PET Imaging

Allan Klotsche

Indeterminate lesion on PET/CT classified by PET/MRI for 53-y-old man with lung cancer. Contrast-enhanced CT (A), PET (B), and fused 18F-FDG PET/CT (C) images are displayed in comparison with contrast-enhanced T1-weighted MRI (D), PET, and fused 18F-FDG PET/MRI (F) images. In CT (A), hyperdense, subcentimeter liver lesion (arrows) in segment VII is suggestive of transient hepatic attenuation difference or small hemangioma. As malignancy cannot be excluded, it needs further investigation. On PET/MRI, lesion is clearly classified as metastasis because of contrast enhancement and tracer uptake due to later acquisition time point. Follow-up CT confirmed diagnosis after 78 d. Images created by Ole Martin, University Dusseldorf, Medical Faculty and Benedikt Schaarschmidt, University Hospital Essen.

Tau (blue) and amyloid (orange) distribution patterns for super-agers, normal-agers and MCI patients, when compared to a group of younger, healthy, cognitively normal, amyloid-negative individuals. Brain projections are depicted at an uncorrected significance level of p < .0001. Color bars represent the respective t-statistic. Image courtesy of Merle C. Hoenig, Institute for Neuroscience and Medicine II - Molecular Organization of the Brain, Research Center Juelich, Juelich, Germany, and Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany.

PSMA PET/CT accurately detects recurrent prostate cancer in 67-year-old man. 18F-DCFPyL-PSMA PET/CT shows extensive, intensely PSMA-avid local recurrence in prostate (bottom row; solid arrow) in keeping with the known tumor recurrence in the prostate. Right: PET shows extensive, intensely PSMA-avid local recurrence in prostate (top row; solid arrow) and a solitary bone metastasis in left rib 2 (bottom row; dotted arrow). Image courtesy of Ur Metser, et al.

PET/CT imaging showing uptake and retention of 86Y-NM600 (imaging agent) in immunocompetent mice bearing prostate tumors. PET imaging data was employed to estimate tumor dosimetry and prescribe an immunomodulatory 90Y-NM600 (therapy agent) injected activity. Image courtesy of R Hernandez et al., University of Wisconsin-Madison, WI.

Adult male with decades of right neck pain, discomfort and tightening following birth injury. The patient had failed multiple standard therapeutic maneuvers before presenting for 18F-FDG PET/MR imaging. Images shows abnormally elevated FDG uptake (white arrows; SUVmax = 1.2) observed in a linear pattern in the space in the posterolateral right neck, between the oblique capitis inferior and the semispinalis capitis muscles, where the greater occipital nerve resides. By comparison, the same region on the contralateral, asymptomatic side of the neck has an SUVmax = 0.7. This result encouraged a surgeon to explore the area. The surgeon ultimately found a collection of small arteries wrapped around the nerve in this location. The small arteries underwent lysis by the surgeon and the patient reported tremendous relief of symptoms. (A) Coronal thick slab MIP of 18F-FDG PET. (B) Axial LAVA FLEX MRI through the cervical spine. (C) Axial PET at the same slice as the axial MRI. (D) Fused axial PET/MRI. Image courtesy of Cipriano, et al., Stanford University, CA.