Indian Journal of Nuclear Medicine
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   Table of Contents - Current issue
Coverpage
April-June 2019
Volume 34 | Issue 2
Page Nos. 83-181

Online since Monday, April 8, 2019

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EDITORIAL  

Ethical conundrum in nuclear medicine research in India Highly accessed article p. 83
Kanhaiyalal Agrawal, Bikash Ranjan Meher, Biswa Mohan Padhy
DOI:10.4103/ijnm.IJNM_171_18  
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COMMENTARY Top

Phase analysis: A new armamentarium in nuclear cardiology Highly accessed article p. 86
Dharmender Malik
DOI:10.4103/ijnm.IJNM_36_19  
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ORIGINAL ARTICLES Top

Equilibrium radionuclide angiography in evaluation of left ventricular mechanical dyssynchrony in patients with dilated cardiomyopathy: Comparison with electrocardiographic parameters and speckle-tracking echocardiography Highly accessed article p. 88
Abhinav Singhal, Bangkim Chandra Khangembam, Sandeep Seth, Chetan Patel
DOI:10.4103/ijnm.IJNM_165_18  
Purpose of the Study: The purpose of this study was to study the role of equilibrium radionuclide angiography (ERNA) in the assessment of left ventricular (LV) mechanical dyssynchrony in patients with dilated cardiomyopathy (DCM), by correlating the findings with electrocardiographic parameters and speckle-tracking echocardiography (STE). Methods: This was a prospective observational study. A total of 55 patients with a mean age 42.5 ± 11 years (range: 19–61 years) diagnosed with DCM underwent ERNA and echocardiography sequentially. On ERNA, phase images of LV were obtained, and standard deviation of LV mean phase angle (SD LVmPA) was derived to quantify intra-LV mechanical dyssynchrony (ILVD). Similarly, on STE, “dyssynchrony index” was calculated as the standard deviation of time-to-peak systolic circumferential strain (SDCS) of the six mid-LV segments. The cutoff values used to define mechanical dyssynchrony were SD LVmPA >13.2° (or >27.1 ms) and SDCS >74 ms on ERNA and STE, respectively. The results obtained from the two modalities were then compared. Results: Speckle-tracking analysis could be done on the echocardiographic data of only 42 patients. Paired data from ERNA and STE studies of these 42 patients (26 males and 16 females) were compared, which showed no significant difference in the detection of ILVD (P = 0.125). The two modalities showed good agreement with Cohen's kappa value of 0.78 (P < 0.0001). SD LVmPA and SDCS values showed moderately strong linear correlation (ρ = 0.69; P < 0.0001). No significant association of mechanical dyssynchrony on ERNA or STE was found with QRS duration and with the presence or absence of left bundle branch block. ILVD was also found to be negatively correlated with LV ejection fraction. Conclusion: ERNA is comparable to STE for the assessment of LV mechanical dyssynchrony.
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Unilateral graves' disease: The lesser known Highly accessed article p. 96
Ranadheer Gupta Manthri, Nimmagadda Ajit, Suresh Vaikakkara, B Vijayalakshmi Devi, Tekchand Kalawat
DOI:10.4103/ijnm.IJNM_11_19  
Background: Here, we present a retrospective study conducted from 2009 to 2018, which showed the presence of unilateral uptake of radioactive tracer on 99mTc thyroid scintigraphy scan in 15 patients with Graves' disease. Materials and Methods: All these patients had either clinical features of Graves' disease or elevated thyroid hormone levels along with ultrasonographic features, showing either normal thyroid gland or diffuse thyroiditis. The scintigraphic features revealed increased uptake in one lobe of the thyroid gland with the other lobe being normal. Results: Of the 15 patients, 13 were females and two were males. The mean age of the patients was 47 years with standard deviation of 3.4 years (range 26–70 years). Eight of the 15 patients had increased uptake on the right lobe and seven had increased uptake in the left lobe. Conclusion: This study shows that there exists an entity called unilateral Graves' disease which should be further evaluated.
