Coronavirus disease (COVID-19) outbreak has profoundly changed the organization of hospital activities. We present our experience of reorganization of a nuclear medicine service settled in Northern Italy during the pandemic period of March and April 2020 characterized a government-mandated lockdown. Our service remained open during the whole period, performing approximately 80% of the routine practice, while maintaining it COVID-free despite the geographical context characterized by a high risk of...
Tue Aug 11, 2020 03:00
A 7-year-old boy presented with diffuse bone pain. FDG PET/CT was performed to find the possible underlying malignant cause of hypercalcemia. The images demonstrated multiple foci of abnormal FDG activity at the sites of periosteal reaction. In addition, calcium deposit was noted in the basal ganglia, stomach, and the colon. History taking revealed that the patient had routinely taken an over-the-counter “supplement” that contains a high dose of vitamin D. One week after calcitonin therapy and stopping...
Tue Aug 11, 2020 03:00
A man experienced pain in the right hemithorax 6 months after a first-line therapy for multiple myeloma (MM). FDG PET/CT showed a large extramedullary extent in the right hemithorax, which was biopsy proven. During the second-line treatment, FDG PET/CT showed no response as well as a suspected myocardium spread, a rare extramedullary location in MM. 18F-Fluorocholine PET/CT and then MRI confirmed myocardium lesions. This case confirms that 18F-fluorocholine PET/CT is able to detect MM recurrence...
Tue Aug 11, 2020 03:00
A 47-year-old woman with a history of surgically treated abdominal paraganglioma and left thigh melanoma underwent an 18F-FDOPA PET/CT for suspected locoregional recurrence of paraganglioma. 18F-FDOPA PET/CT disconfirmed this recurrence but revealed 2 FDOPA-avid left inguinal lymph nodes, confirmed on a subsequent 18F-FDG PET/CT. Excision and pathology characterized these lymph nodes as melanoma metastases. 18F-FDOPA PET/CT is a widely used and valuable tool in the assessment of paraganglioma, both...
Tue Aug 11, 2020 03:00
Wermer/MEN1 syndrome is composed of the triad of pancreatic, pituitary, and parathyroid (3P’s) tumors. We describe the 68Ga-DOTANOC PET/CT findings of a 43-year-old man, which revealed the classic 3P’s of MEN1 syndrome with somatostatin receptor expression. The patient further underwent surgery for parathyroid lesions, which were suggestive of adenomas. Received for publication March 14, 2020; revision accepted June 20, 2020. Conflicts of interest and sources of funding: none declared. ...
Tue Aug 11, 2020 03:00
Amyloid deposition can lead to Alzheimer disease and cerebral amyloid angiopathy. Rarely, it presents as a solitary focal deposition, primary cerebral amyloidoma, which can be misinterpreted as a neoplasm because of the “tumor-like” appearances. We present the case of a 54-year-old woman where MRI revealed a T2-hyperintense mass periventricular in the white matter with moderate contrast enhancement. Pathological investigation revealed AL (lambda) amyloidoma. 18F-florbetapir PET/CT was used to support...
Tue Aug 11, 2020 03:00
We presented a case of 64-year-old woman with pathologically diagnosed lung adenocarcinoma. Brain metastases were highly suspected due to the appearance of neurological symptoms. However, no abnormal finding in the brain was observed on 18F-FDG PET/CT. Contrast-enhanced MRI showed the presence of leptomeningeal metastases but with a negative cerebrospinal fluid analysis. For this reason, the patient underwent 68Ga-FAPI PET/CT, later fused with MRI scans that showed intense uptake of 68Ga-FAPI in...
Tue Aug 11, 2020 03:00
Osteosarcoma is usually 18F-FDG–avid. Here we report a case of an 18-year-old young man with widespread osteoblastic and slight osteolytic changes, which had diffusely increased 68Ga-DOTATATE uptake in the osseous lesions, whereas the 18F-FDG PET/CT was unrevealing. The final diagnosis is synchronous multifocal osteosarcoma based on the pathological, clinical, and imaging features. Received for publication May 19, 2020; revision accepted June 18, 2020. Conflicts of interest and sources of...
