Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Economic Sanctions on Iran and Nuclear Medicine131203910.22038/aojnmb.2018.36919.1248ENSeyed Rasoul ZakaviNuclear Medicine Research Center, Mashhad University of Medical Sciences0000-0002-8276-2134Journal Article20181216"It is not a wise choice!", this was the reaction of my father when I applied for nuclear medicine residency program 26 years ago. The old retired officer continued that hi-tech nuclear medicine is dependent on multiple advanced sections that may not be easily available especially in the developing countries. Now he is not alive to see that political misconducts have added fuel to the fire.<br /> Global shortage of Technetium-99m in recent years revealed the vulnerability of nuclear medicine and dependency of our clinical departments on the policies of the governments to support production of radiotracers (1). Although the mission of International Atomic Energy Agency (IAEA) is to "accelerate and enlarge the contribution of atomic energy to peace, health, and prosperity throughout the world", its application is highly affected by local governmental policies (2) <br /> Recent unilateral withdrawal of USA from Iran nuclear deal (Joint Comprehensive Plan Of Action-JCPOA) followed by imposing economic, trade and financial sanctions against Iran, has deleterious effect on nuclear medicine either on supply of radiotracers or spare parts of nuclear medicine devices (3). Although medicine is apparently not included in the list of sanctions, secondary sanction, aviation and transport embargo as well as financial restrictions, made it extremely difficult for medical companies to be able to do any transaction. Payment for the drugs or instruments and shipment of the goods to and from Iran have turned to a lengthy, difficult and risky task. Nuclear medicine seems to be at particular risk due to its link with atomic energy agency.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Clinical Impact of 18F-FDG PET/CT on the Management of Gynecologic Cancers: One Center Experience4121120810.22038/aojnmb.2018.11208ENAkram Al-ibraheemKing Hussein Cancer Center0000-0002-0978-4716Abedallatif AlSharifDepartment of Radiology & Nuclear Medicine, Jordan University hospital, Amman, JordanRamiz Abu-HijlihDepartment of Radiation Oncology, King Hussein Cancer Center, Amman, JordanImad JaradatDepartment of Radiation Oncology, King Hussein Cancer Center, Amman, JordanAsem MansourDepartment of Radiology, King Hussein Cancer Center, Amman, JordanJournal Article20180516Objective(s): We aim to investigate the clinical impact of 18F-FDG PET/CT in managing patients with gynecological malignancies and pelvic or extrapelvic lymph nodes that are of equivocal significance on conventional imaging.<br />Methods: We retrospectively evaluated 18F-FDG PET/CT scans of patients with gynecologic tumors who were referred to King Hussein Cancer Center from January 2010 to August 2014. PET/CT results were compared with MRI and CT findings. We evaluated sensitivity and specificity of 18F-FDG PET/CT, its role in changing treatment plan<br />and its positive predictive value (PPV) and negative predictive value (NPV).<br />Results: Ninety seven patients (mean age: 49 years) underwent 18F-FDG/PET in the study period (40 cervical, 37 endometrial and 20 ovarian cancers). PET/CT scan provided additional information in 23 patients; upstaging 4.1% (4 patients; 3 true positive) and down staging in 19.5% (19 patients; 15 true negative). As a result, treatment strategy was changed from curative to palliative in three patients, and modification of radiation field or additional curative therapy was implemented following exclusion of distant metastasis in 11 patients. Mean follow up time for the whole cohort was 35 months (range 6 - 60 months). NPV of 18F-FDG PET/CT in detecting extrapelvic lymphadenopathy was 83.3%.<br />Conclusion: 18F-FDG PET/CT has high clinical impact in management of gynaecological cancers as it alters the treatment plan in a substantial number of patients who had equivocal findings on conventional imaging,<br />as well as it offers excellent validity in lymph nodes staging.