Focal F-18 FDG uptake mimicking malignant gastric localizations disappearing after water ingestion on PET/CT images.
Diffuse, increased gastric wall F-18 FDG uptake is widely observed during PET/CT examinations, frequently unrelated to malignant findings, but simply caused by inflammatory disease, physiological emptying, or visceral thickening. Hence, elevated F-18 FDG gastric uptake can lead to equivocal misinterpretation, especially in patients with known gastric malignant disease, at posttherapy reevaluation. Gastric wall contraction can increase F-18 FDG uptake, especially for a remnant stomach, increasing the percentage of false-positive results with a direct impact on therapeutic management. One field PET/CT acquisition centered on the hypochondrial regions a few minutes after water ingestion should be performed routinely if standard images are doubtful (increased tracer uptake and visceral thickening) to differentiate benign from malignant uptake.
Imperiale
Alessio
A
Hopital de Hautepierre, Service de Biophysique et de Medecine Nucleaire, Strasbourg, France. alessio.imperiale@chru-strasbourg.fr
Cimarelli
Sébastien
S
Sellem
Dorra Ben
DB
Blondet
Cyrille
C
Contantinesco
André
A
D000284:Administration, Oral; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D008657:Metabolic Clearance Rate / Q000187:drug effects; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D013270:Stomach / Q000000981:diagnostic imaging / Q000187:drug effects; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods; D014867:Water / Q000008:administration & dosage*
D019275:Radiopharmaceuticals; D014867:Water; D019788:Fluorodeoxyglucose F18