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   2016| July-September  | Volume 31 | Issue 3  
    Online since June 7, 2016

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Metastatic mimics on bone scan: “All that glitters is not metastatic”
Archi Agrawal, Nilendu Purandare, Sneha Shah, Venkatesh Rangarajan
July-September 2016, 31(3):185-190
DOI:10.4103/0972-3919.183605  PMID:27385887
In this pictorial review, cases where benign diseases caused a diagnostic dilemma on bone scan are illustrated. This review highlights the value of correlative imaging- single-photon emission computed tomography/computed tomography (CT), CT, and magnetic resonance imaging in solving the diagnostic problem by exact localization and characterization of the lesions. All these eventually lead to increased diagnostic confidence, better and more accurate reporting and avoidance of delay in initiation of treatment due to equivocal results. The imaging features of these benign pathologies – which are “mimics of metastatic disease,” are elaborated so that the reader can incorporate them while reporting so as to avoid mis-interpretations.
  8,969 466 -
Objective improvement in renal function post-Dietl's crisis: Documented on renal dynamic scintigraphy
Girish Kumar Parida, Madhavi Tripathi, Kunal Kumar, Nishikant Damle
July-September 2016, 31(3):240-241
DOI:10.4103/0972-3919.181527  PMID:27385903
Dietl's crisis is one of the treatable causes of intermittent abdominal pain. The pain is due to acute hydronephrosis that leads to stretching of the pelvis. The most common cause of this intermittent hydronephrosis is aberrant renal vessel at lower pole that causes pelvi-ureteric junction obstruction.(PUJO). High insertion of the ureter is one of the other rare causes. We present a case of 5-year-old boy with intermittent abdominal pain and distension with ultrasonography features of gross left hydronephrosis. Renal dynamic scan.(RDS) with ethylene dicysteine showed negligible functioning left kidney. On third follow-up day, the patient passed a lot of urine with decrease in abdominal pain and distension. Then, again the patient was sent to us 8.days after the first study for repeat RDS, which showed significant improvement in function and decreased in the size of left kidney though with persistent PUJO. On exploration high insertion of the ureter at pelvis was found to be the cause and was treated.
  2,921 137 -
Therapeutic applications of radioactive 131iodine: Procedures and incidents with capsules
Marwa Al Aamri, Ramamoorthy Ravichandran, John Pichy Binukumar, Naima Al Balushi
July-September 2016, 31(3):176-178
DOI:10.4103/0972-3919.183603  PMID:27385885
Background: Treatments for thyrotoxicosis and carcinoma thyroid are carried out by oral administration of radioactive iodine (131I) in the form of liquid or capsules. The liquid form of 131I has higher risk factors such as vapourization, spillage and need for management of higher activity wastes. Use of 131I in capsule form simplify procedures of handling compared to liquid form of 131I. The guidelines of safe handling and quality assurance aspects for therapeutic use 131I are well outlined by International Atomic Energy Agency (IAEA) reports. Aim: A few unusual incidents with I-131 capsules encountered in the past need to be highlighted from health physics point of view. Materials and Methods: In Royal Hospital, Oman, I-131 is imported in capsules, and the total activity handled/year steadily increased over 10 years. Discrete activities range from 185 MBq (5 mCi) up to 7.4 GBq (200 mCi). In four incidents deviations in standard operational procedures were recorded. Results: Nature of incidents is described as follows: (1) After assay of activity, the capsule was directly put in the lead container with missing of inner cap. (2) Patient poured water in the Perspex tube, when the capsule was handed over to her, making an emergency situation. (3) In 3 high activity capsules (2 nos 2.96 GBq, 1 no. 4.26 GBq), observed sticky behavior in capsule holder on the 2nd day post receipt, which were in order on the 1st day. (4) A capsule could not be swallowed by a patient, which was taken back from the mouth. Monitoring of patient later did not show residual ingested activity. Conclusions: The report documents some of the unusual incidents for information to other centers engaged in such radioactive administrations.
