Artifacts in FDG PET and PET/CT

  • Masashi Kawaguchi
  • Ukihide Tateishi
  • Tomio Inoue
  • E. Edmund Kim
Chapter

Abstract

As the number of clinical positron emission tomography (PET) units is increasing, interpretation of PET images requires knowledge of the possible pitfalls that may occur because of artifacts and mimic pathology. In addition, the advent of combined PET/computed tomography (CT) scanners in clinical imaging practice has brought its own specific pitfalls and artifacts. These artifacts may be caused by various factors such as injection, attenuation material, image reconstruction, contamination, patient movements, and pathologic variants. Knowledge of the normal distribution of fluorodeoxyglucose (FDG) and its pathologic variation is essential before interpreting PET scans as well as an awareness of potential false positive and negative cases that can occur. With attention to detail in the preparation of patients, together with appropriate imaging protocols and experience in interpretation, many pitfalls can be avoided.

Keywords

Attenuation Iodine Tuberculosis Adenosine Radionuclide 

References

  1. 1.
    Kawano T, Suzuki A, Ishida A, Takahashi N, Lee J, Tayama Y, et al. The clinical relevance of thymic fluorodeoxyglucose uptake in pediatric patients after chemotherapy. Eur J Nucl Med Mol Imaging. 2004;31:831–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Kamel EM, Goerres GW, Burger C, von Schulthess GK, Stenert HC. Recurrent laryngeal nerve palsy in patients with lung cancer: detection with PET-CT image fusion: report of six cases. Radiology. 2002;224:153–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Lerman H, Mtese U, Grisaru D, Fishman A, Lievshitz G, Even-Sapir E. Normal and abnormal 18F-FDG endometrial and ovarian uptake in pre- and postmenopausal patients: assessment by PET/CT. J Nucl Med. 2004;45:266–71.PubMedGoogle Scholar
  4. 4.
    Yeung HWD, Grewal RK, Gonen M, et al. Patterns of 18F-FDG uptake in adipose tissue and muscle: a potential source of false-positives for PET. J Nucl Med. 2003;44:1789–96.PubMedGoogle Scholar
  5. 5.
    Alibazoglu H, Megremis D, Ali A, et al. Injection artifact on FDG-PET imaging. Clin Nucl Med. 1998;23:264–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Minn H, Nuutila P, Lindholm P, et al. In vivo effects of insulin on tumor and skeletal muscle glucose metabolism in patients with lymphoma. Cancer. 1994;73:1490–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Nakamoto Y, Osman M, Cohade C, et al. PETCT: comparison of quantitative tracer uptake between germanium and CT transmission attenuation-corrected scans. J Nucl Med. 2002;43(9):1137–43.PubMedGoogle Scholar
  8. 8.
    Goerres GW, Hany TF, Kamel E, et al. Head and neck imaging with PET and PET/CT: artefacts from dental metallic implants. Eur J Nucl Med. 2002;29:369–70.Google Scholar
  9. 9.
    Kamel EM, Burger C, Buck A, von Schulthess GK, Goerres GW. Impact of metallic dental implants on CT-based attenuation correction in a combined PET/CT scanner. Eur Radiol. 2003;13:724–8.PubMedGoogle Scholar
  10. 10.
    Antoch G, Freudenberg LS, Egelhof T, et al. Focal tracer uptake: a potential artifact in contrast-enhanced dual-modality PET/CT scans. J Nucl Med. 2002;43:1339–42.PubMedGoogle Scholar
  11. 11.
    Goerres GW, Kamel E, Seifert B, Burger C, Buck A, Hany TF, et al. Accuracy of image coresistration of pulmonary lesions in patients with non-small cell lung cancer using an integrated PET/CT system. J Nucl Med. 2002;43:1469–75.PubMedGoogle Scholar
  12. 12.
    Cook GJR, Fogelman I, Maisey MN. Normal physiological and benign pathological variants of F-18 deoxyglucose PET: potential for error in interpretation. Semin Nucl Med. 1996;26:308–24.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Masashi Kawaguchi
    • 1
  • Ukihide Tateishi
    • 1
  • Tomio Inoue
    • 1
  • E. Edmund Kim
    • 2
    • 3
  1. 1.Department of RadiologyYokohama City University Graduate School of MedicineYokohamaJapan
  2. 2.Departments of Nuclear Medicine and Diagnostic RadiologyThe University of Texas MD Anderson Cancer Center and Medical SchoolHoustonUSA
  3. 3.Graduate School of Convergence Science and TechnologySeoul National UniversitySeoulSouth Korea

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