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18F-DOPA PET/CT was performed to evaluate congenital hyperinsulinism in a 55-day-old boy with hypoglycemia. The images revealed not only a focal 18F-DOPA–avid lesion in the pancreas but also in a left thoracic paraspinal neuroblastoma.
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The gallbladder is generally located at the anterolaterally situated gallbladder fossa on the undersurface of the liver, whereas choledochal cyst, as a dilation of the common bile duct, is located more posteromedially. We reported an... more
The gallbladder is generally located at the anterolaterally situated gallbladder fossa on the undersurface of the liver, whereas choledochal cyst, as a dilation of the common bile duct, is located more posteromedially. We reported an ectopically located gallbladder, which appeared to be a choledochal cyst on hepatobiliary scintigraphy in a 10-year-old girl.
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An I-MIBG scan was obtained to evaluate a right adrenal mass in a 10-year-old boy, which showed no elevated activity in the lesion. However, diffuse increased activity was noted in the right forearm with typical manifestation of an... more
An I-MIBG scan was obtained to evaluate a right adrenal mass in a 10-year-old boy, which showed no elevated activity in the lesion. However, diffuse increased activity was noted in the right forearm with typical manifestation of an "arterial injection." Different from a prior case report, no symptoms or signs related to arterial injection were observed in our patient.
Research Interests: Medicine, Humans, Child, Male, Clinical Sciences, and 4 moreLesion, Injections, Forearm, and Arteries
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Adjuvant and neoadjuvant chemotherapy has altered the metastatic pattern of osteosarcoma. Overwhelming majority of the metastases from osteosarcoma are to the lungs and to the bones. Uncommon metastases to other sites can occur but... more
Adjuvant and neoadjuvant chemotherapy has altered the metastatic pattern of osteosarcoma. Overwhelming majority of the metastases from osteosarcoma are to the lungs and to the bones. Uncommon metastases to other sites can occur but usually accompany pulmonary and skeletal metastases. Here, we describe an asymptotic 14-year-old boy with solitary retroperitoneal metastasis as the initial relapse of osteosarcoma revealed by FDG PET/CT.
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Sentinel node localization is the second most important development in this century after conservative lumpectomy for the treatment of early breast cancer. The sentinel node mapping is a new multidisciplinary approach for staging of... more
Sentinel node localization is the second most important development in this century after conservative lumpectomy for the treatment of early breast cancer. The sentinel node mapping is a new multidisciplinary approach for staging of axilla in an accurate and less morbid way as compared to axillary node dissection. Sentinel lymph node biopsy in patients with breast cancer has been adopted rapidly into clinical practice. The accuracy of sentinel lymph node biopsy is more than 95%, when performed meticulously (by an experienced multidisciplinary team) with proper patient selection. Sentinel lymph node biopsy is most widely used for both palpable and non-palpable T1 and T2 tumors. Recent studies show application of sentinel lymph node technique in patients with locally advanced breast cancer and after neoadjuvant chemotherapy. Therefore, sentinel lymph node biopsy technique has application in developing countries and other countries where screening for breast cancer is not common and mo...
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Radiotracers used in renal scintigraphy, such as Tc-99mlabeled mercaptoacetyltriglycine (MAG3) or diethylenetriaminepentaacetic acid (DTPA), are not known to be able to accumulate in the spleen. However, for some less experienced readers,... more
Radiotracers used in renal scintigraphy, such as Tc-99mlabeled mercaptoacetyltriglycine (MAG3) or diethylenetriaminepentaacetic acid (DTPA), are not known to be able to accumulate in the spleen. However, for some less experienced readers, radioactivity of unsuspected free Tc-99m pertechenate in the stomach can easily be confused to be in the spleen in posterior views which are used to acquire renal images. We report here such cases.
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Neuroblastoma is among the most common extracranial solid tumors in pediatric patients and typically arises anywhere from the neck to pelvis but most commonly in the adrenal glands. It is extremely rare for a patient to have extensive... more
Neuroblastoma is among the most common extracranial solid tumors in pediatric patients and typically arises anywhere from the neck to pelvis but most commonly in the adrenal glands. It is extremely rare for a patient to have extensive metastases from neuroblastoma without primary tumor being identified. We present a 3-year-old with widespread bone and bone marrow involvement of the disease revealed on both FDG PET/CT and MIBG scan, which was pathologically proven as neuroblastoma. However, extensive imaging did not detect primary tumor anywhere.
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Intensive immunosuppressive regimens effectively reduce acute or chronic rejection in transplant patients, while these regimens can result in long term side-effects such as viral infection, fever, secondary tumor(s) etc. Our aim was to... more
Intensive immunosuppressive regimens effectively reduce acute or chronic rejection in transplant patients, while these regimens can result in long term side-effects such as viral infection, fever, secondary tumor(s) etc. Our aim was to evaluate the role of 18-fluoro-2-deoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in pediatric transplant patients. Forty one (18)F-FDG PET/CT scans in 18 patients before or after transplantation were analyzed retrospectively. One patient had PET/CT scan prior to transplantation. Seventeen patients had PET/CT scan(s) following transplantation. The PET/CT scan was used to evaluate the therapy response of post transplant lymphoproliferative disorder (PTLD) in 11 patients, establish the cause of fever of unknown origin (FUO) in 5 patients, and restage in 2 patients. PET/CT scan showed development in 3 PTLD patients, improvement in 4 PTLD patients, development and improvement in 1 PTLD patient, new lesions in 1 PTLD patient...