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Single-photon emission computed tomography myocardial ischemia detection in high-risk asymptomatic patients: correlation with coronary calcium score and high-sensitivity C-reactive protein p. 99
Irena Mitevska, Elizabeta Srbinovska, Lily Stojanovska, Emilija Antova, Vasso Apostolopoulos, Marijan Bosevski
DOI:10.4103/ijnm.IJNM_152_18  
Background: The association between myocardial ischemia in high-risk patients with coronary calcium score (CCS) and high-sensitivity C-reactive protein (hs-CRP) is not well established. Aims: We evaluated the correlation between hs-CRP, CCS, and myocardial ischemia in asymptomatic high-risk patients without known coronary artery disease (CAD). Materials and Methods: We prospectively assessed 68 asymptomatic high-risk outpatients without known CAD. One-day rest-stress Tc-99m single-photon emission computed tomography (SPECT) myocardial perfusion imaging and multislice computed tomography were performed. Multivariate regression analysis was performed for the assessment of predictors of myocardial ischemia. Standard risk factors and hs-CRP values were analyzed. Results: CCS >0 Agatston score was observed in 26 patients (46.4%). Seven patients had CCS between 10 and 99 AU, 8 patients between 100 and 400 AU, and 11 patients had CCS >400 AU. Mild ischemia was noted in 11 patients, moderate ischemia in 10 patients, and severe ischemia in 6 patients. Hs-CRP was >1 mg/L in 39 patients, of whom 8 patients had CCS >0, 13 patients had normal SPECT results, 6 patients had mild ischemia, and 12 patients had moderate and severe ischemia. Multivariate regression analysis showed independent predictors for increased CCS: low-density lipoprotein cholesterol (odds ratio [OR]: 2.891; P = 0.001); age >70 years (OR: 2.568; P = 0.001); and smoking (OR: 1.931; P = 0.001). We found hs-CRP to be an independent predictor of myocardial ischemia (OR: 4.145; 95% confidence interval: 1.398–7.471, P = 0.001). Conclusion: hs-CRP was an independent predictor of myocardial ischemia. hs-CRP might improve the selection of high-risk asymptomatic patients for myocardial SPECT imaging.
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Tc-99m glucoheptonate single photon emission computed tomography-computed tomography for detection of recurrent glioma: A prospective comparison with N-13 ammonia positron emission tomography-computed tomography p. 107
Bangkim Chandra Khangembam, Abhinav Singhal, Rajeev Kumar, Chandrasekhar Bal
DOI:10.4103/ijnm.IJNM_164_18  
Purpose of the Study: To assess the efficacies of Tc-99m glucoheptonate single photon emission computed tomography-computed tomography (Tc-99m GHA SPECT-CT) and N-13 ammonia positron emission tomography-computed tomography (N-13 NH3PET-CT) in detecting recurrent glioma. Materials and Methods: Fifty-five consecutive, histologically proven, and previously treated glioma patients (age, 38.9 ± 12.2 years; 61.8% males) presenting with clinical suspicion of recurrence were evaluated with Tc-99m GHA SPECT-CT and N-13 NH3PET-CT. Images were evaluated both qualitatively and semiquantitatively. A combination of clinicoradiological follow-up, repeat imaging, and/or biopsy (when available) was considered as the reference standard. Results: Based on the reference standard, 28/55 (50.9%) patients had recurrence. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy of Tc-99m GHA SPECT-CT, and N-13 NH3PET-CT were 85.7%, 85.2%, 85.7%, 85.2%, 85.5% and 78.6%, 88.9%, 88.0%, 80.0%, 83.6%, respectively (concordant findings in 46 patients). The performances of the two modalities were equivalent both in overall and subgroup McNemar analyses (P = 0.508, overall; P = 0.687, low grade; P = 1.000, high grade). Conclusion: Tc-99m GHA SPECT-CT is an alternative imaging modality equally efficacious as N-13 NH3PET-CT in detecting recurrent glioma.
