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Pathologies of the lower abdomen and pelvis: PET/CT reduces interpretation errors due to urinary contamination

Published:September 20, 2007DOI:https://doi.org/10.1016/j.clinimag.2007.07.004

      Abstract

      Aim

      The aim of this study was to assess the frequency of indeterminate 18F-fluorodeoxyglucose (FDG) accumulations on positron emission tomography (PET) and PET/computed tomography (CT) images in patients with pelvic pathologies.

      Methods

      We retrospectively evaluated 536 focal FDG accumulations of 166 PET/CT examinations. A consensus reading of PET/CT images, clinical data, and other imaging tests was the standard of reference to assess sensitivities and specificities of PET and PET/CT. Frequencies of indeterminate findings and intraobserver agreement were evaluated.

      Conclusion

      PET/CT improves the anatomic delineation and the correct assignment of physiologic and pathologic uptake.

      Keywords

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      References

        • Huebner RH
        • Park KC
        • Shepherd JE
        • Schwimmer J
        • Czernin J
        • Phelps ME
        • Gambhir SS
        A meta-analysis of the literature for whole-body FDG-PET detection of colorectal cancer.
        J Nucl Med. 2000; 41: 1177-1189
        • Vitola J
        • Delbeke D
        Positron emission tomography for evaluation of colorectal carcinoma.
        Semin Roentgenol. 2002; 37: 118-128
        • Drieskens O
        • Oyen R
        • Van Poppel H
        • Vankan Y
        • Flamen P
        • Mortelmans L
        FDG-PET for preoperative staging of bladder cancer.
        Eur J Nucl Med Mol Imaging. 2005; 32: 1412-1417
        • Shreve PD
        • Anzai Y
        • Wahl RL
        Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants.
        Radiographics. 1999; 19: 61-77
        • Subhas N
        • Patel PV
        • Pannu HK
        • Jacene HA
        • Fishman EK
        • Wahl RL
        Imaging of pelvic malignancies with in-line FDG PET-CT: case examples and common pitfalls of FDG PET.
        Radiographics. 2005; 25: 1031-1043
        • Miraldi F
        • Vesselle H
        • Faulhaber PF
        • Adler LP
        • Leisure GP
        Elimination of artifactual accumulation of FDG in PET imaging of colorectal cancer.
        Clin Nucl Med. 1998; 23: 3-7
        • Leisure GP
        • Vesselle HJ
        • Faulhaber PF
        • et al.
        Technical improvements in fluorine-18-FDG PET imaging of the abdomen and pelvis.
        J Nucl Med Technol. 1997; 25: 115-119
        • Lin WY
        • Hung GU
        • Tsai SC
        A pitfall of FDG-PET image interpretation: accumulation of FDG in the dependent area of the urinary bladder after bladder irrigation—the usefulness of the prone position.
        Clin Nucl Med. 2005; 30: 638-639
        • Schaffler GJ
        • Groell R
        • Schoellnast H
        • Kriegl D
        • Ruppert-Kohlmaier A
        • Schwarz T
        • Aigner RM
        Digital image fusion of CT and PET data sets—clinical value in abdominal/pelvic malignancies.
        J Comput Assist Tomogr. 2000; 24: 644-647
        • Hany TF
        • Steinert HC
        • Goerres GW
        • Buck A
        • von Schulthess GK
        PET diagnostic accuracy: improvement with in-line PET-CT system: initial results.
        Radiology. 2002; 225: 575-581
        • Amit A
        • Beck D
        • Lowenstein L
        • Lavie O
        • Bar Shalom R
        • Kedar Z
        • Israel O
        The role of hybrid PET/CT in the evaluation of patients with cervical cancer.
        Gynecol Oncol. 2006; 100: 65-69
        • Lerman H
        • Metser U
        • Grisaru D
        • Fishman A
        • Lievshitz 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: 266-271
        • Cohade C
        • Osman M
        • Leal J
        • Wahl RL
        Direct comparison of (18)F-FDG PET and PET/CT in patients with colorectal carcinoma.
        J Nucl Med. 2003; 44: 1797-1803
        • Sironi S
        • Messa C
        • Mangili G
        • Zangheri B
        • Aletti G
        • Garavaglia E
        • Vigano R
        • Picchio M
        • Taccagni G
        • Maschio AD
        • Fazio F
        Integrated FDG PET/CT in patients with persistent ovarian cancer: correlation with histologic findings.
        Radiology. 2004; 233: 4334-4340
        • Grisaru D
        • Almog B
        • Levine C
        • Metser U
        • Fishman A
        • Lerman H
        • Lessing JB
        • Even-Sapir E
        The diagnostic accuracy of 18F-fluorodeoxyglucose PET/CT in patients with gynecological malignancies.
        Gynecol Oncol. 2004; 94: 680-684
        • Sironi S
        • Buda A
        • Picchio M
        • Perego P
        • Moreni R
        • Pellegrino A
        • Colombo M
        • Mangioni C
        • Messa C
        • Fazio F
        Lymph node metastasis in patients with clinical early-stage cervical cancer: detection with integrated FDG PET/CT.
        Radiology. 2006; 238: 272-279
        • Picchio M
        • Sironi S
        • Messa C
        • Mangili G
        • Landoni C
        • Gianolli L
        • Zangheri B
        • Vigano R
        • Aletti G
        • De Marzi P
        • De Cobelli F
        • Del Maschio A
        • Ferrari A
        • Fazio F
        Advanced ovarian carcinoma: usefulness of [(18)F]FDG-PET in combination with CT for lesion detection after primary treatment.
        Q J Nucl Med. 2003; 47: 77-84
        • Kostakoglu L
        • Hardoff R
        • Mirtcheva R
        • Goldsmith SJ
        PET-CT fusion imaging in differentiating physiologic from pathologic FDG uptake.
        Radiographics. 2004; 24: 1411-1431
        • Bruzzi JF
        • Truong MT
        • Marom EM
        • Mawlawi O
        • Podoloff DA
        • Macapinlac HA
        • Munden RF
        Incidental findings on integrated PET/CT that do not accumulate 18F-FDG.
        AJR Am J Roentgenol. 2006; 187: 1116-1123
        • Even-Sapir E
        • Parag Y
        • Lerman H
        • Gutman M
        • Levine C
        • Rabau M
        • Figer A
        • Metser U
        Detection of recurrence in patients with rectal cancer: PET/CT after abdominoperineal or anterior resection.
        Radiology. 2004; 232: 815-822
        • Dizendorf EV
        • Treyer V
        • Von Schulthess GK
        • Hany TF
        Application of oral contrast media in coregistered positron emission tomography–CT.
        AJR Am J Roentgenol. 2002; 179: 477-481
        • Antoch G
        • Freudenberg LS
        • Stattaus J
        • Jentzen W
        • Mueller SP
        • Debatin JF
        • Bockisch A
        Whole-body positron emission tomography–CT: optimized CT using oral and IV contrast materials.
        AJR Am J Roentgenol. 2002; 179: 1555-1560