The sales of PET/CT scanners now represent approximately 80% of the PET market. criteria may be misleading and may not always allow differentiation between benign and malignant lesions. CiteSeerX - Document Details (Isaac Councill, Lee Giles, Pradeep Teregowda): Standard application of CT intravenous contrast agents in com-bined PET/CT may lead to high-density artifacts on CT and atten-uation-corrected PET. J Nucl Med2005 Mar;46(3):429-35. In addition, FDG uptake can occur in benign conditions such as infectious, inflammatory, and iatrogenic lesions. F-18 FDG PET/CT Imaging in Normal Variants, Pitfalls and Artifacts in the Abdomen and Pelvis Mboyo D. T. Vangu * and Jaleelat I. Momodu Department of Nuclear Medicine and Molecular Imaging, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa Oncologic FDG PET/CT is prone to many pitfalls and incidental findings, largely related to whole-body imaging and the nonspecific mechanism of FDG. Normal variants, artefacts and interpretative pitfalls in PET imaging with 18-fluoro-2-deoxyglucose and carbon-11 methionine. Radiographics. Christina M. Thuerl. Benefits of using FDG PET/CT for image-guided biopsy are presented along with pitfalls to avoid. Pitfalls and artifacts in 18FDG PET and PET/CT oncologic imaging. Whole body positron emission tomography (PET)/computed tomography (CT) imaging with [18F]-fluoro-2-deoxy-D-glucose (FDG) is widely used in oncologic imaging. 18 F-2-Fluoro-2-deoxyglucose (FDG) is the workhorse of oncological PET/CT departments. This review will highlight some of the problems regarding abdominal PET/CT . Differential Diagnosis 13%. 第四章 FDG PET/CT影像判讀的陷阱：生理性及良性變異. To avoid associated diagnostic pitfalls, we designed and compared different intravenous contrast injection protocols for routine whole-body PET/CT. Course ID: Q00346 Category: . This article reviewed a variety of processes that can lead to potential false-positive and false-negative findings. FDG PET/CT Pitfalls in Gynecologic and Genitourinary Oncologic Imaging1 The role of whole-body positron emission tomography (PET)/ computed tomography (CT) with fluorodeoxyglucose (FDG) is now established in the assessment of many gynecologic and genito- urinary malignant tumors. The combination of FDG PET and contrast-enhanced CT has been found to be superior to contrast-enhanced CT alone and to unenhanced FDG PET/CT for precise definition of disease in patients with abdominal and pelvic malignant diseases [1, 2]. This uptake is quite variable and knowledge of common patterns of biodistribution of various radiotracers is helpful in clinical practice. Additional artifacts related to the examination's dual . Hybrid Imaging: Artifacts and Pitfalls ach, intestines, bowel, brown fat, urinary tract etc.) The focus is particularly on FDG PET/CT, with coverage of the basic principles, clinical indications, typical and atypical appearances, normal variations and artifacts, advantages, limitations, and pitfalls. Prospective Evaluation of 99mTc MDP Scintigraphy, 18F NaF PET/CT, and 18F FDGnPET/CT for Detection of Skeletal . 53 year old female with rectal adenocarcinoma metastatic to the liver status post low anterior resection followed by adjuvant chemotherapy. PET/CT > Artifacts & Pitfalls > Elevated Glucose Level. [60] 2011 68 T2-weighted and DWI FDG PET/CT High detection rate and PPV with T2-weighted DWI, evaluated side by side (72%, 89%) and by fusion (74%, 91%) Gutzeit et al. Its role in staging, restaging, and response assessment of various cancers is already established. Keywords Fig. Abstract. Fig 2. Total metabolic tumor volume (TMTV) derived from 18 F-FDG PET/CT baseline studies is a promising prognostic factor in diffuse large B-cell lymphoma (DLBCL) (1,2) and other types of lymphoma (3-5).DLBCL is the most frequent non-Hodgkin lymphoma, being present in about 30%-40% of non-Hodgkin lymphoma cases worldwide. Fig 3. This is important for clinicians and radiologists, alike, in that effective and accurate . have reported that 29% of 18F-FDG uptake is by non-tumoral tissue [3].Neu-trophils and activated macrophages also show an Many potential pitfalls and artefacts have previously been described with 18F-FDG PET imaging, but more continue to become apparent as worldwide experience increases. 1 Radiology, University of Alabama at Birmingham, Birmingham, AL. Proper interpretation of pediatric (18)F FDG PET/CT studies requires knowledge of the normal distribution of (18)F FDG uptake in children, as well as of the aforementioned . FDG PET and PET/CT. pet-ct-and-pet-mri-in-neurology-swot-analysis-applied-to-hybrid-imaging 2/10 Downloaded from guidebook.ihep.org on January 27, 2022 by guest musculoskeletal system. In this chapter, we will mainly focus on normal variants and artefacts in 18 F-FDG PET/CT studies. This article describes the normal uptake, distribution, and excretion of Fluorine-18-labeled deoxyglucose (l8F FDG) as well as normal variations, response to treatment regimes, artifacts, and potential pitfalls . While most pitfalls and artifacts are common for all indications with metabolic imaging with [18F]FDG-PET/CT, there are specific variants and pitfalls in lung cancer and malignant pleural mesothelioma. [2]. 