Pitfalls in oncologic diagnosis with FDG PET imaging: Physiologic and benign variants
Pitfalls in oncologic diagnosis with FDG PET imaging: Physiologic and benign variants
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DOI：
10.1148/radiographics.19.1.g99ja0761
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发表时间：
1999-01-01
期刊：
影响因子：
5.5
通讯作者：
Wahl, RL
中科院分区：
文献类型：
--
作者：
Shreve, PD;Anzai, Y;Wahl, RL
正电子发射断层扫描（PET）的一个快速兴起的临床应用是用葡萄糖类似示踪剂2-[氟-18]氟-2-脱氧-d -葡萄糖（FDG）检测和分期癌症。正确解释FDG PET图像需要了解示踪剂的正常生理分布，经常遇到的生理变异，以及可能与恶性肿瘤混淆的FDG摄取的良性病理原因。静脉给药一小时后，高FDG活性出现在大脑、心肌和尿路（由于排泄途径）。在其他地方，示踪剂活性通常较低，这一事实允许在许多恶性肿瘤中敏感地显示示踪剂积累。在使用示踪剂1小时后获得的身体FDG PET图像上经常遇到的解释陷阱可能被误认为是癌症。这些缺陷包括消化道、甲状腺、骨骼肌、心肌、骨髓和泌尿生殖道中可变的生理性FDG摄取，以及愈合骨、淋巴结、关节、感染部位的良性病理性FDG摄取，以及局部感染反应和无菌性炎症反应的病例。在许多情况下，这些生理变异和FDG摄取的良性病理原因可以被明确识别和适当分类；在其他情况下，如淋巴结对炎症或感染的反应，局灶性FDG摄取是非特异性的。
A rapidly emerging clinical application of positron emission tomography (PET) is the detection and staging of cancer with the glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Proper interpretation of FDG PET images requires knowledge of the normal physiologic distribution of the tracer, frequently encountered physiologic variants, and benign pathologic causes of FDG uptake that can be confused with a malignant neoplasm. One hour after intravenous administration, high FDG activity is present in the brain, the myocardium, and-due to the excretory route-the urinary tract. Elsewhere, tracer activity is typically low, a fact that allows sensitive demonstration of tracer accumulation in many malignant neoplasms. Interpretive pitfalls commonly encountered on FDG PET images of the body obtained 1 hour after tracer administration can be mistaken for cancer. Such pitfalls include variable physiologic FDG uptake in the digestive tract, thyroid gland, skeletal muscle, myocardium, bone marrow, and genitourinary tract and benign pathologic FDG uptake in healing bone, lymph nodes, joints, sites of infection, and cases of regional response to infection and aseptic inflammatory response. In many instances, these physiologic variants and benign pathologic causes of FDG uptake can be specifically recognized and properly categorized; in other instances, such as the lymph node response to inflammation or infection, focal FDG uptake is nonspecific.