Quality and Safety in Healthcare, Part LXXXIV: Using Patient Safety Culture Surveys to Improve High Reliability Organizations
An important approach to improve the reliability of healthcare organizations is the use of patient safety culture surveys to identify areas that need improvement. Commonly found areas that need development include having more superior leadership regarding safety, improving communications such as with the Ticket to Ride Program and WalkRounds, enhancing teamwork, and using certain collections of “reliability-enhancing work practices.” (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: From the American College of Nuclear Medicine Source Type: research

Congenital Melanocytic Nevi Syndrome With Leptomeningeal Melanoma
The incidence of congenital melanocytic nevi (CMNs) is 1% to 6% for small- to intermediate-size nevi to 1 in 500,000 for giant size nevi. Large and satellite CMNs are known to be associated with neurocutaneous melanosis and central nervous system malformations such as Dandy-Walker malformation, defects of the vertebra-skull, and intraspinal lipomas. We hereby present a case of CMN syndrome in an 18-year-old girl with leptomeningeal melanoma, evaluated with MRI, adequately staged, and screened with FDG PET. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Unexpected Detection of Skeletal Muscle Renal Cell Carcinoma Metastasis With 99mTc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) Scan
We report the case of a 70-year-old man with a history of surgically removed RCC who referred to 99mTc-Tektrotyd scintigraphy for the evaluation of a pancreatic tail lesion. The scan revealed intense tracer uptake in a left splenius cervicis muscle lesion that on biopsy was consistent with metastatic RCC. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Intense 68Ga-Pentixafor Activity in Idiopathic Retroperitoneal Fibrosis
A 52-year-old man was admitted to our hospital with lower abdominal and low back pain, and abdomen CT at an outside hospital presented a retroperitoneal mass with left urinary tract obstruction and hydronephrosis. In 68Ga-pentixafor PET/CT, the retroperitoneal mass showed intense radioactivity. Subsequently, the patient underwent biopsy of the retroperitoneal mass. The pathological examination showed only fibrous tissue without tumor cells. The patient was finally diagnosed with idiopathic retroperitoneal fibrosis. Our case demonstrated that idiopathic retroperitoneal fibrosis had intense uptake of 68Ga-pentixafor. (Source...
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Superiority of 68Ga-FAPI-04 in Delineation of Soft Tissue and Liver Metastases in Chromophobe Renal Cell Carcinoma for Restaging
We described findings of 18F-FDG PET/CT and 68Ga-FAPI-04 PET/CT of metastatic chromophobe RCC in a 56-year-old woman. 68Ga-FAPI-04 PET/CT demonstrated that the metastatic lesions in the liver, left posterior abdominal wall, and the left waist had intense uptake of 68Ga-FAPI-04, which was higher than that of 18F-FDG on 18F-FDG PET/CT. 68Ga-FAPI-04 PET/CT also delineated the metastatic lesions more clearly than 18F-FDG PET/CT. This case highlights 68Ga-FAPI-04 PET/CT may be promising in restaging of chromophobe RCC. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Solitary Abdominal Wall Metastasis From Rectal Carcinoma Revealed on FDG PET/CT
We report FDG PET/CT findings of a solitary abdominal wall metastasis from rectal carcinoma in a 40-year-old man. On FDG PET/CT, it presents as a solitary soft tissue mass in the anterior abdominal wall with an SUVmax of 9.54. The final pathology supported a diagnosis of metastasis from rectal carcinoma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

