Indian Journal of Nuclear Medicine
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   2017| April-June  | Volume 32 | Issue 2  
    Online since March 16, 2017

 
 
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ORIGINAL ARTICLES
Clinical utility of gallium-68 PSMA PET/CT scan for prostate cancer
Kumaraswamy G Kallur, Prashanth G Ramachandra, Krishnappa Rajkumar, Shivakumar S Swamy, Indiresh Desai, Raghavendra M Rao, Shekhar Gowda Patil, PS Sridhar, Nagaraj Madhusudhan, Raghunath S Krishnappa, Veerendra Bhadrasetty, Hemantha M Kumara, SD Santhosh, Basavalingaiah S Ajaikumar
April-June 2017, 32(2):110-117
DOI:10.4103/0972-3919.202255  PMID:28533638
Background: Prostate cancer is biologically and clinically a heterogeneous disease that makes imaging evaluation challenging. One of the important challenges in this cancer is to detect recurrent disease. Biochemical response using Prostate Specific Antigen (PSA) and Imaging using several PET tracers have poor sensitivity and specificity. Therefore, we analyse the role of Ga68-PSMA (Prostate Specific Membrane Antigen) imaging in prostate cancer, which is a new PET tracer. Methods: In this study, we evaluated PET scans of 262 patients with diagnosis of prostate cancer. These patients were scanned using Ga68-PSMA for either staging or response evaluation. Results: 336 PSMA scans were performed. Ga68-PSMA scan resulted in the detection of extra-prostatic disease in 53.2% of cases when done at baseline before commencing any treatment. The sensitivity of Ga68-PSMA at baseline with histopathological diagnosis was 95% with 95% CI ranging from 86% to 98%. The positive predictive value was high at 98% with 95% CI ranging from 91% to 99%. In 26 (10%) patients who had surgical castration, Ga68-PSMA scan was able to detect disease progression / castration resistance in 100% of cases. The outcome of castration-resistant prostate cancer was compared with other cases where castration was not done. In those who did not undergo castration, there was a significantly better response by hormone therapy (p = 0.03) and radiotherapy (p = 0.01) on Ga68-PSMA. The sensitivity of Ga68-PSMA response with biochemical response was 66.7% with 95% CI ranging between 46 %- 82.7%. Ga68-PSMA response did not correlate with biochemical response. Conclusion: Ga68-PSMA has good sensitivity for diagnosis, staging, restaging, evaluation of therapy response and prognostication in prostate cancer.
  3,706 545 -
Estimation of whole body radiation exposure to nuclear medicine personnel during synthesis of 177lutetium-labeled radiopharmaceuticals
Geetanjali Arora, Rajesh Mishra, Praveen Kumar, Madhav Yadav, Sanjana Ballal, Chandrasekhar Bal, Nishikant Avinash Damle
April-June 2017, 32(2):89-92
DOI:10.4103/0972-3919.202245  PMID:28533634
Purpose of the Study: With rapid development in the field of nuclear medicine therapy, radiation safety of the personnel involved in synthesis of radiopharmaceuticals has become imperative. Few studies have been done on estimating the radiation exposure of personnel involved in the radio labeling of 177Lu-compounds in western countries. However, data from the Indian subcontinent are limited. We have estimated whole body radiation exposure to the radiopharmacist involved in the labeling of: 177Lu-DOTATATE, 177Lu-PSMA-617, and 177Lu-EDTMP. Materials and Methods: Background radiation was measured by keeping a pocket dosimeter around the workbench when no radioactive work was conducted. The same pocket dosimeter was given to the radiopharmacist performing the labeling of 177Lu-compounds. All radiopharmaceuticals were synthesized by the same radiopharmacist with 3, 1 and 3 year experience, respectively, in radiolabeling the above compounds. Results: One Curie (1 Ci) of 177Lu was received fortnightly by our department. Data were collected for 12 syntheses of 177Lu-DOTATATE, 8 syntheses of 177Lu-PSMA-617, and 3 syntheses of 177Lu-EDTMP. Mean time required to complete the synthesis was 0.81, 0.65, and 0.58 h, respectively. Mean whole body radiation exposure was 0.023 ± 0.01 mSv, 0.01 ± 0.002 mSv, and 0.002 ± 0.0006 mSv, respectively. Overall mean radiation dose for all the three 177Lu-compounds was 0.014 mSv. Highest exposure was obtained during the synthesis of 177Lu-DOTATATE. Conclusion: Our data suggest that the manual radiolabeling of 177Lu compounds is safe, and the whole body radiation exposure to the involved personnel is well within prescribed limits.
