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Increased Bone Marrow 18F-Choline Uptake in a Patient with Hepatocellular Carcinoma and Thalassemia Intermedia

10.4274/mirt.galenos.2019.03064

  • Luca Filippi

Received Date: 09.08.2019 Accepted Date: 30.09.2019 Mol Imaging Radionucl Ther 2020;29(1):45-48

A 57-year-old male with history of thalassemia intermedia and hepatocellular carcinoma underwent a positron emission tomography/computed tomography (PET/CT) scan with 18F-choline before radioembolization procedure with 90Y-microspheres. The PET/CT scan with 18F-choline demonstrated highly increased tracer incorporation within a gross lesion in the hepatic dome coupled with diffuse activity in bone marrow, this latter aspect was probably due to the compensatory hematopoiesis stimulation induced by chronic hemolysis. This pattern of skeletal 18F-choline uptake should be considered as a peculiar PET/CT finding in thalassemic patients.

Keywords: 18F-choline, positron emission tomography/computed tomography, hepatocellular carcinoma, thalassemia

Ethics

Informed Consent: This article does not contain any studies with human participants or animals performed by any of the authors.

Peer-review: Externally and internally peer-reviewed.

Financial Disclosure: The author declared that this study received no financial support.

Images

  1. Schillaci O, Calabria F, Tavolozza M, Cicciò C, Carlani M, Caracciolo CR, Danieli R, Orlacchio A, Simonetti G. 18F-choline PET/CT physiological distribution and pitfalls in image interpretation: experience in 80 patients with prostate cancer. Nucl Med Commun 2010;31:39-45.
  2. Aessopos A, Kati M, Farmakis D. Heart disease in thalassemia intermedia: a review of the underlying pathophysiology. Haematologica 2007;92:658-665.
  3. Mancuso A. Hepatocellular carcinoma in thalassemia: A critical review. World J Hepatol 2010;2:171-174.
  4. Hartenbach M, Weber S, Albert NL, Hartenbach S, Hirtl A, Zacherl MJ, Paprottka PM, Tiling R, Bartenstein P, Hacker M, Haug AR. Evaluating Treatment Response of Radioembolization in Intermediate-Stage Hepatocellular Carcinoma Patients Using 18F-Fluoroethylcholine PET/CT. J Nucl Med 2015;56:1661-1666.
  5. Filippi L, Schillaci O, Bagni O. Recent advances in PET probes for hepatocellular carcinoma characterization. Expert Rev Med Devices 2019;16:341-350.
  6. Schmitt CR, Schmitt CT, Hinds PR, Sawyer KJ. Use of 18F-Fluciclovine to Diagnose Recurrent Prostate Carcinoma in a Patient With Beta-Thalassemia. Clin Nucl Med 2019;44:544-545.
  7. Savir-Baruch B, Zanoni L, Schuster DM. Imaging of Prostate Cancer Using Fluciclovine. Urol Clin North Am 2018;45:489-502.
  8. Bagni O, Filippi L, Schillaci O. Incidental detection of colorectal cancer via 1(8)F-choline PET/CT in a patient with recurrent prostate cancer: usefulness of early images. Clin Nucl Med 2015;40:328-330.