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Knowledge of the true sensitivity of any imperfect test is necessary for an accurate decision analysis, because it can affect the optimal diagnostic-therapeutic pathway. Although few studies report results of bilateral simultaneous TABs, such data are important because they permit the calculation of the true TAB sensitivity. The authors believe that this mathematical method is superior to observational methods (e.g., clinical criteria) for estimating the true sensitivity of a TAB.

Learning Objectives: On successful completion of this activity, participants should be able to discuss (1) the elements of a concise and complete oncologic 18 F-FDG PET/CT report; (2) the importance of obtaining and including in the report a focused history of the patient malignancy and treatments; and (3) the importance of interpreting both the 18 F-FDG PET and the CT findings of PET/CT and of integrating both the metabolic and the anatomic components in the report.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, participants can access this activity through the SNMMI Web site (http:// www.snmmi.org/ce_online) through May 31, 2016.The written report (or its electronic counterpart) is the primary mode of communication between the physician interpreting an imaging study and the referring physician. The content of this report not only influences patient management and clinical outcomes but also serves as legal documentation of services provided and can be used to justify medical necessity, billing accuracy, and regulatory compliance. Generating a high-quality PET/CT report is perhaps more challenging than generating a report for other imaging studies because of the complexity of this hybrid imaging modality. This article discusses the essential elements of a concise and complete oncologic 18 F-FDG PET/ CT report and illustrates these elements through examples taken from routine clinical practice. At most facilities, the written report (or its electronic counterpart) is the primary mode of communication between the physician interpreting an imaging study and the referring physician. This report often serves as the basis for medical treatment decisions (1) and is used by third-party payers to justify medical necessity for the study and validity of reimbursement (2). Several authors have previously addressed the topic of reporting quality in the medical literature. Studying the process and quality of reporting not only is a necessity but also provides a unique opportunity to examine and refine the role imaging physicians play in medical care (3).The number of combined PET/CT studies performed annually has markedly increased over the last decade. It is estimated that between 2001 and 2010, the number of active PET/CT systems in the United States increased by approximately 10-fold (from approximately 200 to more than 2,000), and the number of PET examinations performed in the United States increased nearly 7-fold (from about 250,000 to more than 1.7 million) (4). At some institutions, PET/CT is now the most frequently performed nuclear medicine...

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the diagnostic and predictive value of interim and end-of-treatment PET in HL and NHL; (2) the role of response-adapted therapy in the clinical management of lymphoma; and (3) the newly-emerging applications of interim and end-of-treatment PET in lymphoma.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through January 2020.Interim and end-of-treatment PET/CT have become central to the evaluation of Hodgkin and non-Hodgkin lymphoma. This review article seeks to aid clinical decision making by providing an overview of available data on the diagnostic and prognostic value of PET/CT imaging for response assessment and pretransplant evaluation in lymphoma. The relative strengths and limitations of these techniques in various disease subtypes and clinical scenarios are explored, along with their current standards for reporting and latest developments. Particular attention is given to response-adapted therapy, which is emerging as a cornerstone of clinical management. CTandPETwi th 18 F-FDG have come to play integral roles in evaluating Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Soon after the incorporation of CT into staging and response assessment criteria, the advantages of using PET's metabolic data in conjunction with CT's structural information for these applications began to become apparent. This combination was especially helpful in the staging and restaging of lymphoma. It was shown to reliably identify the 80%-95% of posttreatment residual masses that are nonmalignant, thereby sparing patients unnecessary therapy and morbidity, and it was shown to alter staging in 20% of cases, most frequently upstaging patients by better detecting bone marrow involvement (1,2).After the integration of PET into the International Working Group criteria in 2007, PET/CT was widely adopted as a first-line imaging tool for evaluating end-of-treatment response in lymphoma (3). Subsequent studies laid the groundwork for the Deauville 5-point scale (D5PS) criteria, designed for the visual interpretation of PET scans (4). This was expanded by the Lugano guidelines, which established PET/CT as the modality of choice for staging and response assessment in 18 F-FDG-avid subtypes of lymphoma but maintained CT as the preferred tool for the small histologic subset with low or variable avidity (5). These guidelines are pa...

NUT midline carcinoma is a very rare, poorly differentiated, highly aggressive cancer originating from midline body locations, most often in adolescents or young adults. Advanced local disease and distant hematogenous metastases are typical. NMC is genetically defined by chromosomal rearrangements of the NUT gene on chromosome 15q14 forming a BRD4-NUT fusion oncogene which blocks epithelial differentiation, resulting in uncontrolled cell growth. Use of FDG PET/CT for imaging of NMC has not been previously reported. This case demonstrates that FDG PET can assess NMC disease extent and may be useful in assessing response to chemotherapy.

Apart from the common causes of thyrotoxicosis, such as Graves' disease and functioning nodular goiters, there are more than 20 less common causes of elevated free thyroid hormones that produce the symptoms and signs of thyrotoxicosis. This review describes these rarer conditions and includes 14 illustrative patients. Thyrotropin and free thyroxine should be measured and, when the latter is normal, the free triiodothyronine level should be obtained. Measurement of the uptake of 123 I is recommended for most patients.