  1,163 169 -
Comparison of SPECT/CT and planar lympho-scintigraphy in sentinel node biopsies of oral cavity squamous cell carcinomas
Piyush Chandra, Sanket Dhake, Sneha Shah, Archi Agrawal, Nilendu Purandare, Venkatesh Rangarajan
April-June 2017, 32(2):98-102
DOI:10.4103/0972-3919.202244  PMID:28533636
Introduction: Evidence supporting the use of Sentinel node biopsy (SNB) for nodal staging of early oral squamous cell carcinomas (OSCC) appears to be very promising. Pre-operative lymphatic mapping using planar lymphoscinitigraphy (PL) with or without SPECT/CT in the SNB procedure is useful in sentinel node localization and for planning appropriate surgery. Recently, a large prospective multi-centric study evaluating SNB in cutaneous melanoma, breast and pelvic malignancies, demonstrated that adding SPECT to PL leads to surgical adjustments in a considerable number of patients. Our aim of this study was to evaluate the incremental value of additional SPECT/CT over PL alone in SNB for OSCC. Materials and Methods: This was a retrospective analysis of 44 patients (40- tongue, 4- buccal mucosa) with T1-T2, clinically N0 oral cavity SCC who underwent sentinel node biopsy procedure. PL and SPECT lymphoscinitigraphy images were compared for pre-operative mapping of sentinel nodes. Results: Using a handheld gamma probe, a total of 179 sentinel nodes were harvested, with a mean of 4.06 per patient. PL revealed 75 hotspots with a mean of 1.70 per patient, and SPECT/CT revealed 92 hotspots with a mean of 2.09 per patient. Additional hotpots were identified in 14 patients on SPECT/CT, which included 4 patients, where PL did not detect any sentinel nodes. Conclusion: Pre-operative SPECT/CT in addition to planar lympho-scinitigraphy in sentinel node biopsies of oral cavity SCC detects more number of sentinel nodes compared to planar imaging alone. The higher sensitivity of SPECT combined with better anatomical localization using diagnostic CT may further improve the precision of SNB procedure.
  1,032 160 -
Tc-99m ethylenedicysteine and Tc-99m dimercaptosuccinic acid scintigraphy-comparison of the two for detection of scarring and differential cortical function
Anitha Dharmalingam, Shwetal U Pawar, Sandesh V Parelkar, Suruchi S Shetye, Mangala K Ghorpade, Gundu H Tilve
April-June 2017, 32(2):93-97
DOI:10.4103/0972-3919.202240  PMID:28533635
Context: The differential cortical function obtained by Tc-99m EC is comparable to that of Tc-99m DMSA. However, identification of scars on Tc-99m EC images needs to be studied. Aims: The aim of the study is to evaluate role of Tc-99m EC for detection of scarring and differential cortical function by comparing with Tc-99m DMSA. Settings and Design: Prospective observational study of recurrent UTI; minimum 6 weeks after acute episode; when urine examination is negative for pus cells. Materials and Methods: Forty-seven children with normal positioned kidneys underwent Tc-99m EC and DMSA scintigraphy. The DRF and cortical phase images of both studies in the same image matrix size were evaluated by two independent observers for scarring; Tc-99m DMSA was considered as the gold standard. Statistical analysis used: MS Excel 2007 and GraphPad Instat V3.1 and ROC analysis. Results: There was no significant difference in the detection of scarring using two studies with Cohen’s kappa coefficient (κ) 0.932. The sensitivity and specificity of Tc-99m EC for detection of scarring was 98.75% and 99.15%, respectively. There was good agreement between the differential cortical function calculated using two studies. Conclusions: The summed Tc-99m EC images with an acceptable high image contrast allow detection of cortical scarring in patients with normal kidney positions. It is an excellent single-modality comprehensive investigational agent for renal parenchymal defects, function, and excretion evaluation with the added advantages of lower cost, convenience, and low radiation exposure to the child.
