A 74-year-old man underwent lung scintigraphy to rule out pulmonary embolism. Planar images revealed an abnormal midline uptake of ^99mTc macroaggregated albumin (MAA), which localized to several thoracic vertebrae, as revealed by single photon emission computed tomography / computed tomography. Contrast-enhanced computed tomography demonstrated stenosis of the left brachiocephalic vein for median sternotomy. By vascular stenosis, vessels to the vertebrae developed as a collateral pathway. Additionally, ^99mTc MAA was administered from the left median cubital vein in this patient.

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A 3-year-old girl was hospitalized for examining the lower leg edema. The blood examination revealed TP (3.6 g/dL), Alb (1.7 g/dL), and hypoproteinemia. In addition, ^99mTc-HSA-D scintigraphy was performed to ascertain the presence of protein leakage from the intestinal tract. Although a diffuse RI distribution in the left lower quadrant was observed in a 1-h image, the movement of the RI distribution to the right lower quadrant was observed in the 6-h image acquired after the meal. Furthermore, the colon was being illustrated in the 24-h image. We confirmed the existence of protein leakage from the small intestinal mucosa. On interviewing the mother regarding the usual dietary content, it was found that approximately 800 mL of milk was fed to the patient per day. An allergy test revealed milk allergy, which was diagnosed as a series of protein-losing gastroenteropathy caused by excessive milk consumption.

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To our knowledge, this is the first case report showing differences in the temporal PET and MR imaging findings of the bone-marrow on ¹⁸F-FDG PET/MRI after G-CSF administration. PET/MRI performed one day after G-CSF administration showed remarkably increased FDG uptake on PET but normal signal intensities on MRI, in the bone marrow. Conversely, there was no increased FDG uptake but high signal intensities on diffusion-weighted imaging and T2 weighted images, 21 days after G-CSF administration. These findings suggest contiguous changes of glucose metabolism and cellularity of activated red bone marrow due to G-CSF administration.

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Metastatic pulmonary calcification (MPC) is calcium deposition in normal pulmonary parenchyma due to abnormal calcium metabolism. We present a case report of rapid progression of MPC due to primary hyperparathyroidism with hypercalcemia and acute renal failure. CT demonstrated rapidly progressive high-attenuation consolidation predominately in the upper lung fields. Bone scan revealed bilateral diffuse lung uptake suggesting MPC. Rapid progression of MPC is rare and may be misdiagnosed as air-space disease. Bone scan is useful for diagnosis of MPC, particularly when CT finding is atypical.

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A 79-year-old man presented with progressive respiratory distress. CT revealed the smooth thickening of airway walls, thyroid cartilage, cricoid cartilage, and costal cartilage. ¹⁸F-FDG uptake was observed in nasal, thyroid, cricoid, and costal cartilage on PET/CT. Biopsy was performed on costal cartilage and the histology observed was consistent with relapsing polychondritis (RPC). FDG-PET/CT is useful for the diagnosis of RPC and selection of biopsy sites.

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In bone scintigraphy, bone scan index (BSI) has recently been shown to be useful for quantitative assessment of bone metastasis in patients with prostate cancer. We report our experience with the use of a new BSI analysis software for technetium-99m hydroxymethylene diphosphonate ^99mTc-HMDP) bone scanning. Deep learning is accomplished using a database of identified bone anatomy structures of 246 patients, and accordingly, the skeleton is classified into 12 segments: skull, sternum, cervical spine, thoracic spine, lumbar spine, sacrum, clavicle, scapula, humerus, ribs, pelvis, and femur. It also identifies abnormal accumulation through deep learning using a database of identified sites of abnormal accumulation in 896 patients with prostate cancer as supervised data. Each bone area in the 12 segments is calculated for each patient, and the local BSI is calculated from the area of each bone metastasis in each segment. The sum of local BSI is defined as BSI, and the number of bone metastases is defined as the number of hot spots. The analysis was performed on a 64-bit Windows 10 personal computer with Intel® CoreTMi7-8550U and 16.0 GB RAM. The time required for analyzing bone scintigraphy for a patient was approximately 20 seconds. Some cases actually used are presented in the text.

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