1.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.
2.Incremental Role of ¹⁸FDG PET/CT in Assessment of Testicular Viability
Venkata Subramanian KRISHNARAJU ; Dharmender MALIK ; Rajender KUMAR ; Giridhar S BORA ; Bhagwant Rai MITTAL ; Anish BHATTACHARYA
Nuclear Medicine and Molecular Imaging 2018;52(5):377-379
Testicular torsion is a common differential diagnosis of acute scrotal pain along with acute epididymo-orchitis, which may lead to testicular non-viability. Doppler ultrasound and testicular scintigraphy are two routinely used modalities for the assessment of testicular viability. However, in some cases, these investigations may prove inadequate in differentiating between the two entities with widely differing management. Here, we present a case of a 52-year-old male with questionable viability of testis, who was investigated initially using testicular scintigraphy and was further subjected to a regional 18F-FDG PET/CT scan, in view of inconclusive findings with the conventional modalities.
Diagnosis, Differential
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Fluorodeoxyglucose F18
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Humans
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Male
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Middle Aged
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Positron-Emission Tomography and Computed Tomography
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Radionuclide Imaging
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Spermatic Cord Torsion
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Testis
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Ultrasonography
3.Incremental Role of ¹â¸FDG PET/CT in Assessment of Testicular Viability
Venkata Subramanian KRISHNARAJU ; Dharmender MALIK ; Rajender KUMAR ; Giridhar S BORA ; Bhagwant Rai MITTAL ; Anish BHATTACHARYA
Nuclear Medicine and Molecular Imaging 2018;52(5):377-379
Testicular torsion is a common differential diagnosis of acute scrotal pain along with acute epididymo-orchitis, which may lead to testicular non-viability. Doppler ultrasound and testicular scintigraphy are two routinely used modalities for the assessment of testicular viability. However, in some cases, these investigations may prove inadequate in differentiating between the two entities with widely differing management. Here, we present a case of a 52-year-old male with questionable viability of testis, who was investigated initially using testicular scintigraphy and was further subjected to a regional 18F-FDG PET/CT scan, in view of inconclusive findings with the conventional modalities.
4.Incidentally Detected Gallbladder Carcinoma: Can F‑18 FDG PET/CT Aid in Staging and Prognostication?
Venkata Subramanian KRISHNARAJU ; Rajender KUMAR ; Bhagwant Rai MITTAL ; Harjeet SINGH ; Piyush AGGARWAL ; Harmandeep SINGH ; Thakur Deen YADAV ; Ritambhra NADA ; Vikas GUPTA ; Rajesh GUPTA
Nuclear Medicine and Molecular Imaging 2024;58(3):104-112
Purpose:
Incidental gallbladder carcinoma (IGBC) is diagnosed in post-cholecystectomy specimens for benign indications, where the role of 2-fluro-2-deoxyglucose positron emission tomography/computed tomography(FDG-PET/CT) is not clearly defined. The present study aimed to assess the benefits of staging and prognosticating with FDG-PET/CT in IGBC.
Materials and Methods:
A retrospective observational study from a tertiary-care center from January 2010 to July 2020 was performed. The demographic, clinical, histopathological, and treatment-related histories were collected. FDG-PET/CT-image findings were compared with survival outcomes through telephonic follow-up. The chi-square test was used for comparing frequencies. The univariate and multivariate survival estimates were analyzed using the Kaplan–Meier analysis and the Cox-proportional hazard model, respectively. Log-rank test was used to compare the Kaplan–Meier curves.
Results:
The study included 280 postcholecystectomy participants (mean age: 52 ± 11 years; women: 227) of whom 52.1% had open surgery(146/280). Residual disease in the gallbladder fossa (54.8% vs. 36.6%, p = 0.002) and liver infiltration (32.9% vs. 22.4%, p = 0.05) were seen more frequently in open surgery compared to laparoscopic surgery, while anterior abdominal wall deposits were more common in laparoscopy(35.1% vs. 24%,p = 0.041). FDG-PET/CT changed the management in 10% (n = 28) of patients compared to contrast-enhanced CT. The median survival was 14 months (95%CI-10.3–17.7). A higher stage of the disease on the FDG-PET/CT (loco-regional disease-HR 4.86, p = 0.006; metastatic disease-HR 7.53, p < 0.001) and the presence of liver infiltration (HR-1.92, p = 0.003) were independent predictors of poor survival outcomes.
Conclusion
FDG-PET/CT detects residual and metastatic disease in patients with IGBC, enabling the institution of appropriate management and acting as a tool for prognostication of survival.