  984 160 -
CASE REPORTS
Hepatic pseudolesion in SVC obstruction - 99mtechnetium sulfur colloid scan equivalent of quadrate lobe hot spot sign on computerized tomography
Reddy Ravikanth, Arun George, Babu Philip
April-June 2017, 32(2):128-129
DOI:10.4103/0972-3919.202249  PMID:28533642
An area of increased activity in segment IV of liver (quadrate lobe) on 99mTc-sulfur colloid (TSC) scans has been well documented in patients with superior vena cava obstruction. Similarly intense enhancement of the quadrate lobe in the arterial phase may be seen on computed tomography in patients of superior vena cava syndrome. We present this imaging finding in a case of malignant thymoma causing superior vena cava syndrome and discuss the physiological cause and importance of this sign.
  1,012 99 -
Image findings of rare case of peritoneal carcinomatosis from non small cell lung cancer and response to erlotinib in F-18 FDG positron emission tomography/computed tomography
Koramadai Karuppusamy Kamaleshwaran, Jephy Joseph, Radha krishnan Kalarikal, Ajit Sugunan Shinto
April-June 2017, 32(2):140-142
DOI:10.4103/0972-3919.202239  PMID:28533646
Lung cancer is currently one of the most common malignancies in the world. Metastatic disease is observed in ~ 40% of patients with lung cancer, with the most common sites of metastasis being the bone, liver, brain and adrenal glands. Peritoneal carcinomatosis (PC) is defined as the progression of the primary cancer to the peritoneum. PC is a rare clinical event in lung cancer. Tyrosine kinase inhibitors targeting the epidermal growth factor receptor (EGFR), such as erlotinib are used for the treatment of patients with advanced non-small cell lung cancer (NSCLC). F-18 FDG PET/CT has proven capable of predicting response to therapy with erlotinib. We present a rare F-18 FDG PET/CT image findings of a 45 year old male with NSCLC with PC treated with erlotinib showing response to the treatment.
  841 100 -
Atypical parathyroid adenoma with multiple brown tumors as initial presentation: A rare entity
VS Krishna Mohan, Manishi L Narayan, Arun Mukka, Bharath Bachimanchi, Amit Kumar Chowhan, B Vijayalakshmi Devi, Suresh Vaikkakara, Alok Sachan
April-June 2017, 32(2):133-136
DOI:10.4103/0972-3919.202234  PMID:28533644
Brown tumors seen in hyperparathyroidism are rare, non-neoplastic lesions because of abnormal bone metabolism, and they can mimic benign bone tumors or malignancy. Although biopsy is considered as the gold standard for diagnosis, it can be inconclusive. As the diagnosis of brown tumors is often challenging, a high index of suspicion is essential for diagnosis. We present a case of 21-year-old woman who presented with multiple painful bony lesions, which were initially misdiagnosed as fibrous dysplasia. Due to persistent bone pain and deterioration in her physical mobility, she was referred to tertiary care centre. After thorough clinical workup, she underwent Tc-99m methylene diphosphonate bone scintigraphy that raised strong clinical suspicion of hyperparathyroidism and brown tumors. Subsequently, Tc-99m-methoxy isobutyl isonitrile (MIBI) parathyroid scintigraphy revealed a solitary MIBI avid focal lesion, suggestive of left inferior parathyroid adenoma. Later parathyroidectomy was performed and histopathological examination confirmed it as atypical parathyroid adenoma.
