Rodney Hicks, AM’s Post

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Professor of Medicine, the University of Melbourne and Monash University

"When we think we know all the answers, we stop looking for them."   -      Eric Barker, from "Barking Up the Wrong Tree: The Surprising Science Behind Why Everything You Know About Success Is (Mostly) Wrong" As our experience with dynamic "all organ" imaging grows, we continue to question how and when to best incorporate it into our clinical protocols to provide the optimum convenience and diagnostic outcomes for our patients. Approaches to improving detection of prostate bed recurrences through early imaging (See: Uprimny, C. et al. EJNMMI 2017;44:1647–55) or forced diuresis (See: Uprimny, C. et al. J Nucl Med 2021; 62:1550–57), provide options for conventional field-of-view scanners but still aren't widely used, seemingly for workflow reasons. We think the ability to compare kinetics of uptake or clearance of activity may help to better characterize abnormalities outside the pelvis as well as a plethora of physiologically and pathologically relevant findings not apparent on delayed imaging. However, I admit, we are still learning and have many questions still to answer. In the case below, anastomotic and right pedicle recurrences are seen very early in a 10-minute dynamic series reconstructed as 1-minute frames, but difficult to  assess on delayed imaging while a pulmonary metastasis has the same kinetics as the prostate bed disease, increasing confidence in its nature.

Awesome example! Thanks for sharing, Rodney!

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Nice sir. What was the primary prostate Gleason’s score in this case?

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