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Value of the postablative thyroglobulin measurements for assessment of disease-free status in patients with differentiated thyroid cancer p. 118
Nahla Dessoki, Ibrahim Nasr, Ahmed Badawy, Ismail Ali
DOI:10.4103/ijnm.IJNM_142_18  
Aim: The aim of the study is to evaluate the value of thyroid-stimulating hormone (TSH)-stimulated thyroglobulin (sTg) measurements by the end of the 1st-year postablation in differentiated thyroid cancer (DTC) patients with biochemical non complete response (indeterminate and incomplete response). Patients and Methods: One hundred patients with DTC underwent near-total thyroidectomy and radioactive remnant ablation by iodine-131 (I131) with regular follow-up every 6 months during the first 2 years and at 6–12-month intervals thereafter by I131 whole-body scan (WBS), neck ultrasound, and sTg measurement in the hypothyroid state (TSH >30 mU/L). Patients were divided according to the imaging findings and sTg level into three groups: excellent response (ER) – no evidence of disease by imaging and sTg <1 ng/mL, indeterminate or acceptable response (AR) – nonspecific findings on imaging studies and sTg < 10 ng/mL, and incomplete response (IR) – patients with incomplete structural and/or incomplete biochemical response (sTg > 10 ng/mL). Results: The follow-up at 6-month postablation showed ER in 3 (3%) patients, AR in 29 (29%) patients, and IR in 68 (68%) patients. The second follow-up at 9–12-month postablation showed dramatic biochemical response with ER, indeterminate, and IR in 50 (50%), 34 (34%), and 16 (16%) patients, respectively, and 14 (14%) patient had structural recurrence. This change is highly statistically significant (P = 0.00). In the last follow-up (ranges from 3 to 10 years), 53 (55.8%) patients achieved ER, 42 (44.2%) AR and no patient with non complete response. The change in patients with IR between the second and the last follow-up is also statistically significant (P = 0.001). Conclusion: sTg measurement by the end of the 1st year is more reliable in the follow-up of patients with DTC and biochemical non complete response and considered significant predictor of disease-free status. Patients with biochemical IR still have the chance to achieve ER or AR by the passage of time without additional therapies.
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Energy window and contrast optimization for single-photon emission computed tomography bremsstrahlung imaging with yttrium-90 p. 125
Youssef Bouzekraoui, Farida Bentayeb, Hicham Asmi, Faustino Bonutti
DOI:10.4103/ijnm.IJNM_150_18  
Purpose: In yttrium-90 (Y-90) single-photon emission computed tomography (SPECT) imaging, the choice of the acquisition energy window is not trivial, due to the continuous and broad energy distribution of the bremsstrahlung photons. In this work, we investigate the effects of the energy windows on the image contrast to noise ratio (CNR), in order to select the optimal energy window for Y-90 imaging. Materials and Methods: We used the Monte Carlo SIMIND code to simulate the Jaszczak phantom which consists of the six hot spheres filled with Y-90 and ranging from 9.5 to 31.8 mm in diameter. Siemens Symbia gamma camera fitted with a high-energy collimator was simulated. To evaluate the effect of the energy windows on the image contrast, five narrow and large energy windows were assessed. Results: The optimal energy window obtained for Y-90 bremsstrahlung SPECT imaging was 120–150 keV. Furthermore, the results obtained for CNR indicate that the high detection is only for the three large spheres. Conclusion: The optimization of energy window in Y-90 bremsstrahlung has the potential to improve the image quality.
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CASE SERIES Top

