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Nuclear Medicine Community

Nuclear Medicine Community

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  • Category: General
    Description: This community provides latest cases, discussions, news, publications and more valuable information for the Nuclear Medicine subspecialty. Join now - it's free!
    About Group
    Category: General Created: Saturday, 17 April 2010 Group Admin: Radiolopolis Team Description: This community provides latest cases, discussions, news, publications and more valuable information for the Nuclear Medicine subspecialty. Join now - it's free!
  • If anyone has cases that they can contribute for the Case Review Series in Nuclear Medicine I am interested in corresponding with you. We could use CNS cases, unusual general nuclear medicine cases, artifacts and QA example and PET/CT cases with more novel radio tracers, especially from those who are practicing in Europe. The FDA in the US is a little behind in approving newer PET radio tracers.
    3 years ago

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This community provides latest cases, discussions, news, publications and more valuable information for the Nuclear Medicine subspecialty. Join now - it's free!
Category
General
Created
Saturday, 17 April 2010
Group Admin
Radiolopolis Team
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Random Cases

Pathological bone fracture from breast metastasis on bone scan
Pathological bone fracture from breast metastasis on bone scan
13 years old male?
13 years old male?
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Acute cholecystitis on HIDA scan
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Urinary leak after renal transplant
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Novel location of xanthogranulomatous inflammation causing false-positive FDG PET/CT

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Intravascular Large B-Cell Lymphoma Presenting with Diffusely Increased Pulmonary FDG Up-take withou
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Featured case

Pathological bone fracture from breast metastasis on bone scan
OK, let's approach this systematically: 1. What type of study is this? 2. What is the underlying disease (or is the patient healthy?) 3. Can you guess what happened in the interim? The left image is the new one and the right image is a study done 2 months prior. Answer: 1. Type of study and technique (left image): Whole body bone scan with delayed images after IV injection of 25.5 mCi technetium 99m MDP IV. (Can you guess where injected - based on the images?) The right image is a comparison study performed 2 months prior. 2. The underlying disease is bilateral lobular carcinoma of the breast, s/p bilateral mastectomy, chemo- and radiation therapy - now with multiple osseous metastases. Imaging findings (left image): Focus of intense uptake in the anterior right upper chest wall is from a port injection. In the interim, there is increase in uptake throughout the proximal and mid left humeral shaft. The L1 vertebral body uptake has increased in intensity. There is a new focus of tracer uptake within the inferior left sternum. Unchanged appearance of subtle foci of tracer uptake in the left temporal skull, left upper cervical spine, left lateral seventh rib, T6, T8, T9, T11 thoracic vertebral bodies, L3, L4 and L5 lumbar vertebral bodies and tip of the sacrum, compatible with osseous metastasis. Increased uptake is identified in the bilateral acromioclavicular joints, sternoclavicular joints, sacroiliac joints is again seen, most consistent with degenerative change. 3. What happened? The patient suffered from a pathological fracture of the left humeral shaft due to a metastatic lesion. The high uptake are mostly reparative changes from the fracture (and surgical repair). Additional image (radiograph of the left humerus) demonstrates an oblique fracture of the humeral shaft - exactly at the location where one focus was seen on the comparison study. (distal fracture fragment is minimally displaced superiorly)

Pathological bone fracture from breast metastasis on bone scan

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