T-cell immunoglobulin mucin 3 (TIM-3) is a transmembrane protein that plays an important role in several autoimmune diseases. The relationship between TIM-3 and excessive immune responses in immune thrombocytopenia (ITP) is still unknown. In this study, we evaluated the relationship between the expression of TIM-3 on peripheral blood mononuclear cells in patients with ITP and the disease severity. The frequency of lymphocyte and monocyte subsets and their TIM-3 expression were evaluated in patients with acute ITP (n ¼ 45) and in healthy control (n ¼ 20) using flow cytometry. Based on bleeding severity, patients were classified into 3 subgroups as mild (n ¼ 12), moderate (n ¼ 25), and severe (n ¼ 8) bleeding. T-helper lymphocytes was found to be significantly decreased in the severe bleeding group compared to the mild and moderate bleeding groups, while CD56high natural killer (NK) cells were significantly expanded in severe bleeding group. In contrast, classical, intermediate, and nonclassical monocytes, natural killer T lymphocyte (NKT), and CD56dim NK cells showed no significant changes among different patient groups. This alteration of lymphocyte and monocyte subsets was associated with significant decrease in TIM-3 expression on CD56high NK cells, T-helper lymphocytes, NKT cells, and nonclassical monocytes in patients with ITP compared to the controls. Lower level of TIM-3 was found in severe bleeding group compared to mild and moderate bleeding groups. These results indicate that TIM-3 may be involved in the pathogenesis of ITP which subsequently can represent an opportunity for new therapeutic plan, moreover. This may have a prognostic value for disease severity.

T-cell immunoglobulin mucin 3 (TIM-3) is a transmembrane protein that plays an important role in several autoimmune diseases. The relationship between TIM-3 and excessive immune responses in immune thrombocytopenia (ITP) is still unknown. In this study, we evaluated the relationship between the expression of TIM-3 on peripheral blood mononuclear cells in patients with ITP and the disease severity. The frequency of lymphocyte and monocyte subsets and their TIM-3 expression were evaluated in patients with acute ITP (n ¼ 45) and in healthy control (n ¼ 20) using flow cytometry. Based on bleeding severity, patients were classified into 3 subgroups as mild (n ¼ 12), moderate (n ¼ 25), and severe (n ¼ 8) bleeding. T-helper lymphocytes was found to be significantly decreased in the severe bleeding group compared to the mild and moderate bleeding groups, while CD56high natural killer (NK) cells were significantly expanded in severe bleeding group. In contrast, classical, intermediate, and nonclassical monocytes, natural killer T lymphocyte (NKT), and CD56dim NK cells showed no significant changes among different patient groups. This alteration of lymphocyte and monocyte subsets was associated with significant decrease in TIM-3 expression on CD56high NK cells, T-helper lymphocytes, NKT cells, and nonclassical monocytes in patients with ITP compared to the controls. Lower level of TIM-3 was found in severe bleeding group compared to mild and moderate bleeding groups. These results indicate that TIM-3 may be involved in the pathogenesis of ITP which subsequently can represent an opportunity for new therapeutic plan, moreover. This may have a prognostic value for disease severity.

We report the case of a 74-year-old man with seropositive rheu- matoid arthritis (RA) and radiographic osteoarthritis (OA) who underwent dual-phase high-resolution 99mTc-MDP SPECT/CT. Early radiotracer en- hancement was noted in 2 RA joints of the right hand, both presenting with a ring-like uptake pattern around the joint, consistent with synovitis. Insig- nificant early enhancement was noted at the first carpometacarpal joint, de- spite presentation of CT features of OA. The delayed-phase enhancement patterns were distinct, showing asymmetry in RA joints, but a symmetric, joint-centered pattern for the OA joint.

The presence of ectopic thyroid tissue in 2 or more different sites is rare. A 12-year-old girl presented with midline anterior neck swelling in the infrahyoid region with subclinical hypothyroidism. Thyroid scanning with 99mTc-pertechnetate was performed, and SPECT/CT was ordered for further evaluation. Two hyperdense lesions demonstrating intense ra- diotracer uptake were seen in the midline at the base of the tongue and infrahyoid neck. We emphasis the role of hybrid SPECT/CT for charac- terization and localization of suspected ectopic thyroid tissue.

The presence of ectopic thyroid tissue in 2 or more different sites is rare. A 12-year-old girl presented with midline anterior neck swelling in the infrahyoid region with subclinical hypothyroidism. Thyroid scanning with 99mTc-pertechnetate was performed, and SPECT/CT was ordered for further evaluation. Two hyperdense lesions demonstrating intense ra- diotracer uptake were seen in the midline at the base of the tongue and infrahyoid neck. We emphasis the role of hybrid SPECT/CT for charac- terization and localization of suspected ectopic thyroid tissue.

