Renal Ewing sarcoma (EWS) is an exceptionally rare pediatric malignancy that may mimic neuroblastoma on conventional imaging. We report a 6-year-old boy presenting with a left suprarenal mass suspicious for neuroblastoma. The initial biopsy was inconclusive. I-131 metaiodobenzylguanidine (mIBG) scintigraphy demonstrated no tracer uptake within the mass. Subsequent Ga-68 DOTANOC PET/CT revealed only mild somatostatin receptor expression, whereas F-18 FDG PET/CT showed intense hypermetabolism. Given the discordant molecular imaging profile, repeat biopsy with fluorescence in situ hybridization confirmed EWSR1 gene rearrangement consistent with renal Ewing sarcoma. This case highlights the diagnostic value of multimodality nuclear imaging in pediatric renal masses and emphasizes that an mIBG-negative, intensely FDG-avid lesion with low somatostatin receptor expression should prompt consideration of renal EWS and re-evaluation of histopathology.

Fluorodeoxyglucose PET/computed tomography plays a central role in the management of melanoma and soft-tissue sarcoma by enabling comprehensive metabolic imaging for staging, response assessment, and prognostication. It improves detection of distant disease and guides clinical decision-making, particularly in advanced stages. Quantitative PET parameters enhance prognostic evaluation, while emerging applications such as radiomics and artificial intelligence are shaping its role in precision oncology. Careful interpretation is required to account for limitations, including false-positive findings and atypical response patterns associated with immunotherapy.

Renal Ewing sarcoma (EWS) is an exceptionally rare pediatric malignancy that may mimic neuroblastoma on conventional imaging. We report a 6-year-old boy presenting with a left suprarenal mass suspicious for neuroblastoma. The initial biopsy was inconclusive. I-131 metaiodobenzylguanidine (mIBG) scintigraphy demonstrated no tracer uptake within the mass. Subsequent Ga-68 DOTANOC PET/CT revealed only mild somatostatin receptor expression, whereas F-18 FDG PET/CT showed intense hypermetabolism. Given the discordant molecular imaging profile, repeat biopsy with fluorescence in situ hybridization confirmed EWSR1 gene rearrangement consistent with renal Ewing sarcoma. This case highlights the diagnostic value of multimodality nuclear imaging in pediatric renal masses and emphasizes that an mIBG-negative, intensely FDG-avid lesion with low somatostatin receptor expression should prompt consideration of renal EWS and re-evaluation of histopathology.

We report the 18 F-fluorodeoxyglucose positron emission tomography-computed tomography findings in a 40-year-old woman who was referred to our department with a suspicion of inflammatory bowel disease. The incidental findings of hypermetabolism in muscles of bilateral forearms, hands, legs, and bilateral feet due to walking about and wringing of hands by the patient during the uptake period postinjection are reminiscent of the forearm bracelets and boots worn by Wonder Woman, a fictional comic character, as part of her Amazonian armour.

FDG PET/CT is widely used in oncology but may occasionally show non-neoplastic hypermetabolic processes. We report incidental detection of probable ictal/peri-ictal hypermetabolism on follow-up FDG PET/CT in a 39-year-old woman with treated breast carcinoma and prior left temporal metastatectomy. Imaging demonstrated a postoperative cavity in the left temporal lobe and a focal intensely FDG-avid cortical area in the left posterior parietal region without CT correlate or other evidence of active systemic disease. The imaging pattern favored seizure-related cortical hypermetabolism rather than tumor recurrence. Recognition of this uncommon pitfall is important to avoid false-positive interpretation and inappropriate upstaging.

We report the case of a 55-year-old male diagnosed with Erdheim-Chester disease, who underwent 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) for baseline evaluation as well as posttreatment. The patient was treated with interferon-alpha but was lost to follow-up due to COVID pandemic, 2 years later the disease status, and the response to therapy was documented using FDG-PET/ CT. We would also like to highlight the varied presentations of lesions in kidneys, retroperitoneum, lungs, and paranasal sinuses with special focus on atypical finding of the kidney. Thus, FDG-PET/CT is a useful modality for demonstrating response to therapy and mapping the disease status in Erdheim-Chester disease and therefore helps in further planning of management.

