1
|
Tsukamoto S, Kawabata K, Kawamura H, Takata K, Hosono M. Differentiating Brown Tumor From Bone Metastasis in Parathyroid Cancer Using 18 F-FDG PET and 99m Tc-MIBI SPECT. Clin Nucl Med 2024; 49:444-446. [PMID: 38389211 DOI: 10.1097/rlu.0000000000005115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
ABSTRACT A 69-year-old woman presented with a right clavicle pain. CT revealed a pathological fracture of the right clavicle, multiple osteolytic lesions, and a left cervical mass. 18 F-FDG PET/CT demonstrated a marked FDG uptake in the cervical mass and osteolytic lesions indicative of metastatic parathyroid cancer. 99m Tc-MIBI SPECT/CT revealed either faint or no uptake in the osteolytic lesions. However, a histopathological analysis after a parathyroidectomy and right clavicle biopsy confirmed the diagnosis of parathyroid cancer and the presence of benign brown tumors secondary to hyperparathyroidism. Postoperative imaging showed sclerotic change and a decreased FDG uptake in the bone lesions.
Collapse
Affiliation(s)
- Suzune Tsukamoto
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
| | - Kazuna Kawabata
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
| | - Hitomi Kawamura
- Department of Diagnostic Radiology, Graduate School of Medicine, Kyoto University, Kyoto
| | - Kuniaki Takata
- Department of Otolaryngology, Head and Neck Surgery, Tenri Hospital, Nara
| | - Makoto Hosono
- Department of Radiology, Kindai University Faculty of Medicine, Osaka, Japan
| |
Collapse
|
2
|
Mohammadinejad P, Kim A, Koshevarova V, Murphy M, Shagun F, Bhargava P. Synchronous Endometrial Cancer Detected on 68 Ga-DOTATATE PET/CT. Clin Nucl Med 2024; 49:96-97. [PMID: 37883216 DOI: 10.1097/rlu.0000000000004947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
ABSTRACT A 50-year-old woman with history of metastatic neuroendocrine tumor underwent a follow-up PET/CT with 68 Ga-DOTATATE. An enlarged uterus with diffuse increased uptake warranted further investigation with an MRI that showed mass-like thickening of the endometrium, T2 hyperintensity, lobulated contour, and invasion of more than 50% of the myometrium. Biopsy revealed endometrial carcinoma with mucinous features. Mild to moderate uptake of the 68 Ga-DOTATATE by the uterus can be a normal physiological finding; however, it should prompt further investigation, particularly in a postmenopausal woman with concerning imaging or clinical findings.
Collapse
Affiliation(s)
| | - Alex Kim
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX
| | - Victoria Koshevarova
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX
| | - Micah Murphy
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX
| | - Fnu Shagun
- Buddhist Mission Hospital, Ranchi, Jharkhand, India
| | | |
Collapse
|
3
|
Zhang Y, Wang P, Liu M, Liu Y, Jing H. Increased Uptake of Brown Tumor in 99m Tc-HYNIC-TOC Scintigraphy Mimicking Postoperative Recurrence of Tumor-Induced Osteomalacia. Clin Nucl Med 2023; 48:978-979. [PMID: 37703478 DOI: 10.1097/rlu.0000000000004831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
ABSTRACT A 61-year-old man underwent a resection of tumor in the left tibia that caused osteomalacia 11 years ago. Postoperative bone pain and fatigue symptoms were briefly relieved but then recurred. To identify potential recurrent tumors, 99m Tc-HYNIC-TOC scintigraphy was performed. Images revealed an osteolytic lesion in the right tibia with increased uptake. The lesion was subsequently resected, which pathologically proved a brown tumor. Symptoms of bone pain and weakness caused by osteomalacia did not relieve 4 months after the operation. Here, we present a rare case of brown tumor with high activity on 99m Tc-HYNIC-TOC SPECT/CT, mimicking a culprit tumor of osteomalacia.
