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False positive and false negative FDG-PET scans in various thoracic diseases.

Chang JM, Lee HJ, Goo JM, Lee HY, Lee JJ, Chung JK, Im JG - Korean J Radiol (2006 Jan-Mar)

Bottom Line: Fluorodeoxyglucose (FDG)-positron emission tomography (PET) is being used more and more to differentiate benign from malignant focal lesions and it has been shown to be more efficacious than conventional chest computed tomography (CT).However, FDG is not a cancer-specific agent, and false positive findings in benign diseases have been reported.Furthermore, in diseases located near the physiologic uptake sites (heart, bladder, kidney, and liver), FDG-PET should be complemented with other imaging modalities to confirm results and to minimize false negative findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.

ABSTRACT
Fluorodeoxyglucose (FDG)-positron emission tomography (PET) is being used more and more to differentiate benign from malignant focal lesions and it has been shown to be more efficacious than conventional chest computed tomography (CT). However, FDG is not a cancer-specific agent, and false positive findings in benign diseases have been reported. Infectious diseases (mycobacterial, fungal, bacterial infection), sarcoidosis, radiation pneumonitis and post-operative surgical conditions have shown intense uptake on PET scan. On the other hand, tumors with low glycolytic activity such as adenomas, bronchioloalveolar carcinomas, carcinoid tumors, low grade lymphomas and small sized tumors have revealed false negative findings on PET scan. Furthermore, in diseases located near the physiologic uptake sites (heart, bladder, kidney, and liver), FDG-PET should be complemented with other imaging modalities to confirm results and to minimize false negative findings. Familiarity with these false positive and negative findings will help radiologists interpret PET scans more accurately and also will help to determine the significance of the findings. In this review, we illustrate false positive and negative findings of PET scan in a variety of diseases.

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Related in: MedlinePlus

Tuberculoma in a 53-year-old female.A. Contrast-enhanced CT scan shows a round mass in the left lower lobe.B. Axial FDG-PET image shows intense uptake (arrow) in the left upper lobe suggesting a malignant condition with a maximum standardized uptake value of 4.3. The pathologic examination reveals tuberculoma. Another lesion showing high FDG uptake (arrowhead) is a pulmonary artery.
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Figure 3: Tuberculoma in a 53-year-old female.A. Contrast-enhanced CT scan shows a round mass in the left lower lobe.B. Axial FDG-PET image shows intense uptake (arrow) in the left upper lobe suggesting a malignant condition with a maximum standardized uptake value of 4.3. The pathologic examination reveals tuberculoma. Another lesion showing high FDG uptake (arrowhead) is a pulmonary artery.

Mentions: Tuberculoma is one of the most well-known diseases that show intense FDG uptake (Fig. 3A). Active granulomatous processes such as tuberculosis have been reported to accumulate FDG (1, 2). Tuberculoma typically appears as a fairly discrete nodule or mass (Fig. 3B) in which repeated extensions of infection have created a central caseous necrosis surrounded by a mantle of epithelioid cells and collagen with peripheral inflammatory cell infiltration (1).


False positive and false negative FDG-PET scans in various thoracic diseases.

Chang JM, Lee HJ, Goo JM, Lee HY, Lee JJ, Chung JK, Im JG - Korean J Radiol (2006 Jan-Mar)

Tuberculoma in a 53-year-old female.A. Contrast-enhanced CT scan shows a round mass in the left lower lobe.B. Axial FDG-PET image shows intense uptake (arrow) in the left upper lobe suggesting a malignant condition with a maximum standardized uptake value of 4.3. The pathologic examination reveals tuberculoma. Another lesion showing high FDG uptake (arrowhead) is a pulmonary artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2667579&req=5

Figure 3: Tuberculoma in a 53-year-old female.A. Contrast-enhanced CT scan shows a round mass in the left lower lobe.B. Axial FDG-PET image shows intense uptake (arrow) in the left upper lobe suggesting a malignant condition with a maximum standardized uptake value of 4.3. The pathologic examination reveals tuberculoma. Another lesion showing high FDG uptake (arrowhead) is a pulmonary artery.
Mentions: Tuberculoma is one of the most well-known diseases that show intense FDG uptake (Fig. 3A). Active granulomatous processes such as tuberculosis have been reported to accumulate FDG (1, 2). Tuberculoma typically appears as a fairly discrete nodule or mass (Fig. 3B) in which repeated extensions of infection have created a central caseous necrosis surrounded by a mantle of epithelioid cells and collagen with peripheral inflammatory cell infiltration (1).

Bottom Line: Fluorodeoxyglucose (FDG)-positron emission tomography (PET) is being used more and more to differentiate benign from malignant focal lesions and it has been shown to be more efficacious than conventional chest computed tomography (CT).However, FDG is not a cancer-specific agent, and false positive findings in benign diseases have been reported.Furthermore, in diseases located near the physiologic uptake sites (heart, bladder, kidney, and liver), FDG-PET should be complemented with other imaging modalities to confirm results and to minimize false negative findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.

ABSTRACT
Fluorodeoxyglucose (FDG)-positron emission tomography (PET) is being used more and more to differentiate benign from malignant focal lesions and it has been shown to be more efficacious than conventional chest computed tomography (CT). However, FDG is not a cancer-specific agent, and false positive findings in benign diseases have been reported. Infectious diseases (mycobacterial, fungal, bacterial infection), sarcoidosis, radiation pneumonitis and post-operative surgical conditions have shown intense uptake on PET scan. On the other hand, tumors with low glycolytic activity such as adenomas, bronchioloalveolar carcinomas, carcinoid tumors, low grade lymphomas and small sized tumors have revealed false negative findings on PET scan. Furthermore, in diseases located near the physiologic uptake sites (heart, bladder, kidney, and liver), FDG-PET should be complemented with other imaging modalities to confirm results and to minimize false negative findings. Familiarity with these false positive and negative findings will help radiologists interpret PET scans more accurately and also will help to determine the significance of the findings. In this review, we illustrate false positive and negative findings of PET scan in a variety of diseases.

Show MeSH
Related in: MedlinePlus