Limits...
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.

Show MeSH

Related in: MedlinePlus

Post-chemotherapy related decreased lymph node uptake in a 57-year-old male lung cancer patient.A. Pre-chemotherapy FDG-PET fusion CT shows increased FDG uptake in the subcarinal lymph node with a maximum standardized uptake value of 9.4.B. After two months of chemotherapy, the residual lesion in the subcarinal area is noted.C. FDG-PET fusion CT shows no abnormal FDG uptake.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2667579&req=5

Figure 18: Post-chemotherapy related decreased lymph node uptake in a 57-year-old male lung cancer patient.A. Pre-chemotherapy FDG-PET fusion CT shows increased FDG uptake in the subcarinal lymph node with a maximum standardized uptake value of 9.4.B. After two months of chemotherapy, the residual lesion in the subcarinal area is noted.C. FDG-PET fusion CT shows no abnormal FDG uptake.

Mentions: In several previous reports, it has been well documented that FDG uptake usually decreases after chemotherapy, and this correlates with therapeutic response. Decreased FDG uptake after irradiation is mainly due to the reduced number of metabolically active tumor cells. However, a decrease of FDG PET does not always predict a good response because FDG can differentiate metabolically active cells from dead cells, but cannot differentiate biologically viable from metabolically active cells (22) (Fig. 18).


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)

Post-chemotherapy related decreased lymph node uptake in a 57-year-old male lung cancer patient.A. Pre-chemotherapy FDG-PET fusion CT shows increased FDG uptake in the subcarinal lymph node with a maximum standardized uptake value of 9.4.B. After two months of chemotherapy, the residual lesion in the subcarinal area is noted.C. FDG-PET fusion CT shows no abnormal FDG uptake.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 18: Post-chemotherapy related decreased lymph node uptake in a 57-year-old male lung cancer patient.A. Pre-chemotherapy FDG-PET fusion CT shows increased FDG uptake in the subcarinal lymph node with a maximum standardized uptake value of 9.4.B. After two months of chemotherapy, the residual lesion in the subcarinal area is noted.C. FDG-PET fusion CT shows no abnormal FDG uptake.
Mentions: In several previous reports, it has been well documented that FDG uptake usually decreases after chemotherapy, and this correlates with therapeutic response. Decreased FDG uptake after irradiation is mainly due to the reduced number of metabolically active tumor cells. However, a decrease of FDG PET does not always predict a good response because FDG can differentiate metabolically active cells from dead cells, but cannot differentiate biologically viable from metabolically active cells (22) (Fig. 18).

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