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Diagnostic Accuracy of Positron Emission Mammography with 18F-fluorodeoxyglucose in Breast Cancer Tumor of Less than 20 mm in Size13211144310.22038/aojnmb.2018.31101.1213ENFuzuki YanoDepartment of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine0000-0002-7427-7235Masatoshi ItohSendai Medical Imaging Clinic (Gazo Kenshin)Hisashi HirakawaDepartment of Breast Surgery, Tohoku Kosai HospitalSeiichi YamamotoDepartment of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, JapanAkira YoshikawaInstitute for Materials Research, Tohoku UniversityJun HatazawaOsaka University Graduate School of MedicineJournal Article20180414Objective(s): To investigate the diagnostic accuracy of positron emission mammography (PEM) and positron emission tomography/computed tomography (PET/CT) for small breast tumors of less than 20 mm in size.<br />Methods: The study was conducted on a total of 100 subjects (i.e., 50 patients with pathologically proven breast cancer and 50 normal cases of medical screening). The total number of tumors was 54 (mean size: 11±5.1 mm, range:<br />4-20 mm). The diagnostic accuracy of PEM alone, PET/CT alone, and combined PET/CT and PEM was evaluated by two nuclear medicine physicians based on visual inspection. The two groups (i.e., tumors of ≤ 10 mm and > 10-20 mm) were<br />compared in terms of the diagnostic capability of the three modalities (PEM alone, PET/CT alone, and PET/CT+PEM).<br />Results: The sensitivities of PEM alone, PET/CT alone, and combined PET/CT and PEM were 72%, 60%, and 76%, respectively. The specificities of these tests were 98%, 100%, and 98%, respectively. Furthermore, the accuracies of these diagnostic modalities were 85%, 79%, and 87%, respectively. The combined PET/CT and PEM showed significantly higher sensitivity and accuracy than PET/CT alone (P=0.005 and P=0.02, respectively). In addition, PEM demonstrated a<br />significantly higher sensitivity than PET/CT in the ≤ 10 mm group (P=0.03); however, no difference was observed between the two modalities in the > 10 mm group in terms of sensitivity.<br />Conclusion: 18F-fluorodeoxyglucose PET had limited capability for the detection of small breast cancers of < 10 mm. Combined PET/CT and PEM showed higher sensitivity and accuracy, compared to PET/CT alone.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Dopamine Transporter imaging with Tc-99m TRODAT-1 SPECT in Parkinson’s disease and its correlation with clinical disease severity22281147710.22038/aojnmb.2018.30356.1208ENAsra PatelDepartment of Nuclear Medicine and PET-CT,
Apollo Hospitals, Chennai, Tamilnadu,
India0000-0002-0787-6561Shelley SimonDepartment of Nuclear Medicine and PET-CT,
Apollo Hospitals, Chennai, Tamilnadu
India0000-0001-5976-9816Indirani ElangovenDepartment of Nuclear Medicine and PET-CT
Apollo Hospitals, Chennai, Tamilnadu,
India0000-0003-1916-8316Jaykanth AmalchandranDepartment of Nuclear Medicine and PET-CT
Apollo Hospitals, Chennai, Tamilnadu
IndiaAvani JainDepartment of Nuclear Medicine and PET-CT
Apollo Hospitals, Chennai, Tamilnadu
IndiaThangalakshmi SDepartment of Nuclear Medicine and PET-CT
Apollo Hospitals, Chennai, Tamilnadu
IndiaJournal Article20180321Objective(s): To evaluate the role of Tc-99m TRODAT-1 Single Photon Emission Computed Tomography (SPECT) in Parkinson’s Disease (PD) by assessing the correlation of clinical disease severity, disease duration and age at onset of disease with specific uptake ratio of Tc-99m TRODAT-1 in striatum.<br />Methods: The study included 63 patients in age range of 40-72 years with clinical diagnosis of PD and nine controls. Clinical history of patients was obtained regarding age at onset of disease and disease duration. Disease severity in each patient was assessed using H and Y stage and UPDRS. Tc-99m TRODAT-1 SPECT was performed and specific uptake ratios were calculated for six regions in bilateral striata, caudate nuclei and putamina. Difference in specific uptake ratios between different stages of disease was analyzed for statistical significance. Specific uptake ratios were correlated with UPDRS, motor score of UPDRS, duration of disease and age at onset of disease using Pearson’s correlation co-efficient.<br />Results: Median specific uptake ratio was found to be least in contralateral putamen for all H and Y stages. There was a statistically significant difference between specific uptake ratios of controls vs stage 1, stage 1 vs 2, 1 vs 3, 1 vs 4, and 2 vs 4 for all 6 regions. The difference in uptake ratio between 3 and 4 H and Y stages was significant only for contralateral<br />regions. There was no significant difference in uptake ratio between 2 and 3 H and Y stages. The uptake ratios showed a strong negative correlation with UPDRS and motor score, a weak negative correlation with duration of disease and no significant correlation with age at onset of disease.