  787 136 -
INTERESTING IMAGES
Cerebral toxoplasmosis masquerading CNS lymphoma on FDG PET-CT in post renal transplant patient
Anirban Mukherjee, Chandrasekhar Bal, Madhavi Tripathi, Chandan Jyoti Das, Shamim Ahmed Shamim
April-June 2017, 32(2):148-149
DOI:10.4103/0972-3919.202254  PMID:28533649
20 year old post renal transplant patient developed recurrent episodes of seizure. MRI revealed focal lesion in right parieto-occipital lobe with perilesional edema. FDG PET-CT revealed multiple hypermetabolic lesions in bilateral cerebral hemisphere. Subsequent biopsy from the lesion demonstrated bradyzoites of Toxoplasma gondii with inflammatory cells and thereby, a confirmatory diagnosis of cerebral toxoplasmosis was made. This case demonstrates the fact that increased FDG uptake in cerebral lesions in post transplant patient should be interpreted with caution and confirmed with histopathological correlation.
  772 108 -
ORIGINAL ARTICLES
Development and validation of the suprathreshold stochastic resonance-based image processing method for the detection of abdomino-pelvic tumor on PET/CT scans
Kartik Saroha, Anil Kumar Pandey, Param Dev Sharma, Abhishek Behera, Chetan Patel, Chandrashekhar Bal, Rakesh Kumar
April-June 2017, 32(2):103-109
DOI:10.4103/0972-3919.202247  PMID:28533637
Purpose: The detection of abdomino-pelvic tumors embedded in or nearby radioactive urine containing 18F-FDG activity is a challenging task on PET/CT scan. In this study, we propose and validate the suprathreshold stochastic resonance-based image processing method for the detection of these tumors. Methods: The method consists of the addition of noise to the input image, and then thresholding it that creates one frame of intermediate image. One hundred such frames were generated and averaged to get the final image. The method was implemented using MATLAB R2013b on a personal computer. Noisy image was generated using random Poisson variates corresponding to each pixel of the input image. In order to verify the method, 30 sets of pre-diuretic and its corresponding post-diuretic PET/CT scan images (25 tumor images and 5 control images with no tumor) were included. For each sets of pre-diuretic image (input image), 26 images (at threshold values equal to mean counts multiplied by a constant factor ranging from 1.0 to 2.6 with increment step of 0.1) were created and visually inspected, and the image that most closely matched with the gold standard (corresponding post-diuretic image) was selected as the final output image. These images were further evaluated by two nuclear medicine physicians. Results: In 22 out of 25 images, tumor was successfully detected. In five control images, no false positives were reported. Thus, the empirical probability of detection of abdomino-pelvic tumors evaluates to 0.88. Conclusion: The proposed method was able to detect abdomino-pelvic tumors on pre-diuretic PET/CT scan with a high probability of success and no false positives.
  752 97 -
INTERESTING IMAGES
PSMA expression in multinodular thyroid neoplasm on simultaneous Ga-68-PSMA PET/MRI
Amarnath Jena, Shuaib Zaidi, Vikas Kashyap, Abhishek Jha, Sangeeta Taneja
April-June 2017, 32(2):159-161
DOI:10.4103/0972-3919.202248  PMID:28533654
PSMA PET is increasingly being used in imaging of recurrent prostate carcinoma. A case with suspected recurrent Prostate carcinoma (PCa), raised PSA (Prostate specific antigen) and suspected spinal metastases was referred for whole body Ga-68-PSMA PET/MRI. The study revealed PSMA avid recurrent prostate mass and extensive osseous metastases. Abnormal PSMA uptake in the thyroid gland prompted USG-guided FNAC which revealed Hurthle cell neoplasm. Histopathological examination (HPE) of excised gland showed multiple Hurthle cell adenomas in both lobes of thyroid along with foci of papillary thyroid carcinoma which on immunohistochemistry were thyroglobulin positive and PSA negative.
