Background: Myocardial perfusion imaging (MPI) plays a crucial role in diagnosing coronary artery disease (CAD), with single-photon emission computed tomography (SPECT) being a widely accepted method. The accuracy of MPI relies on image quality and the expertise of physicians. While CZT-SPECT cameras offer advantages, they can be susceptible to attenuation artifacts. Therefore, our objective was to evaluate the diagnostic accuracy of CZT-SPECT and SPECT/CT in a clinical setting. Method: We conducted a prospective single-center study involving patients with known or suspected stable ischemic heart disease who underwent SPECT-MPI using CZT-SPECT and SPECT/CT scanners, and the latter was equipped with cardiofocal collimation. Experienced physicians performed analysis and reporting based on automated quantification and visual image interpretation. Results: A total of 77 patients (32 women (41.6%) and 45 men (58.4%) with an average age of 71.9 ± 8.9 years) were included. The agreement between readers regarding the final conclusion based on imaging reporting using both devices was very high (Kappa 0.87–0.93). Per-vessel analysis revealed a trend suggesting that CZT-SPECT was superior to conventional SPECT/CT in terms of sensitivity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, although the difference did not reach statistical significance. Conclusion: Our study demonstrated that CZT-SPECT imaging offers comparable diagnostic accuracy, improved patient comfort, and eliminates CT-induced radiation compared to SPECT/CT. These findings suggest that cardiac CZT-SPECT imaging has the potential to become a valuable imaging modality in clinical practice.

To investigate the value of ¹⁸F-FDG-PET/CT in predicting the occurrence of brain metastases in melanoma patients, in this retrospective study 201 consecutive patients with pathology-proven melanoma, between 2008 and 2021, were reviewed. Those who underwent ¹⁸F-FDG-PET/CT for initial staging were considered eligible. Baseline assessment included histopathology, ¹⁸F-FDG-PET/CT, and brain MRI. Also, all patients had serial follow-ups for diagnosing brain metastasis development. Baseline ¹⁸F-FDG-PET/CT parameters were analysed using competing risk regression models to analyze their correlation with the occurrence of brain metastases. Overall, 159 patients entered the study. The median follow-up was six years. Among clinical variables, the initial M-stage and TNM-stage were significantly correlated with brain metastasis. Regarding ¹⁸F-FDG-PET/CT parameters, regional metastatic lymph node uptake values, as well as prominent SULmax (pSULmax) and prominent SUVmean (pSUVmean), were significantly correlated with the outcome. Cumulative incidences were 10% (6.3–16%), 31% (24.4–38.9%), and 35.2% (28.5–43.5%) after 1, 5, and 10 years. There were significant correlations between pSULmax (p-value < 0.001) and pSULpeak (p-value < 0.001) and the occurrence of brain metastases. The higher these values, the sooner the patient developed brain metastases. Thus, baseline ¹⁸F-FDG-PET/CT may have the potential to predict brain metastasis in melanoma patients. Those with high total metabolic activity should undergo follow-up/complementary evaluations, such as brain MRI.

Background: As there are comparative studies between ⁶⁸Ga-PSMA and ^99mTc-PSMA and spectrum of PSMA expression, this is the first case report that notifies distribution of ^99mTc-PSMA on COVID-19 pneumonia era on the literature. Case presentation An asymptomatic 70-Y-old male who is known case of prostate adenocarcinoma underwent initial staging. SPECT/CT of the chest region reveals bilateral peripheral multifocal ground glass opacities which shows ^99mTc-PSMA uptake. Diagnosis of corona virus was confirmed by positive RT-PCR. Discussion: Unexclusive role of radiotracers in nuclear medicine has an importance for wide range of applications. Comparison between ⁶⁸Ga-PSMA and ^99mTc-PSMA in detection of metastatic disease in prostate cancer is also under evaluation. Conclusions: This case implicates possible role of PSMA imaging in inflammation/infection process as well as necessity for lung review in hybrid imaging especially during this recent pandemic.

Background: Basal cell carcinoma (BCC) is the most common cutaneous malignancy, characterized by slow progression and a low propensity for metastasis. Metastatic basal cell carcinoma (mBCC) occurs in fewer than 0.1% of the cases, most frequently involving the lungs, lymph nodes, or bones. Although rare, mBCC is associated with poor prognosis and presents unique diagnostic and therapeutic challenges. Case Presentation: We report a 77‐year‐old male with a remote history of multiple head‐and‐neck BCCs, including aggressive histologic subtypes (basosquamous and micronodular), treated predominantly with Mohs surgery; the margin status varied across procedures (some tumor free and some positive). Ten years after the initial lesion, the patient developed progressive dyspnea and was found to have bilateral pulmonary nodules on chest CT. PET/CT demonstrated increased FDG uptake, and a CT‐guided biopsy of the right lung nodule confirmed mBCC. There was no evidence of local recurrence at the original excision sites. p16/HPV studies were not performed on the prior cutaneous primaries. Conclusion: This case highlights the potential for delayed pulmonary metastasis in BCC, even years after apparently curative treatment. The absence of local recurrence and the bilateral lung involvement suggest hematogenous spread. Clinicians should remain vigilant for metastatic disease in patients with a history of high‐risk BCC, particularly when new pulmonary symptoms arise. Imaging and immunohistochemistry are critical for diagnosis, and early detection may improve therapeutic outcomes in this rare and aggressive manifestation. In this patient, the presence of aggressive histologic subtypes and prior positive margins likely increased metastatic risk.

Background: Pleural effusion (PE) is a frequent clinical condition with diverse etiologies including heart failure, infections, and malignancies. While the color of pleural fluid is rarely considered diagnostic, unusual discolorations may offer important clinical clues. We report what appears to be only the third documented case of purple PE (PPE) in the medical literature. This case was associated with Acinetobacter baumannii infection, a rarely reported cause of PPE, providing additional insight into its potential pathophysiology. Case Presentation: A 54 year‐old obese male with multiple comorbidities—including COPD, heart failure, and recent pulmonary embolism—was admitted with acute respiratory failure. He was found to have a right‐sided PE requiring drainage. Initial fluid analysis revealed an exudative, lymphocyte‐predominant effusion with no evidence of infection. However, the fluid in the drainage bag gradually turned deep purple, and Acinetobacter baumannii was later isolated from the catheter and collection bag. The patient was treated with colistin and meropenem, with full clinical recovery and resolution of discoloration. Discussion: Although the exact mechanism remains unclear, PPE may share pathophysiologic pathways with Purple Urine Bag Syndrome, involving bacterial metabolism of tryptophan‐derived compounds. This case highlights the importance of visual inspection of pleural fluid and emphasizes that unusual discoloration—while not diagnostic in itself—should prompt thorough microbiological and biochemical evaluation. Key Clinical Message: Unusual pleural fluid discoloration should prompt immediate microbiological evaluation, as it may indicate infection with uncommon or multidrug‐resistant organisms, even in the absence of typical infection signs.