Asia Oceania Journal of Nuclear Medicine and Biology最新文献

{"title":"2-[¹⁸F]-FDG PET/CT in rasmussen encephalitis: guiding diagnosis and treatment in a young adult with sudden onset.","authors":"Mattoli Maria Vittoria, Francesca Serani, Stefano L Sensi","doi":"10.22038/aojnmb.2025.84963.1606","DOIUrl":"https://doi.org/10.22038/aojnmb.2025.84963.1606","url":null,"abstract":"<p><p>Rasmussen encephalitis (RE) is a rare condition characterized by a chronic inflammatory disorder due to unilateral inflammation of the cerebral cortex. Typically, it involves one cerebral hemisphere and manifests through intractable epileptic seizures. Its occurrence in adults is infrequent. We present a case of a 28-year-old woman who was brought to the emergency room due to the sudden onset of uncontrolled seizures. The use of 2-[¹⁸F]-FDG PET/CT (FDG-PET) helped in the differential diagnosis between autoimmune seronegative encephalitis and Rasmussen encephalitis. Even though FDG-PET is not a mandatory diagnostic criterion in the clinical evaluation of RE patients, the presented case and the available literature suggest its usefulness as a valuable diagnostic tool in patients with uncertain diagnosis, emphasizing its potential as a reliable adjunct in challenging diagnostic scenarios and for patient follow-up.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"13 2","pages":"2023-2207"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526285","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 non-invasive, reference region-based method for quantification of cerebral blood flow and oxygen metabolism using oxygen-15 labeled gases and positron emission tomography.","authors":"Hiroshi Ito, Masanobu Ibaraki, Ryo Yamakuni, Naoyuki Ukon, Shiro Ishii, Kenji Fukushima, Hitoshi Kubo, Kazuhiro Takahashi","doi":"10.22038/aojnmb.2025.81433.1578","DOIUrl":"https://doi.org/10.22038/aojnmb.2025.81433.1578","url":null,"abstract":"<p><strong>Objectives: </strong>Measurement of cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO₂) by positron emission tomography (PET) with oxygen-15 labeled gases is widely used for investigation into the pathophysiology of occlusive cerebrovascular disease. However, all methods for quantification of CBF, CBV, OEF, and CMRO₂ by PET with oxygen-15 labeled gases require invasive arterial blood sampling. The present study developed a reference region-based method for quantification of CBF, CBV, OEF, and CMRO₂ using PET and oxygen-15 labeled gases based on the steady-state method without invasive arterial blood sampling.</p><p><strong>Methods: </strong>The CBF, CBV, OEF, and CMRO₂ were measured in patients with occlusive cerebrovascular disease by PET using ¹⁵O-labeled gases, C¹⁵O₂, C¹⁵O, and ¹⁵O₂, with the steady-state method. In the present method, the ratios of values in a brain region to the reference region for CBF, CBV, OEF, and CMRO₂ were calculated without invasive arterial blood sampling.</p><p><strong>Results: </strong>Good correlations were observed for the ratios of values of the cerebral lesion to the reference brain region for CBF, CBV, OEF, and CMRO₂ calculated by the present method as compared with those obtained by the steady-state method with arterial blood sampling, indicating its validity. Simulation studies showed that errors in estimated values calculated by the present method were negligibly small for both conditions of misery perfusion and matched hypoperfusion.</p><p><strong>Conclusion: </strong>A simple method for noninvasive quantification of CBF, CBV, OEF, and CMRO₂ using PET and oxygen-15 labeled gases could be developed based on the steady-state method. This method can be used to investigate the pathophysiology of occlusive cerebrovascular disease.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"13 2","pages":"126-137"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526286","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":"Follow up assessment on the first local theranostic intra-cavitary Yttrium-90 citrate colloid irradiation for refractory cystic craniopharyngioma: Is it still a valuable treatment option?","authors":"Nadiah Abd Razak, Pung Choon Ping, Kamalia Kamarulzaman, Siti Zarina Amir Hassan","doi":"10.22038/aojnmb.2025.83694.1594","DOIUrl":"https://doi.org/10.22038/aojnmb.2025.83694.1594","url":null,"abstract":"<p><p>Craniopharyngioma is a rare, benign intracranial tumour that can present with solid, cystic, or mixed solid-cystic characteristics. This case report aims to discuss the follow up assessment of our patient after one year of the irradiation therapy for craniopharyngioma. A 43-year-old male who has underlying refractory cystic craniopharyngioma requiring two-weekly aspirations, complicated with visual impairment and panhypopituitarism, was referred to our department for intra-cavitary irradiation therapy. Initial diagnostic assessment with Tc-99m MAA followed by dose calculation using the Backlund formula were conducted prior to the therapy. The patient received 6.22 mCi (230.14 MBq) of Ytrrium-90 citrate colloid via the Ommaya reservoir to deliver a radiation dose of 300 Gy to the tumour. Positive outcomes were observed as signified by the reduction on the aspirated cystic frequency and volume, tumour volume, improvement on the visual function and stable hormonal level. Despite the complications, the intra-cavitary irradiation therapy has demonstrated a significant and valuable therapeutic option for our patient in the management of refractory cystic craniopharyngioma.