Surgical failure in temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) may reflect insufficient disruption of epileptogenic networks. We investigated whether integrating quantitative spatial patterns of regional atrophy and hypometabolism, along with clinical features, could provide complementary prognostic information for postoperative seizure freedom. T1-weighted MRI, 18F-FDG-PET, and postoperative CT scans of patients with TLE-HS were retrospectively analyzed against a validated healthy control cohort to compute age- and gender-adjusted W-score maps. Regional relationships of atrophy and hypometabolism were assessed using bivariate correlations and multiple regression analyses. Machine learning models integrating laterality of seizure onset, preoperative (extra-)temporal atrophy/hypometabolism extent, seizure frequency, focal to bilateral tonic-clonic seizures during the preceding year, and resection volume were developed to predict seizure freedom 1 year after surgery. Model interpretability was assessed via permutation-based variable importance analysis. The cohort comprised 101 patients with TLE-HS (48 left, LHS; 53 right, RHS), including 72 patients who underwent anterior temporal lobectomy. Distinct modality-specific patterns emerged: hypometabolism was significantly greater than local atrophy in left temporo-limbic cortex in TLE-LHS, while atrophy exceeded hypometabolism in bilateral occipital regions in TLE-RHS. Positive correlations between local atrophy and hypometabolism were more robust in ipsilateral temporo-limbic cortex in TLE-LHS. The combined model integrating preoperative atrophy and hypometabolism features (AUC: 0.56-0.64) significantly outperformed single-modality models (pfdr < 0.05). Notably, incorporating clinical factors further enhanced predictive performance (AUC: 0.63-0.70) and model calibration. This comprehensive preoperative clinical-imaging model achieved robust prognostic efficacy that was not significantly improved by the addition of actual postoperative resection volumes. Structural MRI and 18F-FDG-PET reveal complementary facets of the epileptogenic network in TLE-HS. While integrating multimodal imaging with clinical metrics demonstrates significant synergistic potential for predicting surgical outcomes, our models remain exploratory. External validation in independent multi-center cohorts is required before translating these findings into precise clinical tools for surgical planning.

Solitary corpus cavernosum metastasis from prostate cancer is extremely rare, particularly as an isolated nodular lesion. We report 2 patients who developed rapid prostate-specific antigen (PSA) elevation following radical prostatectomy without prior evidence of metastatic disease. 68Ga-PSMA PET revealed isolated PSMA-avid nodules in the corpus cavernosum (SUVmax: 4.46 and 22.46, respectively). Following salvage radiotherapy, both patients showed a marked decline in PSA levels. These cases highlight the utility of 68Ga-PSMA PET in detecting atypical metastases in oligometastatic disease.

The Jinchanghe iron-copper-lead-zinc deposit is located in the northern part of the Baoshan block in the western Yunnan.In this paper,the newly discovered tourmaline in the Jinchanghe deposit is taken as the research object.Combined with the field geological investigation and petrographic observation,the electron probe and laser ablation analytical techniques have been used to analyze compositions of tourmalines in three different occurrences(TurⅠ,TurⅡ,and TurⅢ).The TurⅠ tourmaline occurred mainly in patchy aggregates of small particles;The TurⅡ tourmaline occurred in needle-column crystals with medium sizes;The TurⅢ tourmaline occurred mainly in bundle-,fan-,and radial-shaped aggregates with relatively large sizes of euhedral crystals.Based on analytical results,tourmalines in the deposit belong to the schorl-dravite solid solution series of the alkaline tourmaline with substitution mechanisms of FeMg-1,Fe3+Al-1 and x□ Al(NaR2+)-1.Generally,tourmalines of the deposit are predominantly characterized with positive Eu anomalies and negative Ce anomalies,indicating that they were formed in a relatively high oxygen fugacity(fo2)environment.In addition,tourmalines with different occurrences have similar REE distribution patterns,indicating that they were mostly fromed in a same hydrothermal system.It is believed that the formation of tourmalines in the Jinchanghe deposit was mainly related to the interaction of fluids sourced from metasedimentary rocks and metamorphic volcanic rocks.

>1. Objective The Gejiu-Bozhushan-Laojunshan tin-tungsten polymetallic metallogenic belt is located in southeastern Yunnan. It is bounded by the Mile-Shizong Fault and the Yangzi Plate to the north and west, respectively, while the Honghe Fault represents its southwestern boundary. It is adjacent to the Ailaoshan Fault, and extends to Guangxi and Vietnam to the southeast (Fig.1a; Liu JP et al., 2021).

