Paget Disease as Common Pitfall on PET with Different Radiopharmaceuticals in Oncology: Not All That Glitters Is Gold!

Dondi, Francesco; Albano, Domenico; Treglia, Giorgio; Bertagna, Francesco

doi:10.3390/jcm11185372

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…Nowadays, diagnosis of PDB is usually a secondary finding on an abnormal X-ray, CT, MRI, or hybrid imaging (positron emission tomography and CT; PET/CT) [5,[25][26][27][28][29][30][31] and/or elevated alkaline phosphatase activity of an unknown etiology, as in our patient [21,24]. The characteristics listed above that lead to the diagnosis are related to earlier and wider access to medical examinations.…”

Section: Discussionmentioning

confidence: 99%

Newly Diagnosed Monostotic Paget’s Disease of Bone during Living Kidney Donor Candidate Evaluation

Jędrzejuk

Poznański

Szewczyk³

et al. 2023

Biomedicines

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The popularity of living-donor organ donation has increased recently as an alternative to deceased-organ donation due to the growing need for organs and a shortage of deceased-donor organs. This procedure requires an in-depth health assessment of candidates, who must be in excellent physical and mental health. We present a potential living-kidney donor withdrawn from donation due to a newly diagnosed Paget’s disease of bone (PDB). The patient underwent computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy, and bone densitometry with trabecular bone score (TBS) assessment. The sole lumbar vertebra affected by PDB was investigated comprehensively, non-invasively, quantitatively, and qualitatively.

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Section: Discussionmentioning

confidence: 99%

Newly Diagnosed Monostotic Paget’s Disease of Bone during Living Kidney Donor Candidate Evaluation

Jędrzejuk

Poznański

Szewczyk³

et al. 2023

Biomedicines

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PET/CT in Primary Tumors of the Osseous Spine

Ceyssens

2023

Medical Radiology

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An incidental finding of the Lincoln sign on FDG PET-CT in a patient with rectosigmoid adenocarcinoma giving rise to the diagnosis of Paget's disease

Abdul Onny,

Kemis Yahyah,

Arumugam

et al. 2024

Egypt J Radiol Nucl Med

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Background Paget's disease is a metabolic disorder characterized by disorderly bone remodeling process of excessive osteoclastic and osteoblastic activities leading to a structurally disorganized appearance of the bone. Paget's disease is usually diagnosed based on the clinical presentation of bony pain, raised serum alkaline phosphatase, and typical radiological changes. Bone scintigraphy with 99mTc-labeled radiotracers is commonly used to assess disease extent, and one of the classical findings of Paget's disease on bone scintigraphy is diffuse radiotracer uptake in the mandible bone, widely described as Lincoln or Black Beard sign. On the other hand, FDG PET-CT is commonly used in cancer imaging and frequently for staging or assessing recurrence in various malignancies. However, its use in evaluating Paget's disease is not established, attributed mainly to the heterogeneity of FDG uptake in Paget's disease and the high false-positive and negative findings. Case presentation A 57-year-old female with metastatic mucinous rectosigmoid adenocarcinoma underwent multiple surgeries and completed 12 chemotherapy cycles with no evidence of local recurrence in the colon or distant metastasis. In the tenth year of active surveillance, her serum CEA levels were found to be elevated, yet there was no evidence of cancer spread from colonoscopy and contrast-enhanced CT. An 18F-FDG PET-CT was then ordered, to which a unique diffuse FDG uptake pattern in the mandible was seen, resembling the Lincoln or Black Beard sign classically described in bone scintigraphy. This appearance was then verified by congruent uptake during a 99mTc-MDP scan, thus leading to the diagnosis of Paget's disease. Conclusion The Lincoln sign is not limited to bone scintigraphy. Hence, we intend to add this FDG PET-CT finding to enrich the literature on the Lincoln sign and when to expect this pattern.

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Paget Disease as Common Pitfall on PET with Different Radiopharmaceuticals in Oncology: Not All That Glitters Is Gold!

Abstract: Paget’s disease (PD) is a benign but chronic condition characterized by the presence of abnormal homeostasis and remodeling of the bone, resulting in high osteoblastic and osteoclastic activity. Commonly, this disease affects 3–4% of the population over the age of 40 [1–3]. [...]

Cited by 3 publications

References 42 publications

Newly Diagnosed Monostotic Paget’s Disease of Bone during Living Kidney Donor Candidate Evaluation

Newly Diagnosed Monostotic Paget’s Disease of Bone during Living Kidney Donor Candidate Evaluation

PET/CT in Primary Tumors of the Osseous Spine

An incidental finding of the Lincoln sign on FDG PET-CT in a patient with rectosigmoid adenocarcinoma giving rise to the diagnosis of Paget's disease

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