[Malignant tumor with false negative 18F-FDG PET image]

Full Abstract

OBJECTIVE:
To investigate the FDG uptake characteristics, the factors affecting 18F-FDG uptake and the extra CT diagnostic value of 18F-FDG PET/CT scan in the malignant tumor with false negative 18F-FDG PET image.

METHODS:
The data of PET/CT image in 17 patients with various kinds of cancers were reviewed and analyzed by visual observation and semi-quantity analysis ( SUV). The results were compared with the CT and histopathological diagnosis, respectively.

RESULTS:
Of 6 well-differentiated HCC patients confirmed by histopathological diagnosis, one had two lesions in the right lobe of the liver. One of these two lesions showed low FDG uptake on 18F-FDG PET scan and low density on CT scan. The other one was not shown on either 18F-FDG PET or plain CT scan. But on enhanced CT scan, these two lesions were found to be inhomogeneous with high density at arterial phase. The false negative 18F-FDG PET images of one gastric signet ring cell carcinoma in the gastric fundus with right adnexa metastasis, 3 renal cell carcinoma, one greater omentum and peritoneal metastatic adenocarcinoma and one well-differentiated prostate cancer were caused by normal physical uptake in the digestive tract or FDG retention in the urinary system due to normal excretion. The size of three metastases was smaller than or equal to 1 cm in diameter, however, two primary lesions of these metastases showed high FDG uptake and only one was negative on either 18F-FDG PET or CT scan. In this series, 68.8% of the primary tumors and 66.7% of metastases were found to show abnormal density on CT scan, and 31. 2% of the primary tumors and 33. 3% of metastases were not detectable on either PET or CT images.

CONCLUSION:
False negative 18F-FDG PET in malignant tumor may be correlated with the pathologic type, differentiation degree and the lesion size. Combining CT information with PET or paying attention to the scan methods during 8 F-FDG PET examination may reduce the rate of false negative 18F-FDG PET diagnosis in various kinds of malignant tumors.

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Author information

Author/s: Dong, Meng-jie (MJ); Lin, Xinag-tong (XT); Zhao, Jun (J); Guan, Yi-hui (YH); Zuo, Chuan-tao (CT); Chen, Xiang (X); Dai, Jia-zhong (JZ); Jiang, Bao-dong (BD);

Affiliation: PET Canter Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.

Journal and publication information

Publication Type: English Abstract; Journal Article

Journal: Zhonghua zhong liu za zhi [Chinese journal of oncology] (Zhonghua Zhong Liu Za Zhi), published in China. (Language: chi)

Reference: 2006-Sep; vol 28 (issue 9) : pp 713-7

Dates: Created 2007/02/05; Completed 2008/02/14;

PMID: 17274383, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adenocarcinoma - radiography; radionuclide imaging; secondary
Adult
Aged
Carcinoma, Hepatocellular - pathology; radiography; radionuclide imaging
Carcinoma, Renal Cell - pathology; radiography; radionuclide imaging
Carcinoma, Signet Ring Cell - pathology; radiography; radionuclide imaging
False Negative Reactions
Female
Fluorodeoxyglucose F18 - diagnostic use
Humans

Kidney Neoplasms - pathology; radiography; radionuclide imaging
Liver Neoplasms - pathology; radiography; radionuclide imaging
Male
Middle Aged
Omentum - radiography; radionuclide imaging
Peritoneal Neoplasms - radiography; radionuclide imaging; secondary
Positron-Emission Tomography - methods
Radiographic Image Enhancement
Stomach Neoplasms - pathology; radiography; radionuclide imaging
Tomography, X-Ray Computed

Associated Chemicals: Fluorodeoxyglucose F18 (63503-12-8)

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