99mTc MDP scintigraphy and 18F FDG PET/CT. It is essential for radiolo-gists interpreting PET/CT to be aware of these artifacts and pitfalls and techniques to mitigate them. Breast 13%. diaphragm motion during breathing, bowel motion, bladder filling). Elevated Glucose Level. F-18 FDG Multiple radiotracers may be used for PET/CT including FDG and F18-sodium fl uoride. J Nucl Med 45(2):266-271 19. Mol 53 year old female with rectal adenocarcinoma metastatic to the liver status post low anterior resection followed by adjuvant chemotherapy. 1. In this sense, CT is often a useful component of PET/ CT for image interpretation. Potential pitfalls 4.1 Brown-fat FDG uptake 4.2 Lipomatous hipertrophy of the interatrial septum 4.3 Pleural uptake related to talc pleurodesis 4.4 Teflon injection of the vocal cord 4.5 Radiation-induced injuries 4.6 Iatrogenic causes of FDG uptake 4.7 Muscular FDG . A glucose analogue, FDG is transported into the . 18F-FDG PET/CT and Musculoskeletal findings: Pearls and Pitfalls. artifacts PET with 18 F-FDG is one of the fastest growing techniques in nuclear medicine today. 13A, 13B, 13C), and in some difficult cases, biopsy of ambiguous lesions visualized on 18F FDG PET/CT may be needed to reach the correct diagnosis. 18. Abstract. Sequential follow-up 18F FDG PET/CT scans after surgery help in differentiating postoperative changes from tumor recurrence (Fig. Cook GJ, Maisey MN, Fogelman I. Despite new artifacts being introduced by combined PET/CT imaging, it is likely that many pitfalls caused by normal variant uptake may be avoided by the ability to correctly attribute 18 FDG activity to a structurally normal organ on CT. Several artifacts can mimic a 2-deoxy-2-[18F] fluoro-d-glucose (FDG) avid malignant lesions and therefore recognition of these artifacts is clinically . In this review, we discuss why normal tissues, dental-related metal artifacts, and dental infections are considered to be the important pitfalls in the diagnosis of primary oral cancers using 18F-FDG-PET-CT. The influence of different treatments on FDG uptake, timing, frequency of examination, and survival advantage are evaluated and discussed. Appropriate timing of PET/CT exam after therapeutic intervention and careful evaluation with knowledge will provide accurate interpretation. 4) To show current and future development of novel tracers for PET/CT. FDG PET/CT Pitfalls in Gynecologic and Genitourinary Oncologic Imaging. SUMMARY: [18F]FDG-PET is a widely used technique for specific evaluation of disease and treatment response in oncology. Due to diffusely increased FDG activity within the musculature, the study was . Download full-text PDF. PET/CT > Artifacts & Pitfalls > Physical Activity. In the chest, common PET/CT applications include the evaluation of solitary pulmonary nodules, cancer staging, assessment of response to therapy, and detection of residual or . But FDG is a marker of glycolysis and, thus, is neither specific for malignancy nor for a particular tumor. Author(s): Yang, Jaewon; Sohn, Jae Ho; Behr, Spencer C; Gullberg, Grant T; Seo, Youngho | Abstract: PurposeTo demonstrate the feasibility of CT-less attenuation and scatter correction (ASC) in the image space using deep learning for whole-body PET, with a focus on the potential benefits and pitfalls.Materials and methodsIn this retrospective study, 110 whole-body fluorodeoxyglucose (FDG) PET . Due to extensive research and well defined and standardized response criteria, the role of [18F]FDG-PET/CT is well defined in these malignancies. Find this author on Google Scholar. Pitfalls and Artifacts in. 18F-NaF PET/CT: Normal Variants and Pitfalls. Interpreting radiologists must maintain constant vigilance for these common pitfalls. The purpose of this paper is to introduce the principles of PET/CT imaging and describe the artifacts associated with it. Liu Y (2009) Benign ovarian and endometrial uptake on FDG PET-CT: patterns and pitfalls. prominent left and right ventricular FDG uptake, as well as the known .. list of all within one article, but we have concen- trated on 18 FDG scan of the head and neck demonstrating physiological uptake in the. 22-year-old male with history of Hodgkin's disease treated with chemotherapy. 