We present the case of a 12-year-old boy with sacral Ewing sarcoma post-chemotherapy, undergoing F-18 FDG PET/CT for treatment response assessment. Initial imaging demonstrated a metabolically active lytic-sclerotic lesion involving S2-S4 vertebrae, with marked resolution of uptake following treatment. Incidentally, follow-up PET/CT revealed bilateral testes positioned in the anterior abdominal wall, consistent with recent laparoscopic testicular transposition, performed prophylactically to prevent gonadal damage before pelvic radiotherapy. This finding underscores the need for nuclear medicine physicians to differentiate physiological FDG uptake in transposed testes from pathological uptake. This is the first reported PET/CT image-based documentation of this unique clinical scenario.

Primary Sjögren syndrome (SS) is an autoimmune disease affecting exocrine glands, with predisposition to development of lymphoma (lymphomagenesis). We report a case of Sjogren’s syndrome and discuss the role of FDG PET/CT in the primary diagnosis of lymphoma transformation in SS. Furthermore, we reviewed the literature regarding the utility of FDG PET/CT to assess systemic disease activity and also its role in the SS associated lymphoma with light into the new PET tracers that can be explored for these indications in the future. Published data suggest promising role of FDG PET/CT in SS associated lymphomas, and demands larger studies for its establishment.

OBJECTIVE:This systematic review aims to assess the diagnostic performance of FDG PET/CT and FAPi PET/CT in patients with gastric carcinoma, specifically for the evaluation of primary tumors, metastatic lymph nodes, and metastatic lesions. METHODS:Following PRISMA guidelines, relevant databases were searched until January 20, 2023. Studies reporting histopathology or surgical outcomes as the reference standard were included. Pooled estimates of diagnostic accuracy were generated using meta-analysis. RESULTS:Six studies with 167 patients who underwent FDG PET/CT and 169 patients who underwent FAPi PET/CT were included. For the detection of primary gastric carcinoma, FDG PET/CT demonstrated a pooled sensitivity of 0.86 (95% CI 0.47-0.98) and specificity of 0.70 (95% CI 0.39-0.90). The pooled positive likelihood ratio was 2.9 (95% CI 1.0-8.4), and the negative likelihood ratio was 0.21 (95% CI 0.03-1.30). The diagnostic odds ratio was 14 (95% CI 1-224), and the area under the SROC curve was 0.82. For FAPi PET/CT, pooled sensitivity and specificity for detecting primary gastric carcinoma were 0.90 (95% CI 0.90-0.90) and 0.50 (95% CI 0.50-0.50), respectively. The pooled positive and negative likelihood ratios were 1.8 (95% CI 1.8-1.8) and 0.20 (95% CI 0.20-0.20), respectively. The diagnostic odds ratio was 9 (95% CI 9-9), and the area under the SROC curve was 0.54. CONCLUSION:FAPi PET/CT demonstrated comparable diagnostic performance to FDG PET/CT in the diagnosis of primary gastric carcinoma, lymph nodal metastases, and metastatic lesions. When compared to histopathology or surgical findings, FAPi PET/CT showed good sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio.

This article discusses the role of various imaging modalities in diagnosing and managing surgical renal conditions in pediatric patients. It emphasizes the importance of tailored surgical interventions based on accurate imaging assessments. The cases presented cover a range of conditions, including pelvic-ureteric junction obstruction, vesicoureteric reflux, congenital renal anomalies, and postoperative management. The article underscores the pivotal role of various imaging modalities in diagnosing and managing a spectrum of surgical renal conditions in pediatric patients, providing valuable insights for clinical decision-making.