Research Interests: Treatment Outcome, Adolescent, Medicine, Transplantation, Humans, and 13 moreChild, Female, Male, Fever of Unknown Origin, Differential Diagnosis, Multimodal imaging, Retrospective Studies, Reproducibility of Results, Radiopharmaceuticals, Sensitivity and Specificity, X ray Computed Tomography, Child preschool, and Lymphoproliferative disorders
Objective: 131 I has some certain disadvantages such as stunning effect and suboptimal image quality for diagnostic imaging. Using 123 I for diagnostic whole-body scanning avoids the risk of stunning for subsequent radioiodine treatment... more
Objective: 131 I has some certain disadvantages such as stunning effect and suboptimal image quality for diagnostic imaging. Using 123 I for diagnostic whole-body scanning avoids the risk of stunning for subsequent radioiodine treatment and affords an excellent image ...
Both gastroesophageal reflux (GER) scintigraphy and radionuclide salivagram are commonly used in the detection of pulmonary aspiration in pediatric patients. This investigation is to compare the diagnostic value of these 2 imaging... more
Both gastroesophageal reflux (GER) scintigraphy and radionuclide salivagram are commonly used in the detection of pulmonary aspiration in pediatric patients. This investigation is to compare the diagnostic value of these 2 imaging methods. This retrospective study included 4186 pediatric patients (aged 1 week to 16 years; mean age, 28 months) who underwent a GER scintigraphy and/or radionuclide salivagram. Detection rate of pulmonary aspiration by the 2 imaging techniques was compared. The detection rate for pulmonary aspiration in patients undergoing both procedures was 1.9% (5 of 266) for GER scintigraphy and 22.2% (59 of 266) for radionuclide salivagram. Fifty-six of 59 patients with proven aspiration on radionuclide salivagram demonstrated no such findings on GER scintigraphy, whereas 2 of 5 patients with proven aspiration on GER scintigraphy demonstrated no such findings on radionuclide salivagram. In patients who underwent only 1 procedure (either GER scintigraphy or salivagra...
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FDG PET/CT imaging guidelines require avoiding exercise 24 hours before FDG administration. We report here a case of intense skeletal muscle FDG activity in a 15-year-old adolescent boy who had vigorous exercise 4 days before undertaking... more
FDG PET/CT imaging guidelines require avoiding exercise 24 hours before FDG administration. We report here a case of intense skeletal muscle FDG activity in a 15-year-old adolescent boy who had vigorous exercise 4 days before undertaking FDG PET/CT scan.
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The aim of this study was to describe osseous metabolic activity with respect to age and weight in the spine as expressed through fluorine-18-sodium fluoride (F-NaF) uptake in a healthy male population. Whole-body F-NaF PET/CT scans of... more
The aim of this study was to describe osseous metabolic activity with respect to age and weight in the spine as expressed through fluorine-18-sodium fluoride (F-NaF) uptake in a healthy male population. Whole-body F-NaF PET/CT scans of healthy male participants (22-71 years, 50-145 kg, n=47) were analysed using a global assessment methodology to derive the mean standardized uptake values (SUVmean). Individual regions of the spine (cervical, thoracic and lumbar) along with the aggregate whole spine were assessed and compared as potential functions of age and body weight. Older participants did not have higher F-NaF uptake than younger participants (whole spine, P=0.93; cervical, P=0.12, thoracic, P=0.93; lumbar, P=0.42), whereas increasing body weight was associated with greater tracer uptake (whole spine P=0.003; cervical P=0.01; thoracic P=0.002; lumbar P=0.004). Both the thoracic (average SUVmean=4.864±1.338) and lumbar (average SUVmean=4.939±1.284) spines had significantly elevat...
Research Interests: Spine, Nuclear medicine, Medicine, Humans, Male, and 6 moreYoung Adult, Clinical Sciences, Aged, Middle Aged, Adult, and Sodium Fluoride
Planar whole-body imaging with I-radiolabeled metaiodobenzylguanidine (I-MIBG) is routinely used in the follow-up evaluation of neuroblastoma. In recent years, SPECT with integrated low-dose CT (SPECT/CT) has become more accessible. We... more
Planar whole-body imaging with I-radiolabeled metaiodobenzylguanidine (I-MIBG) is routinely used in the follow-up evaluation of neuroblastoma. In recent years, SPECT with integrated low-dose CT (SPECT/CT) has become more accessible. We investigated how much SPECT/CT can have additional diagnostic value over planar imaging in detection of residual and recurrent neuroblastoma. A total of 170 planar I-MIBG imaging scans with SPECT/CT follow-up scans performed in 147 patients with known high-risk neuroblastoma were retrospectively analyzed. Regions of increased I-MIBG uptake on planar images and the findings on SPECT/CT were compared. In 61% of the studies, the whole-body planar images and SPECT/CT images yielded the same result. In 39% of the time, however, SPECT/CT images provided additional information. In the follow-up of patients with high-risk neuroblastoma, SPECT/CT can significantly improve planar imaging interpretation and impact patient management.
