Physiological Gallbladder Accumulation on 68 Ga-FAPI-46 PET/CT.

Radiolabeled fibroblast activation protein inhibitors (FAPIs) are a novel approach in cancer detection and treatment. Targeting fibroblast activation protein, extensively produced by cancer-associated fibroblasts, FAPI plays a key role in tumor development. Its advanced imaging capabilities offer clearer results in solid tumors compared with traditional methods, drawing significant interest in oncology.

Primary Squamous Cell Carcinoma of the Breast With 18 F-FDG PET/CT.

A 67-year-old woman presented with a palpable breast mass. A biopsy was taken, and the diagnosis was squamous cell carcinoma. Primary squamous cell carcinoma of breast is an extremely rare subtype of invasive breast cancer.

68 Ga-DOTA-FAPI-46 PET/CT Imaging for Restaging in a Patient With Metastatic Pheochromocytoma : Comparison With 68 Ga-DOTA-TATE PET/CT.

Pheochromocytomas (PHEOs) are neural crest-derived tumors originating from the chromaffin cells of the adrenal medulla and were recognized as one of the subtypes of paragangliomas by the World Health Organization in 2022. 68 Ga-labeled somatostatin analog ( 68 Ga-DOTA-NOC, 68 Ga-DOTA-TOC, and 68 Ga-DOTA-TATE) PET imaging has shown significant performance compared with 123 MIBG scintigraphy in the diagnosis of paragangliomas. It is now known that fibroblast activation protein (FAP) is overexpressed by various cancer-associated fibroblasts, including PHEOs.

Radiation Therapy-Induced Fibrous Histiocytoma, Mimicking Local Recurrence and Detected by 18 F-FDG PET/CT in a Patient With Breast Cancer.

A 76-year-old woman was diagnosed breast carcinoma and treated with breast-conserving surgery and chemoradiotherapy. A year after the treatment completion, restaging 18 F-FDG PET/CT scan detected no any pathological finding. However, due to a lesion detected during physical examination on the right thoracic wall adjacent to the primary tumor bed, 18 F-FDG PET/CT imaging was performed 9 months later for restaging.

Bilateral Adrenal Metastasis of Prostatic Adenocarcinoma on 68 Ga-PSMA PET/CT Imaging.

An 84-year-old man with prostate adenocarcinoma underwent 68 Ga-PSMA PET/CT due to PSA recurrence. Foci of 68 Ga-PSMA uptake were observed in bilateral adrenal glands. Adrenal MRI showed metastasis only in the left adrenal gland.

Dual 177 Lu-Prostate-Specific Membrane Antigen and 177 Lu-DOTATATE Therapy in Metastatic Castration-Resistant Prostate Cancer With Neuroendocrine Differentiation.

We present an 87-year-old man diagnosed with prostate cancer and neuroendocrine differentiation, posttherapy results to consecutive 177 Lu-prostate-specific membrane antigen and 177 Lu-DOTATATE. Despite hormonal therapy and chemoradiotherapy, the patient progressed rapidly, and multiple liver and bone metastases showed regression after 177 Lu-prostate-specific membrane antigen and 177 Lu-DOTATATE treatment. Prostate cancer with neuroendocrine differentiation is resistant to treatments; however, treatment with the combination of 177 Lu-DOTATATE therapy may be promising.

A Comparison of 18 F-FDG PET/CT and 68 Ga-PSMA PET/CT in Detecting Osteonecrosis of the Jaw in a Patient With Prostate Cancer.

Medication-related osteonecrosis of the jaw (ONJ) is rare adverse effect of zoledronic acid. We present ONJ detected in a 65-year-old man with prostate cancer who underwent 18 F-FDG PET/CT for metabolic characterization and to exclude a second primary malignancy of the liver lesion observed in 68 Ga-PSMA PET/CT. ONJ has high metabolic activity on 18 F-FDG PET/CT and no PSMA receptor activation on the 68 Ga-PSMA PET/CT.

68 Ga-PSMA PET/CT Found Lower Respiratory Tract Inflammation Due to Inhaler Use.

Prostate-specific membrane antigen (PSMA) is a transmembrane protein physiologically expressed in nonprostatic tissues. Inflammation and infectious diseases could show false-positive PSMA uptake. Herein, we present a 55-year-old patient's findings of inflammation in the lower respiratory tract due to inhaler use in 68 Ga-PSMA PET/CT in a patient with prostate cancer.

68 Ga-Oxine-Labeled Erythrocytes as a New PET Tracer for the Localization of Gastrointestinal Bleeding.

A 69-year-old man presented with recurring drops in hemoglobin levels and suspected gastrointestinal bleeding. Endoscopy did not show a site of bleeding so further examinations became necessary. Scintigraphy and SPECT/CT with 99m TcO 4- -labeled red blood cells were performed without evidence of a hemorrhage.

Image-Guided Fine-Needle Aspiration Cytology for BRCA Mutation Assessment of PSMA-Positive Lymph Node Metastases in a Patient With Metastatic Castration-Resistant Prostate Cancer.

A 64-year-old man with metastatic castration-resistant prostate cancer presented for prostate-specific membrane antigen (PSMA) PET/CT in preparation for 177 Lu-PSMA radioligand therapy. For precedent BRCA mutation assessment, fine-needle aspiration cytology of 2 PSMA-positive lymph node metastases was conducted. The acquired material was suitable for next-generation sequencing-based gene panel diagnostics and did not show a BRCA1 / 2 mutation, thus PSMA radioligand therapy was initiated.

Noninvasive Verification of a Very Small Intraocular Prostate Carcinoma Metastasis by 68Ga-PSMA-11 PET/CT.

