Bae Jung Min, Lee Ho Yun, Choi Joon Young
From the Department of Radiology and Center for Imaging Science (JMB, HYL.); and Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (JYC).
Medicine (Baltimore). 2015 Nov;94(44):e1896. doi: 10.1097/MD.0000000000001896.
18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) is an evolving tool in the field of oncology. 18F-fluorodeoxyglucose, however, is not a specific tool for malignant tumor that it may also accumulate in benign processes. To avoid false-positive interpretation of 18F-FDG-PET/computed tomography (CT), having knowledge of the potential pitfalls is important.The authors present a case of a patient with a lung mass who underwent fluoroscopy-guided transthoracic lung biopsy followed by 18F-FDG-PET/CT scan with a 4-hour interval between biopsy and scanning. Abnormally increased FDG uptake in the mass and pleural effusion was detected. Pathologic examination of the specimen, however, revealed only fibrous tissues with chronic inflammatory cells. On performing CT imaging, 1 month later, the mass and effusion had spontaneously resolved without treatment.Our findings suggest that PET/CT performed immediately following invasive procedures can result in false-positive results and thus mislead diagnosis. Therefore, the interval and order, in which PET/CT and invasive procedures are performed, should be carefully considered in oncologic work-up.
18F-氟脱氧葡萄糖正电子发射断层扫描(18F-FDG-PET)是肿瘤学领域中一种不断发展的工具。然而,18F-氟脱氧葡萄糖并非恶性肿瘤的特异性检测工具,因为它也可能在良性病变中积聚。为避免对18F-FDG-PET/计算机断层扫描(CT)出现假阳性解读,了解潜在的陷阱很重要。作者介绍了一例肺部肿块患者的病例,该患者在荧光镜引导下进行了经胸肺活检,随后进行了18F-FDG-PET/CT扫描,活检与扫描之间间隔4小时。在肿块和胸腔积液中检测到异常增加的FDG摄取。然而,对标本进行病理检查仅发现有慢性炎症细胞的纤维组织。1个月后进行CT成像时,肿块和积液未经治疗自行消退。我们的研究结果表明,侵入性操作后立即进行PET/CT检查可能会导致假阳性结果,从而误导诊断。因此,在肿瘤诊治过程中,应仔细考虑PET/CT和侵入性操作的检查间隔和顺序。