<br />Conclusion: We conclude that Tc-99m TRODAT-1 SPECT can be used to assess the disease severity in PD patients.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Automated classification of pulmonary nodules through a retrospective analysis of conventional CT and two-phase PET images in patients undergoing biopsy29371201410.22038/aojnmb.2018.12014ENAtsushi TeramotoFujita Health University0000-0000-0000-0000Masakazu TsujimotoFujita Health University HospitalTakahiro InoueSchool of Medicine, Fujita Health HniversityTetsuya TsukamotoSchool of Medicine, Fujita Health UniversityKazuyoshi ImaizumiSchool of Medicine, Fujita Health UniversityHiroshi ToyamaDepartment of Radiology, Fujita Health University0000-0002-5341-1693Kuniaki SaitoSchool of Health Sciences, Fujita Health UniversityHiroshi FujitaDep. Electrical, Electronic & Computer Engineering, Fac. Engineering Gifu UniversityJournal Article20180716Objective(s): Positron emission tomography/computed tomography (PET/CT) examination is commonly used for the evaluation of pulmonary nodules since it provides both anatomical and functional information. However, given the dependence of this evaluation on physician’s subjective judgment, the results could be variable. The purpose of this study was to develop an automated scheme for the classification of pulmonary nodules using early and delayed phase PET/ CT and conventional CT images.<br />Methods: We analysed 36 early and delayed phase PET/CT images in patients who underwent both PET/CT scan and lung biopsy, following bronchoscopy. In addition, conventional CT images at maximal inspiration were analysed. The images consisted of 18 malignant and 18 benign nodules. For the classification scheme, 25 types of shape and functional features were first calculated from the images. The random forest algorithm, which is a machine learning technique, was used for classification.<br />Results: The evaluation of the characteristic features and classification accuracy was accomplished using collected images. There was a significant difference between the characteristic features of benign and malignant nodules with regard to standardised uptake value and texture. In terms of classification performance, 94.4% of the malignant nodules were identified correctly assuming that 72.2% of the benign nodules were diagnosed accurately. The accuracy rate of benign nodule detection by means of CT plus two-phase PET images was 44.4% and 11.1% higher than those obtained by CT images alone and CT plus early phase PET images, respectively.<br />Conclusion: Based on the findings, the proposed method may be useful to improve the accuracy of malignancy analysis.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Simplified Dynamic Phantom for Pediatric Renography: A Description of Instrument and Its Performance38481180310.22038/aojnmb.2018.11803ENTakashi KamiyaOsaka University Hospital0000000266998796Tadashi WatabeDepartment of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine0000-0001-8658-2395Koichi FujinoOsaka University HospitalRomanov VictorOsaka University Graduate School of MedicineYoshiki KawamuraOsaka University HospitalKayako IsohashiDepartment of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of MedicineKeiko MatsunagaDepartment of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine
Osaka University Graduate School of Medicine Immunology Frontier Research CenterMitsuaki TatsumiDepartment of Radiology, Osaka University Graduate School of Medicine0000-0000-0000-0000Hiroki KatoDepartment of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of MedicineEku ShimosegawaDepartment of Molcular Imaging in Medicine,Osaka University Graduate School of MedicineJun HatazawaOsaka University Graduate School of MedicineJournal Article20180803Objective(s): Renography is used for the diagnostic evaluation of pediatric patients with a suspected obstruction of urinary tract or impaired renal function. The recommended dose for children have been released by the European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and Japanese Society of Nuclear Medicine. Since acquisition counts in dynamic scintigraphy are affected by the administered doses and sensitivity of the scintillation camera, the scan procedure should be determined independently. In this study, we constructed simplified dynamic phantom imitating pediatric renography and tested its performance.