Central Retinal Artery Occlusion with Concomitant Intracranial Hemorrhage Secondary to Endocarditis.

Purpose: To report a case of central retinal artery occlusion (CRAO) associated with subacute endocarditis secondary to a dental infection. . A 27-year-old male presented with acute monocular vision loss in the setting of a stroke and seizure.

Yttrium-90 dosimetry and implications on tumour response and survival after radioembolisation of chemo-refractory hepatic metastases from breast cancer.

Purpose: The aim of the study was to evaluate the effects of tumour dose on tumour response and overall survival (OS) in patients with chemo-refractory metastatic breast cancer (MBC) to the liver undergoing yttrium-90 radioembolisation (Y90 RE).

Materials And Methods: In 20 consecutive patients with chemo-refractory MBC to the liver undergoing 33 total Y90 RE resin treatments, volumes of interest were drawn around the five largest tumours of the targeted liver lobe on post-Y90 RE Bremsstrahlung single-photon emission computed tomography/computed tomography using MIM software v.6.

Comparison of Tc-99m MAA Planar Versus SPECT/CT Imaging for Lung Shunt Fraction Evaluation Prior to Y-90 Radioembolization: Are We Overestimating Lung Shunt Fraction?

Purpose: To compare lung shunt fraction (LSF) prior to Y-90 radioembolization calculated using planar imaging versus SPECT/CT in patients with hepatocellular carcinoma (HCC).

Methods: A single institution retrospective analysis of technetium-99m macroaggregated albumin (Tc-99m MAA) LSF studies for 293 consecutive patients with HCC between 2013 and 2018 was performed. LSF using planar imaging (PLSF) was compared to retrospectively calculated LSF using SPECT/CT (SLSF) via semiautomated segmentation using MIM v.

Graft-Versus-Host Disease Presenting as a Myositis and Myonecrosis.

Graft-versus-host disease (GVHD) is a major complication of bone marrow transplantation. Polymyositis with myonecrosis is a rare manifestation of GVHD. Here, we report the case of a 32-year-old man with acute myeloid leukemia who developed GVHD after transplant.

Herpetic Eye Disease Study: A Controlled Trial of Topical Corticosteroids for Herpes Simplex Stromal Keratitis.

Purpose: To evaluate the efficacy of topical corticosteroids in treating herpes simplex stromal keratitis.

Methods: The authors performed a randomized, double-masked, placebo-con- trolled, multicenter clinical trial of 106 patients with active herpes simplex stromal keratitis who had not received any corticosteroids for at least 10 days before study enrollment. Patients were assigned to the placebo group (n = 49) or the steroid group (topical prednisolone phosphate; n = 57); both regimens were tapered over 10 weeks.

Uptake of 18F-Fluciclovine in Paget Disease.

Since its recent approval by the United States Food and Drug Administration, fluciclovine PET-CT has gained widespread use for imaging of recurrent prostate cancer patients. As an amino acid-based radiotracer transported by LAT-1 and ASCT-2 transporters, fluciclovine exploits the up-regulation of amino acid transporters in malignant cells. We present a rare case of fluciclovine uptake in Paget disease in a 58-year-old man with suspected recurrent prostate cancer and asymmetric increased left hemipelvic uptake on imaging.

Effects of the New York State Workers Compensation Board Medical Treatment Guidelines on Return to Work.

Objective: Examine the association between New York State Workers' Compensation Medical Treatment Guidelines (Guidelines) adherence and return-to-work after occupational low back injuries. Assess adherence to Guidelines by examining diagnostic and treatment utilization.

Method: Retrospective chart review of cases.

Oncologic F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: What All Physicians Need to Know.

Fluorine-18 fluorodeoxyglucose (F-FDG) positron emission tomography (PET) hybrid examinations (PET/computed tomography, PET/magnetic resonance imaging) have become the most common PET imaging tools in the evaluation of the oncologic patient. Therefore it is of paramount importance that physicians who take care of oncology patients in any capacity are familiar with the basics of when these examinations are indicated, know how to best prepare the patients, and understand the benefits and limitations of the procedure. Additionally, it is important to understand which medical conditions and medications need to be controlled to maintain the diagnostic accuracy of these tests.

