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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

Cryptococcosis in a 68-year-old female.A. Contrast-enhanced CT scan shows a cavitary nodule (arrow) in the left lower lobe.B. Transverse section of a whole body PET image shows increased uptake (arrow) in the left lower lobe and a standardized uptake value of 2.6. The lesion is a round mass-like lesion unlike the CT findings due to respiration artifact.
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Figure 6: Cryptococcosis in a 68-year-old female.A. Contrast-enhanced CT scan shows a cavitary nodule (arrow) in the left lower lobe.B. Transverse section of a whole body PET image shows increased uptake (arrow) in the left lower lobe and a standardized uptake value of 2.6. The lesion is a round mass-like lesion unlike the CT findings due to respiration artifact.

Mentions: Cryptococcosis is an infection caused by the yeast-like fungus Cryptococcus neoformans. This fungus reproduces by budding and forms round, yeast-like cells. Infection occurs by inhaling the fungus into the lungs. Pulmonary lesions are characterized by intense granulomatous inflammation (10). There are some reports which have showed high FDG uptake causing false positive results in cryptococcosis (8) (Fig. 6).


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)

Cryptococcosis in a 68-year-old female.A. Contrast-enhanced CT scan shows a cavitary nodule (arrow) in the left lower lobe.B. Transverse section of a whole body PET image shows increased uptake (arrow) in the left lower lobe and a standardized uptake value of 2.6. The lesion is a round mass-like lesion unlike the CT findings due to respiration artifact.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 6: Cryptococcosis in a 68-year-old female.A. Contrast-enhanced CT scan shows a cavitary nodule (arrow) in the left lower lobe.B. Transverse section of a whole body PET image shows increased uptake (arrow) in the left lower lobe and a standardized uptake value of 2.6. The lesion is a round mass-like lesion unlike the CT findings due to respiration artifact.
Mentions: Cryptococcosis is an infection caused by the yeast-like fungus Cryptococcus neoformans. This fungus reproduces by budding and forms round, yeast-like cells. Infection occurs by inhaling the fungus into the lungs. Pulmonary lesions are characterized by intense granulomatous inflammation (10). There are some reports which have showed high FDG uptake causing false positive results in cryptococcosis (8) (Fig. 6).

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