Incidental focal FDG uptake in heart is a lighthouse for considering cardiac screening

Objectives

Cardiac FDG uptake is known to show a variety of patterns under clinical fasting conditions. We hypothesized that focal FDG uptake in the heart (FUH) represents a sign of cardiac disease risk, especially in coronary artery disease (CAD).The aim of this study was to clarify the relationship between FUH and cardiac disease.

Methods

Cases showing FUH were selected based on comments in diagnostic reports or identification on retrospective review. Quantitative analysis was performed using maximum standardized uptake value (SUV_max), with regions of interest drawn over focal uptake areas in the heart as confirmed by PET/CT and in lateral side of the same slice showing focal FDG uptake.

Results

For the 20 patients (11 men, 9 women) with confirmed FUH, coronary artery stenosis or history of treatment for coronary disease was present in 11 patients (55.0 %), and 2 patients showed apical hypertrophy. Mean SUV_max of FUH did not differ significantly between patients with confirmed cardiac disease and those with no evidence of cardiac disease (P = 0.78).

Conclusions

FUH suggests a high likelihood of CAD in patients without myocardial symptoms. Cardiac screening or a check of the history of cardiac disease is thus worth considering when FUH is seen incidentally on FDG-PET/CT.     

Evaluation of organ-specific glucose metabolism by <Superscript>18</Superscript>F-FDG in insulin receptor substrate-1 (IRS-1) knockout mice as a model of insulin resistance

Objective  

Insulin resistance (IR) is a physiological condition in which the body produces insulin but does not result in a sufficient biological effect. Insulin resistance is usually asymptomatic but is associated with health problems and is a factor in the metabolic syndrome. The aim of the present study is to clarify organ-specific insulin resistance in normal daily conditions using [¹⁸F]-2-fluoro-2-deoxy-d-glucose ([¹⁸F]-FDG).     

Usefulness of F-18 FDG PET/CT in a case of Kaposi sarcoma with an unexpected bone lesion

Bone lesions of Kaposi sarcoma are rare. A 56-year-old man who was HIV positive and was diagnosed with Kaposi sarcoma on the basis of the results of a biopsy of skin lesions, underwent F-18 FDG PET/CT scan for detecting Kaposi sarcoma lesions and other AIDS-related diseases. An abnormal uptake was observed in the lumbar spine. MRI showed a diffuse enhanced spine lesion, and Ga-67 and 2?1Tl scanning were negative. As a result, the lesion was considered to be a Kaposi sarcoma, and the shrinkage of the lesion was noted after the therapy for Kaposi sarcoma.     

Hydrocephalus due to diffuse villous hyperplasia of the choroid plexus

An 8-month-old female presented with hydrocephalus caused by cerebrospinal fluid (CSF) overproduction due to bilateral choroid plexus enlargement, which was clinically diagnosed as diffuse villous hyperplasia of the choroid plexus, but differentiation from bilateral choroid plexus papilloma was difficult. She initially underwent ventriculoperitoneal shunt surgery, but developed marked retention of ascites. Therefore, the peritoneal end of the shunt was removed for external drainage, but excessive CSF (1,500 ml/day) was collected. Computed tomography and magnetic resonance imaging revealed marked symmetric enhancement of the choroid plexuses in the bilateral lateral ventricles. Thallium-201 chloride single-photon emission computed tomography showed pronounced uptake on both early and delayed images, and good washout. CSF examination revealed no abnormalities such as atypical cells, and a ventriculoatrial shunt was inserted, achieving good control of the hydrocephalus.     

PET imaging of colony-stimulating factor 1 receptor: A head-to-head comparison of a novel radioligand, 11C-GW2580, and 11C-CPPC,in mouse models of acute and chronic neuroinflammation and a rhesus monkey

Colony-stimulating factor 1 receptor (CSF1R) is a specific biomarker for microglia. In this study, we developed a novel PET radioligand for CSF1R, ¹¹C-GW2580, and compared it to a reported CSF1R tracer, ¹¹C-CPPC, in mouse models of acute and chronic neuroinflammation and a rhesus monkey. Dynamic ¹¹C-GW2580- and ¹¹C-CPPC-PET images were quantified by reference tissue-based models and standardized uptake value ratio. Both tracers exhibited increased uptake in the lesioned striata of lipopolysaccharide-injected mice and in the forebrains of App^{NL-G-F/NL-G-F}-knock-in mice, spatially in agreement with an increased 18-kDa translocator protein radioligand retention. Moreover, ¹¹C-GW2580 captured changes in CSF1R availability more sensitively than ¹¹C-CPPC, with a larger dynamic range and a smaller inter-individual variability, in these model animals. PET imaging of CSF1R in a rhesus monkey displayed moderate-to-high tracer retention in the brain at baseline. Homologous blocker (i. e. unlabeled tracer) treatment reduced the uptake of ¹¹C-GW2580 by ∼30% in all examined brain regions except for centrum semi-ovale white matter, but did not affect the retention of ¹¹C-CPPC. In summary, our results demonstrated that ¹¹C-GW2580-PET captured inflammatory microgliosis in the mouse brain with higher sensitivity than a reported radioligand, and displayed saturable binding in the monkey brain, potentially providing an imaging-based quantitative biomarker for reactive microgliosis.     

Factors associated with the relapse of cryptogenic and secondary organizing pneumonia

Background

Organizing pneumonia (OP) is a histopathological response pattern to lung inflammation. It is clinically classified into cryptogenic OP and secondary OP, which is associated with various clinical conditions. Rapid resolution with corticosteroids and frequent relapses are common in OP. However, few studies have investigated the factors associated with OP relapse.

腕舟骨骨折关节镜检查的结果及其意义

目的　应用腕关节镜研究腕舟骨骨折后腕关节的反应、合并软组织、软骨损伤与腕骨排列的异常。方法　分析了 5 8例次腕舟骨骨折患者的关节镜检查结果 ,镜检中重点观察了腕关节滑膜、关节软骨、掌侧韧带、骨间韧带、三角纤维软骨和骨折线等内容。结果　舟骨骨折后滑膜增生开始于伤后 2周 ,并经历了波浪式的消涨过程 ,其增生与否与骨折移位无相关性 (P >0 .0 5 ) ;关节软骨的破坏最早在伤后 5周即有表现 ,并有较大比例的患者合并韧带和三角纤维软骨损伤。结论　腕关节镜检查能更清楚地观察腕关节的病变 ,并为完善诊断和制定治疗计划提供有力的依据。