Quintessential role of 18fluorine fluorodeoxyglucose positron emission tomography/computed tomography in differentiation of viable tumor tissue and nondisease desmoplastic residue p. 129
Vatturi Venkata Satya Prabhakar Rao, Vijaya Aditya Yadaraju, Aditya Narayan, Muralidhar Bora, Praveen Adusumalli, Sweta Sinha
DOI:10.4103/ijnm.IJNM_10_19  
The authors report a series of cases of treated nodal, solid malignancies showing persisting physical residue after completion of treatment with 18-F fluorodeoxyglucose positron emission tomography-computerized tomography showing non-avid status conjuring a nondisease desmoplastic residue over morphological disease.
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CASE REPORTS Top

Papillary carcinoma thyroid metastases presenting as thyrotoxicosis post thyroidectomy - A case report p. 134
Kanala Sai Krishnaja, Ramya Priya Rallapeta, Mehabunnisa Shaik, Ranadheer Manthri, Suresh Vaikkakara, TC Kalawat
DOI:10.4103/ijnm.IJNM_128_18  
Thyrotoxicosis can occur in the setting of differentiated thyroid cancer due to functioning metastases. Here, we report a case of a 63 year old woman with papillary carcinoma thyroid who underwent total thyroidectomy and defaulted for further scheduled treatment with high dose radioactive iodine therapy. 2 years after total thyroidectomy, she presented with signs and symptoms of thyrotoxicosis and a scalp swelling on the right side of frontal region. Excision biopsy revealed metastatic deposits of papillary carcinoma thyroid. Even after withdrawal of thyroxine, her serum thyrotropin did not rise and thyroglobulin levels were high, raising the suspicion of high volume tumour burden. I-131 whole body scan was done and it revealed radio iodine avid cervical lymph nodes along with functioning lung and skeletal metastases.
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Edge packing artifact mimicking lytic–sclerotic lesion in bone scan due to spontaneous malfunction of photomultiplier tubes in the gamma camera p. 137
Amit Nautiyal, Deepanjan Mitra, Anirban Mukherjee, Piyali Chatterjee, Anindya Roy
DOI:10.4103/ijnm.IJNM_168_18  
Edge packing is a kind of nonuniformity artifact, which usually appears as an accumulation of counts at the edge of the field of view compared to the central region. The common causes of edge packing artifact in the image are defective collimator, noncalibrated photomultiplier tube (PMT), and improper adjustment of deflector plates of CRT. We hereby discuss the occurrence of edge packing artifact due to a problem with the PMTs in the anterior head of gamma camera system during acquisition of bone scintigraphy which mimics as pathological lytic–sclerotic lesion during whole-body image at anterior acquisition. The artifact was successfully removed after the replacement of malfunctioning PMTs.
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Utility of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography in the detection of primary colonic malignancy presenting as an inguinoscrotal hernia p. 140
Anitha Mandava, Veeraiah Koppula, Zakir Ali Abubakar
DOI:10.4103/ijnm.IJNM_149_18  
Carcinoma of the sigmoid colon presenting in an inguinoscrotal hernia is uncommon. Many of the cases seen in literature were diagnosed only intraoperatively, as most of them had misleading presentations. We report a case of carcinoma of the sigmoid colon in an incarcerated inguinoscrotal hernia with imaging findings of 18F-FDG PET/CT along with a brief review of the literature.
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Osteoid osteoma of distal fibula: A rare location and its management p. 143
Saurav Narayan Nanda, Kanhaiyalal Agrawal, Sandeep Velagada, Sujit Kumar Tripathy
DOI:10.4103/ijnm.IJNM_146_18  