18F-FDG PET/CT plays an increasingly pivotal role in the staging and post-treatment monitoring of high-risk melanoma patients, augmented by the introduction of therapies, including tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICIs), that have novel modes of action that challenge conventional response assessment. identify the PET/CT-related artifacts created from using CT data; 參考文獻. Several artifacts can mimic a 2-deoxy-2-[18F] fluoro-d-glucose (FDG) avid malignant lesions and therefore recognition of these artifacts is clinically . Atlas and Anatomy of PET/MRI, PET/CT, AND SPECT/CT is a unique resource for physicians and residents in nuclear This activity on PET lasts for years and possibly over a decade. PET/CT is a new imaging modality that integrates functional (PET) and structural (CT) information into a single scanning session, allowing excellent fusion of the PET and CT images and thus improving lesion localization and interpretation accuracy. 3) Clinical pitfalls in interpretation: physiologic uptake and iatrogenic procedures. The patient also has poorly controlled insulin-dependent diabetes mellitus. Journal of Nuclear Medicine May 2015, 56 (supplement 3) 1899; Devaki Shilpa Surasi. Lung and pleural neoplasia are no exception to this, thus acknowledging of possible pitfalls and artifacts are mandatory for image interpretation. Data Analysis 12% . Fluorine-18 (18 F) 2-fluoro-2-deoxy-D-glucose (FDG) is the most commonly used positron-emitting radiotracer in PET/CT studies. negative results. 18 F-FDG is an analog of glucose and, as such, a versatile radiopharmaceutical with major applications in oncology, neurology, and cardiology. nefits. The purpose of this retrospective study was to describe the number of occurrences of non‐neoplastic disease‐related FDG‐PET/CT . However, a substantial num- Semin Nucl Med 2004; 34: 122-133 Pitfalls exist, however, when certain contrast agents cause attenuation-correction anomalies that simulate . In addition, FDG uptake can occur in benign conditions such as infectious, inflammatory, and iatrogenic lesions. Talc is a chemical irritant causing an intense inflammatory response. This may be particularly evident in the abdomen when physiological bowel activity or ureteric activity can . Most PET/CT tracers used in clinical practice show some degree of GI uptake. Atlas of PET/CT Imaging in Oncology Author: J. Czernin MD, M. Dahlbom MD, O. Ratib MD, PhD, FAHA, C. Schiepers MD, PhD Published by Springer Berlin Heidelberg ISBN: 978-3-642-62141-3 DOI: 10.1007/978-3-642-18517-5 Table of Contents: Introduction Principles of PET/CT Imaging A Future for PET/CT PET/CT Image Acquisition Protocols and Imaging Data . Positron emission tomography/computed tomography (PET/CT) imaging has been the subject of a series of recent publications in the radiology literature in Brazil (1-10). Indications for F-18 FDG PET/CT in Oncology 1. PET/CT was repeated 24 hours later and focal FDG uptake in right lung was resolved. PET/CT ordered for restaging. The patient also has poorly controlled insulin-dependent diabetes mellitus. 18F‐Fluoro‐deoxyglucose positron emission computed tomography (FDG‐PET/CT) is an emerging diagnostic imaging modality in veterinary medicine; however, little published information is available on physiologic variants, benign processes, and artifacts. Therefore, we recommend inspection of the non-AC images . Despite the high sensitivity of FDG PET in these pelvic malignancies, one of the inherent pitfalls of metabolic imaging has been false positive readings due to increased FDG uptake in benign processes, inflammatory conditions, normal organs and artifacts which can complicate image assessment. Elevated Glucose Level. It is essential . The big advantage of these hybrid PET devices over stand-al (1) Fluorine-18-labeled (18F) fluoro-2- deoxy-D-glucose (FDG) is the predominant radiopharmaceutical for diagnostic oncologic whole-body PET imaging, for clinical brain studies, and for assessment of cardiac viability. A variety of potential FDG-PET/CT interpretation pitfalls and artefacts can be observed on routine head and neck studies. PET/CT is widely used for the evaluation of patients with thoracic malignancies. 8,9 The combined modality PET/CT provides its own specific pitfalls and artifacts. • PET/CT Imaging Artifacts. PET/CT is a new imaging modality that integrates functional (PET) and structural (CT) information into a single scanning session, allowing excellent fusion of the PET and CT images and thus improving lesion localization and interpretation accuracy. 