18F-FDG PET/CT of Primary Extraskeletal Ewing Sarcoma of the Prostate
We report the 18F-FDG PET/CT finding of a 16-year-old adolescent boy who presented with dysuria and was confirmed to be extraskeletal Ewing sarcoma of the prostate by histopathologic findings. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Diagnosis of Traumatic Bronchobiliary Fistula With Late 99mTc-Mebrofenin SPECT/CT
Bronchobiliary fistula (BBF) represents a rare disorder; it consists of abnormal interconnection between the biliary tract and bronchial trees. A 22-year-old woman with persistent chest pain, jaundice, and biliptysis was referred for hepatobiliary scintigraphy under clinical suspicion of a BBF. Patient medical history was consistent with biliary tree reconstruction secondary to an iatrogenic injury during cholecystectomy 4 years ago. Previous complementary studies (CT and MR cholangiopancreatography) were equivocal for diagnosis. Planar dynamic images of hepatobiliary scintigraphy in the first hour were inconclusive. A 24-...
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Brain PET Imaging of 11C-Methionine, 18F-FDG, and 18F-THK5351 in a Case of Lymphomatoid Granulomatosis
A 52-year-old woman complained of upper respiratory symptoms and subsequently developed Wallenberg syndrome. Chest CT and brain MRI revealed multiple nodular lesions in the lungs and brain. She was pathologically diagnosed with low-grade lymphomatoid granulomatosis by lung biopsy. Brain PET examinations using 11C-methionine, 18F-FDG, and 18F-THK5351 were performed. Uptake of 11C-methionine and 18F-FDG was slightly increased in some lesions, likely reflecting the degree of inflammatory cell infiltration. 18F-THK5351 uptake was significantly increased in all lesions, likely reflecting the degree of reactive astrogliosis. Thi...
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Multifocal Extramedullary Relapse With Neuroleukemiosis in a Case of Early T-Cell Precursor ALL: 18F-FDG PET/CT Findings
We present a case of early T-cell ALL on maintenance therapy with multifocal relapse on FDG PET/CT in the cervical lymph nodes, the testis, and the left sciatic nerve. Bone marrow and flow cytometry confirmed the relapse. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Solitary Splenic Metastasis From Endometrial Carcinoma Revealed on FDG PET/CT
We report a case of imaging findings of solitary splenic metastasis in a 53-year-old woman who underwent resection surgery of endometrial carcinoma of uterus 1 year ago. On FDG PET/CT, it presented as a solitary soft tissue mass with an SUVmax of 18.44. The postoperative pathology supported metastasis from endometrial carcinoma. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

FDG PET/CT Aiding in Early Diagnosis of Central Pontine Myelinolysis
We report a 70-year-old man with central pontine myelinolysis who presented in the emergency department with recent onset altered sensorium and tremors (Glasgow Coma Scale score, 13). Laboratory findings revealed hyponatremia and hypokalemia. MRI brain was unremarkable. Subsequently, patient was referred for FDG PET/CT to rule out malignancy or paraneoplastic syndrome. FDG PET revealed focal radiotracer uptake in the pons without any underlying CT abnormality consistent with central pontine myelinolysis, thus aiding in early diagnosis where conventional imaging modality was unremarkable. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Infectious Aortic Aneurysm in a Patient With Leriche Syndrome
We present the case of a 56-year-old man with Leriche syndrome accompanied by an infectious abdominal aortic aneurysm. 18F-FDG PET angiography/CT and 18F-FDG PET/CT provided important information about the thrombus and infected sites. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Pulmonary Artery Angiomatoid Fibrous Histiocytoma Mimicking a Large Pulmonary Embolism
A 39-year-old man presented with progressive dyspnea and lower extremity edema. Doppler ultrasound demonstrated bilateral leg partially occluded venous thromboses. A V/Q scan revealed a mismatched perfusion defect involving the entire right middle and lower lobes. Subsequent CT pulmonary angiogram revealed a mass lesion occluding the right interlobar pulmonary artery. Endobronchial ultrasound–guided fine-needle aspiration of the mass was concerning for neoplasm. 18F-FDG PET/CT demonstrated marked hypermetabolism of the mass lesion. Patient underwent transmediastinal right pneumonectomy with histopathologic diagnosis of p...
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Comparison of 18F-MFBG and 68Ga-DOTATATE PET/CT in the Imaging of Metastatic Paraganglioma and Pheochromocytoma
Two men with metastatic paraganglioma/pheochromocytoma underwent PET/CT examination in our hospital to understand the treatment effect and progression of the disease. Both patients had previously been treated with 131I-MIBG, and at this evaluation, both of them underwent 68Ga-DOTATATE and 18F-MFBG PET/CT. The 68Ga-DOTATATE PET/CT showed more metastases in the images of these 2 patients. This case highlighted that 68Ga-DOTATATE PET/CT is superior to 18F-MFBG PET/CT in detecting metastases from paraganglioma and pheochromocytoma in these 2 patients. (Source: Clinical Nuclear Medicine)
Source: Clinical Nuclear Medicine - November 15, 2022 Category: Nuclear Medicine Tags: Interesting Images Source Type: research