<br />Methods: Simplified dynamic phantom consisted of three components (i.e.,infusion, imitated kidney, and drainage sections). The infusion rates (mL/min) were determined by comparing the time activity curves obtained from patients<br />with normal renal function. The time-points of the maximum counts (Tmax), as well as the two-thirds and one-half of the maximum counts (T2/3 and T1/2) were measured in different doses using the phantom with the best-match infusion rate<br />and duration, and low-energy general-purpose (LEGP) or low-energy highresolution (LEHR) collimators and applying different attenuations.<br />Results: The best-match infusion rates of the phantom to imitate the time activity curve of the normal renal function were 42.0, 1.0, 0.6, and 0.3 mL/min in the arterial, secretory, early-excretory, and late-excretory phases, respectively. When 30 MBq, LEHR collimator and non-water-equivalent phantom were applied, Tmax, T2/3, and T1/2 were 242±15.3, 220±10.0 and 317±25.2 seconds, respectively. Using LEGP collimator and (3 MBq of activity) 5-cm water-equivalent phantom, Tmax, T2/3, and T1/2 values were estimated as 242±5.8, 213±11.5, and 310±17.3 sec, respectively.<br />Conclusion: Our simplified dynamic phantom for pediatric renography could imitate the time activity curves obtained from patients with normal renal function. Tmax, T2/3, and T1/2 could be measured under various settings of dose,collimator, and tissue attenuation.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Impact of Novel Incorporation of CT-based Segment Mapping into a Conjugated Gradient Algorithm on Bone SPECT Imaging: Fundamental Characteristics of a Context-specific Reconstruction Method49571139610.22038/aojnmb.2018.31711.1219ENKyohei OkudaDepartment of Clinical Radiology, Tottori University Hospital, Tottori, Japan0000-0003-2573-4193Susumu FujiiDepartment of Clinical Radiology, Tottori University Hospital, Tottori, JapanShota SakimotoDepartment of Clinical Radiology, Tottori University Hospital, Tottori, JapanJournal Article20180509Objective(s): The latest single-photon emission computed tomography (SPECT)/computed tomography (CT) reconstruction system, referred to as xSPECT Bone™, is a context-specific reconstruction system utilizing tissue segmentation information from CT data, which is called a zone map. The aim of this study was to evaluate the<br />effects of zone-map enhancement incorporated into the ordered-subset conjugated gradient minimization (OSCGM) reconstruction method on SPECT images.<br />Methods: Image quality with zone-map enhanced OSCGM (OSCGMz) and nonenhanced OSCGM methods was compared using various reconstruction parameters. The compartment phantom had 3 radioactive sections with CT values of about 1000, 250, and 0 HU. SPECT data were acquired using a lowenergy high-resolution (LEHR) collimator, with a 256×256 matrix and 2.4-mm pixel size. The performances of the 2 reconstruction methods (OSCGM vs.OSCGMz) were evaluated on the basis of %error, coefficient of variation (%CV), and normalized mean squared error (NMSE), and adequate iterative update numbers were determined. The relative CV representing the ratio of smoothed images to non-smoothed images was calculated to evaluate the effects of the Gaussian filter on each section set with different CT values.<br />Results: On comparing the OSCGM and OSCGMz methods, it was found that the %error of the OSCGMz method tended to show convergence with fewer updates, especially in the high CT value section mimicking bone absorption. In the water<br />section, the %CV of the OSCGMz method was lower than that of the OSCGM method. The NMSE minimum values for the OSCGM and OSCGMz methods were obtained at 30 and 20 updates, respectively. The relative CV for the OSCGMz<br />method in the water section decreased remarkably according to the size of the full width at half maximum (FWHM) of the Gaussian filter.