Therapeutic assessment with fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) is sometimes problematic after radiation therapy. Herein we describe a patient with acute radiation-induced hepatitis in which PET showed dose-dependent FDG uptake. A 50-year-old man underwent FDG PET for staging of esophageal cancer. Chemoradiotherapy was delivered concurrently with a radiation field that expanded from the esophagus into the upper stomach to cover metastasis of the gastric wall. The patient also underwent FDG PET 26 days and 4 months after chemoradiotherapy to evaluate the therapeutic effect. Twenty-eight days after chemoradiotherapy, hematochemistry revealed elevated hepatic enzymes and postcontrast computed tomography showed band-like hypoattenuation in the liver with parenchymal swelling corresponding to the radiation field. FDG PET performed 26 days after chemoradiotherapy showed a wedge-shaped hypermetabolic area in which the degree of FDG uptake correlated with the prescribed radiation dose. Follow-up PET 4 months after therapy showed no abnormal uptake in the liver. Acute radiation-induced hepatitis can be a potential cause of false-positive findings of malignancy on FDG PET scans, and PET images should carefully be compared with the distribution of prescribed dose. Threshold dose might be higher for metabolic changes than for morphologic changes.

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Thallium-201 distribution in the blood was investigated both in vivo and in vitro. Thallium-201 was distributed into the erythrocytes and plasma with the ratio of 1.4•}0.3 to 1.0, immediately after its administration. The uptake of 201Tl into the erythrocytes in vitro were affected by the incubation temperature and the presence of ouabain and KCl; indicating that the 201Tl was uptaken into cells partly through their membranes Na, K-ATPase. Erythrocytes could retain 201Tl in it, whereas 201Tl was present as free ion in the plasma. Thallium-201 was flew out of erythrocytes into the plasma, keeping the ratio of 201Tl in erythrocytes/plasma to be 1.9•}0.2/1.0.

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