Lymphangiography causes false-positive findings on 18F-FDG PET imaging.
BACKGROUND
18F-FDG positron emission tomography (PET) may alter therapeutic management of patients with cervical cancer because 18F-FDG-positive pelvic and para-aortic lymph nodes are associated with lower progression-free survival and vice versa. However, the accuracy of 18F-FDG PET might be impaired by a preceding lymphangiography (LAG).


METHODS
LAG, magnetic resonance (MR)-imaging and 18F-FDG PET were performed in 6 patients with cervical cancer stage FIGO IB and II. All patients were scheduled for radical hysterectomy and pelvic and para-aortic lymphadenectomy. The results of LAG, MR-imaging and 18F-FDG PET were compared with histological findings.


RESULTS
18F-FDG PET showed false-positive foci in both patients who had LAG before PET-study but not in 4 patients who had LAG thereafter. Histology confirmed false-positive 18F-FDG accumulation in lymphnodes to be consistent with granulomateous changes as induced by foregoing LAG.


CONCLUSIONS
Whenever 18F-FDG PET and LAG are performed in the same patient to assess the extent of lymph-node metastases, LAG should always be done after the 18F-FDG PET study to obviate false-positive results.
Reinhardt
Michael J
MJ
Department of Nuclear Medicine, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. michael.reinhardt@ukb.uni-bonn.de
Technau-Ihling
Katja
K
Altehoefer
Carsten
C
Vogelgesang
Dagmar
D
Krause
Thomas M
TM
D000328:Adult; D000368:Aged; D005189:False Positive Reactions; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008220:Lymphography / Q000009:adverse effects*; D008875:Middle Aged; D009367:Neoplasm Staging; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging*
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18