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.

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.

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.

Purpose: To evaluate the diagnostic performance of 18F-flurodeoxyglucose positron emission tomography/contrast enhanced computed tomography (18F-FDG PET/CT) in patients with clinically/radiologically suspected ovarian tumor recurrence and normal tumor markers. Materials and methods: A total of 54 18F-FDG PET/CT studies from 41 patients with sus- pected ovarian tumor recurrence and normal tumor markers were evaluated. Each patient underwent PET/CT with CE-CT scans in the same study. Studies were read independently by one experienced nuclear medicine physician and one experienced radiologist. A four- point score (score 0=definitely benign, score 1=probably benign, score 2=probably malignant and score 3 = definitely malignant) used to assess the presence or absence of recurrence (local, regional or distant). The final diagnosis of tumor status was made on the basis of subsequent follow-up by conventional imaging (CT/MRI), 18F-18F-FDG PET/CT or histopathology whenever possible. Results: Of the 54 studies evaluated, 26 (48%) studies had tumor recurrence and 28 (52%) studies were disease-free based on final diagnosis. Combined 18F-FDG PET/CT vs. CE-CT alone showed sensitivity, specificity and accuracy of 92% vs. 73%, 90% vs. 55%, and 91% vs. 63%, respectively. 18F-18F-FDG PET/CT was signifi- cantly more sensitive, more specific and more accurate compared to CE-CT with P-values of 0.06, 0.006 and 0.0001, respectively. Site-based analyses were also performed and showed significantly higher diagnostic indices for combined FDG-PET/CT. Conclusion: Combined 18F-FDG PET/CT with contrast enhancement is more accurate than CE-CT alone in the diagnosis of ovarian tumor recurrence in patients with normal tumor markers.