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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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Paragonimiasis in a 68-year-old male.A. In the lung window setting, axial transverse CT scan shows linear, wedge shaped consolidation and small centrilobular nodules. Radiologic diagnosis is atypical tuberculosis.B. Coronal section of FDG-PET image shows intense uptake in the right lower lung zone. Bronchoscopic washing and sputum cytology reveals many parasitic eggs of paragonimus species.
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Figure 7: Paragonimiasis in a 68-year-old male.A. In the lung window setting, axial transverse CT scan shows linear, wedge shaped consolidation and small centrilobular nodules. Radiologic diagnosis is atypical tuberculosis.B. Coronal section of FDG-PET image shows intense uptake in the right lower lung zone. Bronchoscopic washing and sputum cytology reveals many parasitic eggs of paragonimus species.

Mentions: During the active phase of paragonimiasis, lung tissue surrounding the parasitic cysts may contain evidence of pneumonia, bronchitis, bronchiectasis, and fibrosis (12) (Fig. 7A). Watanabe et al. (11) reported one case of paragonimiasis mimicking lung cancer which showed high FDG uptake (SUV 4.7 at one hour post-injection, and elevation of SUV to 6.2 at two hours). Although the exact causes of FDG accumulation have not yet been proven, we can expect that inflammatory cells including eosinophlic infiltration, active inflammatory responses and viable worms cause high FDG uptake (Fig. 7B).


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)

Paragonimiasis in a 68-year-old male.A. In the lung window setting, axial transverse CT scan shows linear, wedge shaped consolidation and small centrilobular nodules. Radiologic diagnosis is atypical tuberculosis.B. Coronal section of FDG-PET image shows intense uptake in the right lower lung zone. Bronchoscopic washing and sputum cytology reveals many parasitic eggs of paragonimus species.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 7: Paragonimiasis in a 68-year-old male.A. In the lung window setting, axial transverse CT scan shows linear, wedge shaped consolidation and small centrilobular nodules. Radiologic diagnosis is atypical tuberculosis.B. Coronal section of FDG-PET image shows intense uptake in the right lower lung zone. Bronchoscopic washing and sputum cytology reveals many parasitic eggs of paragonimus species.
Mentions: During the active phase of paragonimiasis, lung tissue surrounding the parasitic cysts may contain evidence of pneumonia, bronchitis, bronchiectasis, and fibrosis (12) (Fig. 7A). Watanabe et al. (11) reported one case of paragonimiasis mimicking lung cancer which showed high FDG uptake (SUV 4.7 at one hour post-injection, and elevation of SUV to 6.2 at two hours). Although the exact causes of FDG accumulation have not yet been proven, we can expect that inflammatory cells including eosinophlic infiltration, active inflammatory responses and viable worms cause high FDG uptake (Fig. 7B).

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