Paravertebral infection (phlegmon) demonstrated by FDG dual-head coincidence imaging in a patient with multiple malignancies.
A 66-year-old woman was referred for a bone scan to assess back pain on a background of breast cancer, melanoma, and rheumatic heart disease. The scan appearance was suspicious for a localized soft tissue neoplasm. An FDG coincidence positron emission tomography (PET) study demonstrated a large FDG-avid soft tissue abnormality. Staphylococcus aureus was isolated from a subsequent needle biopsy. This case illustrates the use of FDG-PET in infection imaging, as well as demonstrating the potential pitfalls in nuclear oncology. Because FDG is not tumor-specific, accumulation in benign lesions may give rise to false-positive results despite a high pretest probability for malignancy.
Nguyen
Quyen H
QH
Department of Nuclear Medicine, St. Vincent's Hospital, Sydney, Australia. quinnguyen@optusnet.com.au
Szeto
Edwin
E
Mansberg
Robert
R
Mansberg
Victor
V
D000368:Aged; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology; D001943:Breast Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D002481:Cellulitis / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D005260:Female; D019788:Fluorodeoxyglucose F18; D015902:Gamma Cameras; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008545:Melanoma / Q000150:complications / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012983:Soft Tissue Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D013203:Staphylococcal Infections / Q000150:complications / Q000000981:diagnostic imaging*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18