Utilizing 99mTc-FAPI-46 SPECT/CT in Detection of Peritoneal Carcinomatosis in Gastric Poorly Differentiated Adenocarcinoma: A Case Report.

We introduce a 61-year-old man with poorly differentiated gastric adenocarcinoma, who previously underwent surgical treatment. In this presentation, he complained of a newly appeared midabdominal mass after the latest chemotherapy session. He was a candidate for diagnostic laparotomy, but in the setting of trial, 99mTc-FAPI-46 SPECT/CT was performed revealing 2 peritoneal masses, which were the only findings of diagnostic surgery subsequent to the scan.

Radiation Pneumonitis With 99m Tc-MDP Uptake in a Patient With Breast Cancer.

We present MDP bone scan findings of radiation pneumonitis in a 45-year-old woman with invasive ductal carcinoma of the right breast, classified as stage IIIa, T3N2M0. The patient underwent a modified radical mastectomy, neoadjuvant chemotherapy, and subsequent radiotherapy, receiving the last session 7 months before the bone scan. Whole-body images acquired 3 hours postinjection of 20 mCi (730 MBq) 99m Tc-MDP showed incidentally increased uptake in the right hemithorax, confined to the lung parenchyma of the right lung on SPECT/CT images.

Quadruplet Therapy in De Novo High-Volume Mixed Neuroendocrine Prostate Cancer Using 177Lu-PSMA: A Case Report.

We present a case of de novo high-volume metastatic prostate cancer with high PSMA expression, partially PSMA-negative, using quadruplet therapy (PROMISE ver. 2 miTNM; miT4N2M1aM1b(dmi) PRIMARY score: 5, PSMA-expression score: 0-3). Because of our patient's partial PSMA negativity and after a multidisciplinary tumor board discussion, we decided to use a modified protocol involving doublet hormonal therapy along with 177Lu-PSMA and radiation therapy to address the PSMA-negative disease.

Initial Staging and Response Evaluation With 18 F-FDG PET/CT in a Rare Case of Nested Variant Urothelial Urethral Cancer.

Primary urothelial urethral cancer is a relatively infrequent but serious form of cancer in the urinary tract, and nested variant is extremely rare. Until now, no studies have been published regarding 18 F-FDG PET/CT in patients with primary urothelial urethral cancer. In this study, we discussed the role of 18 F-FDG PET/CT in the initial staging, treatment response evaluation, and recurrence assessment of a 53-year-old woman with nested variant urothelial urethral cancer, which could lead to timely diagnosis and evaluation of the extent of involvement, thus achieving the best treatment plan for this group of patients.

A crying liver: a scan pattern mimicking spontaneous perforation of the biliary ducts.

A 2-month-old infant was referred for hepatobiliary scintigraphy due to ascites of unknown cause. The top differential diagnosis was spontaneous perforation of the biliary ducts. Delayed images up to 4 hours were against this diagnosis showing normal distribution of the radiotracer throughout the bowel.

Fibroblast Activation Protein Inhibitor Imaging and Therapy in a Patient With Multiple Endocrine Neoplasia Type 2A Syndrome.

A patient with multiple endocrine neoplasia type 2A syndrome who had exhausted several surgeries and radiotherapy was referred to nuclear medicine department for theranostic approaches. [68Ga]-DOTATATE PET/CT and [131I]I-mIBG SPECT/CT were performed, but the degree of uptake was insufficient for using the treatment companion of these tracers. Finally, 1 year later, [68Ga]-FAPI-46 PET/CT showed progressive disease with metastases to the lung, liver, bone, and lymph nodes with intense [68Ga]-FAPI-46 uptake.