Advanced molecular imaging Ingenuity TF PET/CT Clinical case book Oncology cases The print quality of this copy is not an accurate representation of the original.

Clinical case book The print quality of this copy is not an accurate representation of the original.

Ingenuity TF PET/CT Oncology cases Clinical case book The print quality of this copy is not an accurate representation of the original.

Apollo Gleneagles Hospital, 20 Kolkata, India 1. Recurrent fibrolamellar variant of hepatocellular 22 2. Moderately differentiated squamous cell 24 carcinoma of the left lateral border of the tongue, treated by left hemiglossectomy along with left sided modified neck dissection 3. Metastatic adenocarcinoma of right sided 26 cervical lymph node but unknown primary. Treated by right sided radical neck dissection, 2014. Follow up study 4. Metastatic poorly differentiated carcinoma to D8 28 done for unknown primary 5. Adenocarcinoma of the splenic flexure of the 30 colon with infiltration of spleen,...

Isala, Zwolle, The Netherlands 54 1. Primary breast cancer with several axillary 56 2. Breast cancer primary with axillary metastases 58 8 mm and very subtle 4 mm parasternal metastatic lesion 3. Mid-esophageal tumor with mediastinal nodes 60 as small as 3-4 mm picked up on FDG PET and degenerative disease in cervical spine 4. Burkitt lymphoma in the lower abdomen 62 mimicking intestinal loops with small upper abdominal mets anterior to liver 5. Pulmonary adenocarcinoma with extensive 64 metastatic spread to mediastinum, axilla, bone and soft tissue 6. Patient with known colon carcinoma 66 7....

Images we get from the Ingenuity TF are high quality. They allow me to see small lesions and help to provide the necessary information to my referring physicians and enable more personalized care for their patients. The Ingenuity TF gives me great confidence in my diagnostic interpretations and will serve my purposes now and for years ahead as one of my key instruments as molecular imaging evolves.” Dr. Robert Wagner M.D., M.S.M.I.S., FACR, FACNP Professor, Medical Director, Nuclear Medicine

Clinical case book The print quality of this copy is not an accurate representation of the origina

Study 1: Innumerable hypermetabolic lesions in the skin, subcutaneous tissue, lungs, liver, kidneys and bones are consistent with metastatic disease. General characteristics Patient Female Scan characteristics 12.9 mCi F18 FDG 62 min uptake time 60 sec/bed Study 2: 10 weeks later. Disease progression seen in the chest, liver and skeleton. General characteristics Patient Age Height Bodyweight Scan characteristics 11.2 mCi F18 FDG 64 min uptake time 60 sec/bed 8 Clinical case book

Cases Loyola Clinical case book The print quality of this copy is not an accurate representation of the original.

Interval decrease in size and slightly decreased FDG uptake of the right posterior lobe hepatic metastasis, when compared to the previous study. General characteristics Patient Female Age 63 years Height 1.55 m Bodyweight 65 kg Clinical case book Scan characteristics 10.1 mCi F18 FDG 59 min uptake time 90 sec/bed The print quality of this copy is not an accurate representation of the original.

Cases Loyola In addition to visualization of the liver lesion, image contrast capability is demonstrated in the area around the liver. Clinical case book The print quality of this copy is not an accurate representation of the original.

Patient with a history of triple negative breast cancer with right mastectomy, and waxing/waning lung nodules. PET 1 year prior to study 1 was negative for metastases. Scan characteristics PET 9.1 mCi F18 FDG 65 min uptake time 90 sec/bed CT 120 kVp, 75 mAs iDose4, 5 CTDI vol Scan characteristics PET 9.2 mCi F18 FDG 58 min uptake time 90 sec/bed CT 120 kVp, 61 mAs iDose4, 4 CTDI vol Study 1 General characteristics Patient Female Study 2 General characteristics Patient Female Bodyweight 60 kg 12 Clinical case book

Cases Loyola Soft tissue nodule with SUVmax 1.9 Study 2 performed after a CT that demonstrated a growing lung nodule. Reconstruction of the left breast performed since study 1. An FDG-avid, round, 1.1 cm nodule is identified with an SUVmax of 5.2, highly concerning for metastatic disease. SUVmax 5.2 Clinical case book The print quality of this copy is not an accurate representation of the original.

Time of Flight contributes to the image quality seen in this large patient. Visualization of the deep structures (kidneys and spine) compared to peri-renal fat is noted. Lymphadenopthy in the right inguinal region. Diffuse marrow metabolic activity is likely secondary to marrow reconversion from anemia. Scan characteristics PET 11.1 mCi F18 FDG 62 min uptake time 150 sec/bed CT 120 kVp, 140 mAs iDose4, 6.6 CTDI vol General characteristics Patient Female 14 Clinical case book The print quality of this copy is not an accurate representation of the original.

Cases Loyola ToF mage quality in a large patient Lymphadenopthy in the right inguinal region. Observe the correlation with the CT seen on the fusion image. Clinical case book The print quality of this copy is not an accurate representation of the original.

History of carcinoid tumor. Previously identified skull and cervical spine lesions. Lower CT technique for arms up in second study. The patient has a pelvic kidney (activity collection in the r kidney, at the bottom left of the images). Study 1: Patient is 230 pounds. Increased uptake diffusely along the posterior thoracic ribs bilaterally is most likely vascular in nature. Brown fat activity is noted. Scan characteristics PET 12.4 mCi F18 FDG 58 min uptake time 135 sec/bed CT 120 kVp, 100 mAs iDose4, 6.6 CTDI vol Scan characteristics PET 12.2 mCi F18 FDG 61 min uptake time 90 sec/bed CT 120...

Cases Loyola Body position changes from arms down (study 1) to arms up (study 2). Note the similarity in image quality. This is good. Study 1: Right breast lesion with SUVmax of 9.2 is most consistent with primary malignancy. Increased uptake diffusely along the posterior thoracic ribs bilaterally is most likely vascular in nature. Brown fat activity is noted. Study 2: 5 months after study 1. Post operative lumpectomy changes are seen. Multiple metastatic lesions in the skeleton. Study 2: Multiple areas of increased skeletal uptake consistent with metastatic carcinoid. Image quality with multiple...