Metastatic renal osteosarcoma is a rare entity. We report a case of a 52-year-old male postright nephrectomy status presented to us with metastatic renal osteosarcoma. 18-fluorine- fluorodeoxyglucose ( 18 F-FDG) avid lesions were seen in the right renal bed with extension to adjacent hepatic parenchyma. The patient exhibited a favorable response to 6 cycles of carboplatin and doxorubicin with no FDG avid lesions in the postchemotherapy follow-up scan. On 6-month follow-up scan, scan findings reveal a recurrent lesion at the renal bed region infiltrating psoas muscle and liver metastatic lesion. This case highlights the use of 18 F-FDG positron emission tomography/computed tomography in metastatic recurrent extraskeletal osteosarcoma.

Background:To evaluate the role of FDG PET/CT in diagnosing and monitoring rhinocerebral mucormycosis (RCM) and its added value over conventional imaging.Patients and Methods:We conducted a prospective observational study of 47 adults with biopsy-confirmed rhinocerebral mucormycosis between July 2022 and September 2024. All patients underwent FDG PET/CT, and findings were compared with MRI/CT and correlated with microbiological or histopathologic results. PET/CT was used to assess disease extent, identify residual or recurrent disease, and monitor treatment response.Results:Of the 47 patients (43 men, 4 women; mean age 49.4 +/- 12.2 y), 3 were imaged preoperatively and 44 postoperatively. PET/CT detected metabolically active disease in 35 patients, including 6 (12.8%) with lesions not well visualized on MRI/CT. Preoperative SUVmax was higher than postoperative (8.12 vs 6.12), reflecting disease burden reduction after surgery. PET/CT confirmed disease resolution in 12 patients who remained recurrence-free on follow-up. In 32 patients, PET/CT identified residual or recurrent disease, influencing further surgical and medical management. Representative images demonstrate PET/CT detection of active lesions missed on MRI/CT.Conclusions:FDG PET/CT delineates disease extent, guides therapeutic decisions, and confirms treatment response. Incorporating PET/CT into routine clinical management may improve outcomes by enabling timely, targeted interventions.

Background Duplicate records are a common challenge in systematic reviews, arising from database overlap and multiple citation formats. Failure to address duplicates increases reviewer workload and risks bias. Existing tools such as EndNote and Rayyan offer deduplication features, but evaluations highlight trade-offs between sensitivity and specificity. DeDupli, a novel Streamlit-based, privacy-friendly tool, was developed to balance speed, accuracy, and user oversight through automatic and manual deduplication modes. Methods We generated three synthetic RIS datasets (262, 200, and 320 records) with known duplicate clusters to simulate real-world bibliographic search outputs. Three independent reviewers evaluated deduplication performance across EndNote, Rayyan, and DeDupli (automatic and manual modes) in a crossover design. Reviewers recorded duplicates removed, uniques retained, and processing time. Ground truth was used to calculate true positives (TP), true negatives (TN), false positives (FP), and false negatives (FN). Performance metrics included sensitivity, specificity, precision, and F1-score. Results Across 1,564 records with 428 true duplicates, DeDupli achieved perfect sensitivity (1.000), eliminating all duplicates. EndNote and Rayyan achieved perfect specificity and precision (1.000), but each missed 13 duplicates (sensitivity 0.939). DeDupli-Autoprocessed datasets in under 5 seconds but introduced more false positives (precision 0.899, F1 0.947). DeDupli-Manualrequired ~5 minutes, reduced false positives, and improved precision (0.934) and F1 (0.966). By contrast, EndNote (2636 s) and Rayyan (2580 s) required ~40 minutes per dataset. Reviewer-level analysis showed minimal variability, confirming consistency across raters. Conclusion DeDupli demonstrated superior sensitivity and substantial time savings compared with EndNote and Rayyan. Its dual-mode design offers flexibility, allowing users to prioritize either speed (automatic) or accuracy (manual). These results highlight DeDupli as a promising, privacy-friendly solution to streamline deduplication in systematic reviews and meta-analyses. Validation on real-world datasets and integration into review workflows are recommended for future work.