2) Artifacts from the use of CT for attenuation correction: high CT attenuation material, respiratory artifact, truncation artifact. Kwee et al. PET/CT ordered for restaging. Patient had exercised the evening before his PET/CT exam. Artifacts: misregistration, truncation, FDG embolism and extravasation 4. J Nucl Med 2003; 44: 170-176 ; 9 Cook GJ, Wegner EA, Fogelman I. Kubota et al. Normal variants 3. [49] 2009 31 DWI CT DWI similar to CT for disease staging Mixed disease Fisher et al. Combined with computed tomography (CT), PET/CT has increased the diagnostic accuracy and dramatically reduced the acquisition time. 1) The physics of SUV quantification. In addition, there are inherent technical limitations-such as motion artifact (from respiratory motion and bowel peristalsis) and the limited spatial resolution of PET-that may limit the assessment of small-volume . Head and neck cancer is an important topic in oncologic imaging, because imaging findings can aid significantly in the detection, staging, and treatment evaluation of these tumors. F-18 FDG is the most commonly used PET tracer for oncologic PET/CT study. On FDG PET/CT abscesses show a rim of tracer uptake in the periphery with a photopenic center which corresponds to a hypodense collection on CT with air pockets seen occasionally. Effect of Physical Exertion on Muscle Activity. In addition, the advent of combined PET/CT scanners in clinical imaging practice has brought their own specific pitfalls and artifacts. 18 F-Fluoro-Deoxy-Glucose (FDG . understand why FDG PET/CT plays a limited role in the assessment of prostate cancer be familiar with the reasons why FDG PET/CT is thought to have low sensitivity for cystic and mucinous tumors be familiar with the important role of FDG PET/CT in the assessment of lymph node involvement in GYN and GU malignancy staging, and especially in the . The normal biodistribution of these PET radiotracers as well as the technical aspects of image acquisition and inadequate patient preparation affect the quality of . PET/CT is widely used for the evaluation of patients with thoracic malignancies. with the fusion of PET/CT in addition to the artifacts found in each of the separate modalities. Effect of Physical Exertion on Muscle Activity. Patient had exercised the evening before his PET/CT exam. Patients with cervical cancer seem to benefit from the use of PET/CT in estimation of treatment response. At FDG PET, physiologic activity, be-nign conditions, and inflammatory processes can mimic and/or mask disease owing to glucose metabolism that is not specific to malignancy (3,4). bined PET/CT may lead to high-density artifacts on CT and atten-uation-corrected PET. 18F-FDG PET/CT. PET/CT > Artifacts & Pitfalls > Physical Activity. Eur J Nucl Med. 6. Positron emission tomography (PET) and PET-computed tomography (CT) have become routine . The Teaching Point: Calcified lymph nodes can cause attenuation correction artifacts on PET/CT imaging, and this artifact needs to be considered as a potential cause of apparent FDG activity when calcified lymph nodes are present on the CT portion of a PET/CT study in order to avoid misinterpretation and potential patient mismanagement. Although the levels of 18 F-fluorodeoxyglucose (FDG) uptake are usually high in neoplastic diseases, they can also be physiological, due to artifacts. Lymph Nodes 24%. There are several currently available radiotracers, but 18F-FDG is the most commonly utilized due to its widespread availability. FDG PET/CT has been widely adopted Find this author on PubMed. There are several artifacts encountered in PET/CT imaging, including attenuation correction (AC) artifacts associated with using CT for attenuation correction. Physiologic uptake of FDG 2. 22-year-old male with history of Hodgkin's disease treated with chemotherapy. Positron emission tomography/computed tomography--imaging protocols, artifacts, and pitfalls. 1. PET/CT ordered for restaging. 42 Mihailović J, et al. Therefore, there were some cases of oral cancer which were difficult for radiologists to diagnose precisely. Linear FDG uptake is seen along the fistulous communications associated with abscesses [Figure 9]. FDG-PET-CT in Head and Neck Cancer. Positron emission tomography (PET) with [18F]fluorodeoxyglucose (FDG) is rapidly gaining a critical role in the clinical evaluation of patients with cancer. When combining PET and CT imaging, some pitfalls and artifacts are avoided, while others may be newly created or multiplied. Shon IH, Fogelman I (2003) F-18 FDG positron emission tomography and benign fractures. chapter-04-06. Artifacts present on PET/CT include those from both the PET and CT portions of the examination. Gordon BA, Flanagan FL, Dehdashti F. Whole-body . Bockisch A, Beyer T, Antoch G, Freudenberg LS, Kuhl H, Debatin JF, et al. Ann Nucl Med 23(2):107-112 20. Methods: Whole-body PET/CT included a topogram and a single spiral CT scan (2-row) Many potential pitfalls and artifacts have previously been described with (18)F-fluorodeoxyglucose PET imaging, but more continue to become apparent as worldwide experience increases. Abstract. 10 It is essential that a working knowledge of these pitfalls as well as the principles of PET/CT be acquired in order to ensure accurate image interpretation and to optimize patient care.
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