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🩻 Nuclear Medicine & Hybrid Imaging
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13/02/2026

☢️ Hydroxyapatite crystal deposition ☢️ 54-years-old male patient diagnosed with Non-Hodgkin’s lymphoma in remission, presented with low grade fever, mildly elevated WBC, CRP and thigh pain. FDG PET revealed amorphous hyperdense deposits of mild FDG uptake in the iliofemoral ligament.
🗓 Periarticularcalcific deposits in the tendons and soft tissue is caused by hydroxyapatite crystals deposition within the periarticular soft tissue (mostly tendons), most commonly affect the rotator cuff of shoulder at the supraspinatus tendon insertion. It may affect also the capsules, ligaments and bursae with the hip and knee being other common locations. Increased FDG uptake is most likely due to local inflammation caused by hydroxyapatite crystals deposition. The incidence is 2.5-20% in shoulder and less common in hip. Slightly more frequent in females. Patients present with acute or chronic hip pain, elevated WBC, fever with limitation of movement; however the symptoms depend the phase of clinical presentation.

11/02/2026

☢️ CIED Infection ☢️ FDG PET/CT shows intense FDG uptake involving soft tissue fullness surrounding the pocket device tracking along the proximal leads with regional fat infiltration.
🗓 In suspected CIED infection, FDG PET/CT is a valuable modality when there is suspected infection despite normal echocardiograph, negative cultures, and clinical findings are equivocal. It can localize active infection to generator pocket in the anterior chest wall, and/or along the leads, and provide a whole body assessment for metastatic infectious foci. Overall reported (pooled meta-analysis) SN 83-87% and SP 90-94%.
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10/02/2026

☢️ Sister Mary Joseph nodule ☢️ FDG PET/CT scan shows a hypermetabolic umbilical nodular soft tissue lesion of intense uptake, consistent with metastatic Sister Mary Joseph nodule in a gastric cancer patient.
🗓️ Sister Mary Joseph nodule is a metastatic umbilical soft tissue lesion mostly from a direct peritoneal spread, most commonly from intra abdominal adenocarcinoma. Patients usually present with umbilical lesion that can be painful or asymptomatic, it can also be ulcerating or associated with discharge. The reported incidence is 1-3% of intra abdominopelvic malignancies.

09/02/2026

☢️ Cemented acetabular loosening ☢️ SPECT/CT shows irregular osteolysis at the bone-cement interface of the superolateral and intermediate acetabular zones with regions of more than 2 mm corresponding to increased perfusion and delayed tracer uptake. Non union of left greater trochanter with proximal migragtion sitting above the shoulder of femoral stem corresponding to diffuse intense tracer uptake with surrounding soft tissue collection showing increased peripheral perfusion suggestive of chronic remodeling with surrounding inflammatory collection/hematoma. Surgical intervention confirmed acetabular mechanical loosening and inflammatory collection surrounding the greater trochanter.
🗓 Normalization of tracer uptake in cemented hip prosthesis is expected at 12 month and can persist as faint to mild uptake at the femoral zones 1 (trochanteric) and 4 (tip of femoral stem) despite solid fixation. Uptake in acetabular zone I can also be seen. Abnormal uptake at bone-cement interface with corresponding lucency is suggestive of loosening.

07/02/2026

☢️ Calculous cholecystitis ☢️Incidental finding of multiple gallbladder and cystic duct stones, diffuse gallbladder wall thickening with pericholecystic multifocal areas of intense FDG uptake and regional edema. There is focal right greater momentum fat infiltration of minimal FDG uptake. Findings were consistent of acute calculous cholecystitis.
🗓 Acute cholecystitis is characterized by inflammation of the gallbladder, often due to the presence of gallstones blocking the cystic duct or by other causes such as infection. When evaluating acute cholecystitis using FDG PET/CT scan findings include FDG uptake in wall thickening or within the affected areas, within surrounding soft tissue including adjacent hepatic parenchyma, regional edema and fat infiltration, regional peritonitis.

05/02/2026

💧 READ WITH ME | DMSA scan cortical insults

🗓 11-year-old female with history of recurrent UTIs and no prior imaging, referred for DMSA scan as further assessment. Both kidneys contribution to the split function was 50%.

03/02/2026

☢️ Post transplant lymphoproliferative disorder ☢️ Widespread intensely FDG avid nodal disease above and below the diaphragm with extensive extranodal involvement, including bilateral pulmonary nodules/masses, diffuse gastric wall thickening, mesenteric/peritoneal deposits, and multifocal osseous lesions (lytic and sclerotic). Both native kidneys demonstrate diffuse cortical hypermetabolism, with marked diffuse FDG uptake in the transplanted pelvic kidney associated with enlargement, hydronephrosis, and perinephric infiltration. Additional involvement includes splenic hilar nodes, hepatic deposit, and focal FDG avid skin thickening in the right thigh
🗓 PTLD is a spectrum of potentially life threatening lymphoid proliferation occurring following solid organ or hematopoietic transplantation in setting of immunosuppression, often linked to EBV reactivation. The incidence is ~2% and is the second most common malignancy related to post transplantation, renal transplant representing 1-2%. Risk factors include EBV seronegativity, allograft type and CMV infection. Virtually, any organ can be involved including the allograft itself.