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"13 2","pages":"179-184"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526291","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":"¹⁸F-FDG PET/CT in lymphangiosarcoma: A case report and review of literature.","authors":"Nitin Gupta","doi":"10.22038/aojnmb.2024.77689.1548","DOIUrl":"10.22038/aojnmb.2024.77689.1548","url":null,"abstract":"<p><strong>Objectives: </strong>Lymphangiosarcoma is a rare tumor that affects the upper limbs of patients who have undergone breast cancer surgery, including axillary dissection, followed by radiation therapy (RT) to the axilla and has a poor prognosis. ¹⁸F-FDG PET/CT may enable the earlier detection of malignant transformation in a setting of chronic lymphedema and help evaluate the extent and staging of the tumor, allowing earlier initiation of treatment options.</p><p><strong>Case presentation: </strong>We herein report a case of cutaneous lymphangiosarcoma in a 47-year-old breast carcinoma patient, which occurred 9 years after initial surgery and radiation therapy. Distant metastases were detected on ¹⁸F-FDG PET/CT. The patient underwent fore-quarter amputation of the upper limb and concurrent chemo-radiation therapy. However, she succumbed to her disease after 3 cycles of chemotherapy.</p><p><strong>Conclusions: </strong>¹⁸F-FDG PET/CT scan helps in the early detection of malignant transformation and lymphangiosarcoma in a setting of chronic lymphedema in breast carcinoma patients following radiation therapy to the axilla. Furthermore, it helps determine the extent of regional spread and detect metastatic involvement, thus enabling better clinical management of these patients.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"13 1","pages":"107-113"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913763","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 Prospective cohort study investigates the health consequences and biomarkers in Iraqi radiation workers.","authors":"Rasha Sabeeh Ahmed, Haidar Ahmed Shamran, Dunia Ali Shamsi","doi":"10.22038/aojnmb.2025.82707.1583","DOIUrl":"https://doi.org/10.22038/aojnmb.2025.82707.1583","url":null,"abstract":"<p><strong>Objectives: </strong>Objectives: Ionizing radiation has the potential to change the pattern of DNA methylation and can cause oxidative damage that may impact DNA. In this prospective cohort study, the effect of ionizing radiation on Iraqi radiation workers has been estimated by investigating the malondialdehyde levels, DNA methylation, DNA fragmentation, as well as the karyorrhectic, differentiated, and basal cells in buccal tissue.</p><p><strong>Methods: </strong>This work involved 80 participants, 40 hospital X-ray workers, and 40 control. Blood samples have been investigated using the NWLSS™ malondialdehyde assay, the gSYNC™ DNA extraction kit, and the comet assay.</p><p><strong>Results: </strong>The mean values of malondialdehyde level, DNA methylation, and DNA fragmentation (%DNA in tai), in workers were found to be 3.00±0.53, 51.63±26.44, and 26.73±12.67, respectively, while in the control were found to be 0.67±0.11, 13.25±11.30, and 9.09±11.96, respectively. In buccal tissue, the mean values of karyorrhectic cells, differentiated cells, late differentiated cells, and early differentiated cells in workers were found to be 7.70±4.64, 8.98±5.44, 14.74±5.25, and 18.50±6.40, respectively, while in control group were found to be 0.15±0.43, 0.20±0.41, 3.45±1.30, 10.78±1.80, respectively. The level of basal cells in buccal tissue was lower in workers (49.33±18.77) compared to the control group (85.75±2.19).</p><p><strong>Conclusions: </strong>The observed levels of biomarkers in radiation workers suggest adverse health consequences due to their occupational exposure to ionizing radiation. Controlling the exposure of hospital workers is the first step to improving the health of workers, thus decreasing economic and human costs.