Document Detail


Abnormally increased uptake of 18F-FDG in the forearm and hand following intra-arterial injection -- hot forearm and hot hand signs.
MedLine Citation:
PMID:  19470569     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study is to describe the appearance of intra-arterial administration of 18F-fluorodeoxyglucose (18F-FDG). The effect of this finding on the standard uptake values (SUVs) is also briefly discussed. Three cases of 18F-FDG positron emission tomography (PET) scans, detected over 2 years (2004-2006), with different presentations producing hot forearm and hot hand signs are described. It was shown that intra-arterial injections of 18F-FDG producing "the hot forearm sign" and the hot hand sign" are similar to the glove pattern of uptake noted following intra-arterial administration of technetium-99m methylene diphosphonate. Following intra-arterial injection, uptake of 18F-FDG is accentuated by hypoxia and exercise. A comparison is also made with the pattern of soft-tissue uptake seen following true intravenous injections with similar pre-injection vein enhancement techniques to the intra-arterial injections. Evaluation of the maximum intensity projection (MIP) and transaxial PET/CT fusion images of the arm, forearm and hand helps to confirm the diagnosis. Hands are often not included in PET/CT imaging and therefore cases might be missed. In conclusion, intra-arterial injection of 18F-FDG produces a "hot forearm sign" and "hot hand sign". Hands are often not included in PET/CT imaging, and therefore the presence of hot forearm sign should suggest further investigation. It should be mentioned in the radiology report, as it may alter the sensitivity and specificity of the SUV value.
Authors:
K Kumar
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-05-26
Journal Detail:
Title:  The British journal of radiology     Volume:  82     ISSN:  1748-880X     ISO Abbreviation:  Br J Radiol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0373125     Medline TA:  Br J Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  995-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Carl Vinson VA Medical Center, Dublin, GA 31021, USA. o-kuma@msic.med.osaka-cu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Female
Fluorodeoxyglucose F18 / administration & dosage*,  diagnostic use,  pharmacokinetics
Forearm / radionuclide imaging*
Hand / radionuclide imaging*
Humans
Injections, Intra-Arterial
Injections, Intravenous
Male
Medical Errors*
Middle Aged
Positron-Emission Tomography / methods
Radiopharmaceuticals / administration & dosage*,  diagnostic use,  pharmacokinetics
Retrospective Studies
Young Adult
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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