title: FDG PET/CT Pitfalls in Gynecologic and Genitourinary Oncologic Imaging.
abstract: The role of whole-body positron emission tomography (PET)/computed tomography (CT) with fluorodeoxyglucose ( FDG fluorodeoxyglucose ) is now established in the assessment of many gynecologic and genitourinary malignant tumors. FDG fluorodeoxyglucose PET/CT has been widely adopted for staging assessments in patients with suspected advanced disease, in cases of suspected disease recurrence, and for determining prognosis in a number of malignancies. A number of pitfalls are commonly encountered when reviewing FDG fluorodeoxyglucose PET/CT scans in gynecologic and genitourinary cases; these pitfalls can be classified into those that yield potential false-positive or false-negative results. Potential false positives include physiologic uptake of FDG fluorodeoxyglucose by the endometrium and ovaries in premenopausal patients, physiologic renal excretion of FDG fluorodeoxyglucose into the ureters and the urinary bladder, and increased FDG fluorodeoxyglucose activity in benign conditions such as uterine fibroids, pelvic inflammatory disease, and benign endometriotic cysts. Potential false negatives include low-level FDG fluorodeoxyglucose uptake by necrotic, mucinous, cystic, or low-grade tumors and the masking of serosal and peritoneal disease by adjacent physiologic bowel or bladder activity. In addition, there are inherent technical limitations-such as motion artifact (from respiratory motion and bowel peristalsis) and the limited spatial resolution of PET-that may limit the assessment of small-volume malignant disease. Knowledge of the key imaging features of physiologic and nonphysiologic FDG fluorodeoxyglucose uptake, in addition to understanding the principles of adequate patient preparation and PET scanning protocols, is important for accurate interpretation of gynecologic and genitourinary oncologic FDG fluorodeoxyglucose PET/CT studies.©RSNA, 2017.
authors.affiliation: From the Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London W6 8RF, England (A.L., S.R.K., N.B., V.S., S.K., T.D.B.); Faculty of Medicine, Department of Surgery and Cancer (A.L., N.B., T.D.B.), and Department of Surgery and Cancer (A.G.R.), Imperial College London, London, England; and Department of Radiology, the Royal Marsden NHS Foundation Trust, London, England (A.G.R.).
authors.forename: Amish
authors.initials: A
authors.lastname: Lakhani
authors.affiliation: From the Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London W6 8RF, England (A.L., S.R.K., N.B., V.S., S.K., T.D.B.); Faculty of Medicine, Department of Surgery and Cancer (A.L., N.B., T.D.B.), and Department of Surgery and Cancer (A.G.R.), Imperial College London, London, England; and Department of Radiology, the Royal Marsden NHS Foundation Trust, London, England (A.G.R.).
authors.forename: Sairah R
authors.initials: SR
authors.lastname: Khan
authors.affiliation: From the Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London W6 8RF, England (A.L., S.R.K., N.B., V.S., S.K., T.D.B.); Faculty of Medicine, Department of Surgery and Cancer (A.L., N.B., T.D.B.), and Department of Surgery and Cancer (A.G.R.), Imperial College London, London, England; and Department of Radiology, the Royal Marsden NHS Foundation Trust, London, England (A.G.R.).
authors.forename: Nishat
authors.initials: N
authors.lastname: Bharwani
authors.affiliation: From the Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London W6 8RF, England (A.L., S.R.K., N.B., V.S., S.K., T.D.B.); Faculty of Medicine, Department of Surgery and Cancer (A.L., N.B., T.D.B.), and Department of Surgery and Cancer (A.G.R.), Imperial College London, London, England; and Department of Radiology, the Royal Marsden NHS Foundation Trust, London, England (A.G.R.).
authors.forename: Victoria
authors.initials: V
authors.lastname: Stewart
authors.affiliation: From the Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London W6 8RF, England (A.L., S.R.K., N.B., V.S., S.K., T.D.B.); Faculty of Medicine, Department of Surgery and Cancer (A.L., N.B., T.D.B.), and Department of Surgery and Cancer (A.G.R.), Imperial College London, London, England; and Department of Radiology, the Royal Marsden NHS Foundation Trust, London, England (A.G.R.).
authors.forename: Andrea G
authors.initials: AG
authors.lastname: Rockall
authors.affiliation: From the Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London W6 8RF, England (A.L., S.R.K., N.B., V.S., S.K., T.D.B.); Faculty of Medicine, Department of Surgery and Cancer (A.L., N.B., T.D.B.), and Department of Surgery and Cancer (A.G.R.), Imperial College London, London, England; and Department of Radiology, the Royal Marsden NHS Foundation Trust, London, England (A.G.R.).
authors.forename: Sameer
authors.initials: S
authors.lastname: Khan
authors.affiliation: From the Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London W6 8RF, England (A.L., S.R.K., N.B., V.S., S.K., T.D.B.); Faculty of Medicine, Department of Surgery and Cancer (A.L., N.B., T.D.B.), and Department of Surgery and Cancer (A.G.R.), Imperial College London, London, England; and Department of Radiology, the Royal Marsden NHS Foundation Trust, London, England (A.G.R.).
authors.forename: Tara D
authors.initials: TD
authors.lastname: Barwick
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D005833:Genital Neoplasms, Female / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D000072078:Positron Emission Tomography Computed Tomography; D014571:Urologic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D051598:Whole Body Imaging
chemical_list: D019788:Fluorodeoxyglucose F18