18F-FDG PET/CT pitfalls in the diagnostic work-up of inflammation of unknown origin
Authors:
Eva Krčálová 1; Tomáš Kvasnička 2; Eduard Havel 3; Drahomíra Baštecká 4; Jindra Brtková 2; Petr Bradna 4; Jiří Doležal 1
Authors‘ workplace:
Oddělení nukleární medicíny
1; Radiologická klinika
2; Chirurgická klinika
3; 2. lnterní gastroenterologická klinika, Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové a FN Hradec Králové, ČR
4
Published in:
NuklMed 2016;5:33-36
Category:
Casuistry
Overview
76-year-old female patient with inflammation of unknown origin, also suffering from myalgia and arthralgia underwent 18F-FDG PET/CT imaging. The 18F-FDG PET/CT scan revealed not only the usual polymyalgia rheumatica 18F-FDG uptake pattern, but also 18F-FDG avid expansion in the chest wall and pulmonary nodule with increased 18F-FDG uptake. This nodule could be inflammatory or cancerous. Further assessment did not reveal the nature of pulmonary nodule, but also did not find out evidence for malignancy.
Patient symptoms markedly improved, chest wall expansion regressed fully and the pulmonary nodule partially during the corticotherapy.
18F-FDG PET/CT is a senstitive method which can shorten diagnostic work-up in patients with inflammation of unknown origin. Problematic remains its lower specificity, which may result in subsequent (but already targeted) investigations. Particularly when polymyalgia rheumatica typical 18F-FDG uptake pattern is detected concurrently with 18F-FDG avid lesions atypical for this disease as we present in our case.
Key Words:
inflammation of unknown origin, polymyalgia rheumatica, PET/CT
Sources
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Labels
Nuclear medicine Radiodiagnostics RadiotherapyArticle was published in
Nuclear Medicine
2016 Issue 2
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