Clinical PET pp 127-145 | Cite as

Normal and Variable Patterns

  • Ho-Young Lee
  • Myung-Chul Lee
  • E. Edmund Kim


The clinical applications and investigations of positron emission tomography (PET) have been recently increasing. The majority of the clinical PET studies and the use of 18F-fluoro-2-deoxyglucose (FDG) are related to oncology, but the uptake of this radiopharmaceutical is not specific to malignant tissue. There are several physiologic uptakes and artifacts, which make it difficult to evaluate or detect malignant tissue. It is important to be aware of normal variants and benign diseases that may mimic more serious pathology. Uptake of FDG in a number of sites may be variable and may be seen normally in the skeletal muscle after exercise or under tension, in the myocardium, in parts of the gastrointestinal tract, especially the stomach and cecum, and in the urinary tract. Some causes of increased physiologic uptake are avoidable, and measures can be taken to minimize accumulation.1


Axial Body Physiologic Uptake Bone Marrow Uptake Closed Arrow Chest Show 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Cook GJR, Fogelman I, Maisey MN. Normal physiological and benign pathological variants of F-18 deoxyglucose PET scanning: potential for error in interpretation. Semin Nucl Med 1996; 26: 308–314.PubMedCrossRefGoogle Scholar
  2. 2.
    O’Tuama LA, Phillips PC, Smith IR, et al. L-methionine uptake by human cerebral cortex. Maturation from infancy to old age. J Nucl Med 1991; 32: 16–20.PubMedGoogle Scholar
  3. 3.
    Newberg A, Alvi A, Reivich M. Determination of regional cerebral function with FDG-PET imaging in neuropsychiatric disorders. Semin Nucl Med 2002; 32: 13–34.PubMedCrossRefGoogle Scholar
  4. 4.
    Tashiro M, Fujimoto T, Itoh M, et al. 18F-FDG PET imaging of muscle activity in runners. J Nucl Med 1999; 40: 70–76.PubMedGoogle Scholar
  5. 5.
    Shreve PD, Anzai Y, Wahl R. Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. Radiographics 19(1):61–77; Quiz 150–1.Google Scholar
  6. 6.
    Loessner A, Alvi A, Lewandrowski KU, et al. Regional cerebral function determined by FDG-PET in healthy volunteers: normal patterns and changes with age. J Nucl Med 1995; 36: 1141–1149.PubMedGoogle Scholar
  7. 7.
    Hany TF, Gharehpapagh E, Kamel EM, et al. Brown adipose tissue: a factor to consider in symmetrical tracer uptake in the neck and upper chest region. Eur J Nucl Med 2002; 29: 1393–1398.CrossRefGoogle Scholar
  8. 8.
    Yasuda S, Fuji H, Takahashi W, et al. Elevated 18F-FDG uptake in the psoas muscle. Clin Nucl Med 1998; 23: 716–717.PubMedCrossRefGoogle Scholar
  9. 9.
    Kim S-K, Chung J-K, Kim B-T, et al. Relationship between gastrointestinal 18F-FDG accumulation and gastrointestinal symptoms in whole-body PET. Clin Pos Imag 1999; 2: 273–280.CrossRefGoogle Scholar
  10. 10.
    Sugawara Y, Fisher SJ, Zasadny KR, et al. Preclinical and clinical studies of bone marrow uptake of 18F-FDG with or without granulocyte colony stimulating factor during chemotherapy. J Clin Oncol 1998; 16: 173–180.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2004

Authors and Affiliations

  • Ho-Young Lee
  • Myung-Chul Lee
  • E. Edmund Kim

There are no affiliations available

Personalised recommendations