  1,927 217 -
Utility of 18F-choline photon emission tomography/computed tomography in the diagnosis of parathyroid adenoma
Nishikant Avinash Damle, Madhavi Tripathi, Abhishek Behera, Sameer Aggarwal, Chandrasekhar Bal, Shipra Aggarwal, Vivek Aggarwal, Devasenathipathi Kandasamy, Sameer Taywade
July-September 2016, 31(3):207-209
DOI:10.4103/0972-3919.181857  PMID:27385893
Recently, the role of 18F-choline in the detection of parathyroid adenomas has been reported. At our institution, we are currently studying the role of this tracer in comparison to the standard methoxy-isobutyl-isonitrile.(MIBI) scan with single photon emission tomography/computed tomography. Our initial results show that 18F-choline is at least as good as 99mTc-MIBI scan. We present here a representative case of a 45-year-old woman with multiple skeletal lytic lesions and a high parathyroid hormone.(PTH) who underwent both these imaging techniques with concordant results, further confirmed by histopathology and postoperative fall in serum PTH levels.
  1,693 162 -
Compression type stress fracture of femoral neck with equivocal X-ray features diagnosed on 99mTc-MDP SPECT/CT in a case of trivial hip pain
Saurabh Vitalkar, Ashmi S Manglunia, Arvind Kulkarni, Ameya D Puranik
July-September 2016, 31(3):225-228
DOI:10.4103/0972-3919.183614  PMID:27385898
Stress insufficiency fracture is usually diagnosed clinically and on the basis of routine X-ray imaging findings. However, the absence of any known predisposing factors and negative or occult radiographic findings pose diagnostic challenges. We report the case of an elderly male patient who presented with a chief complaint of trivial left hip pain and with equivocal radiographic findings. Triphasic 99mTc-methylene diphosphonate bone scan and single-photon emission computed tomography/computed tomography helped in arriving at the diagnosis of stress insufficiency fracture involving femoral neck.
  1,548 190 -
2-(fluorine-18)-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography after breast conserving surgery: Correlation with molecular markers of breast cancer
Salih Ozguven, Sabahat Inanir, Halil Turgut Turoglu, Tanju Yusuf Erdil, Mustafa Umit Ugurlu, Bahadir Gulluoglu
July-September 2016, 31(3):166-171
DOI:10.4103/0972-3919.181848  PMID:27385883
Aim: To investigate the role of 2-(fluorine-18)-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) early after breast-conserving surgery (BCS) in patients with breast cancer (BC) and whether we can determine which molecular biomarkers of breast carcinoma put the patients at risk. Materials and Methods: This retrospective study involved 88 patients with histologically proven T1 or T2 BC, who were treated with BCS and underwent 18F-FDG PET/CT study. The correlation between biological markers (estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 [HER2], and Ki-67) of the primary tumor and 18F-FDG PET/CT findings was analyzed. Results: 18F-FDG PET/CT demonstrated the presence of BC disease (locoregional disease [LRD], distant metastases, or contralateral BC) in 26 of 88 patients (29.5%). Regarding immunohistochemical profiles, BC expressing high levels of Ki-67 were associated with an increased percentage of LRD, which was the major recurrence pattern on 18F-FDG PET/CT. Although the BC disease was observed more commonly in patients with HER2 positivity compared to those of HER2 negative, the difference did not reach statistical significance. The patients with T2 tumor or a higher histopathological grade had a higher percentage of BC disease. Conclusions: This study demonstrated that patients with early stage BC treated with BCS have a remarkable risk of the presence of BC even early after surgery, and there was a clinically important relationship between 18F-FDG PET/CT findings and biological markers of BC. These findings suggest that high-risk molecular biomarkers (Ki-67, HER2) can be taken into account in the decision-making the process for both preoperative imaging and planning of the surgical approach.
