Visualization of Dialysis-Related Amyloid Arthropathy on 18F-FDG PET-CT Scan

We report a case of dialysis-related amyloid arthropathy in a patient with end-stage renal disease. It presented in our patient as moderately increased FDG uptake in the amyloid deposition in the periarticular tissues and eroding into adjacent bones.

Metabolic and Texture Features of PET/CT Scan to Predict Response in Patients with Locally Advanced Rectal Cancer Treated by Concurrent Neoadjuvant Chemoradiotherapy

Background: Neoadjuvant chemoradiotherapy (nCRT) before surgical resection is the standard treatment for patients with locally advanced rectal cancer (LARC). Radiomics can be used as noninvasive biomarker for response prediction. The purpose of our study was to evaluate the potential of PET/CT texture features to predict the responses of LARC subjects treated with nCRT.Methods: One week prior to nCRT, patients underwent Positron Emission Tomography/Computed Tomography (PET/CT) scan and then received concurrent nCRT. For each patient, intensity, shape and texture-based features were derived from PET/CT images using the IBEX software. The logistic regression classifier was used to identify the responders from non-responders. Results: In this study, 23 patients with LARC were included. The patients’ responses included 5 patients with Grade 0, 7 with Grade 1, 6 with Grade 2, and 5 with Grade 3 according to American Joint Committee on Cancer/College of American Pathologists (AJCC/CAP) pathologic grading. In quantitative texture features analysis, the dissimilarity feature had the highest performance [Area under Curve (AUC) = 0.65] and in metabolic parameters analysis the best performance was for total lesion glycolysis (TLG; AUC= 0.61)Conclusions: In conclusion, performance of quantitative texture features is better than metabolic parameters but their performance should be improved.

Fibrolamellar Hepatocellular Carcinoma: Report of a Rare Case with Rapid Progression and Unusual Metastatic Sites

Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare primary liver cancer that occurs in young adults, and its biology is not well known. We present a 21-year-old woman with metastatic liver cancer 6 months after undergoing embolization procedures for a typical hemangioma. The pathological investigation confirmed metastatic FLHCC. Despite liver mass resection and lung metastasectomy, after 3 months, the tumor recurred. In 18F-FDG PET-CT scan, lung, ovary, colon, and peritoneal invasions were reported. Unfortunately, the patient died a year after diagnosis due to a rapid progression and multiple unusual metastatic sites.

Current Roles of PET/CT in Thymic Epithelial Tumours: Which Evidences and Which Prospects? A Pictorial Review

Background: The use of 18F FDG PET/CT scan in thymic epithelial tumours (TET) has been reported in the last two decades, but its application in different clinical settings has not been clearly defined. Methods: We performed a pictorial review of pertinent literature to describe different roles and applications of this imaging tool to manage TET patients. Finally, we summarized future prospects and potential innovative applications of PET in these neoplasms. Results: 18FFDG PET/CT scan may be of help to distinguish thymic hyperplasia from thymic epithelial tumours but evidences are almost weak. On the contrary, this imaging tool seems to be very performant to predict the grade of malignancy, to a lesser extent pathological response after induction therapy, Masaoka Koga stage of disease and long-term prognosis. Several other radiotracers have some application in TETs but results are limited and almost controversial. Finally, the future of PET/CT and theranostics in TETs is still to be defined but more detailed analysis of metabolic data (such as texture analysis applied on thymic neoplasms), along with promising preclinical and clinical results from new “stromal PET tracers”, leave us an increasingly optimistic outlook. Conclusions: PET plays different roles in the management of thymic epithelial tumours, and its applications may be of help for physicians in different clinical settings.

Cancer of unknown primary origin presented with rapid deterioration without significant symptoms, a case report

A 34-year-old woman with flank pain was referred for suspicious lymphadenopathy. PET/CT scan revealed disseminated lesions without apparent primary origin. Although she did not complain of any symptoms, after rapid deterioration, she died of respiratory distress and cardiac arrest. Her strong beliefs contribute to symptoms tolerance and late diagnosis.