Skip to main content
SpringerLink
Log in

Physiological 18F-FDG uptake in the ovaries and uterus of healthy female volunteers

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Good knowledge of physiological 18F-fluorodeoxglucose (18F-FDG) uptake in the healthy population is of great importance for the correct interpretation of 18F-FDG positron emission tomography (PET) images of pathological processes. The purpose of this study was to investigate the physiological 18F-FDG uptake in the ovaries and uterus of healthy female volunteers.

Methods

One hundred and 33 healthy females, 78 of whom were premenopausal (age 37.2±6.9 years) and 55 postmenopausal (age 55.0±2.7 years), were examined using whole-body 18F-FDG PET and pelvic magnetic resonance (MR) imaging. Focal 18F-FDG uptake in the ovaries and uterus was evaluated visually and using standardised uptake value (SUVs). Anatomical and morphological information was obtained from MR images.

Results

Distinct ovarian 18F-FDG uptake with an SUV of 3.9±0.7 was observed in 26 premenopausal women out of 32 examined during the late follicular to early luteal phase of the menstrual cycle. Eighteen of the 32 women also showed focal 18F-FDG uptake in the endometrium, with an SUV of 3.3±0.3. On the other hand, all nine women in the first 3 days of the menstrual cycle demonstrated intense 18F-FDG uptake in the endometrium, with an SUV of 4.6±1.0. No physiological 18F-FDG uptake was observed in the ovaries or uterus of any postmenopausal women.

Conclusion

In women of reproductive age, 18F-FDG imaging should preferably be done within a week before or a few days after the menstrual flow phase to avoid any misinterpretation of pelvic 18F-FDG PET images.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Cook GJ, Fogelman I, Maisey MN. Normal physiological and benign pathological variants of 18-fluoro-2-deoxyglucose positron-emission tomography scanning: potential for error in interpretation. Semin Nucl Med 1996;26:308–14.

    CAS  PubMed  Google Scholar 

  2. Gordon BA, Flanagan FL, Dehdashti F. Whole-body positron emission tomography: normal variations, pitfalls, and technical considerations. AJR 1997;169:1675–80.

    CAS  PubMed  Google Scholar 

  3. Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. Radiographics 1999;19:61–77.

    CAS  PubMed  Google Scholar 

  4. Yasuda S, Ide M, Takagi S, Shohtsu A. Intrauterine accumulation of F-18 FDG during menstruation. Clin Nucl Med 1997;22:793–4.

    Article  CAS  PubMed  Google Scholar 

  5. Chander S, Meltzer CC, McCook BM. Physiologic uterine uptake of FDG during menstruation demonstrated with serial combined positron emission tomography and computed tomography. Clin Nucl Med 2002;27:22–4.

    Article  PubMed  Google Scholar 

  6. Lerman H, Metser U, Grisaru D, Fishman A, Kievshitz 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.

    PubMed  Google Scholar 

  7. Watanabe M, Shimizu K, Omura T, Sato N, Takahashi M, Kosugi T et al. A high-throughput whole-body PET scanner using flat panel PS-PMTs. IEEE Trans Nucl Sci 2004;51:796–800.

    Article  Google Scholar 

  8. Tanaka E, Kudo H. Subset-dependent relaxation in block-iterative algorithms for image reconstruction in emission tomography. Phys Med Biol 2003;48:1405–22.

    Article  PubMed  Google Scholar 

  9. Outwater EK, Mitchell DG. Normal ovaries and functional cysts: MR appearance. Radiology 1996;198:397–402.

    CAS  PubMed  Google Scholar 

  10. Togashi K. MR imaging of the ovaries: normal appearance and benign disease. Radiol Clin North Am 2003;41:799–811.

    PubMed  Google Scholar 

  11. Espey LL. Ovulation as an inflammatory reaction—a hypothesis. Biol Reprod 1980;22:73–106.

    CAS  PubMed  Google Scholar 

  12. Kol S, Ben-Shlomo I, Ruutiainen K, Ando M, Davies-Hill TM, Rohan RM, et al. The midcycle increase in ovarian glucose uptake is associated with enhanced expression of glucose transporter 3. J Clin Invest 1997;99:2274–83.

    CAS  PubMed  Google Scholar 

  13. Vanatier D, Dufour P, Tordjeman-Rizzi N, Prolongeau JF, Depret-Moser S, Monnier JC. Immunological aspects of ovarian function: role of the cytokines. Eur J Obstet Gynecol Reprod Biol 1995;63:155–68.

    Article  PubMed  Google Scholar 

  14. Kubota R, Yamada S, Kubota K, Ishiwata K, Tamahashi N, Ido T. Intratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo: high accumulation in macrophages and granulation tissues studied by microautoradiography. J Nucl Med 1992;33:1972–80.

    CAS  PubMed  Google Scholar 

  15. Flint APF, Denton RM. Glucose metabolism in the superovulated rat ovary in vitro. Effects of luteinizing hormone and the role of glucose metabolism in steroidogenesis. Biochem J 1969;112:243–54.

    CAS  PubMed  Google Scholar 

  16. Chase CC Jr, Del Vecchio RP, Smith SB, Randel RD. In vitro metabolism of glucose by bovine reproductive tissues obtained during the estrous cycle and after calving. J Anim Sci 1992;70:1496–1508.

    CAS  PubMed  Google Scholar 

  17. Gull I, Geva E, Lerner-Geva L, Lessing JB, Wolman I, Amit A. Anaerobic glycolysis. The metabolism of the preovulatory human oocyte. Eur J Obstet Gynecol Reprod Biol 1999;85:225–8.

    Article  CAS  PubMed  Google Scholar 

  18. Kunz G, Leyendecker G. Uterine peristaltic activity during the menstrual cycle: characterization, regulation, function and dysfunction. Reprod Biomed Online 2002;4 Suppl 2:5–9.

    PubMed  Google Scholar 

  19. Fujiwara T, Togashi K, Yamaoka T, Nakai A, Kido A, Nishio S, et al. Kinematics of the uterus: cine mode MR imaging. Radiographics 2004;24:e19.

    PubMed  Google Scholar 

  20. Nakai A, Togashi K, Yamaoka T, Fujiwara T, Ueda H, Koyama T, et al. Uterine peristalsis shown on cine MR imaging using ultrafast sequence. J Magn Reson Imaging 2003;18:726–33.

    Article  PubMed  Google Scholar 

  21. Holder WD Jr, White RL Jr, Zugar JH, Easton EJ Jr, Greene FL. Effectiveness of positron emission tomography for the detection of melanoma metastases. Ann Surg 1998;227:764–9.

    Article  PubMed  Google Scholar 

  22. Kao CH. FDG uptake in a huge uterine myoma. Clin Nucl Med 2003;28:249.

    Article  PubMed  Google Scholar 

  23. Fenchel S, Grab D, Nuessle K, Kotzerke J, Reiber A, Kreienberg R, et al. Asymptomatic adnexal masses: correlation of FDG PET and histopathologic findings. Radiology 2002;223:780–8.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, 5000 Hirakuchi, Hamakita, Shizuoka, 434-0041, Japan

    Sadahiko Nishizawa, Masayuki Inubushi & Hiroyuki Okada

Authors
  1. Sadahiko Nishizawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masayuki Inubushi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiroyuki Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sadahiko Nishizawa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nishizawa, S., Inubushi, M. & Okada, H. Physiological 18F-FDG uptake in the ovaries and uterus of healthy female volunteers. Eur J Nucl Med Mol Imaging 32, 549–556 (2005). https://doi.org/10.1007/s00259-004-1703-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-004-1703-x

Keywords

Search

Navigation