  1,474 140 -
Metastasis in urothelial carcinoma mimicking prostate cancer metastasis in Ga-68 prostate-specific membrane antigen positron emission tomography-computed tomography in a case of synchronous malignancy
Manoj Gupta, Partha Sarathi Choudhury, Gurudutt Gupta, Jatin Gandhi
July-September 2016, 31(3):222-224
DOI:10.4103/0972-3919.183615  PMID:27385897
Prostate cancer is the second most common cancer in man. It commonly presents with urinary symptoms, bone pain, or diagnosed with elevated prostate-specific antigen.(PSA) levels. Correct staging and early diagnosis of recurrence by a precise imaging tool are the keys for optimum management. Molecular imaging of prostate cancer with Ga-68 prostate-specific membrane antigen.(PSMA), positron emission tomography-computed tomography.(PET-CT) has recently received significant attention and frequently used with a signature to prostate cancer-specific remark. However, this case will highlight the more cautious use of it. A-72-year-old male treated earlier for synchronous double malignancy.(invasive papillary urothelial carcinoma right ureter and carcinoma prostate) presented with rising PSA.( and referred for Ga-68 PSMA PET-CT, which showed a positive enlarged left supraclavicular lymph node. Lymph node biopsy microscopic and immunohistochemistry examination revealed metastatic carcinoma favoring urothelial origin. Specificity of PSMA scan to prostate cancer has been seen to be compromised in a certain situation mostly due to neoangiogenesis, and false positives emerged in renal cell cancer, differentiated thyroid cancer, glioblastoma, breast cancer brain metastasis, and paravertebral schwannomas. Understanding the causes of false positive will further enhance the confidence of interpretating PSMA scans.
  1,356 160 -
Dopamine transporter single-photon emission computed tomography brain scan: A reliable way to distinguish between degenerative and drug-induced parkinsonism
Shakya Bhattacharjee, Paramananda Vijaya Shankar, Mohammed Elkider
July-September 2016, 31(3):249-250
DOI:10.4103/0972-3919.183620  PMID:27385908
  1,377 137 -
Intrathoracic toxic thyroid nodule causing hyperthyroidism with a multinodular normal functional cervical thyroid gland
Burcu Dirlik Serim, Ulku Korkmaz, Unal Can, Gulay Durmus Altun
July-September 2016, 31(3):229-231
DOI:10.4103/0972-3919.183617  PMID:27385899
Radionuclide scintigraphy with I-131 and Tc-99m pertechnetate (99mTc04) has been widely used in detecting toxic nodules. Intrathoracic goiter usually presents as an anterior mediastinal mass. Mostly the connection between intrathoracic mass and the cervical thyroid gland is clearly and easily identified occurring as a result of inferior extension of thyroid tissue in the neck, which is called as secondary intrathoracic goiter. Completely separated, aberrant or in other words primary intrathoracic goiters arise as a result of abnormal embryologic migration of ectopic thyroid closely associated with aortic sac and descend into the mediastinum. Intrathoracic goiters are generally nontoxic nodules existing with mass effect without causing hyperthyroidism. However, mostly reported cases had enlarged thyroid glands in the neck. This report demonstrates the usefulness of I-131 and 99mTc04scintigraphy for detecting intrathoracic goiter causing hyperthyroidism with a normal functioned cervical thyroid gland.
  1,367 142 -
A rare case of extensive skeletal muscle metastases in adenocarcinoma cervix identified by 18F-fluorodeoxyglucose positron emission tomography/computed tomography scan
Madan Gopal Vishnoi, Anurag Jain, Arun Ravi John, Dharmesh Paliwal
July-September 2016, 31(3):215-218
DOI:10.4103/0972-3919.183609  PMID:27385895
Adenocarcinoma cervix is an uncommon histological subtype of carcinoma cervix; further incidence of skeletal muscle metastases is even rarer. We report the identification of extensive fluorodeoxyglucose (FDG) avid metastatic skeletal muscle deposits in a known case of adenocarcinoma cervix. The largest lesion representative of muscle deposit in the right deltoid was histopathologically confirmed to be metastatic poorly differentiated carcinoma. This report also serves to highlight the importance of 18F-FDG positron emission tomography/computed tomography (CT) as compared to conventional imaging modalities such as CT and ultrasonography and comments better over the description of invasiveness as well as the extent of disease in carcinoma cervix.
