2-fluoro-2-deoxyglucose-6-phosphate and Thoracic-Neoplasms

Integrated computed tomography-positron emission tomography (CT-PET) scanners improve localization of regions of increased [18F]-fluoro-2-deoxy-D-glucose (FDG) uptake and staging accuracy by allowing the near-simultaneous acquisition of coregistered, spatially matched functional and morphologic data in the same examination. However, many benign lesions can accumulate FDG and be potential pitfalls in interpretation. With the increased use of CT-PET in oncologic imaging, misinterpretation of these potential pitfalls can have significant clinical ramifications and alter staging and management. In this article, we review the physiologic uptake of FDG, normal variants, and potential pitfalls in the integrated CT-PET imaging of the thorax and their implications in oncologic imaging.

Topics: Artifacts; Carcinoma, Non-Small-Cell Lung; Glucose-6-Phosphate; Humans; Hyperventilation; Image Processing, Computer-Assisted; Lung Neoplasms; Magnetic Resonance Imaging; Muscle, Skeletal; Pleurodesis; Positron-Emission Tomography; Respiration; Respiratory Muscles; Thoracic Neoplasms; Tomography, X-Ray Computed

The routine use of integrated positron emission tomography computed tomography in the staging and follow-up of patients diagnosed with non-small-cell lung cancer has improved diagnostic accuracy but many incidental extrathoracic findings are routinely encountered. These include physiologic fluorodeoxy glucose avid foci, normal computed tomography variants, and second primary malignancies, all of which have to be differentiated from extrathoracic metastatic disease. Knowledge of these findings is important for correct staging and identification of second primaries.

Topics: Adipose Tissue; Bone Marrow; Brain Neoplasms; Carcinoma, Non-Small-Cell Lung; Glucose-6-Phosphate; Head and Neck Neoplasms; Humans; Lymphatic Metastasis; Positron-Emission Tomography; Thoracic Neoplasms; Thyroid Gland; Tomography, X-Ray Computed; Vocal Cord Paralysis

To characterize the imaging features of thoracic hemangioma, including findings on computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) using 18F-fluoro-2-deoxy-D-glucose (FDG).. Six patients with thoracic wall hemangioma and 2 patients with mediastinal hemangioma were included in this study. Preoperative evaluation was performed using CT (n=7), MRI (n=8), and FDG-PET (n=2). Five cases were pathologically confirmed by surgery and the remaining 3 cases were diagnosed clinically.. On CT, characteristic finding of phleboliths were depicted in 5 of 7 cases (71%). Fat component was demonstrated in 3 of 7 cases with CT (3/7-43%) and 5 of 8 cases with MRI (5/8-63%). On MRI, characteristic finding of high intensity on T2-weighted images was demonstrated in all 8 cases and the high signal intensity was emphasized in all 4 cases on fat-suppression T2-weighted images. Both of two PET scans showed mildly elevated accumulation of FDG.. Phleboliths, fat component, and high intensity on T2-weighted and fat-suppression T2-weighted image were thought to be characteristic findings reflecting the histologic findings. It might be useful to recognize these findings for differentiating hemangiomas from other soft tissue tumors, particularly malignant neoplasms.

Topics: Adolescent; Adult; Aged; Contrast Media; Female; Glucose-6-Phosphate; Hemangioma; Humans; Image Enhancement; Magnetic Resonance Imaging; Male; Mediastinum; Middle Aged; Positron-Emission Tomography; Thoracic Neoplasms; Thoracic Wall; Tomography, X-Ray Computed