Ewing sarcoma (ES) was first reported by Ewing in 1921. It is the second largest malignant bone tumor in children and adolescents, typically occurring in the bones of trunk or limbs . Extraskeletal Ewing sarcoma (EES) was first reported by Tefft et al. in 1969 and is extremely rare, accounting for less than 1% of all sarcomas. It can occur in any part of soft tissue, mostly in the trunk and lower limbs, and rarely in the pleura. We report a 22-year-old case of extraosseous Ewing sarcoma of pleural origin discovered and pathologically confirmed by physical examination. We report its CT manifestations and pathological results, and review the literature to summarize and analyze the clinical and imaging characteristics of extraosseous Ewing sarcoma, in order to improve our understanding of the disease.

Ewing sarcoma (ES) was first reported by Ewing in 1921. It is the second largest malignant bone tumor in children and adolescents, typically occurring in the bones of trunk or limbs . Extraskeletal Ewing sarcoma (EES) was first reported by Tefft et al. in 1969 and is extremely rare, accounting for less than 1% of all sarcomas. It can occur in any part of soft tissue, mostly in the trunk and lower limbs, and rarely in the pleura. We report a 22-year-old case of extraosseous Ewing sarcoma of pleural origin discovered and pathologically confirmed by physical examination. We report its CT manifestations and pathological results, and review the literature to summarize and analyze the clinical and imaging characteristics of extraosseous Ewing sarcoma, in order to improve our understanding of the disease.

ABSTRACT Colonic Castleman disease is very rare. We report FDG PET/CT findings of colonic Castleman disease in a 72-year-old man. On FDG PET/CT, it presented as a colonic soft tissue mass with intense FDG uptake. The final pathology supported a diagnosis of Castleman disease, plasma cell variant. This case hints us, although rare, Castleman disease should be considered as a differential diagnosis when we notice a hypermetabolic colon mass on PET/CT.

We report a case of a 32-year-old man with recurrent fever, cough and left lumbago for more than one month. Computed tomography (CT) and magnetic resonance imaging (MRI) found bilateral multiple pulmonary nodules and a tumor-like mass in the left kidney. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) revealed increased uptake in the right pharyngeal recess along with pulmonary and renal hypermetabolic lesions. The pathologic findings of pulmonary and renal specimens were suggestive of granulomatous inflammatory changes. Further laboratory examinations showed an elevated level of serum cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) and serum proteinase 3-ANCA (PR3-ANCA). Clinical symptoms were significantly improved, and the size of pulmonary and renal lesions reduced following the use of steroids and cyclophosphamide together. Therefore, a final diagnosis of granulomatosis with polyangiitis (GPA) was made.

Abstract Background Extranodal NK/T-cell lymphoma of the breast (ENKTL-Breast) is rarely detected in clinical practice, and its clinicopathological features remain unclear. Results A consecutive 11-year (2010–2020) ENKTL-Breast case series was retrospectively analyzed. Eight cases of ENKTL-Breast were selected, with three primary and five secondary lesions, accounting for 3.5% (8/228) of all breast lymphomas. All patients were female with a median age of 46 years. Lesions presented as solid breast masses (8/8, 100%) and were usually located in the upper outer quadrant of the breast (7/8, 87.5%). B-symptoms were observed in seven (7/8, 87.5%) cases. Two primary ENKTL-Breast cases showed concomitant diseases (IgA nephropathy and chronic active hepatitis B). Histological and immunohistochemical features of ENKTL-Breast were similar to those of ENKTL at other sites. T-cell receptor rearrangement revealed clonality in all examined primary cases (2/2, 100%), but only in one secondary case (1/5, 20%). The disease progressed rapidly in two primary cases and both patients died within 3 and 9 months. For secondary cases, the disease manifested as a disseminated disease, with a median survival time of 6 months. Conclusions Our data suggested that ENKTL-Breast clinically mimics breast cancer to some extent, though B-symptoms might serve as a distinguishing factor. ENKTL-Breast is highly aggressive and patients with this disease exhibit a short survival time. Primary ENKTL-Breast tends to originate from activated cytotoxic T-cells, and immune-related diseases may be involved in its pathogenesis and development.

