Background To report on imaging findings using ⁶⁸Ga-PSMA-HBED-CC PET in a series of 19 breast carcinoma patients. Methods ⁶⁸Ga-PSMA-HBED-CC PET imaging results obtained were compared to routinely performed staging examinations and analyzed as to lesion location and progesterone receptor status. Results Out of 81 tumor lesions identified, 84% were identified on ⁶⁸Ga-PSMA-HBED-CC PET. ⁶⁸Ga-PSMA-HBED-CC SUVmean values of distant metastases proved significantly higher (mean, 6.86, SD, 5.68) when compared to those of primary or local recurrences (mean, 2.45, SD, 2.55, p = 0.04) or involved lymph nodes (mean, 3.18, SD, 1.79, p = 0.011). SUVmean values of progesterone receptor-positive lesions proved not significantly different from progesterone receptor-negative lesions. SUV values derived from FDG PET/CT, available in seven patients, and ⁶⁸Ga-PSMA-HBED-CC PET/CT imaging proved weakly correlated (r = 0.407, p = 0.015). Conclusions ⁶⁸Ga-PSMA-HBED-CC PET/CT imaging in breast carcinoma confirms the reported considerable variation of PSMA expression on human solid tumors using immunohistochemistry.

To review the main applications, advantages and limitations of ¹⁸F-FDG PET and PET/computed tomography (CT), and some other tracers in imaging of tuberculosis (TB). In pulmonary TB, granulomas typically demonstrate increased ¹⁸F-FDG uptake, and areas of active TB can be differentiated from old or inactive disease by dual time point imaging. However, standardized uptake value measurements are high in both TB and malignant lesions, with significant overlap that limits their usefulness. In extrapulmonary TB, ¹⁸F-FDG PET detects more tuberculous lesions than CT, is of value in assessing response to tuberculostatic treatment, and helps in diagnosing spinal infection and identifying TB-related spondylitis; however, again, differentiation of malignant versus TB lymph node involvement is problematic. ¹⁸F-FDG PET can also be considered a marker of disease status in patients with HIV and TB co-infection. Overall, evaluation of treatment response is potentially the most important clinical application of ¹⁸F-FDG PET in TB, owing to its ability to distinguish active from inactive disease. ¹⁸F-FDG PET and PET/CT may assist early diagnosis and facilitate differentiation between malignancies and TB, identification of extrapulmonary TB, staging of TB, and assessment of treatment response.

We aim to assess the additional value of SPECT/CT over planar lymphoscintigraphy (PI) in sentinel node (SN) detection in malignancies with different lymphatic drainage like breast cancer, melanoma and pelvic tumors. METHODS: From 2010 to 2013 1508 patients were recruited in a multicenter study: 1182 breast cancer, 262 melanoma and 64 pelvic malignancies (prostate, cervix, penis, vulva). PI was followed by SPECT/CT 1-3 hours after injection of ^99mTc-colloid particles. Surgery was performed the same or next day. RESULTS: Significantly more SNs were detected by SPECT/CT for breast cancer (2165 vs 1892), melanoma (602 vs 532) and pelvic cancer (195 vs 138), all p<0.001. The drainage basin mismatch between PI and SPECT/CT was 16.5% for breast cancer, 11.1% for melanoma and 51.6% for pelvic cancers. Surgical adjustment was 17% for breast cancer, 37% for melanoma and 65.6% for pelvic cancer. CONCLUSION: SPECT/CT detected more SNs and changed the drainage territory, leading to surgical adjustments in a considerable number of patients in all malignancies studied but especially in the pelvic cancer group due to its deep lymphatic drainage. We recommend SPECT/CT in all breast cancer patients with no SN visualized on PI, all patients with melanoma of head and neck or trunk, all patients with pelvic malignancies, as well as those breast cancer and melanoma patients with unexpected drainage on PI.