FDG-PET/CT pitfalls in gynecological and genitourinary oncological imaging
© Lakhani et al. 2015
Published: 2 October 2015
1. To understand the role of FDG PET/CT imaging in the multimodality investigation of gynecological and genitourinary cancers.
2. To describe the mechanism of action and technical pitfalls of FDG-PET/CT.
3. To highlight key imaging features of physiological and non-physiological FDG uptake and show how this is essential for interpretation of gynecological and genitourinary FDG-PET/CT studies.
4. to review the pathophysiological mechanisms leading to potentially false-positive and false-negative assessments.
° Mechanism of action
° Role in gynecological and genitourinary oncological imaging
° FDG-PET/CT imaging protocols
False positives in gynecological and genitourinary oncological imaging:
∘ Physiological FDG-PET uptake – pictorial examples of uptake in endometrium and ovaries
∘ Non-physiological FDG-PET uptake – pictorial examples of pelvic inflammatory disease, fibroids, endometriosis
False negatives in gynecological and genitourinary oncological imaging:
∘ Physiological FDG-PET uptake – pictorial examples of urinary excretion masking malignant lesions
∘ No/low FDG uptake – pictorial examples of necrotic lymphadenopathy and low grade tumours
Pearls explaining how to minimise false interpretation
FDG-PET/CT has a useful role in gynecological and genitourinary oncological imaging. However, understanding of physiological and non-physiological FDG- PET uptake is vital to understand potential false positive and false negatives in interpretation.
FDG PET/CT should be used as one part of the multimodality investigation of gynecological and genitourinary cancers.
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