OBJECTIVE:To assess the staging, restaging, and treatment strategy determination of extranodal NK/T cell lymphoma (ENKT) by PET/CT real body (true whole-body, TWB) imaging, which is superior to PET/CT limitation of the whole body (limited whole-body, LWB, from skull vertex to upper thighs) by adding 'distal lower extremity' images.METHODS:TWB 18F-FDG PET/CT studies performed for staging and follow-up of ENKTL patients between January 2012 and September 2017 were retrospectively reviewed. Patients in staging group received TWB PET/CT evaluation for staging at the first diagnosis. In follow-up group, patients received follow-up evalution with TWB PET/CT and progressive disease (PD) in the LWB range with or without clinical diagnosis or suspicion before follow-up examination, and then divided into four subgroups: staging (+) PD (－), staging (+) PD (+), staging (－) PD (－), staging (－) PD (+). Then the percentage of unexpected ENKTL lesions found at the distal extremity (outside the LWB range) (P1), and the percentage of changes in the staging, restaging/outcome evaluation (P2) in each group were recorded.RESULTS:Among the 225 patients in the staging group, 200 (88.9%) had tumors confined to LWB, while P1 was 11.1% (25 cases) and P2 was 0.4% (1 case). In the follow-up group, the P1 in staging (+) PD (－)( n=85), staging (+) PD (+)( n=4), staging (－) PD (－)( n=43), staging (－) PD (+) goups ( n=15) were 1.2%, 75.0%, 0%, 26.7%, and P2 were 1.2%, 0%, 0%, 13.3%, respectively. In the follow-up group, regardless of whether the TWB PET/CT examination was performed at the initial diagnosis stage, P1 in PD (－) group and PD (+) group was 0.8 vs. 36.8% ( P<0.000 1), and P2 was 0.8% vs. 10.5% ( P<0.000 1).CONCLUSION:It is not recommended that the TWB PET/CT imaging from the top of the head to the bottom of the foot use for the first diagnosis of ENKTL patients. And for follow-up patients with no clinical evidence of tumor progression or with evidence of tumor progression but whose lesions were limited to LWB at the initial diagnosis of TWB PET/CT staging, LWB PET/CT from the top of the head to the middle of the thigh is recommended for routine follow-up. For ENKTL patients, TWB PET/CT was not performed at the initial stage of diagnosis to detect the condition of lower limbs. If the evidence of tumor progression in the LWB range appeared before the follow-up examination, TWB PET/CT was recommended for the follow-up evaluation to evaluate the systemic tumor involvement.

Angiosarcoma is a rare and aggressive malignancy disease. It constitutes less than 1% of all sarcomas. According to previous reports, angiosarcoma usually shows hypermetabolic features on fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) and therefore 18F-FDG PET/CT may be helpful to staging and assessing therapeutic efficacy. We report a rare case of multicentric bone angiosarcoma in a 51-year-old female patient showing low to mild 18F-FDG uptake, mimicking multiple myeloma, which often presents mild 18F-FDG avid lesions.

The imaging field of view ( FOV) used for most oncological 18 F-fluorodeoxyglucose (FDG) PET/ CT studies, from skull to mid-thigh, is typically a limited whole-body (LWB). This methodol-ogy has been suggested by the Society of Nuclear Medicine and Molecular Imaging and European Association of Nuclear Medicine guidelines. Using routine FOV for LWB may underestimate the true tumor extent because malignancy beyond the FOV might be missed. This review summarizes the optimum scan FOV for different types of tumors. For some tumors (such as lung cancer) that commonly spread to the brain, brain and (or) head should be included in the FOV. For lymphoma, especially pediatric lymphoma, which commonly in-volves lower extremities, true whole-body (TWB) scan should be used for cancer staging and follow up. LWB scan is optimal for melanoma which confined in the field of LWB.

