Indian Journal of Nuclear Medicine最新文献

{"title":"⁶⁸Ga-PSMA PET/CT in a case of recurrent Glioblastoma.","authors":"Arunachalam Raghupathi Vishnu, Nishikant Avinash Damle, Kunhi Parambath Haresh, Madhavi Tripathi, G B Priyanka","doi":"10.4103/ijnm.ijnm_126_24","DOIUrl":"10.4103/ijnm.ijnm_126_24","url":null,"abstract":"<p><p>Glioblastoma multiforme (GBM) is a high-grade brain tumor with a high recurrence rate. We present the case of a 57-year-old man with left frontal lobe GBM who was operated on and received radiation therapy in June 2023 and was referred for ⁶⁸Ga-PSMA 11 PET/CT with a clinical suspicion of recurrence. The scan showed intense tracer uptake in the left frontal lobe lesion with severe edema, which was consistent with recurrence. Our case underscores the role of ⁶⁸Ga PSMA 11 PET/CT imaging of suspected glioblastoma recurrence which is the initial step in GBM theranostics with PSMA.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"40 2","pages":"115-116"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Imaging Parameters of ¹⁸F FDG PET/CT in Differentiating the Ki-67 Index in Carcinoma Breast.","authors":"Deepanksha Datta, Alok Mandal, Akhil Dhanesh Goel, Rajesh Kumar","doi":"10.4103/ijnm.ijnm_168_24","DOIUrl":"10.4103/ijnm.ijnm_168_24","url":null,"abstract":"<p><strong>Background: </strong>The proliferation index (Ki-67 index) is a known independent prognostic marker in carcinoma breast, and its expression is directly proportional to higher recurrence and worse prognosis. However, there is no standard cutoff of the Ki-67 index to determine its low or high expression. In this study, we aim to find the association of various metabolic parameters on ¹⁸F FDG positron emission tomography/computed tomography (PET/CT) with Ki-67 index in carcinoma breast patients and further evaluate its correlation with low and high Ki-67 index groups.</p><p><strong>Materials and methods: </strong>This is a retrospective study conducted in a tertiary hospital in North India between February 2021 and 2024. All histopathologically proven female cases of carcinoma breast with reported Ki-67 index and baseline ¹⁸F FDG PET/CT before any treatment or surgery were included. The metabolic parameters, namely, standardized uptake value (SUVmax), the metabolic ratio of the primary tumor to the liver (SUR), total lesion glycolysis (TLG), and metabolic tumor volume (MTV) were recorded for each case. The correlation between the metabolic parameters and the Ki-67 index was analyzed, and subgroup analysis was done.</p><p><strong>Results: </strong>Sixty-five female patients met the inclusion criteria, and the majority of them presented with intraductal carcinoma. The median value (interquartile range [IQR]) of the Ki-67 index was 40% (IQR: 50%). The primary breast tumor showed median (IQR) of SUVmax, SUR, TLG, and MTV of 10.3 g/mL (7.2), 3.7 (2.9), 102.9 g.cub/mL (184.7), and 16.2 cm³ (25.4), respectively. A significant correlation was noted between all the metabolic parameters studied and the Ki-67 index. In subgroup analysis, a significant difference was noted in all the metabolic parameters between the subgroups of the Ki-67 index ≤25% versus >25%.</p><p><strong>Conclusion: </strong>Metabolic parameters on ¹⁸F FDG PET/CT show a promising role in the determination of the status of proliferation marker Ki-67 index in carcinoma breast.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"40 2","pages":"67-71"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid Scan Conundrum in a Rare Case of McCune-Albright Syndrome.","authors":"Yogita Khandelwal, Nishikant Avinash Damle, Chandrasekhar Bal, Nikhil Tandon, Manasvini Bhatt, G B Priyanka, Bela Jain","doi":"10.4103/ijnm.ijnm_144_23","DOIUrl":"10.4103/ijnm.ijnm_144_23","url":null,"abstract":"<p><p>McCune-Albright syndrome is a rare and challenging disorder characterized by a triad of cutaneous, bone and multiple endocrine abnormalities. We present the case of a 15-year-old female with varied symptoms including precocious puberty, prolactinoma, polyostotic fibrous dysplasia, and hyperthyroidism. On examination, she had a palpable nodule in the right lobe of the thyroid with an atrophic left lobe on ultrasonography. Thyroid scan in this patient posed a diagnostic challenge which was resolved with additional single-photon emission computed tomography/computed tomography (SPECT/CT). On SPECT/CT, she was diagnosed with autonomously functioning thyroid nodule and treated with 15 mCi of ¹³¹I.