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On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
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Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
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Get a free weekly case delivered right to your inbox.
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Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
Introduction to PET/CT Imaging
12 topics, 49 min.
Introduction to PET/CT Imaging
1 m.How to Use the Case Viewer to Evaluate PET/CT Images in this Course
2 m.What is PET/CT Imaging?
7 m.Commonly Used Positron-emitting Radionuclides
2 m.PET/CT Imaging Acquisition
4 m.PET/CT Quality Control
5 m.Quantification of Tracer Uptake
6 m.Factors Impacting Quantification of Tracer Uptake
3 m.Where to Start: Reading a PET/CT Study
9 m.Case: Systematic Approach to Reading a PET/CT Study
9 m.Case: Setting Up Your Imaging Display for a PET/CT Study
5 m.PET/CT Report Example
2 m.Lesson
FDG Use in PET/CT
8 topics, 28 min.
Introduction to FDG
4 m.FDG: Patient Preparation
2 m.FDG: Patterns of Muscle Uptake
6 m.FDG: Patterns of Bone Marrow Uptake and the Effects of G-CSF
5 m.FDG: Patterns of Bone Marrow Uptake and the Effects of Bone Marrow Disease
3 m.Case: Normal Distribution of FDG Tracer
4 m.Case: Abnormal Distribution of FDG (Hyperinsulinemia)
6 m.Cases: Abnormal Distribution of FDG (Hyperinsulinemia, Rhabdomyolysis, Myositis)
2 m.Lesson
FDG: Common Pitfalls and Benign Lesions
9 topics, 21 min.
Lesson
FDG Use in Hematologic Malignancies
8 topics, 40 min.
Role of FDG PET/CT Imaging in Lymphoma: Classification and Staging
7 m.Role of FDG PET/CT Imaging in Lymphoma: Response to Therapy
3 m.Role of FDG PET/CT Imaging in Lymphoma: Follow-up Reports
3 m.FDG Case: Hodgkin's Lymphoma, Initial Presentation
9 m.FDG Case: Hodgkin's Lymphoma, Follow-up
6 m.FDG Case: DLBCL, Initial Presentation
5 m.FDG Case: DLBCL, Follow-up
5 m.FDG Case: Multiple Myeloma
7 m.Lesson
FDG Use in Lung Cancer
5 topics, 17 min.
Lesson
FDG Use in Head & Neck Cancer
3 topics, 14 min.
Lesson
FDG Use in Breast Cancer
2 topics, 8 min.
Lesson
FDG Use in Immunotherapy
3 topics, 18 min.
Lesson
DOTATATE Use in PET/CT
7 topics, 15 min.
Lesson
DOTATATE and FDG Use in Neuroendocrine Tumors
6 topics, 22 min.
Lesson
PSMA Use in PET/CT
4 topics, 9 min.
Lesson
PSMA Use in Prostate Cancer
5 topics, 23 min.
0:01
64-year-old male with
0:05
a pancreatic mass that was diagnosed
0:08
as a well differentiated neuroendocrine tumor.
0:12
DYS disparity was performed for staging.
0:16
Looking at the mip, we can see that there are multiple areas
0:20
of abnormal tracer uptake in the liver.
0:24
There is, uh, very abnormal uptake in the
0:28
upper abdomen as well.
0:30
And so we're gonna go through all these findings on the
0:35
axial plane.
0:37
So starting with the pancreatic mass,
0:43
there is a large heterogeneous pancreatic mass.
0:47
As we can see on the pit,
0:49
there is intense peripheral uptake.
0:52
The center of the lesion has no tracer uptake.
0:57
This mass is centered at the tail of the pancreas,
1:01
but is locally aggressive
1:03
and extends into the splenic hilum as we can see on the CT
1:09
and also in a heterogeneous way on the pit,
1:14
as well as extends toward the left
1:18
pararenal space and involves the left kidney.
1:25
This was the biopsy proven pancreatic neuroendocrine.