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"13 2","pages":"166-178"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526287","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":"Complex immunotherapy-mediated response patterns depicted on serial ¹⁸F-FDG PET imaging of Hodgkin lymphoma patient undergoing pembrolizumab therapy.","authors":"Mohanad Badarneh, Ahmed Saad Abdlkadir, Mohammad Makoseh, Alaa Abufara, Akram Al-Ibraheem","doi":"10.22038/aojnmb.2025.86889.1621","DOIUrl":"https://doi.org/10.22038/aojnmb.2025.86889.1621","url":null,"abstract":"<p><p>Over the past decade, the role of ¹⁸F-Fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing treatment response for lymphoma patients undergoing immunotherapy has been extensively investigated. The advent of immunotherapy has challenged the utility of the established Lugano criteria, prompting the development of novel immunotherapy-specific response criteria now employed in clinical practice. Following ¹⁸F-FDG PET/CT evaluation after up to eight immunotherapy cycles, patients are typically transitioned to conventional imaging modalities if immunotherapy continuation is warranted. This case report illustrates the application of serial ¹⁸F-FDG PET/CT in monitoring a 67-year-old patient with Hodgkin lymphoma receiving immunotherapy, revealing complex, atypical response patterns unresolved by existing criteria. Notably, two episodes of pseudoprogression occurred at two distinct time points, one during cycle 5 and the other during cycle 22. Furthermore, an immunotherapy-enhanced abscopal effect was seen during radio-immunotherapy, leading to short-term disease remission. Our findings suggest that ¹⁸F-FDG PET/CT provides superior predictive value in delineating heterogeneous response patterns, thereby informing critical decisions regarding immunotherapy cessation or adjunctive therapeutic interventions.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"13 2","pages":"185-189"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526289","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":"The utility of quantitative ¹⁸F-FDG PET/CT-derived parameters as prognostic factors for predicting overall survival in radioiodine-refractory differentiated thyroid cancer.","authors":"Mai Hong Son, Nguyen Thi Phuong, Le Ngoc Ha","doi":"10.22038/aojnmb.2025.84029.1596","DOIUrl":"https://doi.org/10.22038/aojnmb.2025.84029.1596","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates the relationship between quantitative ¹⁸F-FDG PET/CT metabolic parameters and overall survival (OS) in patients with radioiodine-refractory differentiated thyroid cancer (RAI-R DTC).</p><p><strong>Methods: </strong>We conducted a prospective analysis of 127 patients with RAI-R DTC. Quantitative metabolic parameters including SUV_max, SUV_mean, SUV_peak, total metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were assessed in ¹⁸F-FDG -avid recurrent or metastatic lesions via ¹⁸F-FDG PET/CT imaging. Patients were monitored for disease progression and mortality for at least one-year post PET/CT imaging. Receiver operating characteristic (ROC) curves were used to establish cut-off values for predicting 5-year mortality, while the Kaplan-Meier method estimated the 5-year survival rate. Univariate and multivariate Cox regression analyses identified prognostic factors associated with OS.</p><p><strong>Results: </strong>The metabolic parameters derived from ¹⁸F-FDG PET/CT demonstrated high sensitivity and specificity for predicting 5-year OS. ROC curve analysis established optimal cut-off values for SUV_max (20.27 g/mL), SUV_mean (7.46 g/mL), SUV_peak (7.8 g/mL), TLG (45.74 g/mL×cm³), and MTV (5.78 cm³) (AUC: 0.82, 0.78, 0.82, 0.82, and 0.86, respectively; p<0.001). Kaplan-Meier analysis revealed significantly lower OS in patients with higher values of these parameters compared to those with lower ones (survival rates: 42.1% vs. 95.6%, 65.5% vs. 96%, 52.3% vs. 96.3%, 46.5% vs. 97.3%, and 57.3 % vs. 98.3%, respectively; p<0.001). Univariate Cox regression identified SUV_max, SUV_mean, SUV_peak, TLG, and MTV as significant predictors of 5-year OS (p<0.05). In multivariate analysis, SUV_peak and MTV emerged as independent predictors of OS.</p><p><strong>Conclusion: </strong>Quantitative ¹⁸F-FDG PET/CT-derived parameters are significant predictors of 5-year OS, exhibiting high sensitivity and specificity. Elevated values of these parameters correlate with increased mortality rates. Our findings suggest that SUV_peak and MTV are independent prognostic factors for 5-year OS in patients with radioiodine-refractory DTC.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"13 2","pages":"156-165"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526294","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":"Bio-distribution study of Tc-99m HMPAO labeled platelet in healthy volunteer.","authors":"Mahdieh Parvizi, Mehrshad Abbasi, Hojjat Ahmadzadehfar, Abbas Tafakhori, Maryam Naseri, Ali Khalaj, Saeed Farzanehfar","doi":"10.22038/AOJNMB.2024.71620.1525","DOIUrl":"https://doi.org/10.22038/AOJNMB.2024.71620.1525","url":null,"abstract":"<p><strong>Objectives: </strong>The bio-distribution of Tc-99m HMPAO labeled platelets (LP), which could be used to image subtle thrombosis, is not reported in a human yet, which is the subject of the current study.