Fibroblast Activation Protein Inhibitor (FAPI) positron emission tomography (PET) imaging has emerged as a useful method for identifying pancreatic disorders, notably pancreatitis. Unlike Fluorine-18 fluorodeoxyglucose (FDG), FAPI uptake is directly proportional to the degree of fibrosis, making it very useful in separating pancreatic tumors from inflammation. Recent investigations have shown that FAPI positron emission tomography/computer tomography (PET/CT) can identify pancreatic inflammation with great sensitivity, providing vital diagnostic information. In this case study, a 52-year-old male with a history of Ewing sarcoma presented with epigastric pain. Pancreatitis was confirmed on a computer tomography (CT) scan showing mild fat stranding in the pancreatic body and tail, in addition to a significant increase in pancreatic head mass, necessitating further evaluation with FDG PET/CT and FAPI PET/CT, as the patient was known to have metastatic sarcoma. While FDG PET/CT revealed an avid infiltrative lesion in the duodenal/pancreatic head area, FAPI PET/CT showed diffuse uptake in the pancreatic body and tail, indicating fibroblast-mediated inflammation consistent with pancreatitis. This case demonstrates the usefulness of FAPI imaging in discriminating between pancreatic metastasis and pancreatitis, with FAPI PET/CT providing crucial diagnostic information when FDG uptake is ambiguous.
Background: Granular cell tumors (GCTs) are uncommon peripheral nerve sheath tumors of Schwann cell origin that may occur throughout the body. However, they rarely occur in the spinal canal. Case Description: A 49-year-old male presented with burning sensation in the left knee. The MRI of the lumbar spine showed an L3-L4 intradural extramedullary tumor. Complete surgical resection was successfully performed and the L3 root burning improved. Histopathologically, the lesion proved to be a benign GCT. Conclusion: Spinal GCTs are rare benign tumors that may be found in an intradural extramedullary location in the spine. The preferred treatment is complete surgical resection as subtotal/partial resection may result in recurrence warranting radiation therapy.
(1) Background: The Kaiser score is a user-friendly tool that evaluates lesions on breast MRI and has been studied in the general population and a few specific clinical scenarios. We aim to evaluate the performance of the Kaiser score in the characterization of additional lesions identified on staging breast MRI. (2) Methods: The Kaiser score of the biopsied additional lesions identified on staging MRI in recently diagnosed breast cancer patients was retrospectively determined. Statistical analysis was performed to evaluate the diagnostic capability of the Kaiser score and whether it is affected by different imaging and pathological parameters of the additional and the index lesion. (3) Results: Seventy-six patients with ninety-two MRI-detected lesions constitute the studied population. There was a statistically significant difference in the Kaiser score between benign and malignant lesions, irrespective of the pathology of the index cancer (p = 0.221) or the size and the imaging features of the additional lesion. Using a cutoff of 5 and above for suspicious lesions, biopsy could have been avoided in 34/92 lesions. (4) Conclusions: The Kaiser score can assist radiologists in the evaluation of additional MRI lesions identified in recently diagnosed breast cancer patients, thus decreasing the number of unneeded biopsies and delays in definitive surgical management.