Focal lung uptake of 18F-fluorodeoxyglucose (18F-FDG) without computed tomography findings

Farsad, Mohsen; Ambrosini, Valentina; Nanni, Cristina; Castellucci, Paolo; Boschi, Stefano; Rubello, Domenico; Fabbri, Mario; Franchi, Roberto; Fanti, Stefano

doi:10.1097/01.mnm.0000175786.27423.42

Cited by 30 publications

(20 citation statements)

References 9 publications

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“…A possible explanation for these artifacts is that microembolisms produced during the injection process are located in small vascular structures of the lung parenchyma [4,5]. When the vascular endothelium is damaged by any cause, such as paravenous injection, high flow of materials, location of the needle tip, or aspiration of blood, tiny blood clots may be produced at the injured site.…”

Section: Discussionmentioning

confidence: 99%

“…When the vascular endothelium is damaged by any cause, such as paravenous injection, high flow of materials, location of the needle tip, or aspiration of blood, tiny blood clots may be produced at the injured site. After detaching from the vein, the tiny clots may enter the small pulmonary vasculature responsible for distal microembolism [4][5][6].…”

Section: Discussionmentioning

confidence: 99%

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Incidental focal F-18 FDG accumulation in lung parenchyma without abnormal CT findings

Jeong

Seo

et al. 2009

Ann Nucl Med

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F-18 fluorodeoxyglucose (FDG) PET/CT that simultaneously offers anatomic and metabolic information is widely used and has become an effective modality in many clinical fields, especially oncology. For accurate interpretation, it is necessary to understand false-positive findings in the F-18 FDG PET image, such as physiologic conditions, findings related to patients' medical and surgical histories, normal variants, and artificial conditions. We report three cases of incidental focal F-18 FDG accumulation in lung parenchyma without abnormal CT findings in the PET/CT images. In the primary PET/CT studies, two cases showed single and one case showed multiple FDG foci in the lung without any CT abnormalities. All FDG accumulations disappeared in PET/CT studies repeated 1-3 days after the primary scannings. These artifacts are probably related to microembolisms attributable to the intravenous injection of F-18 FDG. Therefore, a cautious interpretation of the correspondence between anatomic and metabolic images is required and repeated PET/CT is helpful.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Incidental focal F-18 FDG accumulation in lung parenchyma without abnormal CT findings

Jeong

Seo

et al. 2009

Ann Nucl Med

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“…We found that focal pulmonary arterial hypermetabolism could only be qualitatively detected in 15.2% of cases, indicating that this is an insensitive secondary sign of PE. The differential diagnosis for the finding of pulmonary arterial hypermetabolism includes pulmonary artery sarcoma, pulmonary artery metastasis, and FDG microembolism secondary to paravenous injection (23,24,28). These should be readily distinguishable because of the much higher SUV reported for pulmonary artery malignancies, and because of the presence of extravasation of FDG at the injection site in the case of microembolism.…”

Section: Discussionmentioning

confidence: 99%

The Incidence of Pulmonary Embolism and Associated FDG-PET Findings in IV Contrast-Enhanced PET/CT

et al. 2014

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Rationale and Objectives: Most fluorine-18 fluorodeoxyglucose (FDG)-positron emission tomography with computed tomography (PET/ CT) studies are performed on cancer patients. These patients are at increased risk of pulmonary embolism (PE). In this retrospective review, we determined the rate of PE, and the prevalence of associated FDG-PET findings on intravenous (IV) contrast-enhanced PET/CT. Materials and Methods:We identified all PET/CT studies performed at our institution with a reported finding of PE between January 2005 and October 2012. The medical record was reviewed for symptoms, which were identified after the diagnosis of PE, and whether the patients received treatment. The prevalence of associated FDG-PET findings was determined.Results: A total of 65 total cases of PE (of 182,72 total PET/CT examinations) were identified of which 59 were previously unknown. This gives an incidental PE (IPE) rate of 0.32%. Of the patients where sufficient clinical information was available, 34 of 36 (94%) were treated either with therapeutic anticoagulation or inferior vena cava filter, and 30 of 36 (83%) were asymptomatic in retrospect. Of the patients with IPE, we found nine (15.2%) with associated focal pulmonary artery hypermetabolism, three (5.1%) with hypermetabolic pulmonary infarction, and one with increased isolated right ventricular FDG uptake (1.7%). One case of chronic PE demonstrated a focal hypometabolic filling defect in a pulmonary artery on PET. Conclusions:We found IPE in 0.32% of PET/CT scans. Focal pulmonary artery hypermetabolism or hypometabolism, and hypermetabolic pulmonary artery infarction with the ''rim sign'' were uncommonly associated with PE. These findings could raise the possibility of IPE in non-IV contrast-enhanced PET/CT studies.

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“…8 Activated platelets and fibrin are the major constituents of blood clots and this may account for the high 18 F-FDG uptake of the focal lung lesions observed on PET images. 9 The hot spot in the right liver lobe was indeed at the base of the right lung misplaced due to the respiratory motion.…”

Section: Nuclear Medicinementioning

confidence: 99%

A False Positive Uptake of 18F-Fluorodeoxyglucose in the Liver in PET/CT Scan: Case Report

Yapici¹,

Sahin²,

Ersoy³

et al. 2012

Turkiye Klinikleri J Med Sci

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Focal lung uptake of 18F-fluorodeoxyglucose (18F-FDG) without computed tomography findings

Abstract: The lesions detected by PET may be related to distal lung microembolism originating from the site of paravenous injection.

Cited by 30 publications

References 9 publications

Incidental focal F-18 FDG accumulation in lung parenchyma without abnormal CT findings

Incidental focal F-18 FDG accumulation in lung parenchyma without abnormal CT findings

The Incidence of Pulmonary Embolism and Associated FDG-PET Findings in IV Contrast-Enhanced PET/CT

A False Positive Uptake of 18F-Fluorodeoxyglucose in the Liver in PET/CT Scan: Case Report

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