  1,381 105 -
Role of FDG PET/CT in Baastrup's disease
Padma Subramanyam, Shanmuga Sundaram Palaniswamy
July-September 2016, 31(3):235-237
DOI:10.4103/0972-3919.183604  PMID:27385901
Baastrup's disease is a benign condition, which presents as chronic low back pain. It is also known as “kissing spine syndrome” and refers to close approximation of adjacent spinous processes producing inflammation and back pain. This condition is often misdiagnosed, resulting in incorrect treatment and persistence of symptoms. Diagnosis of Baastrup's disease is verified with clinical examination and imaging studies. Conventionally, clinicians resort to magnetic resonance imaging (MRI) of spine rather than X-ray or computed tomography (CT) in the evaluation of back pain. MRI can additionally identify flattening, sclerosis, enlargement, cystic lesions, and bone edema at the articulating surfaces of the two affected spinous processes. Studies have reported that 18Fluorine fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT) can detect a bursitis or an inflammation as a form of stress reaction despite a negative MRI and 99mTc Methylene diphosphonate (MDP) bone scan. PET/CT is usually not a recommended investigation for this condition. However, this case report highlights the benefit of FDG-PET/CT in identifying the site of inflammatory pathology. It is also known to identify the exact site of inflammation where steroid or local anesthetic injection can be administered to alleviate pain, especially in patients with multilevel vertebral involvement.
  1,319 128 -
A case report of hyperfunctioning metastatic thyroid cancer and rare I-131 avid liver metastasis
Anchisa Kunawudhi, Chetsadaporn Promteangtrong, Chanisa Chotipanich
July-September 2016, 31(3):210-214
DOI:10.4103/0972-3919.183616  PMID:27385894
Thyroid cancer is usually, relatively hypofunctional; most patients with thyroid cancer are clinically euthyroid. The combination of thyroid cancer and thyrotoxicosis is not common. We herein, report a case of follicular thyroid cancer with hyperfunctioning metastasis in a 43-year-old woman who presented with thyrotoxicosis, a cold right thyroid nodule, and low I-131 uptake at the thyroid bed. An additional total body scan with I-131 revealed a large radioiodine avid osteolytic bone metastasis with soft tissue masses and liver metastasis. The patient received treatment with total thyroidectomy, methimazole, and I-131 at a cumulative dose of 600 mCi along with recombinant human thyroid-stimulating hormone before the first I-131 treatment and palliative radiation. The patient had normal liver function test and experienced a mild degree of bone marrow suppression after I-131. At the 2-year follow-up, the patient was still alive with the progression of bone metastases but was doing well with less severe thyrotoxicosis, good ambulation, and an Eastern Cooperative Oncology Group performance status of 2. Clinicians should be aware of the unusual concurrent presentation of thyrotoxicosis and thyroid cancer, a differential diagnosis in patients with thyrotoxicosis and low or normal radioiodine uptake over the neck and also potential pitfalls during radionuclide treatment.
  1,243 156 -
Primary pulmonary lymphoma-role of fluoro-deoxy-glucose positron emission tomography-computed tomography in the initial staging and evaluating response to treatment - case reports and review of literature
Krishan Kant Agarwal, Halanaik Dhanapathi, Aftab Hasan Nazar, Rakesh Kumar
July-September 2016, 31(3):194-197
DOI:10.4103/0972-3919.181529  PMID:27385889
Primary pulmonary lymphoma (PPL) is an uncommon entity of non-Hodgkin lymphoma, which accounts for <1% of all cases of lymphoma. We present two rare cases of PPL of diffuse large B-cell lymphoma, which underwent 18fluorine fluoro-deoxy-glucose positron emission tomography-computed tomography for initial staging and response evaluation after chemotherapy.
