Sestamibi as an alternative to mebrofenin for the diagnosis of acute cholecystitis: An alternative option during supply chain disruption.

Purpose: To determine the accuracy of Tc-99 m sestamibi for the diagnosis of acute cholecystitis during a supply chain disruption of mebrofenin.

Material And Methods: During a national shortage of Tc-99 m mebrofenin in 2019, our institution initiated sestamibi imaging for suspected cases of acute cholecystitis using a standard hepatobiliary imaging protocol. Forty-one patients underwent hepatobiliary imaging with sestamibi, 39 to assess for acute cholecystitis.

Incidental Uptake in a Subacute Stroke on 18 F-Piflufolastat PSMA PET/CT.

Prostate-specific membrane antigen (PSMA) PET/CT has proven to be effective in the evaluation of prostate cancer and has become increasingly used clinically as multiple radiopharmaceuticals have become commercially available. With increasing use, incidental uptake from a variety of nononcologic processes will be encountered and considered interpretive pitfalls. We outline a case of a 71-year-old man who underwent imaging with PSMA PET/CT, which demonstrated uptake in the left parietal-temporal junction that was shown to be a subacute stroke.

68Ga-DOTATATE PET/CT Imaging of Refractory Pituitary Macroadenoma Invading the Orbit.

In addition to gastroenteropancreatic neuroendocrine neoplasms, a wide variety of tumors express somatostatin receptors. Somatostatin receptor imaging, heavily utilized in neuroendocrine oncology, may also have utility in the diagnosis of other neoplasms and raises the possibility of potential therapeutic options. We describe the case of a 60-year-old man who underwent 68Ga-DOTATATE PET/CT, demonstrating an avid invasive pituitary macroadenoma.

The impact of infection and inflammation in oncologic F-FDG PET/CT imaging.

Sites of infection and inflammation can be misleading in oncology PET/CT imaging because these areas commonly show F-FDG activity. Caution in the interpretation must be taken to avoid the misdiagnosis of malignancy. Utilization of both CT findings as well as patient history can help differentiate benign infectious and inflammatory processes from malignancy, although occasionally additional work-up may be required.

Effects of plasma glucose levels on regional cerebral 18F-fluorodeoxyglucose uptake: Implications for dementia evaluation with brain PET imaging.

Purpose: Hyperglycemia affects FDG uptake in the brain, potentially emulating Alzheimer's disease in normal individuals. This study investigates global and regional cerebral FDG uptake as a function of plasma glucose in a cohort of patients.

Methods: 120 consecutive male patients with FDG PET/CT for initial oncologic staging (July-Dec 2015) were reviewed.

Synchronous Metastatic Breast Carcinoma and Parathyroid Adenoma on 18F-FDG PET/CT and 99mTc-Sestamibi Imaging.

In addition to nuclear cardiac and breast imaging, Tc-sestamibi scintigraphy is often used to localize parathyroid adenomas. F- fluorodeoxyglucose (FDG) PET is heavily utilized in oncology, although its use in identifying parathyroid adenomas is limited. We describe a case of a 57-year-old woman who underwent parathyroid scintigraphy and F-FDG PET/CT in the same week due to hyperparathyroidism and an enlarging breast mass, respectively.

The utility of bone scintigraphy with SPECT/CT in the evaluation and management of frostbite injuries.

Objective:: Frostbite is a localized cold-thermal injury resulting from prolonged exposure of flesh to freezing and near freezing temperatures. The depth and extent of frostbite injuries are not easily assessed, from a clinical standpoint, at the time of injury making it challenging to plan appropriate management and treatment.

Methods:: A review of the literature of management of cold-related injuries and retrospective case review of the imaging and clinical course of frostbite injury.

Nuclear Medicine Therapy With 223Radium-dichloride for Osseous Metastases in Prostate Carcinoma.

Painful osseous metastasis resulting from castration-resistant prostate carcinoma is a common clinical problem. Historically, nuclear medicine offered several palliative beta-emitting radiopharmaceuticals targeting the skeleton with the goal of decreasing pain. However, these have largely been replaced by the alpha-emitting agent 223radium (Ra).

Unexpected Vesicoureteral Reflux Into a Nonfunctioning Transplant Kidney on Renal Scintigraphy.

Vesicoureteral reflux after renal transplantation is associated with increase risk of urinary tract infections, renal scarring, and graft failure. We describe a case of a 46-year-old woman with 2 transplant kidneys, one functioning and another nonfunctioning, presenting with pelvic pain after a bilateral periureteral bulking procedure. Diuretic renography was performed to exclude iatrogenic ureteral obstruction.

Effects of Tumor Burden on Reference Tissue Standardized Uptake for PET Imaging: Modification of PERCIST Criteria.

Purpose To examine the effect metabolic burden (tumor and/or cardiac myocyte uptake) has on fluorine 18 fluorodeoxyglucose (FDG) distribution in organs and tissues of interest. Materials and Methods Positron emission tomographic (PET)/computed tomographic (CT) scans at the Ann Arbor Veterans Affairs hospital from January to July 2015 were reviewed. A total of 107 scans (50 patients; mean age, 64.

Multiple Hypermetabolic Subcutaneous Lesions From Hidradenitis Suppurativa Mimicking Metastases on 18F-FDG PET/CT.

Hidradenitis suppurativa is an inflammatory disease associated with subcutaneous nodules/abscesses that occur commonly in the axillary, inguinal, and perineal regions. We describe a case of a 64-year-old man presenting for F-FDG PET/CT for staging of a left vocal cord squamous cell carcinoma. The scan showed uptake in the left vocal cord malignancy and multiple hypermetabolic subcutaneous foci in the right axilla, right buttocks, and scalp in known locations of skin lesions related to hidradenitis suppurativa.

Contemporary imaging of incidentally discovered adrenal masses.

Adrenal lesions are routinely encountered incidentally in clinical practice. Although most of these lesions are benign, malignancy needs to be excluded. Therefore, the initial clinical workup is to exclude aggressive characteristics suggesting malignancy and to identify characteristics predictive of the most common benign lesion, an adrenal adenoma.

Extraosseous Findings on Bone Scintigraphy Using Fusion SPECT/CT and Correlative Imaging.

Objective: Extraosseous radioactivity outside of the expected biodistribution is often encountered on (99m)Tc-methylene diphosphate (MDP) bone scintigraphy, and proper interpretation requires an understanding of the mechanisms underlying this uptake and knowledge of the possible causes, depending on the site or structure involved.

Conclusion: We present examples of extraosseous radiotracer uptake seen on (99m)Tc-MDP bone scans in which either SPECT with integrated CT or correlative imaging improved the study's interpretation.

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature.

PET/CT with (18)F-fluorodeoxyglucose (FDG) or using different radiocompounds has proven accuracy for detection of adrenal metastases in patients undergoing cancer staging. It can assist the diagnostic work-up in oncology patients by identifying distant metastases to the adrenal(s) and defining oligometastatic disease that may benefit from targeted intervention. In patients with incidentally discovered adrenal nodules, so-called adrenal "incidentaloma" FDG PET/CT is emerging as a useful test to distinguish benign from malignant etiology.