A Case of Secondary Hemochromatosis With High Uptake of Liver in F-18 FDG PET/CT Imaging

Hemochromatosis Affects the Distribution of 68 Ga-DOTATATE in the Liver and Spleen

ABSTRACT

Hemosiderosis is a chronic condition characterized by abnormal iron accumulation in tissues. In a PET scan of a 37-year-old woman, we observed an irregular distribution of 68 Ga-DOTATATE in the liver and spleen. Specifically, 68 Ga-DOTATATE appeared to be concentrated primarily in the peripheral regions of these organs, creating a distinctive "shell-like" appearance. This peculiar pattern may be attributed to the substantial accumulation of hemosiderin in the liver and spleen.

"Hepatic Superscan" Revealed on 18 F-FDG PET Due to Drug-Induced Fulminant Hepatitis

ABSTRACT

"Hepatic superscan" could be caused by a variety of etiologies. Here we report a 68-year-old woman with a medication history of cefoperazone and azithromycin for pneumonia recently who underwent 18 F-FDG PET/CT to detect underlying malignancy due to unexplained liver damage and fever of unknown origin. Unexpectedly, "hepatic superscan" without morphologic changes was noted. Unfortunately, aggressive treatment did not reverse the damaged liver function, and the patient rapidly died. Drug-induced fulminant hepatitis was diagnosed clinically. Our case demonstrates that fulminant hepatitis could result in "hepatic superscan" on 18 F-FDG PET despite negative findings on the ultrasonography, CT, and MRI.

Hepatic Angiosarcoma With Diffuse Increased 18 F-FDG Uptake on PET/CT

ABSTRACT

A 51-year-old woman was diagnosed with fulminant hepatic failure based on laboratory indexes. Contrast-enhanced CT demonstrated numerous, widespread lesions in all segments of the liver. 18 F-FDG PET/CT showed the abundant foci of increased 18 F-FDG uptake in the enlarged liver. The liver transplantation was performed due to fulminant hepatic failure. Postoperative pathology demonstrated diffused hepatic angiosarcoma, which should be included in the differential diagnosis of diffuse 18 F-FDG uptake hepatic lesions on PET/CT.

The Importance of Multimodality Imaging in the Diagnosis and Management of Patients with Infiltrative Cardiomyopathies: An Update

Infiltrative cardiomyopathies (ICMs) comprise a broad spectrum of inherited and acquired conditions (mainly amyloidosis, sarcoidosis, and hemochromatosis), where the progressive buildup of abnormal substances within the myocardium results in left ventricular hypertrophy and manifests as restrictive physiology. Noninvasive multimodality imaging has gradually eliminated endomyocardial biopsy from the diagnostic workup of infiltrative cardiac deposition diseases. However, even with modern imaging techniques’ widespread availability, these pathologies persist in being largely under- or misdiagnosed. Considering the advent of novel, revolutionary pharmacotherapies for cardiac amyloidosis, the archetypal example of ICM, a standardized diagnostic approach is warranted. Therefore, this review aims to emphasize the importance of contemporary cardiac imaging in identifying specific ICM and improving outcomes via the prompt initiation of a targeted treatment.

Diffuse Hepatic FDG Activity From Nonmalignant Etiologies

Diffuse increased ¹⁸F-FDG activity is commonly caused by malignant involvement. We describe here cases of diffuse, uniformly increased ¹⁸F-FDG activity due to nonmalignant illnesses in 2 patients: one had parvovirus B19 infection, whereas the other had porphyria, a heme synthesis disorder.