Stegger Lars, Juergens Kai Uwe, Kliesch Sabine, Wormanns Dag, Weckesser Matthias
Department of Nuclear Medicine, University Hospital of Münster, Germany.
Eur Radiol. 2007 Jul;17(7):1784-6. doi: 10.1007/s00330-006-0466-0. Epub 2006 Oct 26.
Fibrous dysplasia is a common benign disorder of bone in which fibro-osseous tissue replaces bone spongiosa. Lesions have a typical appearance on computed tomography (CT) images and regularly show a markedly increased uptake in bone scintigraphy using (99m)Tc-labelled methylene diphosphonate ((99m)Tc-MDP) as radiotracer. The glucose avidity of these lesions depicted by positron emission tomography (PET) using the radiolabelled glucose derivative (18)F-fluoro-2-deoxy-glucose (FDG) is less well known since FDG-PET does not have a role in the assessment of this disease. However, single cases have been reported in which fibrous dysplasia was present in patients undergoing FDG-PET scanning for oncological reasons, and no significant FDG uptake was observed for lesions identified as fibrous dysplasia. We report on a 24-year-old man with known fibrous dysplasia who underwent combined FDG-PET/CT scanning because of suspected recurrence of testicular cancer. In contrast to prior reports, a markedly elevated uptake of FDG was seen in numerous locations that were identified as fibrous dysplasia by CT. Based on this result, we conclude that fibrous dysplasia may mimick malignancy in FDG-PET and that coregistered CT may help to resolve these equivocal findings.
骨纤维异常增殖症是一种常见的骨良性疾病，其中纤维-骨组织替代骨松质。病变在计算机断层扫描（CT）图像上有典型表现，并且在使用（99m）锝标记的亚甲基二膦酸盐（（99m）Tc-MDP）作为放射性示踪剂的骨闪烁显像中经常显示摄取明显增加。正电子发射断层扫描（PET）使用放射性标记的葡萄糖衍生物（18）F-氟-2-脱氧葡萄糖（FDG）所显示的这些病变的葡萄糖摄取情况鲜为人知，因为FDG-PET在该疾病的评估中没有作用。然而，已有单例报道，因肿瘤原因接受FDG-PET扫描的患者存在骨纤维异常增殖症，而被确定为骨纤维异常增殖症的病变未观察到明显的FDG摄取。我们报告一名24岁已知患有骨纤维异常增殖症的男性，因怀疑睾丸癌复发而接受了FDG-PET/CT联合扫描。与先前的报道相反，在CT确定为骨纤维异常增殖症的多个部位观察到FDG摄取明显升高。基于这一结果，我们得出结论，骨纤维异常增殖症在FDG-PET中可能类似恶性肿瘤，而联合CT有助于解决这些不明确的发现。
