Interesting Image

¹¹C-Methionine PET/CT and ¹⁸F-FDG PET/CT in the Evaluation of Adult Alveolar Rhabdomyosarcoma

10.4274/mirt.galenos.2022.96977

• Yuka Hiroshima
• Yoichi Otomi
• Takayoshi Shinya
• Hideki Otsuka
• Masafumi Harada

Received Date: 28.12.2021 Accepted Date: 20.02.2022 Mol Imaging Radionucl Ther 2023;32(1):62-64 PMID: 36819829

• Abstract
• Full Text
• Video - Image
• References
• 5
• 345

A 70-year-old man with a tumor in the nasal and paranasal space, was pathologically diagnosed with an alveolar rhabdomyosarcoma, with right cervical lymph node metastasis. Magnetic resonance imaging revealed a primary tumor in the nasal and paranasal sinuses, with associated intracranial infiltration. ¹¹C-methionine positron emission tomography/computed tomography (PET/CT) revealed increased uptake in the primary tumor and right cervical lymph node metastasis. ¹⁸F-fluorodeoxyglucose PET/CT also revealed increased uptake in the primary tumor and right cervical lymph node. However, the physiological brain uptake overlapped with the primary tumor uptake. Our case suggests the usefulness of ¹¹C-methionine PET/CT for accurately assessing the extent of alveolar rhabdomyosarcoma, especially in cases with intracranial infiltration or those approximating the brain.

Keywords: 11C-methionine, 18F-FDG, alveolar rhabdomyosarcoma, PET/CT

Ethics

Informed Consent: Written informed consent was obtained from the patient.

Peer-review: Externally peer-reviewed.

Authorship Contributions

Concept: Y.O., T.S., Design: Y.O., T.S., Data Collection or Processing: Y.H., Y.O., Analysis or interpretation: Y.O., T.S., H.O., M.H., Literature Search: Y.H., Y.O., Writing: Y.H.

Conflict of Interest: No conflict of interest was declared by the authors.

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

Images

1. van der Graaf WTA, Orbach D, Judson IR, Ferrari A. Soft tissue sarcomas in adolescents and young adults: a comparison with their paediatric and adult counterparts. Lancet Oncol 2017;18:e166-e175.
2. Gennaro N, Marrari A, Renne SL, Cananzi FCM, Quagliuolo VL, Di Brina L, Scorsetti M, Pepe G, Chiti A, Santoro A, Balzarini L, Politi LS, Bertuzzi AF. Multimodality imaging of adult rhabdomyosarcoma: the added value of hybrid imaging. Br J Radiol 2020;93:20200250.
3. Federico SM, Spunt SL, Krasin MJ, Billup CA, Wu J, Shulkin B, Mandell G, McCarville MB. Comparison of PET-CT and conventional imaging in staging pediatric rhabdomyosarcoma. Pediatr Blood Cancer 2013;60:1128-1134.
4. El-Kholy E, El Nadi E, Hafez H, Ahmed S, Younes A, El-Kenanii N, Khalid E. Added predictive value of 18F-FDG PET/CT for pediatric rhabdomyosarcoma. Nucl Med Commun 2019;40:898-904.
5. Ricard F, Cimarelli S, Deshayes E, Mognetti T, Thiesse P, Giammarile F. Additional Benefit of F-18 FDG PET/CT in the staging and follow-up of pediatric rhabdomyosarcoma. Clin Nucl Med 2011;36:672-677.
6. He Q, Zhang L, Zhang B, Shi X, Yi C, Zhang X. Diagnostic accuracy of 13N-ammonia PET, 11C-methionine PET and 18F-fluorodeoxyglucose PET: a comparative study in patients with suspected cerebral glioma. BMC Cancer 2019;19:332.
7. Ito K, Matsuda H, Kubota K. Imaging Spectrum and Pitfalls of (11)C-methionine positron emission tomography in a series of patients with intracranial lesions. Korean J Radiol 2016;17:424-434.
8. Partovi S, Kohan AA, Zipp L, Faulhaber P, Kosmas C, Ros PR, Robbin MR. Hybrid PET/MR imaging in two sarcoma patients- clinical benefits and implications for future trials. Int J Clin Exp Med 2014;7:640-648.