99mTc-Sestamibi Avid Soft Tissue Lesions in Rosai-Dorfman Disease.

Langerhan's histiocytosis is a not uncommon disease, but a related disorder, Rosai-Dorfman (RDD) with extensive or exclusive extranodal distribution, is relatively rare. Ga and PET/CT imaging have typically been used for diagnosis and tracking response to treatment. The authors present a very unusual case wherein lesions of RDD actively accumulated Tc-sestamibi, which was injected as part of a scan to localize a parathyroid adenoma.

Characteristics and Limitations of FDG PET/CT for Imaging of Squamous Cell Carcinoma of the Head and Neck: A Comprehensive Review of Anatomy, Metastatic Pathways, and Image Findings.

Objective: This image-based article illustrates the anatomic regions of squamous cell carcinomas of the head and neck and describes the metastatic pathways in and TNM staging for each region. Both the role and limitations of FDG PET/CT in imaging such cancers are discussed, and cases exemplifying these issues are reported. Also included is a discussion of the use of FDG PET/CT to monitor the response of squamous cell carcinomas of the head and neck to therapy, in addition to a brief comparison of PET/CT with such traditional imaging modalities as CT, MRI, and ultrasound.

The nuclear medicine therapy care coordination service: a model for radiologist-driven patient-centered care.

We developed a longitudinal care coordination service to proactively deliver high-quality and family-centered care in patients receiving radioiodine therapy for thyroid cancer. In an iterative, multidisciplinary team manner, a pretherapy consultation service, which included scripted interactions, documentation, and checklists for quality control, evolved over time into a robust patient-centered longitudinal care coordination nuclear medicine service. Radiation safety precautions, the rationale for therapy, and management of patient expectations were addressed through the initial consultation, and discharge and posttreatment care were managed during subsequent follow-up.

Multimodality imaging of aortitis.

Multimodality imaging of aortitis is useful for identification of acute and chronic mural changes due to inflammation, edema, and fibrosis, as well as characterization of structural luminal changes including aneurysm and stenosis or occlusion. Identification of related complications such as dissection, hematoma, ulceration, rupture, and thrombosis is also important. Imaging is often vital for obtaining specific diagnoses (i.

A simple method for estimating dose delivered to hepatocellular carcinoma after yttrium-90 glass-based radioembolization therapy: preliminary results of a proof of concept study.

Purpose: To investigate a simple semiquantitative method to estimate yttrium-90 ((90)Y) dose delivered with radioembolization to infiltrative hepatocellular carcinoma (HCC).

Materials And Methods: In a prospective study, patients with infiltrative HCC and portal vein thrombosis (PVT) underwent glass-based (90)Y radioembolization including technetium-99m macroaggregated albumin ((99m)Tc-MAA) hepatopulmonary shunt study before therapy and bremsstrahlung single photon emission computed tomography (SPECT)/computed tomography (CT) after (90)Y radioembolization. Baseline magnetic resonance imaging was coregistered with (99m)Tc-MAA and bremsstrahlung SPECT/CT imaging separately.

Quantitative dosimetry for yttrium-90 radionuclide therapy: tumor dose predicts fluorodeoxyglucose positron emission tomography response in hepatic metastatic melanoma.

Purpose: To assess a new method for generating patient-specific volumetric dose calculations and analyze the relationship between tumor dose and positron emission tomography (PET) response after radioembolization of hepatic melanoma metastases.

Methods And Materials: Yttrium-90 ((90)Y) bremsstrahlung single photon emission computed tomography (SPECT)/computed tomography (CT) acquired after (90)Y radioembolization was convolved with published (90)Y Monte Carlo estimated dose deposition kernels to create a three-dimensional dose distribution. Dose-volume histograms were calculated for tumor volumes manually defined from magnetic resonance imaging or PET/CT imaging.

Radiologic reporting: the ethical obligation of the interpreting physician to provide an accurate report.

Objective: This article focuses on the radiology report and examines how related errors can affect patient care even though the radiologist might resist disclosing or discussing reporting errors in a patient-centered way. By using scenarios involving issues in reporting, we hope to show how various ethical theories support the obligation of a radiologist to provide an honest, complete report and to ensure that errors are disclosed to patients.

