PET/CT: Focal lung uptake of 18F-fluordeoxyglucose on PET but no structural alterations on CT

Sánchez, R. Sánchez; Rodrı́guez-Fernández, Antonio; Ramírez-Navarro, A.; Gómez-Río, Manuel; Ramos-Font, C.; Llamas-Elvira, J.M.

doi:10.1016/s1578-200x(10)70021-8

Cited by 2 publications

(1 citation statement)

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“…After excluding a misalignment between PET and CT image planes, focal intense hypermetabolism in the lung with no structural lesion detected on CT should lead to search a 18 F-FDG hot-clot artifact and if necessary, to repeat the study to find a disappearance of the uptake at rescanning. [3] In the medical literature, only few publications are available regarding a high 18 F-FDG uptake with no structural alteration on CT. [2,[4][5][6] Our initial thought was that the lesion responsible for the uptake was too small to be detected on CT (<3mm), but the intense 18 F-FDG uptake (SUV max = 26.1) led us to reconsider our hypothesis because such a size could not be fully detected by the system which has a spatial resolution of about 6 mm. In all reported cases, there was an intense 18 F-FDG uptake and the 18 F-FDG avid lesions without CT abnormality have showed a complete resolution in the follow-up exams.…”

Section: Discussionmentioning

confidence: 99%

Hot-clot artifact in the lung parenchyma on 18F-fluorodeoxyglucose positron emission tomography/computed tomography mimicking malignancy with a homolateral non-small cell lung cancer

et al. 2021

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18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (CT) is an important tool widely used in the oncology to stage and restage various malignancies. Intense focal FDG uptake in the lung parenchyma associated with the absence of anatomical lesion detected on CT can be explained by a lung microembolism, known as hot-clot artifact. We report, to the best of our knowledge, the first case describing a single hot-clot artifact located in the same lung as a histologically proven non-small cell lung cancer.

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Section: Discussionmentioning

confidence: 99%

Hot-clot artifact in the lung parenchyma on 18F-fluorodeoxyglucose positron emission tomography/computed tomography mimicking malignancy with a homolateral non-small cell lung cancer

et al. 2021

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Consequences of radiopharmaceutical extravasation and therapeutic interventions: a systematic review

Pol

Vöö

Bucerius

et al. 2017

Eur J Nucl Med Mol Imaging

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PurposeRadiopharmaceutical extravasation can potentially lead to severe soft tissue damage, but little is known about incidence, medical consequences, possible interventions, and effectiveness of these. The aims of this study are to estimate the incidence of extravasation of diagnostic and therapeutic radiopharmaceuticals, to evaluate medical consequences, and to evaluate medical treatment applied subsequently to those incidents.MethodsA sensitive and elaborate literature search was performed in Embase and PubMed using the keywords “misadministration”, “extravasation”, “paravascular infiltration”, combined with “tracer”, “radionuclide”, “radiopharmaceutical”, and a list of keywords referring to clinically used tracers (i.e. “Technetium-99m”, “Yttrium-90”). Reported data on radiopharmaceutical extravasation and applied interventions was extracted and summarised.ResultsThirty-seven publications reported 3016 cases of diagnostic radiopharmaceutical extravasation, of which three cases reported symptoms after extravasation. Eight publications reported 10 cases of therapeutic tracer extravasation. The most severe symptom was ulceration. Thirty-four different intervention and prevention strategies were performed or proposed in literature.ConclusionsExtravasation of diagnostic radiopharmaceuticals is common. 99mTc, 123I, 18F, and 68Ga labelled tracers do not require specific intervention. Extravasation of therapeutic radiopharmaceuticals can give severe soft tissue lesions. Although not evidence based, surgical intervention should be considered. Furthermore, dispersive intervention, dosimetry and follow up is advised. Pharmaceutical intervention has no place yet in the immediate care of radiopharmaceutical extravasation.

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PET/CT: Focal lung uptake of 18F-fluordeoxyglucose on PET but no structural alterations on CT

Cited by 2 publications

References 6 publications

Hot-clot artifact in the lung parenchyma on 18F-fluorodeoxyglucose positron emission tomography/computed tomography mimicking malignancy with a homolateral non-small cell lung cancer

Hot-clot artifact in the lung parenchyma on 18F-fluorodeoxyglucose positron emission tomography/computed tomography mimicking malignancy with a homolateral non-small cell lung cancer

Consequences of radiopharmaceutical extravasation and therapeutic interventions: a systematic review

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