Unilateral Muscle Artifacts due to Non-compliance During Uptake Phase of 18F-FDG PET/CT in an Oncologic Patient

Abstract

A 49-year-old male patient with a prior history of poor compliance with medical appointments was referred for an 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) for the staging of a rectal squamous cell carcinoma. The PET/CT showed unilateral diffuse skeletal muscle 18 F-FDG uptake as well as bilateral salivary gland uptake artifacts, suggestive of non-compliance with patient preparation instructions. The PET/CT nurse noted that during the 18 F-FDG uptake phase, the patient appeared intoxicated, and she found two beer cans hidden in the waste disposal beside his chair just prior to imaging. The patient only admitted to eating a cookie approximately 30 minutes after the injection of 18 F-FDG PET/CT and denied consuming alcohol during the uptake phase. We present the imaging findings of non-compliance with patient instructions during the uptake phase of 18 F-FDG.

Yield of FDG PET/CT for Defining the Extent of Disease in Patients with Kaposi Sarcoma

“…In our study, FDG PET/CT was poorly efficient in identifying mucous and digestive lesions. For mucous lesions, this may be due to artifacts in oral and genital localizations from the salivary and urinary elimination of the tracer or obliterating pathological FDG uptake [35,36]. Moreover, the limited spatial resolution of PET/CT [37,38], the small volume of KS lesions, and their submucosal locations [16] contribute to the misdiagnosis of digestive lesions.…”