<br />Conclusion: The zone-map enhancement contributed to SPECT reconstruction for the reproduction of radioactive concentrations in bone tissues, using a low number of OSCGM updates. Our findings indicated that the incorporation of zone maps into SPECT reconstruction might improve image quality.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Comparison of Count Normalization Methods for Statistical Parametric Mapping Analysis Using a Digital Brain Phantom Obtained from Fluorodeoxyglucose-positron Emission Tomography58701174510.22038/aojnmb.2018.11745ENWin Thet PeDepartment of Radiological Sciences, International University of Health and Welfare, School of Health SciencesYoshiyuki HosokaiDepartment of Radiological Sciences, International Univercity of Health and Welfare0000-0001-5320-1074Takashi MinagawaDepartment of Diagnostic Image Analysis, Course of Radiological Technology, Tohoku University Graduate School of MedicineKenzo MuroiDepartment of Radiological Sciences, International University of Health and Welfare, School of Health SciencesKenta MiwaDepartment of Radiological Sciences, International University of Health and Welfare, School of Health SciencesAyaka MaruyamaDepartment of Radiological Sciences, International University of Health and Welfare, School of Health SciencesToshiya YamaguchiDepartment of Radiological Sciences, International University of Health and Welfare, School of Health SciencesKazuto OkanoDepartment of Radiological Sciences, International University of Health and Welfare, School of Health SciencesHtwe Khin Moh MohDepartment of Radiological Sciences, International University of Health and Welfare, School of Health SciencesHaruo SaitoDepartment of Diagnostic Image Analysis, Tohoku University Graduate School of MedicineJournal Article20180510Objective(s): Alternative normalization methods were proposed to solve the biased information of SPM in the study of neurodegenerative disease. The objective of this study was to determine the most suitable count normalization method for SPM analysis of a neurodegenerative disease based on the results of different count normalization methods applied on a prepared digital phantom similar to one obtained using fluorodeoxyglucose-positron emission tomography (FDG-PET) data of a brain with a known neurodegenerative condition.<br />Methods: Digital brain phantoms, mimicking mild and intermediate neurodegenerative disease conditions, were prepared from the FDG-PET data of 11 healthy subjects. SPM analysis was performed on these simulations using different count normalization methods. <br />Results: In the slight-decrease phantom simulation, the Yakushev method correctly visualized wider areas of slightly decreased metabolism with the smallest artifacts of increased metabolism. Other count normalization methods were unable to identify this slightly decreases and produced more artifacts. The intermediate-decreased areas were well visualized by all methods. The areas surrounding the grey matter with the slight decreases were not visualized with<br />the GM and VOI count normalization methods but with the Andersson. The Yakushev method well visualized these areas. Artifacts were present in all methods. When the number of reference area extraction was increased, the Andersson method better-captured the areas with decreased metabolism and reduced the artifacts of increased metabolism. In the Yakushev method, increasing the threshold for the reference area extraction reduced such artifacts.<br />Conclusion: The Yakushev method is the most suitable count normalization method for the SPM analysis of neurodegenerative disease.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Effect of Beta Particles Spectrum on Absorbed Fraction in Internal Radiotherapy71831161010.22038/aojnmb.2018.11610ENMahdi GhorbaniBiomedical Engineering and Medical Physics Department, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0001-5518-8870Marjan HashempourPhysics Group, Faculty of Basic Sciences, Hakim Sabzevari University, Sabzevar, Iran,Ernesto AmatoDepartment of Biomedical and Dental Sciences and of Morpho functional Imaging, University of Messina, MessinaCourtney KnaupComprehensive Cancer Centers of Nevada, Las Vegas, Nevada, USA, CourtneyJournal Article20180506Objective(s): The purpose of this research is to study the effect of beta spectrum on absorbed fraction ( ) and to find suitable analytical functions for beta spectrum absorbed fractions in spherical and ellipsoidal volumes with a uniform distribution for several radionuclides that are commonly used in nuclear medicine.