Normal Variants and Pitfalls Encountered in PET Assessment of Gynecologic Malignancies

Overview

Journal PET Clin

Specialty Radiology

Date 2018 Feb 28

PMID 29482753

Citations 2

Authors

Jian Q Yu

Mohan Doss

R Katherine Alpaugh

Affiliations

Soon will be listed here.

Abstract

Combined PET/computed tomography is used for oncological indications. PET/computed tomography benefits from the metabolic information of PET and the anatomic localization of computed tomography. The integrated scanner provides data with accurate registration of anatomy and molecular information. Many physiologic conditions, normal variants, and benign lesions within the pelvis and the body can cause confusion and uncertainty. False-negative results owing to low F-fluorodeoxyglucose uptake from the tumor can produce diagnostic challenges and inaccurate conclusions. This article reviews normal variants and potential pitfalls encountered in PET assessment of gynecologic malignancies to provide useful information for the referring and reporting physicians.

Citing Articles

F-18 FDG PET/CT Imaging in Normal Variants, Pitfalls and Artifacts in the Abdomen and Pelvis.

Vangu M, Momodu J Front Nucl Med. 2024; 1:826109.

PMID: 39355643 PMC: 11440875. DOI: 10.3389/fnume.2021.826109.

Diagnostic accuracy and clinical value of [68Ga]Ga-FAPI-46 PET/CT for staging patients with ovarian cancer: study protocol for a prospective clinical trial.

Bentestuen M, Ladekarl M, Knudsen A, Zacho H BMC Cancer. 2024; 24(1):699.

PMID: 38849741 PMC: 11157941. DOI: 10.1186/s12885-024-12461-w.

References

Lazzari R, Cecconi A, Jereczek-Fossa B, Travaini L, Dell Acqua V, Cattani F . The role of [(18)F]FDG-PET/CT in staging and treatment planning for volumetric modulated Rapidarc radiotherapy in cervical cancer: experience of the European Institute of Oncology, Milan, Italy. Ecancermedicalscience. 2014; 8:405. PMC: 3963705. DOI: 10.3332/ecancer.2014.409. View

Mayoral M, Paredes P, Domenech B, Fuste P, Vidal-Sicart S, Tapias A . F-FDG PET/CT and sentinel lymph node biopsy in the staging of patients with cervical and endometrial cancer. Role of dual-time-point imaging. Rev Esp Med Nucl Imagen Mol. 2016; 36(1):20-26. DOI: 10.1016/j.remn.2016.07.003. View

Sureshbabu W, Mawlawi O . PET/CT imaging artifacts. J Nucl Med Technol. 2005; 33(3):156-61. View

Nogami Y, Banno K, Irie H, Iida M, Masugi Y, Murakami K . Efficacy of 18-FDG PET-CT dual-phase scanning for detection of lymph node metastasis in gynecological cancer. Anticancer Res. 2015; 35(4):2247-53. View

Amit A, Beck D, Lowenstein L, Lavie O, Shalom R, Kedar Z . The role of hybrid PET/CT in the evaluation of patients with cervical cancer. Gynecol Oncol. 2005; 100(1):65-9. DOI: 10.1016/j.ygyno.2005.07.013. View

Bese T, Sal V, Demirkiran F, Kahramanoglu I, Tokgozoglu N, Ilvan S . The Combination of Preoperative Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Mapping in the Surgical Management of Endometrioid Endometrial Cancer. Int J Gynecol Cancer. 2016; 26(7):1228-38. DOI: 10.1097/IGC.0000000000000773. View

Chung H, Kim S, Kim T, Lee S, Kang K, Kim J . Clinical impact of FDG-PET imaging in post-therapy surveillance of uterine cervical cancer: from diagnosis to prognosis. Gynecol Oncol. 2006; 103(1):165-70. DOI: 10.1016/j.ygyno.2006.02.016. View

Prakash P, Cronin C, Blake M . Role of PET/CT in ovarian cancer. AJR Am J Roentgenol. 2010; 194(6):W464-70. DOI: 10.2214/AJR.09.3843. View

Weber W, Gatsonis C, Mozley P, Hanna L, Shields A, Aberle D . Repeatability of 18F-FDG PET/CT in Advanced Non-Small Cell Lung Cancer: Prospective Assessment in 2 Multicenter Trials. J Nucl Med. 2015; 56(8):1137-43. PMC: 4699428. DOI: 10.2967/jnumed.114.147728. View

10.