  1,252 130 -
Rare case of thoracic kidney detected by renal scintigraphy
Aravintho Natarajan, Archi Agrawal, Nilendu Purandare, Sneha Shah, Venkatesh Rangarajan
July-September 2016, 31(3):219-221
DOI:10.4103/0972-3919.181863  PMID:27385896
Intrathoracic kidney is a rare congenital abnormality with lowest frequency among all renal ectopias. Patients with thoracic kidneys are usually asymptomatic, and the condition is usually discovered incidentally during radiological evaluation for other conditions or during thoracic surgery. We report a case of a 62-year-old male who was referred to our department for renal scintigraphy for a nonvisualized left kidney on ultrasonography report. Both Tc-99m dimercaptosuccinic acid and diethylenetriaminepentaacetic acid scans revealed a left thoracic kidney which was confirmed by CT scan of the thorax and abdomen.
  1,242 122 -
Usefulness of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in dermatofibrosarcoma protuberans on treatment with imatinib
Raghava Kashyap, Vamshi Krishna Muddu, Sameera Anantamakula, Satya Sri
July-September 2016, 31(3):191-193
DOI:10.4103/0972-3919.181528  PMID:27385888
Dermatofibrosarcoma protuberans (DFSP) is a rare locally aggressive tumor with distant metastases being unusual. We present a case of metastatic DFSP treated with imatinib showing complete metabolic response to treatment.
  1,199 93 -
Bilateral generalised synovial chondromatosis of the knee: Bone scintigraphic demonstration with radiologic correlation
Tarik Elri, Mehmet Cabuk, Yavuz Sami Salihoglu, Rabiye Uslu Erdemir, Ismail Serifoglu
July-September 2016, 31(3):242-243
DOI:10.4103/0972-3919.181860  PMID:27385904
A 67-year-old woman with a history of bilateral progressive knee pain and swelling was referred for 99mTc-methyl diphosphonate bone scintigraphy. Flow and blood pool images showed bilateral heterogeneous increased uptake and delayed phase revealed mass-looking lobulated heterogeneous increased activity in both of knees extending distal part of the femoral shaft, but no other pathologic uptake was found in rest of the body. A.diagnosis of synovial chondromatosis was made when correlated with X-ray and computed tomography.(CT) images. This is a rare presentation of generalized synovial chondromatosis involving both knees which demonstrated on bone scintigraphy with X-ray and CT correlation.
  1,174 92 -
Depiction of ventriculoperitoneal shunt obstruction with single-photon emission computed tomography/computed tomography
Sabire Yilmaz Aksoy, Betü Vatankulu, Lebriz Uslu, Metin Halac
July-September 2016, 31(3):246-247
DOI:10.4103/0972-3919.181832  PMID:27385906
An 83-year-old male patient with ventriculoperitoneal shunt underwent radionuclide shunt study using single-photon emission computed tomography/computed tomography.(SPECT/CT) to evaluate the shunt patency. The planar images showed activity at the cranial region and spinal canal but no significant activity at the peritoneal cavity. However, SPECT/CT images clearly demonstrated accumulation of activity at the superior part of bifurcation level with no activity at the distal end of shunt as well as no spilling of radiotracer into the peritoneal cavity indicating shunt obstruction. SPECT/CT makes the interpretation of radionuclide shunt study more accurate and easier as compared with traditional planar images.
  1,165 97 -
Impact of sweating on equivalent dose of patients treated with 131Iiodine
Mahdi Haghighatafshar, Aida Banani, Farshid Gheisari, Mohammad Alikhani
July-September 2016, 31(3):172-175
DOI:10.4103/0972-3919.183613  PMID:27385884
Background: Radioiodine therapy is used for the treatment of patients with differentiated thyroid cancer (DTC) who undergo total thyroidectomy. After radioiodine administration, regulations require to quarantine these patients until their retained activity reduces to <33 mCi. Some of the injected radioiodine is excreted by perspiration which helps dose reduction so that performing the activities which stimulate sweating such as exercise may shorten the time of dose reduction. To the best of our knowledge, this is the first study in the literature that has evaluated the impact of specific exercise program on the ambient equivalent dose of 131I gamma rays. Materials and Methods: Patients with DTC without metastasis who had undergone total thyroidectomy and were treated with radioiodine were included in this study. 30 patients were chosen among patients who were able to exercise, did not have renal failure, and did not use diuretics. Patients were divided into two control and intervention groups. Intervention group members walked on treadmills under a specific program, in 3 time intervals. The control group did not have any specific activity. Immediately after each exercise process, both groups took a shower, and their doses were measured by a survey dosimeter. Results: It was revealed that there was a significant difference between mean values before and after each exercise time. The calculated P value which evaluates the overall impact was 0.939 which revealed that there was no significant difference between total ambient equivalent dose reductions of both groups. Conclusion: According to the study, it may conclude that sweating is an effective alternative way for radioiodine excretion, and if sweating is accompanied with well-hydrated status they may have synergism effect to shorten quarantine period. This could be an important consideration in patients which over-hydration is intolerable especially those with cardiac, liver, or renal problems.