<br />Methods: In order to obtain the beta particle absorbed fraction, Monte Carlo simulations were performed by using the MCNPX code. The validation of the simulations was performed by calculating the absorbed fractions in spheres and comparing the results with the data published by other investigators. The absorbed fractions were calculated and compared by using an actual beta energy spectrum with those obtained through the mean beta energy of 14C, 199Au, 177Lu, 131I, 90Sr, 153Sm, 186Re, 32P, 90Y, 38Cl and 88Rb radionuclides.<br />Results: The maximum difference between the absorbed fractions for beta particles accounting for the whole beta spectrum of all the considered nuclides was 29.62% with respect to the mean beta energy case. Suitable analytical relationships were found between the absorbed fraction and the generalized radius, and the dependence of the fitting parameters from beta spectrum energy was discussed and fitted by appropriate parametric functions.<br />Conclusion: The results allowed the calculation of the absorbed fractions from the above stated beta sources uniformly distributed in spherical and ellipsoidal volumes of any ellipticity and volume, in a wide range of practical volumes that are not only used for internal dosimetry in nuclear medicine applications, but also in radiological protection estimates of<br />doses from internal contamination.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101False Negativity of Tc-99m Labeled Sodium Phytate Bone Marrow Imaging Under the Effect of G-CSF Prescription in Aplastic Anemia: A Case Report84881180410.22038/aojnmb.2018.11804ENAkanganyira KaseneneDepartment of Radiology and Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, PR China0000-0003-1844-3494Aju BaidyaDepartment of Radiology and Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, PR ChinaChangyin WangDepartment of Radiology and Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, PR ChinaHai-Bo XuDepartment of Radiology and Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, PR ChinaJournal Article20180807Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic cytokine which controls the differentiation and growth of hematopoietic cells in the bone marrow. We report a severe aplastic anemia (SAA) patient with false-negative 99mTc sodium phytate bone marrow imaging findings under concurrent G-CSF therapy. The first bone marrow imaging showed a normal bone marrow activity. However, the bone marrow biopsy pathology report revealed a lack of hematopoietic cells. Furthermore, the complete blood count indicated severe pancytopenia resulting in the diagnosis of aplastic anemia (AA). A second marrow scan implemented after the stoppage of G-CSF showed an abnormal bone marrow activity, which matched the pathology reports. Accordingly, the concurrent administration of G-CSF was considered as the cause of false-negative bone marrow imaging findings obtained in the first scan. Consequently, it should be kept in mind that a 99mTc sodium phytate bone marrow scintigraphy during the concurrent administration of G-CSF may lead to the achievement of false negative results because it induces changes in bone marrow mimicking a normal marrow scan in patients with AA.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101A Rare Presentation of Colorectal Cancer with Unusual Progressive Intramuscular and Subcutaneous Metastatic Spread89941193410.22038/aojnmb.2018.11934ENReyhaneh Manafi-FaridResearch institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran0000-0003-2833-8276Narjess AyatiNuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-8482-4119Mohammad EftekhariResearch institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.0000-0003-2928-9445Babak FallahiResearch institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran0000-0002-0576-1672Fardad MasoumiTabriz University of Medical Sciences, Tabriz, IranJournal Article20180815Colorectal carcinoma is one of the most common causes of cancer-related death, worldwide. Recently, due to the introduction of novel imaging and therapeutic techniques, five-year survival of patients has increased. However, distant metastasis is still expected in half of the patients. Colorectal cancer tends to target the abdominal cavity, liver, lungs, and