Fluorodeoxyglucose activity associated with a cosmetic poly-L-lactide filler: a potential confounder on positron emission tomography and computed tomography

Dwivedi, Kritica; Prabhu, Sheela; Bradley, Kevin M.

doi:10.1016/j.bjoms.2017.09.011

Cited by 6 publications

(8 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10 Carboxymethylcellulose-polycaprolactone, and polylactic acid fillers may induce LOAEs mimicking tumors after nivolumab (ICI), causing staging difficulties on PET-CT scans. 11,12 During immunotherapy, filler treatments should preferably be postponed, with vigilant follow-up in patients insisting on psychologically motivated treatments. Standard antibiotic and intralesional steroid treatment of LOAEs is permissible, while oral steroids are contraindicated due to potential interruption of immunotherapy.…”

Section: Patient-related Factors History and Selectionmentioning

confidence: 99%

See 1 more Smart Citation

The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments

Heydenrych

Boulle

Kapoor³

et al. 2021

CCID

View full text Add to dashboard Cite

Dermal filler treatments require constant reassessment for improving and safeguarding the rapidly evolving aesthetic field. Suboptimal injection technique, patient selection and product knowledge have touted a concerning increase in filler complications, with new challenges such as the COVID-19 pandemic leading to new paradigms in the understanding, prevention, diagnosis and treatment of complications. The updated 10-point plan has been developed to curtail complications through consideration of causative factors, categorized as patient, product, and procedure-related. Patient-related factors include a preprocedural consultation with careful elucidation of skin conditions (acne, rosacea, dermatitis), systemic disease (allergies, autoimmune disease, underlying bacterial and viral disease (herpes simplex virus, COVID-19 infection), medications (antineoplastic drugs, recreational drugs) and previous cosmetic procedures (including fillers and energy-based devices). Patient assessment should include standardized photography and also evaluate the role of social media, ethnicity, gender, generational, and LGBTQ+ needs. Specified informed consent for both adverse events and their treatment is essential due to the increase in vascular complications, including the risk of blindness. Product-related factors include the powerful advantage of reversibility when using hyaluronic acid (HA) products. Product characteristics such as molecular weight and filler degradation should be understood. Product layering over late or minimally degradable fillers is still inadvisable due to the initial filler being teased into reactivity. Procedural factors such as consistent photographic documentation, procedural planning, aseptic non-touch technique (ANTT), knowledge of topographical anatomy and angiosomes, and technical dexterity including pinch anatomy and needle skills are of pivotal importance. The final section is dedicated to algorithms and checklists for managing and treating complications such as allergic hypersensitivity reactions, vascular events, infection, edema and late-onset adverse events (LOAEs). The updated 10-point plan is a methodical strategy aimed at further minimising the risk of dermal filler complications.

show abstract

Section: Patient-related Factors History and Selectionmentioning

confidence: 99%

“…Carboxymethylcellulose-polycaprolactone, and polylactic acid fillers may induce LOAEs mimicking tumors after nivolumab (ICI), causing staging difficulties on PET-CT scans. 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments

Heydenrych

Boulle

Kapoor³

et al. 2021

CCID

View full text Add to dashboard Cite

show abstract

“… 4 One prior report described a case of bilateral FDG-avidity in the cheeks on PET/CT for squamous cell carcinoma of the tongue 6-13 weeks after PLLA injection. 9 In our case, there was a unilateral focus of FDG-avidity and soft tissue stranding on PET/CT in the location of a prior Merkel cell tumor, which was alarming for recurrence. Detailed discussion with both the patient and radiologist pointed to PLLA injection 9 months prior as the cause of FDG-avidity, highlighting the longevity of this collagen stimulant, though HA filler 12-14 months prior cannot be completely ruled out.…”

Section: Discussionmentioning

confidence: 99%

Fluorodeoxyglucose-avid cosmetic poly-L-lactic acid filler on surveillance imaging for Merkel cell carcinoma

Kim,

Win,

Vaz

et al. 2024

JAAD Case Reports

View full text Add to dashboard Cite

“…3 Calcium hydroxyapatite (CaHa) is also strongly FDG-avid; it is associated with a (SUV) range of 2.9-13.4. 4,5 Poly-Llactic acid (PLLA) similarly presents with increased uptake that is believed to be due to filler-induced subclinical inflammation. 3,5 Given that most fillers show propensity for physiologic FDG uptake, these results can cause confusion in patients where concern for soft tissue malignancy or metastases exist.…”

Section: Discussionmentioning

confidence: 99%

“…For example, HA filler demonstrates an increased FDG uptake many months after injection 3 . Calcium hydroxyapatite (CaHa) is also strongly FDG‐avid; it is associated with a (SUV) range of 2.9–13.4 4,5 . Poly‐L‐lactic acid (PLLA) similarly presents with increased uptake that is believed to be due to filler‐induced subclinical inflammation 3,5 .…”

Section: Discussionmentioning

confidence: 99%

Cosmetic Filler and PET Positivity: The Risk of a False Positive

2023

View full text Add to dashboard Cite

ObjectiveTo discuss a case of hyaluronic acid filler displaying as PET avid resulting in a false positive for local recurrence and review of the literature of how filler presents on PET.Study DesignCase report and literature review.MethodsRetrospective case review of a patient with angiosarcoma with PET‐MRI positivity after hyaluronic acid filler injection. Review of the literature was performed.ResultsA 49‐year‐old female with low grade angiosarcoma of the right cheek pT1N0M0 was treated with wide local excision and staged reconstruction with cervicofacial advancement flap with subsequent adjuvant radiation therapy. Surveillance PET/MRI scans were conducted every 3 months. After one year without recurrence, HA injectable filler was offered to correct resultant right facial soft tissue defect. The patient proceeded with HA filler and was counseled on the risk of local increased SUV on imaging. Her PET/MRI 3 months later revealed postsurgical changes in the right premaxillary soft tissues with associated low‐grade hypermetabolism with max SUV 1.8, which elevated from prior max SUV 0.9. Contralateral left maxillary soft tissues revealed max SUV 0.8. Biopsy was initially favored for concern of local recurrence until the potential for filler to be associated with elevated SUV was discussed. Further evaluation with MRI showed diffusely increased T2 signal with some trace enhancement in the region of PET activity, confirming that findings were consistent with HA filler augmentation per the neuroradiologist team.ConclusionsFillers, including hyaluronic acid, are associated with elevated SUV on PET‐CT. Otolaryngologists should be aware of these features to improve patient counseling, avoid unnecessary procedures, and reduce patient anxiety. Laryngoscope, 2023

show abstract

Fluorodeoxyglucose activity associated with a cosmetic poly-L-lactide filler: a potential confounder on positron emission tomography and computed tomography

Cited by 6 publications

References 5 publications

The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments

The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments

Fluorodeoxyglucose-avid cosmetic poly-L-lactic acid filler on surveillance imaging for Merkel cell carcinoma

Cosmetic Filler and PET Positivity: The Risk of a False Positive

Contact Info

Product

Resources

About