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PET/CT and PET/MRI, Normal Variations, and Artifacts

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Clinical Nuclear Medicine

Abstract

Hybrid positron emission tomography/computed tomography (PET/CT) has emerged a pivotal role in cancer imaging in the last two decades. It allows simultaneous acquisition and assessment of metabolic and morphologic changes which lead to higher accuracy, reporter confidence, and cost-effectiveness when compared with stand-alone performance of each modality.

Various specific radiotracers such as 18F-FDG-, 18F-choline-, 11C-choline-, 18F-sodium fluoride, and the 68Ga-labeled peptide have been introduced in routine clinical practice depending on disease characteristics and the metabolic pathways of the cancerous tissues. However, tracer uptake is frequently not specific to a single pathologic process, and accurate interpretation of PET/CT requires the good knowledge of the normal distribution of different tracers and also incidental findings that are often encountered in clinical practice.

In the last few years, dedicated positron emission tomography/magnet resonance imaging (PET/MRI) has also become commercially available. Although the radiopharmaceutical-related physiologic uptakes and artifacts are mostly similar from PET/CT to PET/MRI, there are different technical artifacts which should be considered for accurate interpretation.

In this chapter, we provide a review concerning the physiologic uptakes of common radiotracers and benign findings in a specific order based on different parts of the body, head and neck, thorax, abdomen, and pelvis.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital, RWTH University, Aachen, Germany

    Mohsen Beheshti, Reyhaneh Manafi-Farid & Werner Langsteger

  2. Department of Nuclear Medicine & Endocrinology, Paracelsus Medical University, Salzburg, Austria

    Mohsen Beheshti

  3. Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Reyhaneh Manafi-Farid

  4. PET-CT Center Khatam, Khatamolanbia Hospital, Tehran, Iran

    Alireza Rezaee

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  1. Mohsen Beheshti
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  4. Werner Langsteger
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Correspondence to Mohsen Beheshti .

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  1. Department of Nuclear Medicine, Klinikum Westfalen - Knappschaftskrankenhaus Academic teaching hospital of the Ruhr University, Dortmund, Nordrhein-Westfalen, Germany

    Hojjat Ahmadzadehfar

  2. Department of Nuclear Medicine, Beta Klinik Bonn, Bonn, Germany

    Hans-Jürgen Biersack

  3. Division of Nuclear Medicine, Department of Radiology, Montefiore Medical Center, Bronx, NY, USA

    Leonard M. Freeman

  4. Albert Einstein College of Medicine, Bronx, NY, USA

    Lionel S. Zuckier

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Beheshti, M., Manafi-Farid, R., Rezaee, A., Langsteger, W. (2020). PET/CT and PET/MRI, Normal Variations, and Artifacts. In: Ahmadzadehfar, H., Biersack, HJ., Freeman, L., Zuckier, L. (eds) Clinical Nuclear Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-39457-8_17

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