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"40 2","pages":"88-91"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathoracic Kidney Detected on DTPA Scan.","authors":"Meghana Prabhu, Abhishek Behera, Manav Suryavanshi, Kailash Panwar","doi":"10.4103/ijnm.ijnm_137_24","DOIUrl":"10.4103/ijnm.ijnm_137_24","url":null,"abstract":"<p><p>Intrathoracic kidney is very rare and has the lowest prevalence among all renal ectopias. We report the case of a 70-year-old male who was referred for diethylenetriaminepentaacetic acid (DTPA) scan as a part of presurgical work-up for a right renal mass. PriorUltrasonography abdomen incorrectly reported left kidney as normal in location. ^99mTc-DTPA renal scan combined with single-photon emission computed tomography - computed tomography revealed impaired global glomerular filtration rate with left kidney in ectopic (intrathoracic) location. 18-fluorodeoxyglucose positron emission tomography-computed tomography images revealed a soft tissue mass completely replacing the right kidney with metastases to bilateral lungs. This case reemphasizes the importance of nuclear medicine imaging in diagnosis and evaluation of the renal function of the intrathoracic kidney.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"40 2","pages":"99-102"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Metastatic Primary Thyroid Sarcoma Evaluated by ¹⁸F-FDG PET/CT.","authors":"Archana Yadav, A V S Anil Kumar, Vempa Satish, Kritika Dewan","doi":"10.4103/ijnm.ijnm_147_24","DOIUrl":"10.4103/ijnm.ijnm_147_24","url":null,"abstract":"<p><p>Among the thyroid malignancies, primary thyroid sarcomas are very rare, comprising < 1% of all thyroid malignancies. Sarcoma, in particular spindle cell sarcomas of the thyroid gland, is very rare and aggressive which carries poor prognosis. Very little has been published regarding imaging findings and metastatic patterns of this rare entity. We report a case of metastatic spindle cell sarcoma of the thyroid presenting with hoarseness of voice and anterior neck swelling. Subsequent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) imaging demonstrated a fluorine-18-FDG avid mass lesion in the left lobe of the thyroid, along with FDG avid cervical lymph nodes and multiple FDG avid nodules of varying sizes in the bilateral lung fields. ¹⁸F-FDG PET/CT proved invaluable in accurately staging this rare case of metastatic high-grade sarcoma originating from the thyroid.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"40 2","pages":"95-98"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Busting Myths and Misinformation about Nuclear Medicine: Public Health Interventions.","authors":"Saurabh RamBihariLal Shrivastava, Prateek Sudhakar Bobhate, Gulshan Ruprao Bandre","doi":"10.4103/ijnm.ijnm_145_24","DOIUrl":"10.4103/ijnm.ijnm_145_24","url":null,"abstract":"<p><p>Nuclear medicine has transformed healthcare delivery and played a crucial role in improving the quality of life of patients. Although nuclear medicine has multiple applications, its usage and acceptance among the general population is being influenced by the prevailing myths and misinformation. The need of the hour is that we must take targeted interventions to address these myths with information to augment the confidence of the general population, including its life-saving potential. In conclusion, nuclear medicine has a broad scope in healthcare delivery but the presence of myths and misconceptions about nuclear medicine has limited its utilization. This calls for organizing public health campaigns, empowering healthcare professionals, and facilitating transparent communication for optimal utilization.