The authors describe a patient with psoriatic arthritis in whom an increased level of F-18 fluorodeoxyglucose (F-18 FDG) uptake was seen in the joints of the hands. The areas of increased activity correlated well with the regions of symptoms reported by the patient. This case illustrates the potential use of F-18 FDG positron emission tomography to quantitatively assess the degree of arthritis activity.

Spleen shows a high physiological uptake on radionuclide somatostatin receptor (SSTR) imaging studies. Autoradiography and immunohistochemistry studies showed that SSTRs are mainly located in the red pulp of the spleen. In this review article we will summarize the significance of splenic uptake in SSTR imaging studies and will also present high resolution splenic images of Ga-68 DOTANOC PET in which splenic distribution of the radiotracer appears to be correlating with the distribution of red pulp.

On radionuclide somatostatin receptor imaging studies, the spleen shows high physiologic uptake. Reducing the intensity of the image settings helps to better assess the distribution of radiotracer in the spleen. In our routine studies, we incidentally recognized that Ga-DOTANOC PET provides higher-resolution splenic images thanIn-octreotide SPECT. Autoradiography and immunohistochemistry studies have shown that somatostatin receptors are located mainly in the red pulp of the spleen. The distribution of Ga-DOTANOC in the spleen appears to correlate with the distribution of red pulp. In this article, we presentGa-DOTANOC PET/CT spleen images of our patients.

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Objectives. A retrospective study of bone scintigraphy to assess the prevalence of steatopygia on bone scintigraphy of obese patients and evaluate its effect on the appearance of the lumbar spine, and the added benefit of SPECT and SPECT/CT in overcoming possible artifacts. Methods. Between 2016 and 2019, patients who underwent bone scintigraphy, BMI ≥ 30, were included. Three nuclear medicine consultants reviewed the studies to determine whether significant steatopygia is present, if it resulted in attenuation of underlying lumber spine and crease edge artifact. SPECT or SPECT/CT images were reviewed to evaluate their impact in diagnosis. Results. 56 patients out of the 100 were noted with steatopygia on planar images. Among the group of 80 obese patients, 50% patients showed steatopygia, while in the group of 20 morbidly obese patients, 80% patients showed steatopygia. 32 patients of the 56 with steatopygia, had significant attenuation at the lower lumber vertebrae. Nine of these patients showed crease edge artifact. SPECT and SPECT/CT clarified the scintigraphic abnormalities noted in all patients including patients with edge artifact alleviating diagnostic difficulty. Among the nine patients with edge artifact, six patients showed normal appearance on SPECT/CT images while three showed true abnormalities. Conclusions. Steatopygia is common on bone scintigraphy of obese patients, higher in females and morbidly obese patients. Obesity related artifacts in bone scintigraphy, including attenuation effect and edge artifact, are common in this patient group. SPECT or SPECT/CT improves the diagnostic accuracy by overcoming the steatopygia effects seen on planar images.