  1,094 136 -
Late metastatic recurrence of penile carcinoma after 10 years: Demonstration with 18F-fluorodeoxyglucose positron emission tomography/computed tomography
Punit Sharma
July-September 2016, 31(3):204-206
DOI:10.4103/0972-3919.183611  PMID:27385892
Penile cancer is rare cancer. While inguinal and pelvic nodal metastasis is common, distant metastasis is rare. We here present the interesting case of a 59-year-old male patient with penile carcinoma, previously treated with penectomy and inguinal lymphadenectomy 10 years earlier. He presented with bone pains and given history of malignancy he was referred for an 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). PET/CT demonstrated multiple 18F-FDG avid bone and lung metastases. No locoregional disease was seen. Biopsy from a lung nodule confirmed the diagnosis, and the patient was started on palliative chemotherapy.
  1,071 112 -
Renal metastasis from papillary carcinoma thyroid detected by whole body iodine scan: A case report and review of the literature
Lekha M Nair, KR Anila, A Sreekumar, VM Pradeep
July-September 2016, 31(3):232-234
DOI:10.4103/0972-3919.183618  PMID:27385900
Papillary carcinoma is the most common thyroid malignancy. Usual sites of metastasis include lungs and bone, but renal metastasis is very rare. Here we present a case of a follicular variant of papillary carcinoma with renal and lung metastasis at presentation.
  1,030 121 -
Developing a personalized treatment model based on molecular biomarkers and imaging in breast cancer: Has the time come?
Partha Choudhury
July-September 2016, 31(3):165-165
DOI:10.4103/0972-3919.183606  PMID:27385882
  969 153 -
Left lobe hypoplasia of thyroid with right lobe ectopia: Radionuclide thyroid scan and ultrasonographic correlation
Parul Mohan, Ashima Vaidya, Manoj Sharma, Sandeep Barthwal, Harsh Mahajan
July-September 2016, 31(3):248-249
DOI:10.4103/0972-3919.183612  PMID:27385907
  1,033 88 -
Unusual case of infantile fibrosarcoma evaluated on F-18 fluorodeoxyglucose positron emission tomography-computed tomography
Akshay Bedmutha, Natasha Singh, Divya Shivdasani, Nitin Gupta
July-September 2016, 31(3):201-203
DOI:10.4103/0972-3919.183610  PMID:27385891
Infantile fibrosarcoma (IFS) is a rare soft-tissue sarcoma originating from extremities and occasionally from axial soft tissue. The prognosis is good with favorable long-term survival. It is rarely metastasizing tumor, the chances being lesser with IFS originating from extremities. Use of neoadjuvant chemotherapy (NACT) as a treatment regime further reduces the chances of local relapse and distant metastasis. The organs commonly affected in metastatic IFS are lungs and lymph nodes. We report an unusual case of an IFS originating from extremity, which received NACT, yet presented with an early metastatic disease involving soft tissues and sparing lungs and lymph nodes, as demonstrated on fluorodeoxyglucose positron emission tomography-computed tomography.
