Document Detail


F-18 fluorodeoxyglucose chest uptake in lung inflammation and infection.
MedLine Citation:
PMID:  10750966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: F-18 fluorodeoxyglucose (FDG) may accumulate at sites of inflammation or infection, making interpretation of whole-body scans difficult in patients with cancer. METHODS: More than 650 whole-body positron emission tomographic (PET) scans performed to examine patients with cancer were reviewed to identify uptake in pulmonary infection or inflammation based on the appearance of F-18 FDG chest uptake, chest radiographs, computed tomography, or all of these. RESULTS: Ten patients had uptake in benign lung disease. Eight patients had head and neck tumors and two patients had breast cancer. Intense focal or multifocal F-18 FDG chest uptake was seen in 6 of 10 scans. This was difficult to distinguish from pulmonary metastases based on the scan appearance. However, in the remaining patients, the uptake was atypical for malignancy and displayed an apical, segmental, or lobar pattern. In all patients, the F-18 FDG lung uptake corresponded to benign radiologic changes (infiltration, consolidation, or atelectasis), and the final diagnosis was pulmonary inflammation or infection. Nine patients were asymptomatic and one patient had clinical aspiration pneumonia. Follow-up PET scans were performed in five patients to evaluate their conditions. Chest uptake disappeared completely in three patients and partially in two patients, and there were no new findings. Variable degrees of F-18 FDG chest uptake have been reported with more than 40 different benign causes. They can be classified based on the underlying mechanism into four major categories: 1) Inflammation or infection, 2) benign tumor, 3) physiologic activity, and 4) iatrogenic. Most of these false-positive cases are included in the first category. CONCLUSIONS: Pulmonary infection or inflammation might predispose patients to localized F-18 FDG chest uptake mimicking pulmonary metastases and limiting the specificity of whole-body scans performed in patients with cancer.
Authors:
S M Bakheet; M Saleem; J Powe; A Al-Amro; S G Larsson; Z Mahassin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  25     ISSN:  0363-9762     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-06-05     Completed Date:  2000-06-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  273-8     Citation Subset:  IM    
Affiliation:
Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. Siema@kfsh.edu.sa
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Breast Neoplasms / radionuclide imaging
Diagnosis, Differential
Female
Fluorine Radioisotopes / diagnostic use
Fluorodeoxyglucose F18 / diagnostic use*,  pharmacokinetics
Head and Neck Neoplasms / radionuclide imaging
Humans
Lung Diseases / radionuclide imaging*
Lung Neoplasms / radionuclide imaging,  secondary
Male
Middle Aged
Radiopharmaceuticals / diagnostic use*,  pharmacokinetics
Respiratory Tract Infections / radionuclide imaging*
Sensitivity and Specificity
Tomography, Emission-Computed*
Chemical
Reg. No./Substance:
0/Fluorine Radioisotopes; 0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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