1:29
It's well differentiated
1:31
because we can see that there is intense TA uptake.
1:35
Other areas of abnormality are all these multiple
1:40
lesions in the liver.
1:41
Some are large like this one on the left helo with central
1:47
NIA and hypo density on ct.
1:51
And some are smaller like this one
1:54
on the edge anteriorly,
1:56
which has a very subtle correlate on the CT
2:00
portion of this study.
2:03
As I mentioned earlier, the MIB images allow us to see areas
2:07
that may be obscured if we scroll through in axial plane.
2:12
And I want to point your attention to this area,
2:17
focal uptake that projects anteriorly into the patient's
2:20
body, that it's subtle
2:23
and I really have to force the window here to see it better.
2:28
These correlated to a soft tissue nodule on the
2:33
left anterior abdominal wall.
2:36
And so, uh, not only we were able to identify, in this case
2:41
the metastatic disease
2:44
and the local involvement
2:47
of the pancreatic mass into the spleen and kidney,
2:51
but we also identified an additional soft tissue metastasis.
2:57
We went back to priors and this was a new finding
3:00
and this showed enhancement on a CT abdomen
3:05
demonstrating that this was not a benign finding,
3:09
but a soft tissue metastasis.
DOTATATE Case: Pancreatic NET
HIDEInteractive Transcript
0:01
64-year-old male with
0:05
a pancreatic mass that was diagnosed
0:08
as a well differentiated neuroendocrine tumor.
0:12
DYS disparity was performed for staging.
0:16
Looking at the mip, we can see that there are multiple areas
0:20
of abnormal tracer uptake in the liver.
0:24
There is, uh, very abnormal uptake in the
0:28
upper abdomen as well.
0:30
And so we're gonna go through all these findings on the
0:35
axial plane.
0:37
So starting with the pancreatic mass,
0:43
there is a large heterogeneous pancreatic mass.
0:47
As we can see on the pit,
0:49
there is intense peripheral uptake.
0:52
The center of the lesion has no tracer uptake.
0:57
This mass is centered at the tail of the pancreas,
1:01
but is locally aggressive
1:03
and extends into the splenic hilum as we can see on the CT
1:09
and also in a heterogeneous way on the pit,
1:14
as well as extends toward the left
1:18
pararenal space and involves the left kidney.
1:25
This was the biopsy proven pancreatic neuroendocrine.
1:29
It's well differentiated
1:31
because we can see that there is intense TA uptake.
1:35
Other areas of abnormality are all these multiple
1:40
lesions in the liver.
1:41
Some are large like this one on the left helo with central
1:47
NIA and hypo density on ct.
1:51
And some are smaller like this one
1:54
on the edge anteriorly,
1:56
which has a very subtle correlate on the CT
2:00
portion of this study.
2:03
As I mentioned earlier, the MIB images allow us to see areas
2:07
that may be obscured if we scroll through in axial plane.
2:12
And I want to point your attention to this area,
2:17
focal uptake that projects anteriorly into the patient's
2:20
body, that it's subtle
2:23
and I really have to force the window here to see it better.
2:28
These correlated to a soft tissue nodule on the
2:33
left anterior abdominal wall.
2:36
And so, uh, not only we were able to identify, in this case
2:41
the metastatic disease
2:44
and the local involvement
2:47
of the pancreatic mass into the spleen and kidney,
2:51
but we also identified an additional soft tissue metastasis.
2:57
We went back to priors and this was a new finding
3:00
and this showed enhancement on a CT abdomen
3:05
demonstrating that this was not a benign finding,
3:09
but a soft tissue metastasis.
Report
Faculty
Elisa Franquet Elia, MD
Assistant Professor of Radiology
UMass Chan Medical School
Tags
Response and assessment
Pancreas
PET/CT DOTATATE
PET
Other Systems
Oncologic Imaging
Nuclear Medicine
Neuroendocrine
Neoplastic
General Oncologic Imaging Concepts
Gastrointestinal (GI)
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