The presence of ectopic thyroid tissue in 2 or more different sites is rare. A 12-year-old girl presented with midline anterior neck swelling in the infrahyoid region with subclinical hypothyroidism. Thyroid scanning with 99mTc-pertechnetate was performed, and SPECT/CT was ordered for further evaluation. Two hyperdense lesions demonstrating intense ra- diotracer uptake were seen in the midline at the base of the tongue and infrahyoid neck. We emphasis the role of hybrid SPECT/CT for charac- terization and localization of suspected ectopic thyroid tissue.

The presence of ectopic thyroid tissue in 2 or more different sites is rare. A 12-year-old girl presented with midline anterior neck swelling in the infrahyoid region with subclinical hypothyroidism. Thyroid scanning with 99mTc-pertechnetate was performed, and SPECT/CT was ordered for further evaluation. Two hyperdense lesions demonstrating intense ra- diotracer uptake were seen in the midline at the base of the tongue and infrahyoid neck. We emphasis the role of hybrid SPECT/CT for charac- terization and localization of suspected ectopic thyroid tissue.

The presence of ectopic thyroid tissue in 2 or more different sites is rare. A 12-year-old girl presented with midline anterior neck swelling in the infrahyoid region with subclinical hypothyroidism. Thyroid scanning with 99mTc-pertechnetate was performed, and SPECT/CT was ordered for further evaluation. Two hyperdense lesions demonstrating intense ra- diotracer uptake were seen in the midline at the base of the tongue and infrahyoid neck. We emphasis the role of hybrid SPECT/CT for charac- terization and localization of suspected ectopic thyroid tissue.

Objective The aim of this study was to evaluate the diagnostic performance of combined fluorine-18 fluorodeoxyglucose (18F-FDG) PET/contrast-enhanced computed tomography (Ce-CT) in comparison with Ce-CT alone for the detection of residual/recurrent tumor after initial treatment of malignant ovarian tumors. Patients and methods The study prospectively recruited 111 patients with a clinical suspicion of ovarian tumor recurrence. Each patient underwent 18F-FDG PET/ computed tomography (CT) with low-dose CT, followed immediately by Ce-CT. Study-based analyses for a total of 136 scans were carried out. For each study, 11 subsites were assessed on a four-point score (score 0 = definitely benign, score 1 = probably benign, score 2 = probably malignant, and score 3 = definitely malignant). The subsites were collectively categorized into four groups: local tumor site, peritoneum, pelvi-abdominal lymph nodes, and other sites (e.g. liver, lung, bone, brain, etc). The final diagnosis of disease status was made on subsequent follow-up by conventional imaging (CT/MRI), 18F-FDG PET/CT, or histopathology whenever possible. Results Ofthe136studiesevaluated,97(71%)studieshad recurrent/residual disease and 39 (29%) studies were disease free on the basis of the final diagnosis. 18F-FDG PET/Ce-CT and Ce-CT had a sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of 96 versus 84%, 92 versus 59%, 90 versus 59%, 97 versus 84%, and 95 versus 76%, respectively. 18F-FDG PET/Ce-CT was significantly more sensitive, specific, and accurate compared with Ce-CT, with P-values of 0.002, 0.001, and less than 0.0001, respectively. Site-based analyses also showed significant differences. Conclusion Combined18F-FDG PET/Ce-CT significantly outperforms Ce-CT alone in the post-treatment detection of malignant ovarian tumors.

Purpose: To identify the non-neoplastic variants of the sternal uptake in patients known to have a primary tumor, referred for detection of metastases elsewhere. Materials and methods: This retrospective study was approved by the Institutional Review Board. Fifty eligible patients (17 males & 33 females) known to have a primary tumor underwent 99mTc- MDP-bone scan for detection of metastases. All patients underwent SPECT/CT of the chest region. For each patient, 10 subsites were evaluated (right & left sternoclavicular joints, right and left first costo-sternal articulation, manubrium sterni, manubriosternal junction, body of the sternum, xiphisternal junction, xiphoid process and other sub-sites (e.g. chondro-sternal articulations)). The uptake was described as normal or abnormal. CT findings were categorized as normal/abnor- mal (arthritis, degenerative, developmental & congenital). Any patient with suspicious metastatic sternal lesion based on CT findings or abnormal tracer uptake was excluded. Results: A total of 500 sub-sites were analyzed. Increased uptake was seen in 189 sub-sites. Of them, 133 showed abnormal CT findings (95 arthritis, 33 degenerative, 3 developmental & 2 con- genital) and 56 sites were unremarkable. Of the 311 with normal uptake, only 18 showed abnormal CT findings (8 arthritis & 10 degenerative). The association was statistically significant (P 0.001). Conclusion: Increased sternal uptake is significantly associated with CT structural abnormalities and knowledge of these non-neoplastic variants is essential for correct interpretation of SPECT/ CT bone scans especially in patients with known cancers.