Osteoid osteoma (OO) of distal fibula is extremely rare, and only few cases are reported in the literature. We report a case of OO of distal fibula and its surgical management at our tertiary care hospital.
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Peritoneal lymphomatosis mimicking peritoneal carcinomatosis from ovarian malignancy on F-18 fluorodeoxyglucose positron emission tomography/computed tomography p. 147
Raja Senthil, Vadavattathu Padmanabhan Gangadharan, Arun Ramachandran Nair Visakh, Pushpa Mahadevan, Thara Pratap
DOI:10.4103/ijnm.IJNM_39_19  
Peritoneal lymphomatosis is relatively uncommon cause of diffuse malignant peritoneal disease, and differentiating it from other causes of diffuse peritoneal disease such as peritoneal carcinomatosis is often difficult on imaging. Common findings observed in peritoneal lymphomatosis in contrast to other etiologies include frequent nodal involvement and splenomegaly. We present a case of diffuse peritoneal disease along with ovarian lesions in the absence of abdominal lymphadenopathy or splenomegaly on fluorodeoxyglucose positron emission tomography–computed tomography in the setting of elevated cancer antigen-125 levels, mimicking primary ovarian malignancy causing peritoneal carcinomatosis, which was finally proven to be lymphoma.
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Advantages of the 99mTc-sestamibi single-photon emission computed tomography/computed tomography in occult parathyroid adenoma and concomitant thyroid papillary carcinoma p. 150
Enrique Cadena-Pineros, Carmen Amelia De Los Reyes, Augusto Llamas-Olier, Alfredo Ernesto Romero-Rojas
DOI:10.4103/ijnm.IJNM_28_19  
Hyperparathyroidism and concurrent thyroid nodular disease are prominent. In contrast, concomitant papillary thyroid cancer and hyperparathyroidism are uncommon (1%–2%). Parathyroid adenomas in unusual locations are difficult to detect by conventional diagnostic imaging. 99mTc-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) has increased the localizing success rate of these lesions since it provides specific functional and anatomical information, improving exploratory parathyroid surgery planning and decreasing operative time, unnecessary dissections, complications, and morbidity. We confirmed its usefulness in a patient with an occult parathyroid adenoma that was clearly identified by 99mTc-sestamibi SPECT/CT 2 weeks after a thyroidectomy for papillary carcinoma. The SPECT/CT results allowed us to successfully perform efficient reexploration of the thyroid bed, in a retroesophageal parathyroid adenoma by minimally invasive surgery.
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18F-fluorodeoxyglucose positron emission tomography/computed tomography in the assessment of occult involvement in widespread granulomatosis with polyangiitis (Wegener's granulomatosis) p. 153
Hussein Rabie Saleh Farghaly, Abdullah Othman Alqarni, Hatem Ahmed Nasr
DOI:10.4103/ijnm.IJNM_151_18  
Granulomatosis with polyangiitis (GPA) can be classified as classic triad of organ involvement consisting of lungs, upper respiratory tract/sinuses, and kidneys; limited which is not having the full triad; or widespread with additional organ involvement for example prostate, spleen, skin, eyes or peripheral nervous system and occasionally other organs. GPA is associated with increased 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT). PET/CT has the advantages of whole-body imaging and detecting metabolic abnormality before structural changes. FDG PET/CT is used to assess the extent of the disease in GPA and can detect site of occult disease involvement where there are metabolic evidence of defined organ involvement with no CT or clinical evidence. This may result in upgrading of the disease from limited to classic triad or from classic triad to widespread.
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TECHNICAL NOTE Top