Angiosarcoma is a rare type of soft-tissue sarcoma, constituting only 1% out of all soft-tissue sarcomas pathologically originating from lymphatic or vascular endothelial cells. Angiosarcomas are reported to be very aggressive with a high incidence of metastases to different sites; therefore, it is very important to determine disease extension and detect local recurrence and/or distant metastases for appropriate management. We report a case of a 55-year-old Indian male who presented with soft-tissue thickening of the left cheek for which biopsy revealed angiosarcoma and was referred for fludeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) to assess the extent of disease highlighting the potential role of FDG PET/CT in rare malignancies like angiosarcomas.

BACKGROUND:To evaluate the role of FDG PET/CT in diagnosing and monitoring rhinocerebral mucormycosis (RCM) and its added value over conventional imaging. PATIENTS AND METHODS:We conducted a prospective observational study of 47 adults with biopsy-confirmed rhinocerebral mucormycosis between July 2022 and September 2024. All patients underwent FDG PET/CT, and findings were compared with MRI/CT and correlated with microbiological or histopathologic results. PET/CT was used to assess disease extent, identify residual or recurrent disease, and monitor treatment response. RESULTS:Of the 47 patients (43 men, 4 women; mean age 49.4 ± 12.2 y), 3 were imaged preoperatively and 44 postoperatively. PET/CT detected metabolically active disease in 35 patients, including 6 (12.8%) with lesions not well visualized on MRI/CT. Preoperative SUVmax was higher than postoperative (8.12 vs 6.12), reflecting disease burden reduction after surgery. PET/CT confirmed disease resolution in 12 patients who remained recurrence-free on follow-up. In 32 patients, PET/CT identified residual or recurrent disease, influencing further surgical and medical management. Representative images demonstrate PET/CT detection of active lesions missed on MRI/CT. CONCLUSIONS:FDG PET/CT delineates disease extent, guides therapeutic decisions, and confirms treatment response. Incorporating PET/CT into routine clinical management may improve outcomes by enabling timely, targeted interventions.

The prevalence of double primary prostate and bladder cancer is not uncommon. Though both share a common pathway of malignant transformation, they bear to differ in the case of 2-[ 18 F]FDG PET/CT and [ 68 Ga]Ga-PSMA uptake. We present a case of double primary cancer involving the bladder and prostate, where the prostatic primary showed intense [ 68 Ga]Ga-PSMA uptake with non-avid skeletal and pulmonary metastases, which showed intense 2-[ 18 F]FDG uptake, thus showing discordance due to different clonal origins.

Aim This study aimed to evaluate the potential role of 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) in providing a targeted approach for diagnosing the etiology of Pyrexia of Unknown Origin (PUO). Methods A total of 573 PUO patients were included in this ambispective study, with a mean age of 39.40 ± 4.6 years. Patients underwent FDG PET/CT scans using dedicated hybrid scanners. PET/CT data were interpreted by experienced nuclear medicine physicians. The study analyzed the guidance provided by FDG PET/CT for appropriate biopsy sites and assessed concordance between PET/CT findings and histopathological examination. Results Out of the 573 patients, a final diagnosis was reached for 219 patients, including malignancy, infectious causes, noninfectious inflammatory causes (NIID), and precancerous conditions. FDG PET/CT played a crucial role in guiding clinicians to appropriate biopsy sites, contributing to a higher diagnostic yield. Concordance between PET/CT findings and histopathological examination emphasized the noninvasive diagnostic potential of PET/CT in identifying underlying causes of PUO. Overall, FDG PET/CT contributed to guiding the appropriate site of biopsy or concordance of the first differential diagnosis with the final diagnosis in 50.05% of cases. Conclusion This study highlights the valuable role of FDG PET/CT in providing a targeted approach for diagnosing PUO, showcasing its potential in guiding clinicians towards appropriate biopsy sites and improving the diagnostic yield. The findings underscore the importance of integrating FDG PET/CT into the diagnostic pathway for PUO, ultimately enhancing patient management and outcomes. Further prospective studies are necessary to validate these results and refine the integration of FDG PET/CT in the diagnosis of PUO.