Tue Aug 11, 2020 03:00
The patient was a 61-year-old man with a history of neck pain starting around October 2019. CT of the neck showed a lytic lesion at the right skull base. Subsequent MRI demonstrated an enhancing destructive mass in the right skull base centered in the occipital bone and condyle involving the jugular foramen and hypoglossal canal. An 18F-FDG PET/CT was performed showing increased FDG uptake in the right jugular foramen tumor. In addition, a PET/CT with 68Ga-[DOTA-Tyr3]-octreotate (68Ga-DOTATATE) demonstrated...
Tue Aug 11, 2020 03:00
Giant cell tumor (GCT) of bone is benign and typically shows osteolytic changes on x-ray, whereas osteosarcoma is malignant and generally shows osteolytic and osteoblastic mixed images. We experienced a rare case of GCT with atypical radiological findings. The tumor found in the right knee of a 15-year-old girl comprised a wide range of osteoblastic and osteolytic lesion in medial femur. Technetium uptake, however, was detected only in osteoblastic part, and immunohistochemical staining of biopsy...
Tue Aug 11, 2020 03:00
Metastatic deposit in the inguinal canal is an uncommon finding. Few tumors such as pancreatic cancer, rectal cancer, and ovarian cancer have been described previously with metastatic inguinal canal deposit. We present here a case of prostate cancer with an uncommon inguinal canal deposit that was detected on 68Ga–prostate-specific membrane antigen PET/CT. Received for publication February 2, 2020; revision accepted June 14, 2020. Conflicts of interest and sources of funding: none declared....
Tue Aug 11, 2020 03:00
Purpose Esophagectomy with extended lymph node (LN) dissection is a standard treatment for resectable esophageal cancer to prevent recurrence, but severe, potentially life-threatening postoperative complications are still important issues. Accurate diagnosis of LN metastases would enable the decision to dissect or leave the LNs in regions with high risk of complications. Advancements in intraoperative gamma probe and radioactivity detectors have made intraoperative navigation surgery possible...
Tue Aug 11, 2020 03:00
PET targeting the translocator protein (TSPO) expression is an interesting approach to detect neuroinflammation, as TSPO is upregulated in activated macrophages and microglia. Considering the variable pathophysiology of multiple sclerosis (MS) variants, we compare TSPO PET using 18F-GE-180 in 3 different demyelinating diseases of the central nervous system: relapsing-remitting MS, tumefactive MS, and Baló’s concentric sclerosis. Visualization of neuroinflammation and its PET patterns in addition...
Tue Aug 11, 2020 03:00
The chief nursing officer serves in multiple roles, but among the most important are being the chief administrator for the division of nursing, the chief voice in the organization to engage and empower nurses as professionals, and a major leader for increasing patient satisfaction, quality, and safety. Each of these roles has overlapping responsibilities, and failure in any one of could result in failure in all of them. If all of these roles are done well, the value of the care rendered by the healthcare...
Tue Aug 11, 2020 03:00
Numerous expected competencies of a chief nursing officer are outlined in this article including communication, ability to build relationships, expertise about the environment of healthcare and its future directions, leadership, expertise in business matters, combating bullying, encouraging shared decision making, and optimizing interdisciplinary teams and the use of advanced practice providers. These skills are also expected of most other healthcare executives, whether or not they are nurses, because...
Tue Aug 11, 2020 03:00
Magnet recognition has value that benefits patients; nurses, physicians, and other providers; the healthcare organization; and the community. This includes not only better job satisfaction, more empowerment, and less turnover for nurses, but also better outcomes for patients, more research and evidence-based practice, a superior reputation for the organization, and an easier time recruiting for the organization. Received for publication May 25, 2020; revision accepted June 10, 2020. Conflicts...
Tue Aug 11, 2020 03:00
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