Position statement on the non-invasive diagnosis of patients with ATTR pardiac amyloidosis, endorsed by the Hellenic Society of Nuclear Cardiology, for the Nuclear Medicine practitioners.

Cardiac amyloidosis is a rare condition characterized by the accumulation of abnormal proteins called amyloids in the heart tissue. These amyloids can disrupt the normal functioning of the heart and lead to a variety of symptoms and complications.

Positron emission tomography after response to rituximab-CHOP in primary mediastinal large B-cell lymphoma: impact on outcomes and radiotherapy strategies.

End-of-treatment (EoT) PET/CT is used as a guide to omit radiotherapy (RT) patients with primary mediastinal large B-cell lymphoma (PMBCL). We present the mature and extended results of a retrospective study evaluating the prognostic significance of EoT-PET/CT after adequate response to R-CHOP. Among 231 consecutive PMLBCL patients, 182 underwent EoT-PET/CT and were evaluated according to the Deauville 5-point scale (D5PS) criteria.

Cardiac Magnetic Resonance Versus Single-Photon Emission Computed Tomography for Detecting Coronary Artery Disease and Myocardial Ischemia: Comparison with Coronary Angiography.

Background: This study aimed to compare the diagnostic accuracy of stress single-photon emission computed tomography (SPECT) and stress cardiac magnetic resonance (CMR) for the assessment of coronary artery disease (CAD) in the same patients, using coronary angiography as the reference standard.

Methods: Thirty patients with known or suspected CAD who were referred for exercise SPECT myocardial perfusion imaging (MPI) for the evaluation of myocardial ischemia underwent stress CMR MPI and computed tomography coronary angiography (CTCA) or selective coronary angiography (SCA). The data from the two stress modalities were compared against the data from angiography.

I-131 Postablation SPECT/CT Predicts Relapse of Papillary Thyroid Carcinoma more Accurately than Whole Body Scan.

Background/aim: The aim of the study was to prospectively compare I-131 postablation Whole Body scan (WBS) and Single Photon Emission Computerized Tomography/Computerized Tomography (SPECT/CT) scan on thyroid cancer patients.

Patients And Methods: Overall, 58 patients with papillary thyroid carcinoma were submitted to total thyroidectomy and I-131 remnant ablation. Post-ablation WBS and SPECT/CT scans performed on the same day were compared.

Evaluation of the Performance of 18F-Fluorothymidine Positron Emission Tomography/Computed Tomography (18F-FLT-PET/CT) in Metastatic Brain Lesions.

18F-fluorothymidine (18F-FLT) is a radiolabeled thymidine analog that has been reported to help monitor tumor proliferation and has been studied in primary brain tumors; however, knowledge about 18F-FLT positron emission tomography/computed tomography (PET/CT) in metastatic brain lesions is limited. The purpose of this study is to evaluate the performance of 18F-FLT-PET/CT in metastatic brain lesions. A total of 20 PET/CT examinations (33 lesions) were included in the study.

PET Counting Response Variability Depending on Tumor Location, Activity, and Patient Obesity: A Feasibility Study of Solitary Pulmonary Nodule Using Monte Carlo.

We aim to investigate the counting response variations of positron emission tomography (PET) scanners with different detector configurations in the presence of solitary pulmonary nodule (SPN). Using experimentally validated Monte Carlo simulations, the counting performance of four different scanner models with varying tumor activity, location, and patient obesity is represented using a noise equivalent count rate (NECR). NECR is a well-established quantitative metric which has positive correlation with clinically perceived image quality.

Internal Auditory Canal Tumor as an Incidental Finding on a Choline PET/CT Scan in a Prostate Cancer Patient.

An 84-year-old man with a history of prostate cancer, treated with radiotherapy, presented with an increase in PSA levels. F-choline PET/CT showed foci of increased choline uptake in L4 and L5 vertebrae, suggestive of bone metastases and another focus in the right cerebellopontine angle. A brain MRI revealed a focus of intense contrast enhancement in the same region, consistent with an acoustic neuroma.

The Significance of PET/CT in the Initial Staging of Hodgkin Lymphoma: Experience Outside Clinical Trials.

Aim: To examine the real-life impact of baseline positron-emission tomography/computed tomography (PET/CT) in Hodgkin lymphoma (HL).

Patients And Methods: A total of 162 consecutive patients with HL were retrospectively studied.

Results: Disease was up-staged in 26 patients (16%) and down-staged in 9 (6%).

Although Non-diagnostic Between Necrosis and Recurrence, FDG PET/CT Assists Management of Brain Tumours After Radiosurgery.

Aim: To re-evaluate the role of (18)F-fluoro-deoxy-D-glucose (FDG) positron emission tomography/ computer assisted tomography (PET/CT) co-registered with magnetic resonance imaging (MRI) in differentiating adverse radiation effect (ARE) from tumour recurrence after Gamma Knife radiosurgery of brain tumours.

Patients And Methods: Twenty-seven PET/CT studies co-registered with MRI were performed on 16 patients after radiosurgery, with 12/16 patients having multiple radiosurgery treatments. Long term follow-up was used for evaluation, with 3/16 patients being histopathologically confirmed.

Hypermetabolic Calcified Lymph Nodes on 18Fludeoxyglucose-Positron Emission Tomography/Computed Tomography in a Case of Treated Ovarian Cancer Recurrence: Residual Disease or Benign Formation?

