18F-FDG PET/CT Findings in a Patient With Neutrophilic Leukemoid Reaction Associated With Multiple Myeloma

An, Caixia; Zhai, Luoping; Geng, Hui-Xia; Wang, Pingzhi; Zhang, Wanchun

doi:10.1097/rlu.0000000000002999

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…This feature “looks too good” due to the diffuse and symmetric skeletal uptake, similar to the appearance of a bone scan. To date, diffuse tracer uptake in the skeleton/bone marrow as a skeletal superscan pattern on 18 F-FDG PET/CT has been previously reported in hematological diseases (including two cases of multiple myeloma ( 12 , 13 ), two cases of lymphoma and two cases of acute lymphoblastic leukemia ( 6 , 14 – 16 ), and one case of hemophagocytic lymphohistiocytosis) ( 17 ), nine cases of solid tumors with extensive bone metastasis ( 11 , 18 – 25 ), and metabolic diseases with three cases of hyperparathyroidism and one case of renal osteodystrophy ( 26 – 29 ). By reviewing all the medical images of the reports, the hematological diseases revealed greater homogeneous radiotracer uptake in the skeleton, as in our case, and the metabolic diseases all had a specific skull and mandible intense uptake pattern.…”

Section: Discussionmentioning

confidence: 99%

Case report: 18F-FDG PET/CT skeletal superscan-like in an adult patient with acute lymphoblastic leukemia

Hu,

Dai,

Wang

et al. 2024

Front. Oncol.

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We herein describe a rare case of adult acute lymphoblastic leukemia with an 18florine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) skeletal superscan-like appearance. The degree of bone marrow uptake was so intense that it far exceeded the level of physiological cerebral uptake and radiourinary activity. The distribution was remarkably similar to a superscan seen on skeletal scintigraphy. Skeletal superscans of 18F-FDG PET/CT have been reported in hematological diseases, solid tumors with extensive bone metastasis, and metabolic diseases. Thus, we reviewed the PET/CT images of cases reported, indicating that more homogeneous distribution, without primary tumor and specific mandibular and skull activity, may be suggestive of hematological diseases.

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Section: Discussionmentioning

confidence: 99%

Case report: 18F-FDG PET/CT skeletal superscan-like in an adult patient with acute lymphoblastic leukemia

Hu,

Dai,

Wang

et al. 2024

Front. Oncol.

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Superscan Pattern on Bone Scintigraphy: A Comprehensive Review

Askari,

Shakeri,

Roustaei

et al. 2024

Diagnostics

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Background/Objectives: The superscan pattern is a characteristic finding on bone scintigraphy, associated with a variety of metabolic bone diseases, malignancies, and other conditions. This pattern is characterized by a diffuse and intense uptake of radiotracer throughout the entire skeleton. Despite being a relatively rare finding, the superscan pattern can have significant clinical implications. Methods: This comprehensive review summarizes the available literature on the superscan pattern, focusing on its pathophysiology, clinical significance, and differential diagnoses. Relevant studies and case reports were analyzed to outline the diagnostic challenges associated with the interpretation of bone scintigraphy featuring the superscan pattern. Results: The literature highlights the clinical significance of the superscan pattern in various metabolic and oncologic conditions. Misinterpretation of this pattern can lead to diagnostic challenges, especially in distinguishing it from other pathologic conditions. Differential diagnosis remains crucial in the accurate interpretation and subsequent management of patients with this finding. Conclusions: This review provides a comprehensive overview of the superscan pattern on bone scintigraphy, aiming to assist clinicians in recognizing and managing this rare yet clinically important finding.

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Diagnostic value of WB-DWI versus 18F-FDG PET/CT for the detection of multiple myeloma

Zhang,

Bian

et al. 2023

Indian Journal of Cancer

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Background: Whole-body diffusion-weighted imaging (WB-DWI) is commonly used for the detection of multiple myeloma (MM). Comparative data on the efficiency of WB-DWI compared with F-18 fluoro-2-deoxy-d-glucose positron emission tomography-computed tomography (18F-FDG PET/CT) to detect MM is limited. Methods: This was a retrospective, single-center study of 22 patients with MM enrolled from January 2018 to December 2019. All patients underwent WB-DWI and 18F-FDG PET/CT. Pathological and clinical manifestations, as well as radiologic follow-up, were used for diagnosis. The overall accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of both methods were compared. The apparent diffusion coefficient (ADC) values of MM lesions and false-positive lesions were estimated. Results: A total of 214 MM bone lesions were evaluated. There was no significant difference in the accuracy of WB-DWI and PET/CT (86.92 versus 88.32%). Though WB-DWI had a higher sensitivity (99.26% versus84.56%) and PET-CT had a higher specificity (96.10% versus 64.56%), these differences were not statistically significant. There was a statistically significant difference in PPV (83.33% versus 96.64%) and NPV (98.08% versus 77.89%) of WB-DWI and PET/CT, respectively. The ADC value for MM lesions was significantly lower than that for false-positive lesions (P < 0.001). Receiver operating curve analysis showed that the AUC was 0.846, and when the cut-off value was 0.745 × 10-3 mm2/s, the sensitivity and specificity were 86.3 and 83.4%, respectively, which distinguished MM lesions from non-MM lesions. Conclusion: WB-DWI and PET-CT scans have similar overall accuracy for detecting MM lesions. The higher PPV of PET-CT and NPV of WB-DWI make them complementary imaging modalities. The ADC value for MM lesions is significantly lower than that for false-positive lesions. An ADC cutoff value of 0.745 × 10-3 mm2/s results in sensitivity and specificity of 86.3 and 83.4%, respectively.

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18F-FDG PET/CT Findings in a Patient With Neutrophilic Leukemoid Reaction Associated With Multiple Myeloma

Cited by 3 publications

References 23 publications

Case report: 18F-FDG PET/CT skeletal superscan-like in an adult patient with acute lymphoblastic leukemia

Case report: 18F-FDG PET/CT skeletal superscan-like in an adult patient with acute lymphoblastic leukemia

Superscan Pattern on Bone Scintigraphy: A Comprehensive Review

Diagnostic value of WB-DWI versus 18F-FDG PET/CT for the detection of multiple myeloma

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