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British Journal of Radiology (2007) 80, e283-e286
© 2007 British Institute of Radiology
doi: 10.1259/bjr/31280356
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Multimodality imaging of direct ureteric involvement in non-Hodgkin's lymphoma using PET/CT, CT urography and antegrade CT pyelography

E Ghersin, MD 1,5 Z Keidar, MD, PhD 2,5 D J Eldad, MD 3,5 R Bar-Shalom, MD 2,5 D Fischer, MD 1 and S Halachmi, MD 4,5

Departments of 1 Diagnostic Imaging, 2 Nuclear Medicine, 3 Hematology and 4 Urology, Rambam Health Care Campus, B. Rapaport School of Medicine and 5 Technion – Israel Institute of Technology, Haifa, Israel


Figure 1
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  		Figure 1. Positron emission tomography/computed tomography (PET/CT) for restaging of recurrent non-Hodgkin's lymphoma (NHL): (a) whole body maximal intensity projection (MIP) PET; (b) transaxial PET; (c) fused PET/CT; and (d) transaxial CT images. The MIP image shows multiple foci of FDG uptake above and below the diaphragm. Linear activity is demonstrated in the left abdomen (solid arrow). Transaxial PET/CT images at the level of the mid-abdomen localize the finding to a distended left ureter (+).

 

Figure 2
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  		Figure 2. (a,b) CT urography: curved multiplanar reformats of the left collecting system and ureter, projected in (a) coronal and (b) sagittal planes, respectively. Note the left hydronephrosis (*) and dilatation of the upper left ureter secondary to moderate concentric thickening of the left-middle ureteric segment wall, accompanied by filiform narrowing of the affected ureteric lumen (solid arrows). Also note the normal opacification of the distal left ureteric lumen, indicating moderate obstruction (dotted arrows). (c,d) Antegrade CT pyelography several months later: curved multiplanar reformats of the left collecting system and ureter, projected in (c) coronal and (d) sagittal planes, respectively. Note the left hydronephrosis (*) owing to progression of the ureteric pathology, with continuous involvement of upper and middle-left ureteric segments, and the more pronounced thickening of the affected ureteric segments wall (solid arrows). Also note the poor opacification of the distal left ureteric lumen, indicating significant obstruction (dotted arrows).

 

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  		Figure 3. Positron emission tomography/computed tomography (PET/CT) for evaluation after chemotherapy and autologous bone marrow transplantation: (a) whole-body maximal intensity projection (MIP) PET; (b) transaxial PET; (c) fused PET/CT; and (d) transaxial CT images show no foci of abnormal tracer distribution and no evidence of disease. There is no increased uptake in the left ureter, which appears of normal thickness (+). The left kidney is drained using a left percutaneous nephrostomy catheter.

 




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