Recent studies have demonstrated that F-18-FDG PET/CT might indeed be useful in specific phases of prostate cancer, especially for aggressive primary prostate tumors. Therefore, our study aimed to evaluate its diagnostic performance in the detection of metastatic lesions in patients with high-risk prostate cancer with comparison to conventional imaging. The study included 67 patients with newly diagnosed high risk prostate cancer, who underwent FDG PET/CT for imaging evaluation. Of these patients, 40 underwent additional MRI with diffusion-weighted imaging (DWI-MRI) for the assessment of lymph node metastases and 46 underwent Tc-99m-MDP bone scintigraphy for the assessment of bone involvement. All lymph nodes were diagnosed based on pathological analysis, and bone lesions were diagnosed based on comprehensive clinical examinations or clinical/imaging follow-up. Diagnostic performances were compared between FDG PET/CT and DWI-MRI regarding lymph node metastases, between FDG PET/CT, and BS regarding bone involvement. The sensitivity and specificity regarding identifying nodal metastases of high risk prostate cancer were 84.6% and 96.3% for FDG PET/CT, 46.2% and 100% for DWI-MRI, respectively. For detection of bone lesions, FDG PET/CT showed a higher specificity than BS (92.0% vs. 80.0%) despite the same sensitivity (90.4% vs 90.4%). Current results indicated that F-18-FDG PET/CT may be useful in imaging evaluation of metastatic extent in high risk prostate cancer, and might help clinicians formulate the treatment plan.

1756 Objectives It has been found that the 18F-FDG uptake by vertebral bodies of the spine was not uniform on PET/CT by clinical observation. There is limited investigation about the 18F-FDG accumulation of smaller localized areas of the spine. More detailed metabolic characteristics have not been defined. The objective of present study was to characterize the pattern of 18F-FDG uptake by regions of the spine on 18F-PET, which may assist clinicians in identifying underlying disease on early stage and avoiding misdiagnosis of physiological uptake. Methods Cancer screening patients who have had more than two consecutive 18F-PET scans were selected. Those patients who have not received prior treatment that had affected the bone marrow were included. Patients with bone metastases, trauma, benign and/or malignant hematologic disorders which were proved by follow-up PET scan and those with fever, infection and autoimmune inflammation at first scan were excluded from the study. Only the first PET scan was used to calculate the standardized uptake value (SUV) of 18F-FDG by each vertebra from C1 to S5. The vertebra with highest SUV was determined. The changes of SUV from C1 to S5 were determined by curve estimation regression using SPSS 13.0 software. SUV comparisons between vertebra and liver were also made. Results Twenty five [15 male, 10 female; mean age 43.36±9.79 (23-67) years] patients were included based on inclusion and exclusion criteria. Overall, our study revealed that the spinal 18F-FDG uptake was not uniform. For all of the cases, the highest SUV [2.37±0.36 (1.8-3.1)] originated from T8, with caudal and cephalic gradual decrease. The lowest SUV [0.96±0.20 (0.6-1.4)] was found on S5. For each of the cases, 12 cases had 1 most active vertebra and 10 cases had 2 and 3 cases had 3 vertebrae with the same uptake level. All of these most active vertebrae came from T4 to L4 segment (1, 3, 6, 3, 7, 4, 4, 4, 5, 2, 0, 1 and 1 respectively). We find the highest SUV from middle and lower thoracic vertebrae (I. e. from T5 to T12) in all but 1 case. When compared with liver, the vertebral SUV was lower than that of liver [from -22.2%±14.4% (-48.7%-8.7%) to -68.4%±7.0% (-80.7%--53.3%)]. Only 3 cases had a slightly higher [5.9%±2.9% (3.3%-13.0%)] vertebral SUV than that of liver, and 1 of whom affected 13 vertebrae and the others affected 1. Conclusions The 18F-FDG uptake by spine is not uniform. It has a tendency to increase from the caudal and cephalic of spine to middle and lower thoracic vertebrae that may be related to the normal distribution of the red bone marrow. All of the vertebrae had a lower or slightly higher SUV than that of liver.

