Ravikanth Reddy
Department of Radiology, St. John's Hospital, Kattappana, Kerala, India.
World J Nucl Med. 2020 Oct 7;20(1):7-16. doi: 10.4103/wjnm.WJNM_85_20. eCollection 2021 Jan-Mar.
2-deoxy-2-(Fluorine-18) fluoro-D-glucose (F-FDG) positron emission tomography/computed tomography (PET/CT) has been used exclusively to diagnose malignancies. However, increased F-FDG uptake is not always limited to malignant lesions. This imaging review demonstrates the physiological F-FDG uptake of normal structures in the thorax and illustrates many benign pathological lesions with standardized uptake value >2.5. These various conditions can be broadly categorized into three groups: infective lesions, active granulomatous diseases such as sarcoidosis, noninfectious/inflammatory, or proliferative conditions such as radiation pneumonitis, postlung transplant lymphoproliferative disorders, occupational pleuropulmonary complications, and postsurgical conditions, all of which can demonstrate varying degrees of F-FDG uptake on PET/CT based upon the degree of inflammatory activity. Familiarity of false-positive findings improves the PET/CT evaluation accuracy of benign lesions of the thorax. Radiation exposure and surgical history correlation along with imaging cross check evaluation of radiographs and magnetic resonance images for the anatomic location remains the mainstay of PET/CT characterization of positive findings.
2-脱氧-2-(氟-18)氟-D-葡萄糖(F-FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)一直仅用于诊断恶性肿瘤。然而,F-FDG摄取增加并不总是局限于恶性病变。本影像学综述展示了胸部正常结构的生理性F-FDG摄取,并举例说明了许多标准化摄取值>2.5的良性病理病变。这些不同情况可大致分为三组:感染性病变、如结节病等活动性肉芽肿性疾病、非感染性/炎症性或增殖性情况,如放射性肺炎、肺移植后淋巴增殖性疾病、职业性胸膜肺并发症和术后情况,所有这些情况都可根据炎症活动程度在PET/CT上显示不同程度的F-FDG摄取。熟悉假阳性结果可提高PET/CT对胸部良性病变的评估准确性。辐射暴露和手术史相关性以及对X线片和磁共振图像进行解剖定位的影像学交叉对照评估仍然是PET/CT对阳性结果进行特征描述的主要依据。