Breast specific gamma imaging (BSGI) is a nuclear medicine breast imaging technique. The sensitivity of BSGI is unaffected by post-operative scars or implants, and thus, BSGI is helpful for the differential diagnosis of postoperative recurrence. Here, the authors report a case of diffuse chest wall recurrence on the side of radical mastectomy that was not detected by BSGI, but was detected using other nuclear medicine imaging techniques.

A case of three primary malignancies in one patient is rare. We report on a case of three primary malignancies including myxofibrosarcoma, renal cell cancer, and prostate cancer in one 18F-fluorodeoxyglucose (FDG) positron emission tomography/ computed tomography (PET/CT) evaluation of a 75-year-old man. PET/CT showed different FDG meabolism in each tumor.

We compared the results of early follow-up of F-18 FDG PET/CT and MRI performed within one month after radiation therapy for cervix cancer patients. We conducted a retrospective review of the clinical data of cervix cancer patients whose PET/CT and pelvic MRI performed at staging and within one month from the end of RTx. SUVmax on PET/CT and size on MRI of the primary tumor were analyzed. We compared %change of SUVmax and size between staging and follow-up. A total of 27 patients were enrolled. At staging, larger tumor showed high SUVmax. At follow-up, no significant correlation was observed between size and SUVmax. In 77.8% of patients, changes in SUVmax were well correlated with changes in size. No correlation was observed between % change and value at staging in both SUVmax and size. Except for six patients who showed significant FDG uptake without evidence of a mass on MRI, % changes of size and SUVmax were well correlated. Metabolic change can be accessible on early follow-up PET/CT at±1 month from the end of the RTx of cervix cancer. However, careful interpretation of PET/CT is needed due to possible radiation-induced hypermetabolism even without a definite mass on MRI.

A 56 year-old women with a history of breast cancer underwent Tc-99m Hydroxymethylene Diphosphonate (HDP) bone scintigraphy at an annual follow-up, and abnormal focal uptake was observed in the right upper abdomen. However, subsequent single photon emission computed tomography/computed tomography (SPECT/CT) successfully delineated the uptake in a normal gallbladder. It was concluded that the abnormality had been caused by unusual Tc-99m HDP excretion and not by a metastatic lesion. Follow-up studies confirmed this diagnosis. This case demonstrates the usefulness of SPECT/CT in patients with unusual gallbladder uptake by bone scintigraphy.