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"40 2","pages":"124-126"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additive Value of Cardiac Dyssynchrony Parameters using Rest Myocardial Perfusion SPECT in the Diagnosis of Cardiac Sarcoidosis: A Cross-sectional Analytical Study.","authors":"Kabilash Dhayalan, Harish Goyal, Lara Churchill, Raja Selvaraj, Dhanapathi Halanaik","doi":"10.4103/ijnm.ijnm_86_24","DOIUrl":"10.4103/ijnm.ijnm_86_24","url":null,"abstract":"<p><strong>Background: </strong>Cardiac sarcoidosis is a challenging condition to diagnose with potentially severe consequences. Early diagnosis is crucial, but existing criteria help in diagnosis, not without limitations. This study explores the status of cardiac dyssynchrony parameters measured through gated myocardial perfusion single-photon emission computed tomography (SPECT) in diagnosing cardiac sarcoidosis.</p><p><strong>Methods: </strong>We conducted a retrospective analytical study using data from patients who underwent cardiac inflammation imaging study (which includes myocardial perfusion SPECT and fluorodeoxyglucose positron emission tomography (FDG PET) under cardiac inflammatory protocol) between September 2018 and September 2021. The images were analyzed independently by two experienced nuclear medicine physicians. The patients were categorized as sarcoidosis positive or negative based on the Japanese Circulation Society (JCS) 2016 guidelines. Cardiac dyssynchrony parameters were assessed using phase analysis of the gated SPECT study.</p><p><strong>Results: </strong>Among the 22 patients (11 males, 11 females), 9 were positive for cardiac sarcoidosis according to JCS 2016 criteria. Data from 9 normal control subjects were analyzed separately. The dyssynchrony parameters assessed on gated SPECT studies were significantly higher in sarcoidosis-positive patients (mean phase standard deviation [PSD] =43.05 and phase histogram bandwidth [PHB] =108.11) compared to normal control subjects (mean PSD = 19.68 and PHB = 56.22, <i>P</i> = 0.01). However, these parameters did not show a significant difference compared to sarcoidosis-negative patients (mean PSD = 51.13, mean PHB = 143.23, <i>P</i> = 0.293).</p><p><strong>Conclusion: </strong>Cardiac dyssynchrony parameters from gated myocardial perfusion SPECT are higher in sarcoidosis patients when compared to the normal control subjects. The potential role in aiding the diagnosis of early cardiac sarcoidosis should be further investigated. To validate these findings and assess their clinical utility, further research is needed with larger sample sizes, early-stage disease, and elimination of confounding factors.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"40 2","pages":"72-78"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of ATTR Cardiac Amyloidosis in Patients with Left Ventricular Hypertrophy Using Tc-99m Pyrophosphate Scintigraphy.","authors":"V M Vimala Priyadharshini, Indirani Muthukrishnan, Shelley Simon","doi":"10.4103/ijnm.ijnm_156_24","DOIUrl":"10.4103/ijnm.ijnm_156_24","url":null,"abstract":"<p><strong>Introduction: </strong>Amyloidosis is characterized by the extracellular deposition of fibrillar proteins, leading to tissue damage and dysfunction. Cardiac amyloidosis (CA) occurs when these fibrils accumulate in the heart's extracellular matrix, causing infiltrative cardiomyopathy, heart failure, and potentially death. Early diagnosis is imperative in accurate management. Transthyretin amyloidosis, either hereditary or age-related, is a common cause of CA, often presenting with left ventricular hypertrophy (LVH) and heart failure with preserved ejection fraction (HFpEF). This study investigates the utility of Tc-99 m Pyrophosphate (Tc-99 m PYP) imaging in diagnosing Transthyretin Amyloidosis ((ATTR)-CA) in patients with unexplained LVH.