Conclusion: Radiologists should be willing to make corrections when necessary and ethical theories and principles are available to guide them in their duty to care for their patients.

MIBG superscan of metastatic paraganglioma occurring with neurofibromatosis type 1.

A Tc MDP bone superscan occurs when osseous activity is extremely intense and genitourinary and soft tissue activity is not identified. A similar phenomenon has been described with metaiodobenzylguanidine (MIBG) in metastatic pheochromocytoma and neuroblastoma. We present a case of metastatic paraganglioma resulting in an MIBG superscan.

Unusual case of emphysematous cystitis seen on FDG PET/CT.

Emphysematous cystitis is a rare condition requiring immediate aggressive medical attention. Here, we describe a very unusual case of emphysematous cystitis seen on FDG PET/CT. This finding was discovered in an 84-year-old man undergoing FDG PET/CT to monitor a known diagnosis of IgG4-related nodular sclerosis.

Work-related chronic low back pain-return-to-work outcomes after referral to interventional pain and spine clinics.

Study Design: A retrospective cohort study.

Objective: To evaluate return-to-work outcomes in patients with chronic, work-related low back pain referred to pain treatment centers and/or spine clinics (PTCs/SCs).

Summary Of Background Data: Return-to-work outcomes in cases of work-related chronic low back pain after referral to PTCs and/or SCs have not been previously studied.

Prognostic value of 18f-fluorodeoxyglucose positron emission tomography-computed tomography in predicting survival in patients with unresectable metastatic melanoma to the liver undergoing yttrium-90 radioembolization.

Purpose: To investigate the prognostic value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in predicting survival in patients with unresectable metastatic melanoma to the liver undergoing yttrium-90 ((90)Y) radioembolization.

Materials And Methods: A retrospective review of 12 patients with unresectable hepatic melanoma metastases (5 patients with cutaneous metastases, 7 patients with ocular metastases) who underwent (18)F-FDG PET-CT before (90)Y was performed. Metabolically significant tumors, defined as having a long-axis diameter ≥ 1 cm and maximum standardized uptake value (SUV(max)) ≥ 2.

Does colon cancer ever metastasize to bone first? a temporal analysis of colorectal cancer progression.

Background: It is well recognized that colorectal cancer does not frequently metastasize to bone. The aim of this retrospective study was to establish whether colorectal cancer ever bypasses other organs and metastasizes directly to bone and whether the presence of lung lesions is superior to liver as a better predictor of the likelihood and timing of bone metastasis.

Methods: We performed a retrospective analysis on patients with a clinical diagnosis of colon cancer referred for staging using whole-body 18F-FDG PET and CT or PET/CT.

Tumor blood flow measured by perfusion computed tomography and 15O-labeled water positron emission tomography: a comparison study.

Objectives: To compare blood flow measurements of tumors assessed by perfusion computed tomography (pCT) and the clinical gold standard of 15O-labeled water positron emission tomography (15O-PET).

Methods: Blood flows were estimated by pCT (4-row multidetector, CT Perfusion 3.1) and 15O-PET (Posicam, first-pass model) in 14 patients with solid tumors, totaling 22 index tumors and 57 matched pairs of examinations.

Slitlamp biomicroscopy and photographic image analysis of herpes simplex virus stromal keratitis.

Objective: To validate photographic bioimaging for evaluating the severity of herpes simplex virus keratitis.

Methods: Stromal keratitis of patients in the Herpetic Eye Disease Study was clinically measured with a slitbeam micrometer and then photographed at trial entry. Calibrated images of 169 eyes were analyzed for the size, location, and density of stromal keratitis and endotheliitis, with shape factor as a function of area and perimeter.

Inguinal herniation of a bladder diverticulum on PET/CT and associated complications.

Inguinal herniation of the urinary bladder is not routinely seen in clinical practice. Most patients are asymptomatic and are diagnosed incidentally on diagnostic imaging or during the course of surgical repairs. Bladder herniation has previously been reported on ultrasonography and computed tomography, but not on positron emission tomography (PET) imaging.