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ABSTRACT
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ABSTRACT Patients with bladder cancer have a significantly higher likelihood of having a metachronous second primary malignancy. A 72-year-old man with a history of bladder cancer underwent FDG PET/CT scan to evaluate possible pulmonary... more
ABSTRACT Patients with bladder cancer have a significantly higher likelihood of having a metachronous second primary malignancy. A 72-year-old man with a history of bladder cancer underwent FDG PET/CT scan to evaluate possible pulmonary metastases. The PET/CT images demonstrated that there were metabolically active lung nodules which were consistent with malignancy. In addition, foci of hypermetabolism were noted in the liver, the left adrenal gland and the ascending and descending colon. Histopathological examination demonstrated that the foci of abnormal FDG activity in the colon were due to 2 distinct primary colon cancers. Due to the higher prevalence of a metachronous second primary tumor in patients with bladder cancer, caution is warranted in interpreting possible metastatic lesions on FDG PET/CT imaging in this clinical setting.
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Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled vocabulary for indexing life sciences content.< br/> Note that... more
Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled vocabulary for indexing life sciences content.< br/> Note that some records do not have MeSH. These include Patents and the latest PubMed and PubMed Central records.
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Research Interests: Biomedical Engineering, Macrophages, Platelet, Controlled release, Liver, and 15 moreAnimals, Male, Nanotubes, Colloids, Drug Delivery Systems, Gelatin, Rat, Drug Carriers, Excipients, Platelet Count, Isotope Labeling, Mononuclear Phagocyte System, Immunosuppressive Agents, Phytic acid, and Pharmacology and pharmaceutical sciences
PURPOSE Although positron emission tomography (PET) of the brain has been successfully used in adults, the experience in the pediatric population is limited. The objective of this study was to determine the role of FDG-PET in detecting... more
PURPOSE Although positron emission tomography (PET) of the brain has been successfully used in adults, the experience in the pediatric population is limited. The objective of this study was to determine the role of FDG-PET in detecting residual disease or tumor recurrence after surgery and/or radiation therapy in pediatric population. METHOD AND MATERIALS Seventy one patients (42 male, 29 female; mean age 12 ±3 years, range 3-18 years) who had surgery and/or radiation therapy were recruited to this study. PET images were acquired with a dedicated brain PET scanner (G-PET) after the intravenous administration of 130 µCi/Kg of 18F-FDG. The PET study was considered positive when the uptake of FDG was higher than that of the adjacent brain tissues. Clinical outcome and follow-up were considered as the gold standard. RESULTS Positive findings were observed in 40 patients, while an absence of disease activity was reported in 31 patients. The number of true positives, true negatives, false...
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Diffuse and uniform FDG uptake in the ribs and the intercostal muscles might appear similar on FDG-PET images and a reliable differentiation between the two is important for accurately identifying the underlying process. The former... more
Diffuse and uniform FDG uptake in the ribs and the intercostal muscles might appear similar on FDG-PET images and a reliable differentiation between the two is important for accurately identifying the underlying process. The former usually suggests excessive contraction of intercostal muscles mostly due to chronic obstructive pulmonary disease, whereas the latter signifies either bone marrow stimulation or involvement by a pathologic process. At times, images may appear confusing and may be misinterpreted. However, in both clinical settings, there are additional ancillary signs, which are helpful in making a correct diagnosis. We herein present 2 case vignettes from each category in which other ancillary signs helped to distinguish FDG rib uptake from intercostal muscle uptake.
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An imbalance in bone remodeling results in many metabolic bone diseases, such as osteoporosis. fluorine-18 sodium fluoride PET imaging allows the assessment of bone remodeling process in a anatomy specific manner. On the other hand... more
An imbalance in bone remodeling results in many metabolic bone diseases, such as osteoporosis. fluorine-18 sodium fluoride PET imaging allows the assessment of bone remodeling process in a anatomy specific manner. On the other hand structural imaging modalities such as MRI can now generate high resolution images of bone including the trabecular and cortical microstructure. Molecular (functional) imaging with PET in conjunction with structural imaging has the potential to improve the way metabolic bone diseases are managed in the clinic.
ABSTRACT It is well known that bone marrow stimulants such as granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) can cause diffuse and increased FDG accumulation in bone marrow on... more
ABSTRACT It is well known that bone marrow stimulants such as granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) can cause diffuse and increased FDG accumulation in bone marrow on positron emission tomography (PET) imaging. Therefore, diffuse bone marrow FDG uptake is commonly attributable to the effect of hematopoietic cytokines. However, diffuse bone marrow FDG uptake can also be caused by other etiologies. We report a patient with chronic myeloid leukemia who had images similar to hematopoietic cytokine-mediated FDG bone marrow uptake.
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