</p><p><strong>Method: </strong>The platelets were extracted from 49 ml whole blood and labeled with Tc-99m HMPAO, then re-injected to the healthy volunteer. Anterior and posterior whole body imaging was done by a dual-head gamma camera 3, 18, 33, 46, 81, 124, 190 min and 15 hours after injection. Also a whole-body SPECT was done at 137 min post-injection. The area under the curves of the spleen, liver, left kidney, bladder, right lung, brain, and abdominal aorta ROIs was calculated to estimate the accumulation of labeled platelets within the organs.</p><p><strong>Results: </strong>The spleen was the target organ. The kidneys, liver, and heart were also remarkably visualized. The thyroid, stomach, bladder, or gastrointestinal (GI) uptake/activity was not significant. The stomach visualization was enhanced after ingestion at 60 min. The sagittal and lateral sinuses were delineated, and the background of the brain was very low. During the study, the area under the curve of activity was 738, 308, 302, 196, 230, 121, 79, 216, 529, 369, 162, and 54 counts. min/pixel for spleen, liver, heart, right lung, left kidney, right iliac artery, sagittal sinus, thyroid, bladder, stomach, GI, and background, respectively.</p><p><strong>Conclusion: </strong>The quality of the scan with low dose Tc-99m HMPAO LPs is optimal. We documented the bio-distribution of LPs. The optimal imaging time was 80-120 min post-injection when the free Tc-99m and GI transit were negligible. The sagittal and lateral sinuses were visualized enabling detection of possible clots in the vessels.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"12 2","pages":"142-148"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756872","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 Finding of Triple Ectopic Thyroid: Case Report and Review of the Literature.","authors":"Fatima Zeineddine, Gerard El-Hajj, Marie-Ange Hajj, Rita Chahinian","doi":"10.22038/AOJNMB.2024.75895.1532","DOIUrl":"https://doi.org/10.22038/AOJNMB.2024.75895.1532","url":null,"abstract":"<p><p>Ectopic thyroid tissue is a rare congenital anomaly, with the presence of three simultaneous ectopic foci being exceedingly rare. We describe a case of a totally asymptomatic 26-year-old male discovered to have triple ectopic thyroid following incidental elevated thyroid-stimulating hormone (TSH) levels. Subsequent ultrasonography of the neck showed an absent thyroid gland in its conventional location. A Technetium-99m pertechnetate (Tc-99m) thyroid scan showed three distinct foci of radiotracer uptake in the upper cervical, lingual, and sublingual regions, corresponding to triple ectopic thyroid. An extensive review of the literature was conducted to provide a broader understanding and deeper insights into this uncommon condition. This case underscores the pivotal role of Technetium-99m thyroid scanning in diagnosing triple ectopic thyroid, particularly in instances where the orthotopic thyroid gland is absent. A comprehensive understanding of this rare entity is indispensable for radiologists and clinicians, enabling accurate diagnosis and informed decision-making regarding the appropriate therapeutic strategies.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"12 2","pages":"179-184"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756876","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":"¹⁸F-FDG PET/CT imaging of IgG4-producing MALT lymphoma with multiple site involvement.","authors":"Kodai Kawaji, Seiji Kurata, Katsuhisa Matsuo, Hiroaki Miyoshi, Jun Akiba, Fumihiko Mouri, Akiko Sumi, Kiminori Fujimoto, Toshi Abe","doi":"10.22038/AOJNMB.2023.73477.1512","DOIUrl":"10.22038/AOJNMB.2023.73477.1512","url":null,"abstract":"<p><p>¹⁸F-FDG PET/CT is regarded as a modality utilized for the purpose of lesion localization, staging and assessment of treatment response in patients with lymphoma. However, it is difficult that we diagnose among multifocal lymphoma, IgG4-related disease (IgG4-RD), or a combination of both conditions when confronted with multiple sites of ¹⁸F-FDG uptake with heightened serum IgG4 levels. We present a case of a 72-year-old male who was suspected of Sjögren's syndrome based on symptoms of xerostomia accompanied by swelling of the bilateral upper eyelid and salivary glands. Following a diagnostic biopsy that revealed mucosa-associated lymphoid tissue (MALT) lymphoma as a possible finding, ¹⁸F-FDG PET/CT was conducted, which demonstrated multiple sites of ¹⁸F-FDG accumulation. While multifocal MALT lymphoma was initially suspected, the coexistence of IgG4-RD could not be definitively ruled out due to the elevated serum IgG4 levels. Subsequent histopathological and immunohistochemical examinations confirmed the diagnosis of IgG4-producing MALT lymphoma. After receiving systemic therapy with rituximab, the swelling of the bilateral upper eyelid and parotid glands resolved upon visual examination, and the serum IgG4 levels returned to within the normal range in a few months. No new lesions were detected during the subsequent follow-up examinations conducted over a period of 3 years.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"12 1","pages":"52-56"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073265","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}