Focal F-18 FDG uptake mimicking malignant gastric localizations disappearing after water ingestion on PET/CT images

Clin Nucl Med. 2006 Dec;31(12):835-7. doi: 10.1097/01.rlu.0000246819.37532.e2.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Diagnosis, Differential
  • Diagnostic Errors / prevention & control*
  • False Positive Reactions
  • Female
  • Fluorodeoxyglucose F18 / pharmacokinetics*
  • Gastric Mucosa / metabolism
  • Humans
  • Metabolic Clearance Rate / drug effects
  • Middle Aged
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Stomach / diagnostic imaging
  • Stomach / drug effects
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / metabolism*
  • Subtraction Technique
  • Tomography, X-Ray Computed / methods
  • Water / administration & dosage*

Substances

  • Radiopharmaceuticals
  • Water
  • Fluorodeoxyglucose F18