  673 111 -
CASE REPORTS
Image findings of a rare case of neuroendocrine tumor metastatic to orbital extraocular muscle in Gallium-68 DOTANOC positron emission tomography/computed tomography and therapy with lutetium-177 DOTATATE
Koramadai Karuppusamy Kamaleshwaran, Jephy Joseph, Indra Upadhya, Ajit Sugunan Shinto
April-June 2017, 32(2):125-127
DOI:10.4103/0972-3919.202236  PMID:28533641
Metastatic tumor is one of several etiologies of space-occupying masses in the orbit that accounts for 1-13% of all orbital masses. In the adult patient population, breast cancer is the most common tumor to metastasize to the orbit, followed by metastasis from the lung, prostate, and gastrointestinal tract. Carcinoid tumors are rare neuroendocrine neoplasms derived from enterochromaffin cells, which are found primarily in the gastrointestinal tract and bronchial tree. Liver metastases are the classic presentation of distant disease. Although rare, metastatic carcinoid to the extraocular muscles (EOMs) has been relatively well described in both retrospective case reports and clinical series in the ophthalmology literature, but not in nuclear medicine. Positron emission tomography/computed tomography (PET/CT) using Ga-68-labeled somatostatin-analogues have shown superiority over other modalities for imaging of Neuroendocrine tumor We describe a case of bilateral EOM metastasis from carcinoid lung in Ga-68 DOTANOC PET/CT and treatment with Lu -177 DOTATATE.
  626 138 -
FDG PET-CT: Need for vigilance in patients treated with bleomycin
Anna N Paschali, Gopinath Gnanasegaran, Gary J Cook
April-June 2017, 32(2):122-124
DOI:10.4103/0972-3919.202242  PMID:28533640
Bleomycin-induced interstitial lung disease is not a rare complication of treatment and may prove to be fatal if not suspected early in its course. As FDG PET-CT has become an essential clinical tool for interim and end-of-treatment response assessment in oncology, it is important that radiologists/nuclear medicine specialists be aware of the features of this potentially treatable condition so that treatment can be instigated during an early reversible phase before pulmonary damage has occurred. Herein, we report two cases of bleomycin toxicity featuring different patterns on the treatment-response assessment FDG PET-CT scan.
  641 102 -
INTERESTING IMAGES
Peritoneal super scan on 18F - FDG PET-CT in a patient of burkitt's lymphoma
Shambo Guha Roy, Girish Kumar Parida, Sarthak Tripathy, Abhinav Singhal, Shamim Ahmed Shamim, Madhavi Tripathi
April-June 2017, 32(2):155-156
DOI:10.4103/0972-3919.202250  PMID:28533652
Peritoneal lymphomatosis is seen less frequently, but when seen, it is mostly associated with aggressive variants of malignancies. FDG uptake has been reported in peritoneal lymphomatosis both in DLBCL and Burkitt's lymphoma. We report a case of Burkitt's lymphoma with involvement of entire peritoneum, which looks like a “peritoneal super scan” on FDG PET-CT.
  600 90 -
Increased F-FDG uptake in bilateral gynecomastia secondary to feminizing adrenal tumor: A rare case report and review of literature
Priyanka Verma, Gaurav Malhotra, Sneha Kothari, Rajlaxmi Jagtap, Ramesh V Asopa
April-June 2017, 32(2):145-147
DOI:10.4103/0972-3919.202246  PMID:28533648
A 21 year old male who presented with painful enlargement of both the breasts and a hyperestrogenic state, was found to harbor a heterogeneous mass arising from the right adrenal on contrast enhanced Computed Tomography abdomen. The mass was hypermetabolic with no regional, nodal or distant metastases on Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography /Computed Tomography examination. Notably, substantial tracer uptake was seen in bilateral gynecomastia. The patient underwent a right adrenalectomy with the histopathology report confirming adrenocortical carcinoma. This case demonstrates utility of FDG PET/CT in adrenocortical carcinoma. However, when interpreting FDG PET/CT as a staging tool in oncological male patients, one should consider gynecomastia as a possible cause for increased FDG uptake in the breast as it may lead to a false positive interpretation.
