How Hybrid PET/CT Improve Pitfalls and Artifacts in Malignant Lymphoma?

Document Type : Original Paper, PET/CT

Authors

1 Nuclear Medicine Unit, NEMROCK Center, Cairo University, Egypt.

2 Nuclear Medicine Unit, Maadi Armed Forced Hospital, Egypt.

Abstract

18F-FDG PET/CT has become a standard procedure for the evaluation of lymphomas. An understanding of the role of FDG PET/CT in the management of lymphomas and knowledge of its limitations is mandatory for the optimal utilization of this technique. The present study aimed to assist accurate interpretation with proper diagnosis by exclusion of false positive or false negative causes of PET/CT studies. Material and Methods: This retrospective study included 105 adult patients with malignant lymphoma to diagnose possible pitfalls during study interpretation. All clinical and histopathological information were extracted from the patients’ clinical sheet. Results: The study included 105 patients (48patients with HD and 57 patients with NHL). The mean age of all patients was (46.78 ± 16.78) years.The majority of patients were males (61.9%); while (38.1%) were females. Total numbers of pitfalls detected were 373 sites. Physiological Pitfalls were detected in 71 sites, (36 sites had muscle uptake 12 sites had uterine-related uptake pitfalls, 12 sites had brown adipose tissue uptake and 5 sites had unilateral vocal cord uptake. Technical pitfalls were detected in 128 sites (50 sites had contrast-induced artifacts,41 sites had head movement, 36 sites had metallic artifact and one site showed truncation related pitfalls). Therapy related artifacts were detected in 156 sites (56 sites had gastric uptake. 54 sites had splenic & BM uptake and 30 patients had enhanced salivary uptake, while, 6 sites had diminished salivary uptake, 6 patients had thymic hyperplasia and 4 patients had early and late radiation effect). Benign pathological benign conditions were detected in18 sites (9 sites had incidental thyroid uptake and 8 patients had inflammatory lung uptake and one patient had bone fracture). Conclusion: PET/CT is a powerful imaging technique for characterizing pathological lymphomatous lesions with proper evaluation of physiological, technical and post therapy pitfalls or artifacts.

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