Joint accumulations of FDG in whole body PET scans.
OBJECTIVE
To retrospectively evaluate FDG accumulations in major joints in a large series of non-absorption corrected partial body and whole body FDG-PET scans, and to determine the frequency and intensity of accumulation.


METHODS
354 consecutive PET partial- and whole body non-transmission corrected scans of patients obtained for tumor staging were examined with respect to FDG accumulations in the acromio-clavicular (AC)-, gleno-humeral-, hip-, knee- and talo-tibial joints. FDG-uptake was graded using a semi-quantitative scale from 0 (no accumulation) to 4 (very strong accumulation comparable to brain uptake).


RESULTS
Joint activity of grade 1-2 was noted frequently, while grade 3 was rare, occurring only in the knee and shoulder joints, and grade 4 was inexistent. The 43 patients with grade 3 accumulations or with at least 4 joints showing grade 2 uptake were interviewed, but all denied pain specifically referred to a joint. Joint accumulations were seen in 50% of the acromio-clavicular-, 80% in the glenohumeral-, 50% in the hip-, 90% in the knee and 80% in the talo-tibial joints. The intensities of joint accumulations correlated positively and significantly with patient age, ranging from r = 0.7 and p < 0.05 in the knee to r = 0.96 and p < 0.0001 in the AC joint.


CONCLUSIONS
FDG accumulations in the joints in whole body FDG-PET scans are frequent and are very likely not related to symptoms. As there is a strong age correlation, and FDG is known to accumulate in inflammatory lesions, the findings are most likely a result of sub-clinical inflammatory synovial proliferation or other chronic inflammatory processes occurring in aging joints.
von Schulthess
G K
GK
Department of Medical Radiology, Nuclear Medicine University Hospital of Zurich. vonschulthess@dmr.usz.ch
Meier
N
N
Stumpe
K D
KD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D002648:Child; D002675:Child, Preschool; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D007223:Infant; D007596:Joints / Q000000981:diagnostic imaging; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D014018:Tissue Distribution; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18