Focal F-18 fluoro-deoxy-glucose accumulation in the lung parenchyma in the absence of CT abnormality in PET/CT

Dimitrios Karantanis, Rathan M. Subramaniam, Brian P. Mullan, Patrick J. Peller, Gregory A. Wiseman

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

OBJECTIVE: To demonstrate 3 cases of artifactual focal F-18 fluoro-deoxy-glucose accumulation in the lung parenchyma in the absence of any computed tomographic (CT) abnormality. MATERIALS AND METHODS: Three patients were examined: a 30-year-old man who had a positron emission tomography (PET)/computed tomography for restaging a biopsy-proven recurrence of head and neck cancer, a 68-year-old woman who was referred for initial staging of esophageal carcinoma, and a 57-year-old man who had a PET/computed tomography for initial staging of melanoma. In each case, there was intense focal activity in the lung parenchyma with no corresponding CT abnormality. Each patient was further evaluated with a repeat PET scan in days 1 and 3 in the first 2 cases and with a delayed repeat acquisition in the third case. Patients were followed for 24, 10, and 1 month, respectively. RESULTS: In the first 2 cases, the abnormal focal activity in the lungs had resolved in the repeat study. In the third case, the focus of increased activity in the lung had moved more peripherally in the delayed acquisition. Clinical follow-up was negative for disease in the corresponding pulmonary parenchymal sites. CONCLUSIONS: The finding of significant focal accumulation of fluoro-deoxy-glucose in the lung parenchyma in the absence of corresponding CT abnormality was artifactual. This was likely due to injection technique and the creation of particulate embolus. Positron emission tomography/Computed tomographic readers should be aware of this type of artifact to avoid misinterpretation.

Original languageEnglish (US)
Pages (from-to)800-805
Number of pages6
JournalJournal of Computer Assisted Tomography
Volume31
Issue number5
DOIs
StatePublished - Sep 1 2007

Fingerprint

Positron-Emission Tomography
Glucose
Lung
Head and Neck Neoplasms
Embolism
Artifacts
Melanoma
Carcinoma
Biopsy
Recurrence
Injections
Positron Emission Tomography Computed Tomography

Keywords

  • Artifact
  • False-positive FDG-PET scan
  • FDG clot
  • Focal lung FDG uptake
  • PET/CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Focal F-18 fluoro-deoxy-glucose accumulation in the lung parenchyma in the absence of CT abnormality in PET/CT. / Karantanis, Dimitrios; Subramaniam, Rathan M.; Mullan, Brian P.; Peller, Patrick J.; Wiseman, Gregory A.

In: Journal of Computer Assisted Tomography, Vol. 31, No. 5, 01.09.2007, p. 800-805.

Research output: Contribution to journalArticle

Karantanis, Dimitrios ; Subramaniam, Rathan M. ; Mullan, Brian P. ; Peller, Patrick J. ; Wiseman, Gregory A. / Focal F-18 fluoro-deoxy-glucose accumulation in the lung parenchyma in the absence of CT abnormality in PET/CT. In: Journal of Computer Assisted Tomography. 2007 ; Vol. 31, No. 5. pp. 800-805.
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abstract = "OBJECTIVE: To demonstrate 3 cases of artifactual focal F-18 fluoro-deoxy-glucose accumulation in the lung parenchyma in the absence of any computed tomographic (CT) abnormality. MATERIALS AND METHODS: Three patients were examined: a 30-year-old man who had a positron emission tomography (PET)/computed tomography for restaging a biopsy-proven recurrence of head and neck cancer, a 68-year-old woman who was referred for initial staging of esophageal carcinoma, and a 57-year-old man who had a PET/computed tomography for initial staging of melanoma. In each case, there was intense focal activity in the lung parenchyma with no corresponding CT abnormality. Each patient was further evaluated with a repeat PET scan in days 1 and 3 in the first 2 cases and with a delayed repeat acquisition in the third case. Patients were followed for 24, 10, and 1 month, respectively. RESULTS: In the first 2 cases, the abnormal focal activity in the lungs had resolved in the repeat study. In the third case, the focus of increased activity in the lung had moved more peripherally in the delayed acquisition. Clinical follow-up was negative for disease in the corresponding pulmonary parenchymal sites. CONCLUSIONS: The finding of significant focal accumulation of fluoro-deoxy-glucose in the lung parenchyma in the absence of corresponding CT abnormality was artifactual. This was likely due to injection technique and the creation of particulate embolus. Positron emission tomography/Computed tomographic readers should be aware of this type of artifact to avoid misinterpretation.",
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AU - Peller, Patrick J.

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N2 - OBJECTIVE: To demonstrate 3 cases of artifactual focal F-18 fluoro-deoxy-glucose accumulation in the lung parenchyma in the absence of any computed tomographic (CT) abnormality. MATERIALS AND METHODS: Three patients were examined: a 30-year-old man who had a positron emission tomography (PET)/computed tomography for restaging a biopsy-proven recurrence of head and neck cancer, a 68-year-old woman who was referred for initial staging of esophageal carcinoma, and a 57-year-old man who had a PET/computed tomography for initial staging of melanoma. In each case, there was intense focal activity in the lung parenchyma with no corresponding CT abnormality. Each patient was further evaluated with a repeat PET scan in days 1 and 3 in the first 2 cases and with a delayed repeat acquisition in the third case. Patients were followed for 24, 10, and 1 month, respectively. RESULTS: In the first 2 cases, the abnormal focal activity in the lungs had resolved in the repeat study. In the third case, the focus of increased activity in the lung had moved more peripherally in the delayed acquisition. Clinical follow-up was negative for disease in the corresponding pulmonary parenchymal sites. CONCLUSIONS: The finding of significant focal accumulation of fluoro-deoxy-glucose in the lung parenchyma in the absence of corresponding CT abnormality was artifactual. This was likely due to injection technique and the creation of particulate embolus. Positron emission tomography/Computed tomographic readers should be aware of this type of artifact to avoid misinterpretation.

AB - OBJECTIVE: To demonstrate 3 cases of artifactual focal F-18 fluoro-deoxy-glucose accumulation in the lung parenchyma in the absence of any computed tomographic (CT) abnormality. MATERIALS AND METHODS: Three patients were examined: a 30-year-old man who had a positron emission tomography (PET)/computed tomography for restaging a biopsy-proven recurrence of head and neck cancer, a 68-year-old woman who was referred for initial staging of esophageal carcinoma, and a 57-year-old man who had a PET/computed tomography for initial staging of melanoma. In each case, there was intense focal activity in the lung parenchyma with no corresponding CT abnormality. Each patient was further evaluated with a repeat PET scan in days 1 and 3 in the first 2 cases and with a delayed repeat acquisition in the third case. Patients were followed for 24, 10, and 1 month, respectively. RESULTS: In the first 2 cases, the abnormal focal activity in the lungs had resolved in the repeat study. In the third case, the focus of increased activity in the lung had moved more peripherally in the delayed acquisition. Clinical follow-up was negative for disease in the corresponding pulmonary parenchymal sites. CONCLUSIONS: The finding of significant focal accumulation of fluoro-deoxy-glucose in the lung parenchyma in the absence of corresponding CT abnormality was artifactual. This was likely due to injection technique and the creation of particulate embolus. Positron emission tomography/Computed tomographic readers should be aware of this type of artifact to avoid misinterpretation.

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