Optimization of radiation exposure in 18F-sodium fluoride positron emission tomography-computed tomography in bone imaging: Quo vadis p. 157
Rashid Rasheed, Sharjeel Usmani, Syed Ali Raza Naqvi, Fareeda Alkandari, Fahad A Marafi, Saqib Rasheed
DOI:10.4103/ijnm.IJNM_143_18  
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INTERESTING IMAGES Top

18F-fludeoxyglucose positron-emission tomography/computed tomography in encephalocraniocutaneous lipomatosis/haberland syndrome p. 160
Sarthak Tripathy, Madhavi Tripathi, Manjari Tripathi, Nishikant Avinash Damle, Chandrasekhar Bal
DOI:10.4103/ijnm.IJNM_160_18  
Encephalocraniocutaneous lipomatosis (ECCL) is a rare disorder and its clinical presentation constitutes a classic triad of the skin, ocular, and central nervous system involvement. We discuss the 18F-fludeoxyglucose positron-emission tomography/computed tomography findings of an 11-year-old boy with ECCL and drug refractory epilepsy.
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Incidental detection of endometriosis with 18F-fluorodeoxyglucose positron emission tomography-computed tomography in a patient with cervical intraepithelial neoplasia and adenomyosis p. 162
Alex Cheen Hoe Khoo, Ghee Kheng Chew
DOI:10.4103/ijnm.IJNM_27_19  
Endometriosis is commonly associated with chronic pelvic pain and its presentation varies between individuals. The only way to confirm the presence of endometriosis is via keyhole or open surgery. In the presence of hematuria, deep endometriotic infiltration needs to be considered. We share an interesting case highlighting the role of 18F-fluorodeoxyglucose positron emission tomography-computed tomography in evaluating a posterior urinary bladder wall lesion and hypodense liver lesions in a middle-aged woman with presenting with frank hematuria in the background of treated cervical intraepithelial neoplasia and adenomyosis.
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Single photon emission computed tomography/computed tomography detects a second ignored intrathyroidal parathyroid adenoma p. 164
Enrique Cadena-Pineros, Alfredo Romero-Rojas, Dora Romero
DOI:10.4103/ijnm.IJNM_22_19  
The primary hyperparathyroidism (PHPT) is a result of high levels of parathyroid hormone and serum calcium, the most frequent cause is a solitary parathyroid adenoma. Double parathyroid adenoma is <5% of the PHPT. Intrathyroidal parathyroid adenoma (IPA) occurs<3.2%. We present a case of 58-year-old female with persistent primary hyperparathyroidism due to a second undetected IPA, suspected by ultrasound and confirmed by 99mTc sestamibi single-photon emission computed tomography/computed tomography.
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The reperfusion of ischemic vasculitis in a patient with neuropsychiatric lupus: A serial single-photon emission computed tomography study p. 167
Ana Carolina Trevisan, Paulo Louzada, Felipe Arriva Pitella, Mery Kato, Antonio Carlos Santos, Lauro Wichert-Ana
DOI:10.4103/ijnm.IJNM_135_18  
We report a 44-year-old female patient diagnosed with neuropsychiatric systemic lupus erythematosus and probable ischemia secondary to vasculitis in the speech motor region (Broca's area). After corticosteroid treatment, the patient recovered the speech, presented clinical improvement, and SISCOM showed reperfusion of the ischemic area (luxury perfusion).
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Rare presentation of metastatic endometrioid adenocarcinoma of uterus mimicking as second primary in urinary bladder on 18F-fluorodeoxyglucose positron-emission tomography/computed tomography p. 169
Abhishek Sharma, Shelvin Kumar Vadi, Ashwani Sood, Uttam Kumar Mete, Nandita Kakkar, Rakesh Kumar Vashishta, Bhagwant Rai Mittal
DOI:10.4103/ijnm.IJNM_16_19  
We present a case of endometrioid carcinoma metastasis in the bladder mimicking as the second primary of urinary bladder on 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT). The presentations of bladder lesions on 18F-FDG PET/CT are varied, and rare presentations of common malignancies can pose a significant diagnostic challenge as in the index case and highlight the importance of histopathological examination to confirm any unusual FDG uptake confounding the diagnosis.
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Castleman disease masquerading as the posterior mediastinal mass on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography p. 171
Vanshika Gupta, Ritu Verma, Dharmender Malik, Ethel Shangne Belho, Sunila Jain, Harsh Mahajan
DOI:10.4103/ijnm.IJNM_1_19  
A 28-year-old female presented with an incidentally detected mediastinal mass, found on routine chest X-ray. 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) was advised to plan course of further management. FDG-PET/CT findings were suggestive of an FDG-avid soft-tissue mass in the left posterior mediastinum in paravertebral location with left pleural effusion. Overall, PET/CT scan findings favored the possibility of a nerve sheath tumor. However, histopathology along with immunohistochemistry confirmed the diagnosis of Castleman disease.
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Immune checkpoint inhibitors (Nivolumab)-induced enterocolitis demonstrated on 18Fluorine-fluorodeoxyglucose positron emission tomography-computed tomography p. 173
Sharjeel Usmani, Rashid Rasheed, Fahad Marafi, Fareeda Al Kandari
DOI:10.4103/ijnm.IJNM_141_18  
Nivolumab, an immune checkpoint inhibitor, is a humanized anti-programmed death-1 monoclonal antibody that is used for the treatment of various cancers after second-line chemotherapy. We report a 23-year-old male with relapsed Hodgkin's lymphoma Stage IV treated with nivolumab. After 3 months of treatment, he developed watery diarrhea and cramping abdominal pain. Follow-up positron emission tomography-computed tomography scan showed complete metabolic resolution of the disease; however, there is bowel wall thickening and colonic distension with corresponding increased fluorodeoxyglucose uptake. These findings are related to immune-related adverse event associated with nivolumab treatment, i.e., secondary enterocolitis. These adverse events can be successfully treated if timely and appropriately diagnosed.
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LETTERS TO THE EDITOR Top

Oral administration of 18F-fluorodeoxyglucose as a possible and acceptable alternative route in patients with difficult intravenous access p. 176
Avinash Tupalli, Nalli N Harish, Arunav Kumar, Arunraj Sreedharan Thankarajan, Madhavi Tripathi, Bal Chandrasekhar
DOI:10.4103/ijnm.IJNM_17_19  
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Utility of F-18 fluorodeoxyglucose positron emission tomography-computed tomography in a patient presenting with acute paraparesis in detecting isolated relapse of non-Hodgkin's lymphoma infiltrating the spinal cord p. 178
Tarun Kumar Jain, Apurva Sood, Ashwani Sood, Rajender Kumar Basher, Gaurav Prakash, Mahesh Prakash, Bhagwant Rai Mittal
DOI:10.4103/ijnm.IJNM_23_19  
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BOOK REVIEW Top

Basic physics and radiation safety in nuclear medicine p. 180
Bhagwant Rai Mittal, Ashwin Singh Parihar
DOI:10.4103/ijnm.IJNM_47_19  
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