual location detected by F-18 fluorocholine (FCH) PET/CT, where other imaging modalities failed. The post-operative histopathology confirmed the diagnosis of ectopic parathyroid adenoma.
Diagnosis
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Hyperparathyroidism, Primary
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Parathyroid Neoplasms
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Positron-Emission Tomography and Computed Tomography
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Ultrasonography
5.Potential Adjunctive Role of Radiosynovectomy in Primary Synovial Osteochondromatosis of the Knee: A Case Report
Shelvin Kumar VADI ; Devendra Kumar CHOUHAN ; Arun Kumar Reddy GORLA ; Jaya SHUKLA ; Ashwani SOOD ; Bhagwant Rai MITTAL
Nuclear Medicine and Molecular Imaging 2017;51(3):252-255
Primary synovial osteochondromatosis (PSOC) is a rare but clinically significant cause of morbidity especially in the male population. Surgery is the primary treatment of choice, but the recurrence rate is reported to be high. Moreover, the presence of widespread loose bodies makes it a cumbersome procedure. The complete removal of the disease is tough at times and results in early recurrence. Radiosynovectomy is an established technique for treating various joint arthropathies. The role of radiosynovectomy in case of PSOC has not yet been explored. This case report described the case of a young male with PSOC of the knee joint who was treated with radiosynovectomy for pain relief. The patient reported complete relief from the pain along with significant improvement in joint mobility. The post-therapy three-phase bone scan also validated the reduction in joint inflammation. The patient was taken for surgical removal of the redundant loose bodies after a significant improvement in the pain and reduction in inflammation. Post-therapy radiation fibrosis of the synovium also helped in the en bloc removal of the disease. The role of radiosynovectomy in PSOC needs to be further explored concerning its potential role as an adjuvant to surgical procedures.
Chondromatosis, Synovial
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Humans
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Inflammation
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Joints
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Knee Joint
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Knee
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Male
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Radiation Pneumonitis
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Recurrence
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Synovial Membrane
6.Erratum to: Dual Pathologies of Parathyroid Adenoma and Papillary Thyroid Cancer on Fluorocholine and Fluorodeoxyglucose PET/CT
N. T K THANSEER ; Sanjay Kumar BHADADA ; Ashwani SOOD ; Ashwin Singh PARIHAR ; Divya DAHIYA ; Priyanka SINGH ; Rajender Kumar BASHER ; Ashim DAS ; Bhagwant R MITTAL
Nuclear Medicine and Molecular Imaging 2018;52(1):85-85
Owing to an oversight in manuscript preparation, the name of the fifth author was rendered incorrectly. The correct spelling is Divya Dahiya.
7.Dual Pathologies of Parathyroid Adenoma and Papillary Thyroid Cancer on Fluorocholine and Fluorodeoxyglucose PET/CT
N T K THANSEER ; Sanjay Kumar BHADADA ; Ashwani SOOD ; Ashwin Singh PARIHAR ; Divya DAHIYA ; Priyanka SINGH ; Rajender Kumar BASHER ; Ashim DAS ; Bhagwant R MITTAL
Nuclear Medicine and Molecular Imaging 2018;52(2):154-158
¹â¸F-Fluorocholine (FCH) PET/CT is evolving as a functional imaging modality for the preoperative imaging of abnormal parathyroid tissue(s) helping to localize eutopic and ectopic parathyroid tissue and limit the extent of surgery. FCH PET/CT may show incidental uptake in various thyroid lesions necessitating further evaluation, whereas the role of ¹â¸F-fluorodeoxyglucose (FDG) PET/CT in the detection of incidental thyroid nodules is well documented. The case of a middle-aged woman with dual pathology of parathyroid adenoma and papillary thyroid cancer detected on FCH and FDG PET/CT is presented.
8.Erratum to: Dual Pathologies of Parathyroid Adenoma and Papillary Thyroid Cancer on Fluorocholine and Fluorodeoxyglucose PET/CT
N. T K THANSEER ; Sanjay Kumar BHADADA ; Ashwani SOOD ; Ashwin Singh PARIHAR ; Divya DAHIYA ; Priyanka SINGH ; Rajender Kumar BASHER ; Ashim DAS ; Bhagwant R MITTAL
Nuclear Medicine and Molecular Imaging 2018;52(1):85-85
Owing to an oversight in manuscript preparation, the name of the fifth author was rendered incorrectly. The correct spelling is Divya Dahiya.
9.Angiogenesis-Targeted 68Ga-DOTA-RGD 2 PET/CT Imaging: a Potential Theranostic Application in the Case of Chondrosarcoma
Venkata Subramanian KRISHNARAJU ; Rajender KUMAR ; Ashwani SOOD ; Jaya SHUKLA ; Karthikeyan SUBRAMANIAN ; Nandita KAKKAR ; Naresh PANDA ; Bhagwant Rai MITTAL
Nuclear Medicine and Molecular Imaging 2021;55(3):141-145
Chondrosarcoma is a cartilaginous tumor of mesenchymal origin. The histology and grade of the tumor determine the chances of relapse and survival. These tumors usually respond poorly to chemo-radiotherapy in cases of non-resectable and recurrent disease. 18F-FDG PET/CT has been used in evaluation of recurrence. However, these tumors show only mild to moderate FDG avidity due to their lower mitotic activity and large acellular matrix. These tumors are known to have a high degree of angiogenesis, especially in those of higher grade. We present a case of a 53-year-old man with grade II chondrosarcoma of the left femur showing only mild avidity on 18F-FDG PET/CT but showing moderate to intense tracer avidity on 68Ga-DOTA-RGD2PET/CT. This may enable the use of angiogenesis-targeted positron and beta-emitting radiopharmaceuticals as a potentially new theranostic alternative treatment in cases of refractory metastatic chondrosarcoma.