68 Ga-DOTATOC PET/CT in Pancreatic Metastasis From Clear Cell Renal Cell Carcinoma.

ABSTRACT: We present a rare case of a 74-year-old woman who underwent 68 Ga-DOTATOC PET/CT imaging for a suspected neuroendocrine tumor (NET) in the pancreatic head. PET/CT showed a solitary high somatostatis receptor (SSTR)-expressing lesion in the pancreatic head. Fine-needle aspiration of this lesion revealed a metastasis from a clear cell renal cell carcinoma (ccRCC). The patient had undergone nephrectomy 16 years prior due to ccRCC of the right kidney. Our case demonstrates that metastases originating from RCC can have high SSTR expression and therefore might mimic well-differentiated neuroendocrine tumors in 68 Ga-DOTATOC PET/CT.

18F-fluorodeoxyglucose positron emission tomography/ computed tomography as a metabolic marker for functional assessment of spinal tuberculosis after early decompression surgery.

Tuberculosis (TB) of the spine is the most important extra pulmonary form of TB. The lytic destructive variant of spinal TB can destroy the intervertebral discs, vertebral body, collapse, kyphotic deformity, and spinal cord compression. Complicated Pott's disease if not managed early can lead to neurological deficits, so there is a need for early surgical decompression, compliant anti-tubercular therapy, and response evaluation tool. We present two cases of multilevel dorsal spinal TB diagnosed on magnetic resonance imaging spine and baseline 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scan. They underwent early decompression with internal fixation and were followed up for 18 months with serial 18F-FDG PET/CT at 3rd and 18th month, respectively. One patient showed an early complete metabolic response and excellent functional recovery. Another patient showed progressive disease (drug-resistant status) and delayed functional recovery. 18F-FDG PET/CT has an excellent role in assessing response to therapy and thus helps to achieve therapeutic endpoint.

Multimodality Imaging of Anti-Contactin-Associated Protein-Like 2 Antibody-Induced Nonparaneoplastic Limbic Encephalitis: Complementary Role of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography and Magnetic Resonance Imaging.

Autoimmune limbic encephalitis (AE) is an autoimmune-mediated inflammation typically affecting the medial temporal lobes and other limbic structures (cingulate gyrus, orbital cortex, and hypothalamus). It can be associated with underlying malignancy as a paraneoplastic syndrome. Nonparaneoplastic AE is a difficult disease to diagnose and often requires the collaboration of multiple modalities for effective diagnosis and treatment. We describe an interesting case of contactin-associated protein-like 2 antibody-associated nonparaneoplastic limbic encephalitis on fluorine-18 fluorodeoxyglucose positron emission tomography and magnetic resonance imaging.

Krukenburg Tumors Arising from Rare Primary Sites: Role of 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in Management and Outcome.

Krukenberg tumors described by Friedrich Ernst Krukenberg are still fascinating for their mysterious origin. It is known to be a rare entity and commonly originates from adenocarcinoma of stomach. We present three interestingly rare cases of this entity, revealed by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) scan and discuss how F-18 FDG-PET/CT can prognosticate, alter the course of treatment in such patients. Ovarian metastatic deposits were detected in patients with renal cell, duodenal, and gall bladder carcinoma. Three visits were possible in patient with duodenal cancer (favorable response to therapy), two visits in renal cell cancer (progressive disease pattern) and only single visit for gall bladder cancer. Potentials of F-18 FDG-PET/CT scan for Krukenberg disease is still in exploratory phase, but it's applications in diagnosis, disease monitoring, therapeutic response monitoring, and prognosticating are unparalleled with other imaging modalities.

18F-FDG PET/CT of Tuberculosis Meningitis and Carotid Pseudoaneurysm.

A 26-year-old woman presented with a headache, left-sided weakness of the body, and pulsatile swelling above the sternal notch. She was treated for abdominal tuberculosis in the past, two years later she developed miliary tuberculosis and was put on modified regimen of antitubercular drugs in view of drug induced hepatitis. Ultrasound neck revealed saccular aneurysm measuring 4 x 3 cm, located in between common carotid arteries with an eccentric thrombus. MRI brain revealed multiple tuberculoma with thick basal meningeal enhancement. Cerebrospinal fluid was positive for Mycobacterium tuberculosis. F-FDG PET/CT was done to delineate the extent of the disease.

Thoraco-Abdominal Duplication Cyst- Role Tc-99m Pertechnetate SPECT-CT Scintigraphy in Localising Ectopic Gastric Mucosa.

Thoraco-abdominal duplication cyst, a congenital malformation of the posterior primitive foregut rarely presents with anaemia. Ectopic gastric mucosa is seen in around 20%-30% of the enteric duplication cysts. We report the scintigraphic findings of one such case which helped in final diagnosis and management of the patient.

Imaging in extrapulmonary tuberculosis.

Tuberculosis (TB) remains a major global public health problem, with 1.5 million deaths annually worldwide. One in five cases of TB present as extrapulmonary TB (EPTB), posing major diagnostic and management challenges. Mycobacterium tuberculosis adapts to a quiescent physiological state and is notable for its complex interaction with the host, producing poorly understood disease states ranging from latent infection to active clinical disease. New tools in the diagnostic armamentarium are urgently required for the rapid diagnosis of TB and monitoring of TB treatments, and to gain new insights into pathogenesis. The typical and atypical imaging features of EPTB are reviewed herein, and the roles of several imaging modalities for the diagnosis and management of EPTB are discussed.