Barranger E, Kerrou K, Petegnief Y, David-Montefiore E, Cortez A, Darai E . Laparoscopic resection of occult metastasis using the combination of FDG-positron emission tomography/computed tomography image fusion with intraoperative probe guidance in a woman with recurrent ovarian cancer. Gynecol Oncol. 2004; 96(1):241-4. DOI: 10.1016/j.ygyno.2004.09.030. View

11.

Wahl R, Javadi M, Eslamy H, Shruti A, Bristow R . The Roles of Fluorodeoxyglucose-PET/Computed Tomography in Ovarian Cancer: Diagnosis, Assessing Response, and Detecting Recurrence. PET Clin. 2016; 5(4):447-61. DOI: 10.1016/j.cpet.2010.07.008. View

12.

Townsend D, Beyer T, Blodgett T . PET/CT scanners: a hardware approach to image fusion. Semin Nucl Med. 2003; 33(3):193-204. DOI: 10.1053/snuc.2003.127314. View

13.

Nakamura K, Kodama J, Okumura Y, Hongo A, Kanazawa S, Hiramatsu Y . The SUVmax of 18F-FDG PET correlates with histological grade in endometrial cancer. Int J Gynecol Cancer. 2010; 20(1):110-5. DOI: 10.1111/IGC.0b013e3181c3a288. View

14.

Roman-Jimenez G, de Crevoisier R, Leseur J, Devillers A, Ospina J, Simon A . Detection of bladder metabolic artifacts in (18)F-FDG PET imaging. Comput Biol Med. 2016; 71:77-85. DOI: 10.1016/j.compbiomed.2016.02.002. View

15.

Wang X, Koch S . Positron emission tomography/computed tomography potential pitfalls and artifacts. Curr Probl Diagn Radiol. 2009; 38(4):156-69. DOI: 10.1067/j.cpradiol.2008.01.001. View

16.

Frumovitz M, Ramirez P, Macapinlac H, Klopp A, Nick A, Ramondetta L . Anatomic location of PET-positive aortocaval nodes in patients with locally advanced cervical cancer: implications for surgical staging. Int J Gynecol Cancer. 2012; 22(7):1203-7. PMC: 4283482. DOI: 10.1097/IGC.0b013e31825e523a. View

17.

Kwon Y, Gwack J, Im K, Choi D . Foreign body reaction from anti-adhesion material during follow-up of gynaecological malignancies: Mimicking local recurrence. Aust N Z J Obstet Gynaecol. 2016; 56(4):403-7. DOI: 10.1111/ajo.12469. View

18.

Oh D, Huh S, Park W, Ju S, Nam H, Lee J . Clinical outcomes in cervical cancer patients treated by FDG-PET/CT-based 3-dimensional planning for the first brachytherapy session. Medicine (Baltimore). 2016; 95(25):e3895. PMC: 4998314. DOI: 10.1097/MD.0000000000003895. View

19.

Papadopoulou I, Stewart V, Barwick T, Park W, Soneji N, Rockall A . Post-Radiation Therapy Imaging Appearances in Cervical Carcinoma. Radiographics. 2016; 36(2):538-53. DOI: 10.1148/rg.2016150117. View

20.

Yoo J, Choi J, Moon S, Bae D, Park S, Choe Y . Prognostic significance of volume-based metabolic parameters in uterine cervical cancer determined using 18F-fluorodeoxyglucose positron emission tomography. Int J Gynecol Cancer. 2012; 22(7):1226-33. DOI: 10.1097/IGC.0b013e318260a905. View