1728 Objectives Pulmonary inflammatory pseudotumor (PIP) may mimic a malignant process on 18F-FDG PET/CT. We reviewed PIP on PET/CT imaging to allow characterization and identification. Methods Twenty-three patients (13 M, 10 F; 35-68 years) were evaluated. Clinical and CT characteristics were recorded. PET images were reconstructed using a 3D-LOR (line of response) algorithm. CT data were used for attenuation correction and morphological information. Dual time point (DTP) PET/CT scan were performed in 8 patients. Standardized uptake value (SUV) for each lesion, on early (1h after injection, SUVearly) and delayed (2h after injection, SUVdelayed) imaging, were calculated. The change in SUV uptake with DTP scans was defined as retention index (RI), which is: RI=100%×(SUVdelayed-SUVearly)/SUVearly. Results Our patients (table 1) had variable clinical characteristics, respiratory complants (17/23), screening (5/23) and routine(1/23). Twelve patients had normal CBC. Five patients had no tumor marker. Single lesions were present in 21, multiple 2 patients, no lobe predominance, but often subpleural location (19/23). The mean size and SUVearly were 28.7±12.0mm (8mm-56mm) and 4.7±2.5 (0.7-11.0) respectively. All lesions had solid attenuation without calcification or cavitation, but variable margins. Most had accompanied pneumonia (17/23), but necrosis (3/23), satellite nodules (2/23), atelectasis or bronchus obstruction (5/23) and pleural or pericardial effusion (4/23) occured. The mean SUVdelayed and RI of patients with DTP scan were 6.9±3.1 (3.0-11.5) and 24.7%±18.8% (-7%-57%) respectively, of whom SUVdelayed increased significantly (≥10%) in 7 patients. There were 11 patients had regional lymphadenopathy. There was a positive correlation between SUVearly and size, with a Spearman’s correlation coefficient of 0.703 (P＜0.001). Conclusions Though PIP had variable clinical and PET/CT characteristics, there are features suggesting the likelihood of this lesion. DTP scans may not be of value for the differentiation of this lesion from malignancy based on our findings. Research Support There was no extramural funding.

The aim of this study is to analyze the concordance between EDV, ESV and LVEF values derived from 18F-FDG PET, GSPECT and ECHO in patients with myocardial infarction. Sixty-four patients with coronary artery disease (CAD) and myocardial infarction were enrolled in the study. Each patient underwent at least two of the above mentioned studies within 2 weeks. LVEF, EDV and ESV values were analyzed with dedicated software. Statistical evaluation of correlation and agreement was carried out EDV was overestimated by 18F-FDG PET compared with GSPECT [(137.98 ± 61.71) mL and (125.35 ± 59.34) mL]; ESV was overestimated by 18F-FDG PET (85.89 ± 55.21) mL and GSPECT (82.39 ± 55.56) mL compared with ECHO (68.22 ± 41.37) mL; EF was overestimated by 18F-FDG PET (41.96% ± 15.08%) and ECHO (52.18% ± 13.87%) compared with GSPECT (39.75% ± 15.64%), and EF was also overestimated by 18F-FDG PET compared with GSPECT. The results of linear regression analysis showed good correlation between EDV, ESV and LVEF values derived from 18F-FDG PET, GSPECT and ECHO (r = 0.643-0.873, P = 0.000). Bland-Altman analysis indicated that 18F-FDG PET correlated well with ECHO in the Left ventricular function parameters. While GSPECT correlated well with 18F-FDG PET in ESV, GSPECT had good correlation with Echo in respect of EDV and EF; whereas GSPECT had poor correlation with PET/ECHO in the remaining left ventricular function parameters. Therefore, the clinical physicians should decide whether they would use the method according to the patients' situation and diagnostic requirements.

1711 Objectives Hemophagocytic lymphohistiocytosis (HLH), an uncommon entity in children, is a clinical syndrome of hyperinflammation with an uncontrolled and ineffective immune response. HLH is often triggered by infection with an acute clinical presentation including sepsis, fever, inflammatory response, coagulopathy and thrombocytopenia. HLH is often under-recognized with concomitant high morbidity and mortality. HLH may present as a diagnostic enigma. 18F FDG PET/CT may be utilized in an attempt to uncover the etiology of this protean disease. We present the 18F FDG PET/CT appearance of this disease, which has not been previously reported, with the hope of allowing early recognition and treatment of this disease state. Methods Patients were fasted for at least 6 h before intravenous administration of 18F-FDG (55 MBq/kg of body weight) approximately 60 min before imaging. Blood glucose level at that time was Results Four children aged 11-18 years, presenting with unexplained fever, lymphadenopathy, rash and organomegaly, were evaluated by us for probable malignant tumor. A common finding was minimally enlarged to normal sized lymph nodes with significantly increased uptake of 18F FDG, especially involving Waldeyer’s ring and cervical nodes. Hepato-splenomegaly with increased 18F FDG uptake and markedly increased bone marrow 18F FDG uptake were the most frequent findings. The finding of increased splenic and bone marrow uptake with FDG positive, normal sized lymph nodes was the hallmark of this process. Conclusions Recognition of the unique appearance of HLH on 18F FDG PET/CT imaging may lead to earlier intervention which, hopefully, will lead to decreased morbidity and mortality in these often desperately ill children. Research Support There was no extramural funding.