02/02/2026

☢️ Sacral chordoma ☢️ FDG PET/CT scan shows incidental finding of a centrally located, well circumscribed and rounded presacral soft tissue mass of non focal moderate FDG uptake with underlying sacral cortical erosions, displacing the re**um anteriorly. Biopsy revealed chordoma.
🗓️ Chordoma arises from remnants of the notochord embryonic remnants. Sacral chordomas grow slowly and are often asymptomatic initially. However, as they enlarge, they can cause localized pain, numbness, and weakness in the lower back, pelvis, or legs. There are three subtypes conventional chordoma (most common), chondroid chordoma, (best prognosis) and poorly differentiated chordoma (worst prognosis). Metastases can occur in 7-15% of the patient commonly in the lungs, bones, lymph nodes. The degree of FDG uptake can vary among chordomas, and some may exhibit lower uptake levels compared to other types of tumors. Generally they show moderate heterogeneous FDG uptake.

31/01/2026

☢️ Metastatic ependymoma ☢️ FDG PET/CT scan shows hypermetabolic linear to nodular focal areas of intense FDG uptake [SUVmax= 13.1] along the spinal canal/thecal sac over the cervical, dorsal and lumbar levels, without definite hyper or nodular soft tissue densities. Patient had a piecemeal resection of a mass in the 4th ventricle. Immunoprofile (GFAP+, synaptophysin−, β catenin−) supports glial lineage and favors ependymoma over neuronal or embryonal tumors.
🗓 Metastatic ependymoma represents CSF disseminated disease via leptomeningeal seeding rather than hematogenous spread leading to drop metastases along the spinal cord, mostly involving the dorsal surface of the spinal cord, cauda equina and nerve roots. On pathology, tumor cells are typically GFAP positive confirming glial origin, β-catenin negativity argues against activated embryonal tumors and supports the diagnosis of ependymoma, while Synaptophysin argues against neuronal/neuroendocrine tumors. Diagnosis is with MRI, on FDG PET/CT leptomeningeal disease shows variable FDG uptake, low to intense, can be patchy or linear along the spinal cord or caudal equina.

30/01/2026

❓Which of the following statements best describes MIBI uptake in a parathyroid adenoma?

28/01/2026

DUODENAL DIVERTICULA

☢️ Incidental finding of duodenal diverticulum ☢️ Low density saccular out-pouch from the duodenum with gas, fluid, and food debris not showing metabolic activity.
🗓 Most duodenal diverticulum are asymptomatic and found incidentally. Complications are rare including perforation, diverticulitis, abscess, biliary obstruction. Primary diverticula is prolapse of the mucosa through muscularis propria most commonly in the 2nd part of duodenum. Secondary diverticula is prolapse of the entire wall almost exclusively in the 1st part of duodenum.

27/01/2026

☢️ Anterior ankle impingement ☢️ 19-year-old male with history of treated epiphyseal osteoid osteoma, presented with anterior ankle pain. SPECT/CT images demonstrate mildly increased perfusion and delayed tracer uptake in the right ankle anterior central recess, corresponding to a loose ossified fragment and surrounding soft tissue fullness. There is minimal delayed tracer uptake at the site of prior osteoid osteoma corresponding to cystic sclerotic degeneration.
🗓 Anterior ankle impingement presents clinically with pain and stiffness localized to the front of the ankle joint, often exacerbated by activities involving dorsiflexion. This condition typically arises due to repetitive microtrauma or acute injury, leading to soft tissue inflammation, osteophyte formation, or fibrosis within the anterior joint space. Pathologically, it involves the compression of structures such as the anterior tibial plafond or synovial tissue between the tibia and talus during ankle motion. Diagnosis is based on patient history, physical examination findings including tenderness over the anterior joint line, and imaging modalities such as X-rays, MRI, or CT scans to assess for bony abnormalities or soft tissue pathology. Treatment strategies range from conservative measures like rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy to surgical intervention such as arthroscopic debridement or open excision of bony impingements for refractory cases.

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Amman

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Monday	09:00 - 17:00
Tuesday	09:00 - 17:00
Wednesday	09:00 - 17:00
Thursday	09:00 - 14:00
Saturday	09:00 - 17:00
Sunday	09:00 - 17:00

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