  953 156 -
A case of sarcoidosis diagnosed by positron emission tomography/computed tomography
Sabire Yilmaz Aksoy, Elif Özdemir, Aysegül Sentürk, Seyda Türkölmez
July-September 2016, 31(3):198-200
DOI:10.4103/0972-3919.183608  PMID:27385890
Sarcoidosis is a multisystem granulomatous disorder of unknown cause which may affect any organ or system but primarily involve the lungs and the lymphatic system. Extrapulmonary sarcoidosis represents approximately 30-50% of patients. We report the case of a 51-year-old female who presented with increasing complaints of a cough, weakness, weight loss, and chest pain and who was found to have a suspicious lesion on thorax computed tomography(CT). Fluorodeoxyglucose (FDG) positron emission tomography/CT performed for diagnostic purposes demonstrated increased FDG accumulation at the bilateral enlarged parotid and lacrimal gland and in the reticulonodular infiltration area located in the left lung as well as multiple lymphadenopathies with increased FDG accumulation. There were also hepatosplenomegaly and splenic uptake. Skin biopsy showed noncaseating granulomas, and the patient was diagnosed as stage 2 sarcoidosis.
  937 104 -
18F-fluorodeoxyglucose positron emission tomography-computed tomography finding of left gonadal vein thrombosis in a case of renal cell carcinoma
Ravishwar Narayan, Uma Ravishankar, Savita Natarajan, Sandeep Vohra
July-September 2016, 31(3):238-239
DOI:10.4103/0972-3919.183607  PMID:27385902
Tumor thrombus from renal cell carcinoma is commonly reported in renal vein and inferior vena cava with a few reports of gonadal vein involvement. Here, we report a case of an elderly female who underwent fluorodeoxyglucose (FDG) positron emission tomography-computed tomography scan for initial staging of left renal cell carcinoma. Along with an FDG avid left renal mass lesion, scan also revealed FDG avid tumor thrombus in the entire length of the left gonadal vein.
  870 82 -
Importance of assessing nonattenuation-corrected positron emission tomography images in treatment response evaluation of primary cutaneous lymphoma
Piyush Chandra, Archi Agrawal, Nilendu Purandare, Sneha Shah, Venkatesh Rangarajan
July-September 2016, 31(3):244-245
DOI:10.4103/0972-3919.183619  PMID:27385905
Studies have shown previously that nonattenuated corrected (AC) positron emission tomography (PET) images improve detection of superficial lesions when compared to AC images. We present a case of cutaneous lymphoma to demonstrate the importance of assessing nonattenuation-corrected PET images in treatment response evaluation.
  814 92 -
Micronucleus frequencies in groups receiving external or internal radiation
Aysegül Özdal, Taner Erselcan, Öztürk Özdemir, Güler Silov, Zeynep Erdoğan, Özgül Turhal
July-September 2016, 31(3):179-184
DOI:10.4103/0972-3919.183621  PMID:27385886
Objective: In the current study, we aimed to explore whether there is alteration between pre- and post-treatment micronucleus (MN) frequencies induced by internal and external ionizing radiation. Materials and Methods: The study enrolled a total of 67 patients including patients admitted to our hospital for treatment of hyperthyroidism (n = 17), scanning with low-dose I-131 (n = 15), and ablative therapy with high-dose I-131 (n = 15) at Department of Nuclear Medicine as well as patients with different diagnoses receiving external radiotherapy with various doses and durations at Department of Radiation Oncology (n = 20). Thirty-two patients who received radioactive iodine and returned for a follow-up visit at 1 month. Results: Considering both pre- and post-treatment MN frequencies of each group, lowest MN frequencies were detected for patients undergoing screening with low-dose I-131, and highest MN frequencies were found in radiotherapy patients. Comparison of pre- and post-treatment MN frequencies among hyperthyroidism, when pre- and post-treatment MN frequencies compared among hyperthyroidism, I-131 whole body scanning, ablation, and radiotherapy patient groups differences between MN frequencies were significant for each group (P < 0.05). Conclusion: Our study showed that MN analysis might be of value in determining chromosome damage that could potentially occur in patients exposed to internal and external radiation.
  837 24 -