The contribution of positron emission tomography/computed tomography (PET/CT) with 18F-fludeoxyglucose (FDG) in evaluating ovarian cancer recurrence even after a prolonged disease-free interval, and in therapy response is well-described. Calcifications observed in CT, although usually attributed to benign conditions, may actually represent active disease. Such an example of calcified formations is psammoma bodies.

FLT PET/CT in a Case of Demyelinating Disease.

A 32-year-old woman, with spare previous medical history, presented with neurological symptoms of numbness and diplopia. The patient underwent brain MRI, which revealed a lesion of abnormal signal in the midbrain that could be attributed to subacute stroke; however, consecutive MRIs revealed multiple lesions of abnormal signal pointing to demyelinating disease. During symptoms investigation and MRI findings assessment, the patient underwent a FLT PET/CT examination, which revealed lesions of increased FLT uptake, probably indicating active disease and blood-brain barrier disruption.

Prospective PET image quality gain calculation method by optimizing detector parameters.

Background: Lutetium-based scintillators with high-performance electronics introduced time-of-flight (TOF) reconstruction in the clinical setting. Let G' be the total signal to noise ratio gain in a reconstructed image using the TOF kernel compared with conventional reconstruction modes. G' is then the product of G1 gain arising from the reconstruction process itself and (n-1) other gain factors (G2, G3, … Gn) arising from the inherent properties of the detector.

Association between habitual physical activity and brown adipose tissue activity in individuals undergoing PET-CT scan.

Objective: Augmented brown adipose tissue (BAT) mass and activity lead to higher basic metabolic rate which is beneficial against obesity. Our aim was to investigate whether habitual (i.e.

A review of PET normalization: striving for count rate uniformity.

The advent of PET instrumentation signaled the beginning of a new perspective in nuclear medicine diagnostic imaging. PET systems rely on several corrections that must be applied in order to establish accurate and reliable quantification. The inherent properties of PET detector architecture and the crystals themselves are sources of different types of systematic and random errors with subsequent count rate variability that should be accounted for.

Leydig cell tumour of the ovary localised with positron emission tomography/computed tomography.

Androgen-producing ovarian tumours can lead to assessment difficulties because of their small size. We present a case of virilising steroid cell ovarian tumour in a 41-year-old woman localised with Fluorine-18-Deoxyglucose Positron Emission Tomography/Computed Tomography ((18)FDG-PET/CT). Although the biochemical evaluation pointed to an ovarian source of androgen, diagnostic attempts to localise the source of hyperandrogenism with transvaginal ultrasound (US), and magnetic resonance imaging (MRI) of pelvis failed.

The impact of FDG-PET/CT on the management of breast cancer patients with elevated tumor markers and negative or equivocal conventional imaging modalities.

Objective: To evaluate the clinical impact of fluorodeoxyglucose (FDG)-PET/computed tomography (CT) scan on restaging breast cancer patients with rising tumor markers and negative or equivocal findings in conventional imaging studies.

Methods: We studied 46 patients with breast cancer of an average age of 57.6 years (ranging from 38 to 68 years).

Myocardial adrenergic denervation in patients with primary (AL) amyloidosis.

Three patients, 2 women and 1 man, with primary (AL) amyloidosis without congestive heart failure are described; all 3 patients presented reduced I-123 metaiodobenzylguanidine (MIBG) myocardial uptake suggesting marked cardiac sympathetic denervation. This is the first time myocardial adrenergic denervation is described in patients with AL amyloidosis without evidence of congestive heart failure; the observed denervation could be implicated in the pathogenesis of cardiac conduction disturbances which are common in this disease.

Myocardial perfusion and adrenergic innervation in patients with RBBB and LAfB: the effect of altering the activation sequence with right ventricular apical pacing.

The aim of this study was to investigate myocardial perfusion and adrenergic innervation in patients with intraventricular conduction disturbances and to detect any changes caused by alteration of the ventricular activation sequence as a result of right ventricular apical pacing. We studied 15 patients with right bundle branch block (RBBB) and left anterior fascicular block (LAFB), while 15 healthy individuals served as controls. All patients underwent planar and single-photon emission computed tomography (SPECT) myocardial imaging after intravenous infusion of 5mCi 123I-metaiodobenzylguanidine (123I-MIBG) and a SPECT thallium201 myocardial perfusion study before and 3 months after pacemaker implantation.

Relation of cardiac sympathetic innervation to proinflammatory cytokine levels in patients with heart failure secondary to idiopathic dilated cardiomyopathy.

Experimental studies have shown that cytokine production by the heart may be regulated by sympathetic nervous system stimulation of cardiac beta-adrenergic receptors. Proinflammatory cytokine levels are increased in heart failure, whereas cardiac fixation of 123-I-metaiodobenzylguanidine (MIBG) has been used to study myocardial adrenergic innervation. This study was designed to assess the relation between cardiac MIBG uptake and circulating levels of proinflammatory cytokines in patients with idiopathic dilated cardiomyopathy (IDC).

Assessment of myocardial adrenergic innervation in patients with sick sinus syndrome: effect of asynchronous ventricular activation from ventricular apical stimulation.

Objective: To investigate ventricular sympathetic innervation in patients with sick sinus syndrome and to detect regional deterioration of adrenergic innervation caused by asynchronous ventricular activation from right ventricular pacing.

Design: Prospective controlled study.

Setting: Tertiary cardiac referral centre.