Collapse
Affiliation(s)
- Yuwei Zhang
- From the Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, BeijingKey Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, China
| | | | | | | | | |
Collapse
|
4
|
Werner J, Grünig H, Loher H, Fischli S, Strobel K, Wicke C. Localization of Brown Tumors With 18F-Fluorocholine PET/CT Imaging in Severe Primary Hyperparathyroidism. Clin Nucl Med 2023; Publish Ahead of Print:00003072-990000000-00579. [PMID: 37256731 DOI: 10.1097/rlu.0000000000004718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
ABSTRACT We present the case of a 68-year-old woman with a painful tibial tumor and fatigue. Histology and laboratory studies were consistent with a brown tumor secondary to initially unrecognized, severe primary hyperparathyroidism. 18F-fluorocholine PET/CT revealed a large hypermetabolic parathyroid mass and multiple bone foci considered as brown tumors. Unilateral neck exploration confirmed a large parathyroid adenoma. Serum calcium and parathyroid hormone levels normalized quickly, and symptoms subsided gradually after parathyroidectomy. Brown tumors are a rare complication of severe hyperparathyroidism. 18F-fluorocholine PET/CT allows the localization of parathyroid adenomas and brown tumors, and can be used as a single imaging modality.
Collapse
|
5
|
Jacquet-Francillon N, Prevot N. Brown tumors in nuclear medicine: a systematic review. Ann Nucl Med 2023; 37:255-270. [PMID: 36933117 DOI: 10.1007/s12149-023-01832-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/27/2023] [Indexed: 03/19/2023]
Abstract
Brown tumors (BT) are abnormal bone-repair processes and a consequence of hyperparathyroidism. The diagnosis of these lytic lesions in nuclear medicine, while a challenge, is not so rare, because functional imaging is used both in the management of cancer and hyperparathyroidism. The main objective of this review is to summarize the knowledge and the evidence concerning BT and the different imaging modalities in nuclear medicine. A systematic review was performed in Embase, PubMed and Google Scholar from 2005 to 2022. We included articles describing BT in the following imaging modalities: [18F]-fluorodeoxyglucose PET/CT, [18F]-fluorocholine or [11C]-fluorocholine PET/CT, [99mTc]-Sestamibi scintigraphy, bone scan, [18F]-sodium fluoride PET/CT, [68Ga]-FAPI PET/CT; [68Ga]-DOTATATE PET/CT; [11C]-methionine PET/CT. For each modality, appearance, avidity for radiotracer, available quantitative parameters and imaging evolution after parathyroidectomy were collected and analyzed. Fifty-two articles were included for a total of 392 BT lesions. If the diagnosis of BT is evoked on a known lesion, performing a [18F]-fluorocholine PET/CT imaging seems the most appropriate. In [18F]-fluorodeoxyglucose, [18F]-fluorocholine, [18F]-sodium fluoride PET/CT and bone scan, BT can mimic metastatic disease. BT uptakes appear reversible after parathyroidectomy, with a more or less rapid decrease depending on the imaging modality used.
Collapse
Affiliation(s)
- Nicolas Jacquet-Francillon
- Nuclear Medicine Department, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Hopital Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite, France.
