Inguinal Herniation of Urinary Bladder on F-18 Sodium Fluoride (NaF) PET-CT / 대한핵의학회잡지

Inguinal herniation of urinary bladder is uncommon and usually an incidental finding in asymptomatic patients. In some of these patients, residual urine volume and consequently, urinary tracer activity can be higher in the herniated bladder than the native bladder, in which case interpretation can be challenging on conventional planar imaging.We describe an interesting case of physiological activity in a herniated bladder simulating a “tear-drop”. This case serves an important reminder that whilst F-18NaF PET-CT has a similar spectrum of urinary activity to conventional bone scintigraphy; morphological correlation on hybrid imaging is invaluable in ensuring the physiological nature of uptake.

Incremental diagnostic value and impact on patient management of somatostatin receptor scintigraphy with indium-111-pentetreotide in gastroenteropancreatic neuroendocrine tumors

To evaluate the efficacy of somatostatin analog scintigraphy with indium-111-pentetreotide and its overall impact on management in patients with gastroenteropancreatic neuroendocrine tumors [GEP-NET]. Twenty-two consecutive patients with a proven or clinically suspected GEP-NET with or without proven metastases were imaged at 24 and 48 h after injection of [111] In-pentetreotide. The scintigraphic findings were compared with results from conventional imaging methods. The final diagnosis was based on histopathological and surgical findings and complementary radiology. Somatostatin receptor-positive lesions were found in 20 of the patients, whereas conventional methods were positive in 18 patients. Additionally, 13 new tumor sites were discovered by somatostatin receptor scintigraphy in 5 patients [liver: 6; chest: 2; bone: 1; abdomen: 4]. The surgical therapeutic strategy was changed in 7 patients [32%]. Our data reinforced that scintigraphy with [111]In-pentetreotide represents the imaging modality of choice in the initial evaluation of GEP-NET. It is highly accurate and can identify clinically unsuspected lesions and optimize the overall staging. It also guides optimal therapy choice and most importantly identifies patients with inoperable or metastatic disease who might be candidates for high-dose targeted therapy