bones as the common sites of metastasis. Nevertheless, rare cases of muscle metastasis have been reported. This report presents a 23-year-old male, who despite chemotherapy, demonstrated gradual progressive disease and metastases to the submandibular region, lungs, adrenal gland as well as muscles and subcutaneous tissues. He had developed multiple asymptomatic muscular metastases metachronously over two-year time period discovered on an 18FDGPET/CT, namely in the deltoid, external oblique abdominis, rectus abdominis, and quadriceps muscles, as well as one of the extrinsic muscles of the tongue. The presence of distant, especially extrahepatic metastasis, adversely affects the prognosis of colon carcinoma. Since limited cases of muscle metastasis have been reported in carcinoma of colon, the underlying pathophysiology, optimum treatment, and prognostic issues are yet to be substantiated.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101False-positive FDG PET CT Scan in Vertebral Hemangioma95981201010.22038/aojnmb.2018.12010ENShrikant SolavConsultant Incharge, Dr Solav's SPECT Lab, India0000-0002-4653-9912Shailendra VasantraoSalveConsultant Radiologist, Dr Solav's SPECT Lab0000-0002-2124-8254Abhijit PatilConsultant Radiologist, Dr Solav's SPECT Lab, Consultant Radiologist0000-0002-4888-16Journal Article20180620FDG PET CT scan is considered to be a sensitive tool to detect skeletal metastasis in known malignancies. However, it’s high sensitivity and low specificity may account for false positive diagnosis in cases of trauma, infection, inflammation and other benign conditions. Skeletal hemangioma is one of the common benign conditions which are typically ametabolic on FDG PET CT with no uptake on bone scan. However, rarely they may have atypical imaging features and appear hypermetabolic. Other imaging modalities such as MRI and CT scan have typical imaging findings for hemangioma and can be used for evaluation of focal hypermetabolic skeletal lesions. There are atypical imaging characteristics in each of these modalities. Hence when used judiciously they can complement each other and avoid a false positive test result. This case report highlights the importance of bone scan and CT scan in excluding pathological involvement of skeleton with false positive FDG PET scan results.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Extra-striatal Uptake of 99mTc-TRODAT SPECT in a Cerebral Meningioma: A Case Report991021193310.22038/aojnmb.2018.11933ENRamin SadeghiNuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-1666-5440Mahsa SabourNuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, IranAli ShoeibiDepartment of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranSomaye GhahremaniNuclear Medicine Research Center, Ghaem Hospital,Mashhad,IranJournal Article20180218We reported a 71 years old woman, with history of rest and postural tremor, bradykinesia and memory problems. In her dynamic MRI, a contrastenhanced tumor in the cerebellopontine (CP) angle was found which was compatible with a meningioma. 99mTc-TRODAT SPECT showed decreased activity in the left putamen, indicating idiopathic Parkinson disease. There was also a focus of increased activity on the right side of the skull base, which was compatible with meningioma in MRI.Mashhad University of Medical Sciences in collaboration with
AOFNMBAsia Oceania Journal of Nuclear Medicine and Biology2322-57187120190101Sectional Anatomy Quiz III1031071144110.22038/aojnmb.2018.33101.1228ENRashid HashmiUniversity of New South Wales (UNSW)0000-0002-5792-1156Journal Article20180630This series comprises of a quiz pertaining to the identification of salient and important anatomical structures and landmarks expected to be seen at a given level on the computed tomography (CT) image. The representative<br />image is followed by a series of images showing examples of different commonly encountered pathological entities that can be seen at this level in a routine clinical practice. Readers are encouraged to identify highlighted anatomical structures and landmarks in all the images and appreciate how a given abnormality can alter the appearance of normal structures. It is expected that this series will help nuclear physicians in interpretation of the CT component of the single photon emission computed tomography (SPECT) and positron emission tomography (PET) studies.