</p><p><strong>Materials and methods: </strong>This prospective observational study, conducted between January 2023 and June 2024, involved 52 patients with clinical suspicion of CA and left ventricular wall thickness >12 mm. Patients underwent Tc-99 m PYP scintigraphy, and the results were categorized as positive, negative, or equivocal.</p><p><strong>Results: </strong>The study population's mean age was 64.6 years, with a male predominance (69%). Of the 52 patients, 9 (17.3%) had positive, 28 (53.8%) negative, and 15 (28.8%) equivocal Tc-99 m PYP scan results. Echocardiographic features, such as septal hypertrophy and granular speckled appearance, were significantly associated with positive scan findings. Comorbidities such as coronary artery disease and dyslipidemia were also common. Cardiac biomarkers NT-proBNP and troponin I showed elevated levels in patients with positive scan results.</p><p><strong>Conclusion: </strong>Tc-99 m PYP imaging is an effective noninvasive tool for diagnosing ATTR CA, particularly in patients with unexplained LVH. The presence of HFpEF, abnormal ECG, and restrictive features on echocardiography should prompt further investigation for CA. Early diagnosis allows for timely management, improving patient outcomes.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"40 2","pages":"79-87"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental Detection of NSTEMI on Whole-body [¹⁸F] FDG PET/CT.","authors":"Ujwal Bhure, Nina Lampe, Tatjana Leike, Hannes Grünig, Raban Jeger, Klaus Strobel","doi":"10.4103/ijnm.ijnm_163_24","DOIUrl":"10.4103/ijnm.ijnm_163_24","url":null,"abstract":"<p><p>Besides tumor imaging, ¹⁸fluorine-fluorodeoxyglucose (FDG) is equally useful for the detection of inflammatory diseases such as polymyalgia rheumatica and large vessel vasculitis. Critical incidental findings might be observed with FDG positron emission tomography/computed tomography (PET/CT) needing urgent medical attention and intervention. We present a case of an 81-year-old patient with a history of polymyalgia rheumatica. Cardiac activity representing an evolving non-ST segment elevation myocardial infarction was detected incidentally by FDG PET/CT.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"40 2","pages":"117-119"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse Pulmonary ^99mTc-MDP Uptake on Bone Scintigraphy: A Paraneoplastic Hypercalcemia Clue in Cervical Carcinoma.","authors":"Ikram Zahfir, Yassir Benameur, Meryem Aboussabr, Salah Nabih Oueriagli, Omar Ait Sahel, Abderrahim Doudouh","doi":"10.4103/ijnm.ijnm_19_25","DOIUrl":"10.4103/ijnm.ijnm_19_25","url":null,"abstract":"<p><p>^99mTc-methylene diphosphonate bone scintigraphy is a cornerstone imaging modality for skeletal assessment; however, extraosseous radiotracer uptake may signal underlying systemic metabolic derangements. Diffuse pulmonary uptake, classically linked to metastatic calcification, is commonly observed in chronic kidney disease patients with calcium-phosphate homeostasis disruption. We present an uncommon case of bilateral pulmonary ^99mTc-Methylene diphosphonate (MDP) uptake in a 48-year-old female with advanced cervical carcinoma, renal insufficiency, and severe hypercalcemia accompanied by paradoxically normal parathyroid hormone levels. While thoracic computed tomography showed no structural abnormalities, bone scintigraphy demonstrated diffuse pulmonary radiotracer accumulation, consistent with metastatic calcification secondary to calcium-phosphate deposition within alveolar walls. This case underscores the critical need for vigilant monitoring of metabolic complications in oncology patients, especially those with renal impairment, and highlights the diagnostic value of bone scintigraphy in identifying occult extraskeletal pathologies, even when conventional imaging appears unremarkable. The findings advocate for integrating metabolic profiling with functional imaging to better understand atypical tracer uptake patterns in high-risk populations.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"40 2","pages":"120-121"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}