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Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Diffuse Cutaneous Angiosarcoma Involving Scalp and Face on 18 F-FDG and 68 Ga-NODAGA-RGD PET/CT.

Vishwajeet Jadhav1,2, Priyanka Verma1,2, Ashok Chandak1

  • 1Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre Annexe, Parel, Mumbai.

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This study highlights the potential of 68Ga-NODAGA-RGD-PET/CT in diagnosing cutaneous angiosarcoma. This novel imaging approach shows promise for evaluating scalp and brain involvement in aggressive tumors.

Keywords:
angiogenesiscutaneous angiosarcomascalp and face

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiology

Background:

  • Cutaneous angiosarcoma of the scalp is a rare and aggressive malignancy.
  • Accurate initial staging is crucial for effective treatment planning.
  • Conventional imaging may have limitations in assessing specific tumor characteristics.

Purpose of the Study:

  • To evaluate the utility of 18F-FDG-PET/CT and 68Ga-NODAGA-RGD-PET/CT in the initial staging of a patient with cutaneous angiosarcoma of the scalp.
  • To compare the diagnostic capabilities of FDG-PET/CT and Ga-NODAGA-RGD-PET/CT for assessing tumor extent, particularly potential scalp/brain involvement.

Main Methods:

  • A 67-year-old male patient with biopsy-proven cutaneous angiosarcoma underwent staging with 18F-FDG-PET/CT.
  • Subsequent staging utilized 68Ga-NODAGA-RGD-PET/CT, targeting increased angiogenesis.
  • Imaging findings were analyzed for tracer uptake patterns in the scalp, facial, and intracranial regions.

Main Results:

  • 18F-FDG-PET/CT showed increased tracer uptake in the scalp and facial areas, including periorbital and perinasal regions.
  • 68Ga-NODAGA-RGD-PET/CT also revealed enhanced uptake in the same areas, indicating increased angiogenesis.
  • Neither imaging modality showed evidence of bone or brain parenchyma involvement.

Conclusions:

  • 68Ga-NODAGA-RGD-PET/CT, with its lack of physiological brain uptake, shows significant promise as an advanced diagnostic tool for cutaneous angiosarcoma.
  • This novel imaging agent may be valuable for precise evaluation of scalp and potential brain involvement in these aggressive tumors.
  • Further research is warranted to establish 68Ga-NODAGA-RGD-PET/CT as a standard tool for treatment monitoring in cutaneous angiosarcoma.