| | - Nathalie Prevot
- Department of Nuclear Medicine, University Hospital of Saint-Etienne, Saint-Étienne, France.,Univ Jean Monnet, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
| |
Collapse
|
6
|
Talbot JN, Zhang-Yin J, Kerrou K, Aveline C, Vagne B, Bélissant O, Tassart M, Périé S, Bouchard P, Christin-Maitre S, Ménégaux F, Groussin L, Gaujoux S, Balogová S, Montravers F. Multiple endocrine neoplasia type 1 or 4: detection of hyperfunctioning parathyroid glands with 18F-fluorocholine PET/CT. Illustrative cases and pitfalls. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF... 2022; 66:130-140. [PMID: 35005879 DOI: 10.23736/s1824-4785.22.03440-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
18F-fluorocholine (FCH) PET/CT is now well established to detect the hyperfunctioning parathyroid glands (HFPTG) in a case of sporadic primary hyperparathyroidism (pHPT), but only limited evidence is available about the utility of FCH PET/CT to detect the HFPTG in patients with multiple endocrine neoplasia (MEN) type 1 or 4. The pHPT in this context frequently consists in a multiglandular disease with small hyperplastic glands rather than adenomas, which is challenging for imaging modalities. The data of patients with MEN1 or MEN4 after parathyroidectomy referred to FCH PET/CT for presurgical localization of HFPTG were retrospectively reviewed, including follow-up after parathyroidectomy, in search for diagnostic performance and for potential pitfalls. In the present cohort, 16 patients referred to FCH PET/CT as part of their initial pHPT work-up were subsequently operated, 44 abnormal parathyroid glands (PT) were resected, of which 32 (73%) had been detected on FCH PET/CT and 2 considered as equivocal foci. Nine patients referred to FCH PET/CT for recurrent pHPT who were subsequently operated, 14 abnormal PT were resected, all had been detected on FCH PET/CT. FCH PET/CT permitted a unilateral approach for PTx in 4 of them. In one patient with MEN4 and pHPT, the HFPTG could not be visualized on FCH PET/CT but was localized by ultrasonography. Several causes of false positive or false negative results, incidental finding and pitfalls are listed and discussed. FCH PET/CT has a positive benefit/risk ratio in the detection of HFPTG in case of MEN1 (the data in MEN4 being currently very limited) with the most effective detection rate of current imaging modalities for HFPTG, few pitfalls, and an adequate impact on patient management compared to sesta MIBI SPECT and ultrasonography.
Collapse
Affiliation(s)
- Jean-Noël Talbot
- Department of Nuclear Medicine, Hôpital Tenon AP-HP, Sorbonne University, Paris, France
| | - Jules Zhang-Yin
- Department of Nuclear Medicine, Hôpital Tenon AP-HP, Sorbonne University, Paris, France
| | - Khadoun Kerrou
- Department of Nuclear Medicine, Hôpital Tenon AP-HP, Sorbonne University, Paris, France
| | - Cyrielle Aveline
- Department of Nuclear Medicine, Hôpital Tenon AP-HP, Sorbonne University, Paris, France
| | - Benedicte Vagne
- Department of Nuclear Medicine, Hôpital Tenon AP-HP, Sorbonne University, Paris, France
| | - Ophélie Bélissant
- Department of Nuclear Medicine, Hôpital Tenon AP-HP, Sorbonne University, Paris, France
| | - Marc Tassart
- Department of Radiology, Hôpital Tenon AP-HP, Sorbonne University, Paris, France
| | - Sophie Périé
- Department of Head and Neck Surgery, Hôpital Tenon AP-HP, Sorbonne University, Paris, France
| | - Phillipe Bouchard
- Department of Endocrinology, Hôpital Saint-Antoine AP-HP, Sorbonne University, Paris, France
| | - Sophie Christin-Maitre
- Department of Endocrinology, Hôpital Saint-Antoine AP-HP, Sorbonne University, Paris, France
| | - Fabrice Ménégaux
- Department of Surgery, Pitié-Salpétrière University Hospital, Sorbonne University, Paris, France
| | - Lionel Groussin
- Department of Endocrinology, Hôpital Cochin AP-HP, University of Paris, Paris, France
| | - Sébastien Gaujoux
- Department of Pancreatic and Endocrine Surgery, Hôpital Cochin AP-HP, University of Paris, Paris, France
| | - Soňa Balogová
- Department of Nuclear Medicine, Hôpital Tenon AP-HP, Sorbonne University, Paris, France -
- Department of Nuclear Medicine, St. Elisabeth Oncology Institute, Comenius University, Bratislava, Slovakia
| | - Françoise Montravers
- Department of Nuclear Medicine, Hôpital Tenon AP-HP, Sorbonne University, Paris, France
| |
Collapse
|