  595 93 -
CASE REPORTS
Image findings of polyostotic fibrous dysplasia mimicking metastasis in F-18 FDG positron emission tomography/computed tomography
Koramadai Karuppusamy Kamaleshwaran, Jephy Joseph, Radhakrishnan Kalarikal, Ajit Sugunan Shinto
April-June 2017, 32(2):137-139
DOI:10.4103/0972-3919.202237  PMID:28533645
Fibrous dysplasia (FD) of the bone is characterized by the medullary cavity of bones becoming filled with fibrous tissue, and its etiology remains unknown. It is usually asymptomatic and found incidentally on imaging studies that are performed for other purposes. FD may closely mimic the appearance of bony metastatic disease on radiological examinations.We report the case of a 45-year-old female patient, which appeared to have multiple bone lesions on initial workup images.Subsequently, the bone lesions that showed increased FDG uptake on PET/CT in right femur and tibia were identified as FD. The present case is a useful addition to the current body of literature of false positive F-18 FDG PET/CT due to a benign skeletal pathology and underscores the importance of high index of suspicion and careful correlation, whenever one comes across such an unusual PET/CT finding.
  554 108 -
Metastatic brachial plexopathy with brain and spinal metastasis in a case of recurrent breast carcinoma demonstrated on 18F-FDG PET/CT
Sunny J Gandhi, Bhavdeep Rabadiya
April-June 2017, 32(2):118-121
DOI:10.4103/0972-3919.202252  PMID:28533639
We report a case of a 56-year-old woman diagnosed with infiltrating ductal carcinoma of the left breast, who had undergone left modified radical mastectomy followed by radiotherapy and adjuvant chemotherapy. FDG PET-CT showed metastatic brachial plexopathy with intra-spinal and extra-axial brain metastasis. Metastatic brachial plexopathy along with brain and spinal metastasis is a rare condition with very less incidence. The scan also showed left para-sternal anterior chest wall recurrence with antero-superior mediastinal metastasis.18FDG-PET scanning is a useful tool in evaluation of patients with suspected metastatic plexopathy. It may also be useful in distinguishing between radiation-induced and metastatic plexopathy. Typical pattern of FDG uptake and dual time point imaging may increase specificity and require further evaluation.
  543 79 -
INTERESTING IMAGES
18-F-FDG PET/CT in localizing additional CNS lesion in a case of langerhans cell histiocytosis: determining accurate extent of the disease
Shamim Ahmed Shamim, Sarthak Tripathy, Anirban Mukherjee, Chandrasekhar Bal, Madhavi Tripathi
April-June 2017, 32(2):162-163
DOI:10.4103/0972-3919.202253  PMID:28533655
Central nervous system involvement is a rare manifestation of Langerhans cell histiocytosis (LCH), with bone and skin lesions being more frequent. MR remains the investigation of choice for localizing brain lesions. However, due to poor sensitivity of MRI in detecting osseous and pulmonary lesions, it is not used routinely in staging purposes until and unless indicated. We hereby discuss a case of 6-year-old boy of LCH who was referred for 18-F-FDG PET/CT for staging and knowing the extent of the disease, but a lesion in hypothalamus was picked up incidentally on FDG PET-CT study that was confirmed by MRI.
  523 98 -
CASE REPORTS
Unsuspected active ulcerative colitis in a patient with dermatomyositis: A rare association detected on 18F-FDG PET/CT during the search for an occult malignancy
Sampanna Jung Rayamajhi, Arun Kumar Reddy Gorla, Rajender Kumar Basher, Ashwani Sood, Bhagwant Rai Mittal
April-June 2017, 32(2):130-132
DOI:10.4103/0972-3919.202238  PMID:28533643
Dermatomyositis is an inflammatory myopathy with the characteristic features of skin rash and myopathy. We here present a known case of dermatomyositis evaluated with 18F-FDG PET/CT for the presence of any occult malignancy. The scan was negative for the presence of any malignancy. However, it revealed multiple intensely FDG avid colonic strictures that were later proven on colonoscopic biopsy to be ulcerative colitis. Also, a well-known association of bilateral sacroilitis was simultaneously demonstrated on the scan. The present case demonstrates that 18F-FDG PET/CT imaging can serve as a one-stop shop imaging modality in dermatomyositis by facilitating detection of occult primary if any and by providing insight into other rare systemic associations.
