DPS is significantly more sensitive, and at least as specific, compared with DPP in detecting parathyroid abnormalities in patients with primary hyperparathyroidism and should, therefore, be routinely used when DP Tc-99m MIBI is used in this setting. An algorithm for best utilization of this technique to determine the appropriate surgical approach in patients with primary hyperparathyroidism is presented.
We report the case of a 17-year-old girl who presented with a several month history of fevers and abdominal pain. After cytomegalovirus (CMV) and Epstein-Barr virus (EBV) titers returned normal, FDG-PET/CT was obtained due to concern for lymphoma. FDG-PET/CT revealed a pattern of hypermetabolic activity in the adenoids, bilateral cervical lymph nodes, abdominal lymph nodes, and spleen, highly concerning for lymphoma. However, subsequent biopsy of a cervical lymph node revealed lymphadenitis consistent with EBV. This case highlights infection as the most well-known false-positive cause on FDG-PET, and how biopsy is essential to definitively distinguish malignancy from infection.
Spontaneous intracranial hypotension (SIH) is an infrequent clinical entity characterized by cerebrospinal fluid (CSF) hypovolemia due to a CSF leak. The cause of the leak in SIH, however, is largely unknown, though structural meningeal weakness and mechanical stress factors have been postulated. Patients with SIH typically present with postural headaches, and occasionally with other symptomology as well, such as nausea, emesis, neck stiffness, and photophobia. In this case series, we present 4 patients who underwent radionuclide cisternography (RNC) for suspected CSF leak. All patients underwent RNC and MR and/or CT for evaluation. We found that RNC accurately detected and localized a CSF abnormality in all 4 patients, with each patient experiencing symptomatic relief following directed epidural blood patch.
Cardiac PET/CT is an evolving, non-invasive imaging modality that impacts patient management in many clinical scenarios. Beyond offering the capability to assess myocardial perfusion, inflammatory cardiac pathologies, and myocardial viability, cardiac PET/CT also allows for the non-invasive quantitative assessment of myocardial blood flow (MBF) and myocardial flow reserve (MFR). Recognizing the need for an enhanced comprehension of coronary physiology, Siemens Healthineers implemented a sophisticated solution for the calculation of MBF and MFR in 2009. As a result, each aspect of their innovative scanner and image-processing technology seamlessly integrates into an efficient, easy-to-use workflow for everyday clinical use that maximizes the number of patients who potentially benefit from this imaging modality.Electronic supplementary materialThe online version of this article (10.1007/s12350-018-1262-3) contains supplementary material, which is available to authorized users.
The use of diagnostic I-123 pretherapy scintigraphy seems to be superior in many patients to posttherapy I-131 imaging obtained at 7 days in detecting locoregional metastases or remnant in postsurgical patients. This is likely due to the fact that 1 week is too long to wait to perform posttherapy imaging.
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