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Posttherapy 177Lu imaging, however, showed good uptake in all neuroendocrine tumor lesions, including all liver metastases. Therefore, the presence of liver metastases in which the uptake of 68Ga-HA-DOTATATE is not or only slightly higher than in surrounding normal liver tissue should not be an absolute contraindication for PRRT.
A 76-year-old woman underwent 99mTcO4- thyroid scintigraphy to clarify thyrotoxicosis. In addition to suppressed thyroid uptake, an atypical tracer accumulation appeared on already know pulmonary adenocarcinoma in the left lung upper lobe. Surgical pathology was reviewed confirming the diagnosis of lung adenocarcinoma with focal mucins production and excluding a misdiagnosed differentiated thyroid carcinoma metastasis.
A 76-year-old woman underwent 99mTcO4- thyroid scintigraphy to clarify thyrotoxicosis. In addition to suppressed thyroid uptake, an atypical tracer accumulation appeared on already know pulmonary adenocarcinoma in the left lung upper lobe. Surgical pathology was reviewed confirming the diagnosis of lung adenocarcinoma with focal mucins production and excluding a misdiagnosed differentiated thyroid carcinoma metastasis.
Bone is one of the most common sites of prostate cancer recurrence, and 68Ga-prostate-specific membrane antigen (PSMA) uptake by benign bone entities poses a diagnostic dilemma. We describe the case of a 60-year-old man with recurrence in a small presacral node on 68Ga-PSMA PET/CT. Of note, the images also demonstrated bilateral asymmetrical sacroiliac joint uptake. A history of ankylosing spondylitis was subsequently elicited, confirming the radiographic suspicion of sacroiliitis, therefore confirming the nonmalignant nature of 68Ga-PSMA uptake related to sacroiliitis rather than osseous recurrence from prostate carcinoma. 68Ga-PSMA uptake may indicate angioneogenesis in sacroiliitis and consequently may be helpful in assessing disease activity and therapy response.
Bone is one of the most common sites of prostate cancer recurrence, and 68Ga-prostate-specific membrane antigen (PSMA) uptake by benign bone entities poses a diagnostic dilemma. We describe the case of a 60-year-old man with recurrence in a small presacral node on 68Ga-PSMA PET/CT. Of note, the images also demonstrated bilateral asymmetrical sacroiliac joint uptake. A history of ankylosing spondylitis was subsequently elicited, confirming the radiographic suspicion of sacroiliitis, therefore confirming the nonmalignant nature of 68Ga-PSMA uptake related to sacroiliitis rather than osseous recurrence from prostate carcinoma. 68Ga-PSMA uptake may indicate angioneogenesis in sacroiliitis and consequently may be helpful in assessing disease activity and therapy response.
18F-fluciclovine is a radiolabeled synthetic amino acid recently approved by the Food and Drug Administration for evaluating recurrent prostate cancer. Upregulated amino acid transporters in prostate cancer cells result in elevated radiotracer uptake in sites of tumor recurrence. However, 18F-fluciclovine is not specific for prostate cancer. Nonprostatic malignancies and benign conditions can also demonstrate uptake. This information combined with the knowledge about common patterns of prostate cancer recurrence helps guide appropriate management. We present an 87-year-old man with biochemical recurrence for prostate cancer but found to have a urinary bladder wall mass on 18F-fluciclovine PET/CT with moderate avidity. BMS-1 inhibitor nmr Biopsy revealed papillary urothelial carcinoma.
18F-fluciclovine is a radiolabeled synthetic amino acid recently approved by the Food and Drug Administration for evaluating recurrent prostate cancer. Upregulated amino acid transporters in prostate cancer cells result in elevated radiotracer uptake in sites of tumor recurrence. However, 18F-fluciclovine is not specific for prostate cancer. Nonprostatic malignancies and benign conditions can also demonstrate uptake. This information combined with the knowledge about common patterns of prostate cancer recurrence helps guide appropriate management. We present an 87-year-old man with biochemical recurrence for prostate cancer but found to have a urinary bladder wall mass on 18F-fluciclovine PET/CT with moderate avidity. Biopsy revealed papillary urothelial carcinoma.
A 55-year-old woman underwent 18F-FDG and 68Ga-FAPI PET/CT for tumor detection and staging under the prospective study NCT04416165. Both scans showed a mass lesion with increased tracer uptake in the pancreas. Moreover, 68Ga-FAPI PET/CT showed a greater number of abnormal foci in the mesentery and omentum than that shown with 18F-FDG. These abnormal foci were suspected to be metastases from pancreatic cancer. The patient subsequently underwent a cytoreductive surgery, and postoperative histopathology confirmed the diagnosis of acinar cell carcinoma of pancreas. Follow-up 68Ga-FAPI PET/CT (3 months after surgery) showed an excellent response with decreasing 68Ga-FAPI activity in the whole abdomen.
A 55-year-old woman underwent 18F-FDG and 68Ga-FAPI PET/CT for tumor detection and staging under the prospective study NCT04416165. Both scans showed a mass lesion with increased tracer uptake in the pancreas. Moreover, 68Ga-FAPI PET/CT showed a greater number of abnormal foci in the mesentery and omentum than that shown with 18F-FDG. These abnormal foci were suspected to be metastases from pancreatic cancer. The patient subsequently underwent a cytoreductive surgery, and postoperative histopathology confirmed the diagnosis of acinar cell carcinoma of pancreas. Follow-up 68Ga-FAPI PET/CT (3 months after surgery) showed an excellent response with decreasing 68Ga-FAPI activity in the whole abdomen.
In July 2017, an 84-year-old woman was treated for grade III, RH+, HER2- infiltrative ductal carcinoma breast cancer by right mastectomy, adjuvant radiotherapy, and hormone therapy. In April 2020, moderated elevation of the CA-15.3 tumor marker was observed at 53 UI/mL (normal, <25.5 UI/mL). Clinical examination and CT TAP scan showed no argument for relapse. In August 2020, patient presented pain in her left foot. 99mTc-DPD bone scintigraphy showed multiple uptakes regarding osteolytic lesion of the left lower limb with no other pathological uptake. Echo-guided tibial biopsies confirmed breast origin adenocarcinoma, in favor of relapse of the originally treated cancer.
In July 2017, an 84-year-old woman was treated for grade III, RH+, HER2- infiltrative ductal carcinoma breast cancer by right mastectomy, adjuvant radiotherapy, and hormone therapy. In April 2020, moderated elevation of the CA-15.3 tumor marker was observed at 53 UI/mL (normal, less then 25.5 UI/mL). Clinical examination and CT TAP scan showed no argument for relapse.
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