A male patient underwent 68Ga-PSMA-11 PET/CT for the evaluation of a suspected intraocular metastasis in the right eye. Although the choroidal thickening was very small (4 × 2 mm), and ophthalmoscopy as well as MRI were inconclusive, PET/CT imaging showed distinct PSMA expression in the suspected lesion, confirming prostate cancer metastasis. The ability of dedicated PSMA ligand PET/CT imaging to detect small metastases, even with 68Ga-labeled ligands, has been demonstrated.

68 Ga-DOTA-FAPI-04 Imaging of Bilateral Phyllodes Tumor.

We present a case of bilateral Phyllodes tumor located in both breasts in a 41-year-old woman who was detected with increased uptake on 68 Ga-FAPI-04 (fibroblast activation protein inhibitor) and 18 F-FDG PET/CT imaging. The tumor filling up the right breast was identified as borderline Phyllodes. The tumor with mild uptake in the left breast was reported as a benign Phyllodes tumor.

Complex Fibroadenoma Mimicking Breast Cancer on 68Ga-FAPI-04 and 18F-FDG PET/CT.

A 47-year-old woman had complaint of palpable swelling in the left breast for the last 3 weeks. 18F-FDG PET/CT for staging of concomitant invasive carcinoma in the right breast and 68Ga-labeled fibroblast activation protein inhibitor 04 PET/CT imaging in an ongoing study were performed. Increased radiopharmaceutical uptake was observed in both PET/CT imaging in complex fibroadenoma located in the left breast.

Increased FDG Uptake in Skin Rashes Caused by EGFR Inhibitors.

Most patients treated with epidermal growth factor receptor inhibitors develop cutaneous advance effects. The extent and severity of treatment-related skin rashes are associated with good treatment response and prognosis. Herein, we presented increased uptake of the 18F-FDG in skin rashes after treatment with epidermal growth factor receptor inhibitors in 2 patients diagnosed with metastatic colorectal cancer.

Warthin-Like Papillary Thyroid Microcarcinoma With Coincidental Ipsilateral Warthin Tumor of the Parotid Gland Detected on 131 I-SPECT/US and 18 F-PET/US Fusion Imaging.

A 66-year-old woman was referred with an incidental finding of a bilateral papillary thyroid microcarcinoma after thyroidectomy. On the right side, a Warthin-like variant was observed. After radioiodine therapy, whole-body scan revealed an unclear iodine uptake on the right-sided neck.

Excellent Response to Multimodal Therapy Approach in Hyperfunctioning Metastatic Follicular Thyroid Carcinoma Diagnosed on 123 I-SPECT/Ultrasound Fusion Imaging.

An 83-year-old woman presented with new-onset hyperthyroidism and suspicious thyroid nodules on ultrasound (US). Conventional 99m TcO 4 thyroid scintigraphy showed hyperfunctioning areas that could not be clearly assigned to the US findings. With the aid of 123 I-SPECT/US fusion imaging, suspicious nodules were unambiguously identified as autonomously hyperfunctioning lesions.

Chronic Gastritis Mimicking Malignancy on 68 Ga-FAPI-04 PET/CT.

We present 2 patients mimicking malignancy with intense gastric 68 Ga-FAPI-04 uptake on PET/CT. Both patients showed low to moderate 18 F-FDG uptake. Histopathology revealed chronic active gastritis.

Role of 68 Ga-FAPI PET/CT in Screening Malignancy of Familial Adenomatous Polyposis.

A 57-year-old man with familial adenomatous polyposis (FAP) and newly diagnosed colonic adenocarcinoma was referred to 18 F-FDG PET/CT for staging and 68 Ga-FAPI-04 PET/CT for ongoing trial. 18 F-FDG PET/CT showed equal intense 18 F-FDG uptake in the tumor and multiple hypermetabolic polypoid lesions in the entire colorectum. 68 Ga-FAPI-04 PET/CT showed intense 68 Ga-FAPI-04 uptake only at the colonic tumor, without uptake at polypoid lesions.

18 F-FDG PET/CT in Urethral Metastases From Bladder Cancer.

Urethral metastasis of bladder cancer after surgery is rare. We present a 63-year-old man who had surgery for invasive bladder carcinoma and prostate adenocarcinoma 4 years ago and referred for urethral hemorrhage. 18 F-FDG PET/CT was performed for restaging and showed intense linear 18 F-FDG activity in the proximal urethra.

Synchronous Metastatic Medullary Thyroid Carcinoma and Paraesophageal Parathyroid Adenoma Detected on 18 F-Ethylcholine PET/US Fusion Imaging.

An 80-year-old woman with osteoporosis without fractures was referred with asymptomatic primary hyperparathyroidism and elevated calcitonin level. Ultrasound, 99m Tc-pertechnetate scintigraphy, 99m Tc-MIBI scintigraphy, and CT revealed a suspicious thyroid nodule and enlarged submandibular lymph nodes. However, no parathyroid adenoma was depictable.

Gallbladder Metastasis From Renal Cell Carcinoma Revealed With 18 F-FDG PET/CT.

Gallbladder metastasis from renal cell carcinoma is a rare condition. To our knowledge, only 1 case has been reported with 18 F-FDG PET/CT findings. Herein, we report the case of a 53-year-old man with renal cell carcinoma, having gallbladder metastasis revealed with restaging 18 F-FDG PET/CT.

Intense 68 Ga-PSMA Uptake in Neurofibroma Mimicking Cutaneous Metastases in a Patient With Prostate Cancer.

Prostate cancer is the most common cancer in men. 68 Ga-PSMA PET/CT is frequently used in staging and restaging prostate cancer; it is important to keep in mind the causes of false-positives when evaluating imaging. We present findings of 68 Ga-PSMA PET/CT and histopathological features of a 68-year-old prostate cancer man with neurofibroma.