  525 82 -
INTERESTING IMAGES
Extensive visceral calcification demonstrated on 99mTc-MDP bone scan in patient with carcinoma penis and hypercalcemia of malignancy
Sunny J Gandhi, Bhavdeep Rabadiya
April-June 2017, 32(2):150-152
DOI:10.4103/0972-3919.202251  PMID:28533650
Hypercalcemia is a common life-threatening complication associated with several malignancies. Parathyroid-related peptide has been shown to cause hypercalcemia in several solid tumors but rarely in penile cancer. We report a case of penile cancer with hypercalcemia causing metastatic visceral calcification in lungs, liver, and stomach detected on bone scan without significant abnormalities on CT scan.
  526 70 -
Unusual presentation of rare cardiac tumor: The role of F-18-fluorodeoxyglucose positron emission tomography/computed tomography
Sameer Kamalakar Taywade, Nishikant Avinash Damle, Madhavi Tripathi, ST ArunRaj, Averilicia Passah, Amarinder Singh Malhi, Sanjeev Kumar, Chandrasekhar Bal
April-June 2017, 32(2):157-158
DOI:10.4103/0972-3919.202233  PMID:28533653
Primary cardiac tumors are rare with angiosarcoma being the most common among malignant cardiac tumor. We present a case of 30-year-old female patient in whom F-18-fluorodeoxyglucose positron emission tomography/computed tomography demonstrated a necrotic mass in right atrium with multiple fluorodeoxyglucose avid lesions in both upper and lower alveolus, liver, multiple bones, and bilateral lungs. Patient underwent biopsy from gum swelling which revealed metastatic angiosarcoma.
  471 70 -
OBITUARY
Obituary in memory of Dr. Ravi Kashyap
Rajnish Sharma
April-June 2017, 32(2):165-165
DOI:10.4103/0972-3919.204538  
  481 57 -
LETTER TO THE EDITOR
68Ga-DOTA-D Phe1-Tyr3-octreotide (DOTATOC)-PET/CT in a suspected case of recurrent meningioma
Sachin Jain, Ashwani Gupta, Anurag Jain
April-June 2017, 32(2):164-164
DOI:10.4103/0972-3919.202241  PMID:28533656
  447 73 -
INTERESTING IMAGES
F-18-Fluorodeoxyglucose positron emission tomography/computed tomography appearance of extramedullary hematopoesis in a case of primary myelofibrosis
Anirban Mukherjee, Chandrasekhar Bal, Madhavi Tripathi, Chandan Jyoti Das, Shamim Ahmed Shamim
April-June 2017, 32(2):143-144
DOI:10.4103/0972-3919.202235  PMID:28533647
A 44-year-old female with known primary myelofibrosis presented with shortness of breath. High Resolution Computed Tomography thorax revealed large heterogeneously enhancing extraparenchymal soft tissue density mass involving bilateral lung fields. F-18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography revealed mildly FDG avid soft tissue density mass with specks of calcification involving bilateral lung fields, liver, and spleen. Subsequent histopathologic evaluation from the right lung mass was suggestive of extramedullary hematopoesis.
  407 83 -
Primary germ cell tumor of testes with extensive lymph nodal and splenic metastases masquerading lymphoma on 18-F-FDG PET/CT
Sarthak Tripathy, Anirban Mukherjee, Chandrasekhar Bal, Madhavi Tripathi, Saumyaranjan Mallick, Shamim Ahmed Shamim
April-June 2017, 32(2):153-154
DOI:10.4103/0972-3919.202243  PMID:28533651
Germ cell tumors (GCT) account for the 95% of the malignancies associated with testes. They are the most common solid malignancies affecting the males in the age group of 15–35 years. It is known to be bilateral in 3% of cases. We herein present FDG PET-CT findings of a case with biopsy proven GCT with multiple lymph nodal and splenic metastases mimicking lymphomatous neoplasm.
  417 69 -
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