Physiologic variants, benign processes, and artifacts from 106 canine and feline fdg‐pet/computed tomography scans
18F‐Fluoro‐deoxyglucose positron emission computed tomography (FDG‐PET/CT) is an emerging diagnostic imaging modality in veterinary medicine; however, little published information is available on physiologic variants, benign processes, and artifacts. The purpose of this retrospective study was to de...
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Published in | Veterinary radiology & ultrasound Vol. 55; no. 2; pp. 213 - 226 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
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England
Blackwell Publishing Ltd
01.03.2014
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Abstract | 18F‐Fluoro‐deoxyglucose positron emission computed tomography (FDG‐PET/CT) is an emerging diagnostic imaging modality in veterinary medicine; however, little published information is available on physiologic variants, benign processes, and artifacts. The purpose of this retrospective study was to describe the number of occurrences of non‐neoplastic disease‐related FDG‐PET/CT lesions in a group of dogs and cats. Archived FDG‐PET/CT scans were retrieved and interpreted based on a consensus opinion of two board‐certified veterinary radiologists. Non‐neoplastic disease‐related lesions were categorized as physiologic variant, benign activity, or equipment/technology related artifact. If the exact cause of hypermetabolic areas could not be determined, lesions were put into an indeterminate category. A total of 106 canine and feline FDG‐PET/CT scans were included in the study. In 104 of the 106 scans, a total of 718 occurrences of physiologic variant, areas of incidental benign activity, and artifacts were identified. Twenty‐two of 23 feline scans and 82 of 83 canine scans had at least one artifact. Previously unreported areas of increased radiopharmaceutical uptake included foci associated with the canine gall bladder, linear uptake along the canine mandible, and focal uptake in the gastrointestinal tract. Benign activity was often seen and related to healing, inflammation, and indwelling implants. Artifacts were most often related to injection or misregistration. Further experience in recognizing the common veterinary FDG physiologic variation, incidental radiopharmaceutical uptake, and artifacts is important to avoid misinterpretation and false‐positive diagnoses. |
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AbstractList | 18F‐Fluoro‐deoxyglucose positron emission computed tomography (FDG‐PET/CT) is an emerging diagnostic imaging modality in veterinary medicine; however, little published information is available on physiologic variants, benign processes, and artifacts. The purpose of this retrospective study was to describe the number of occurrences of non‐neoplastic disease‐related FDG‐PET/CT lesions in a group of dogs and cats. Archived FDG‐PET/CT scans were retrieved and interpreted based on a consensus opinion of two board‐certified veterinary radiologists. Non‐neoplastic disease‐related lesions were categorized as physiologic variant, benign activity, or equipment/technology related artifact. If the exact cause of hypermetabolic areas could not be determined, lesions were put into an indeterminate category. A total of 106 canine and feline FDG‐PET/CT scans were included in the study. In 104 of the 106 scans, a total of 718 occurrences of physiologic variant, areas of incidental benign activity, and artifacts were identified. Twenty‐two of 23 feline scans and 82 of 83 canine scans had at least one artifact. Previously unreported areas of increased radiopharmaceutical uptake included foci associated with the canine gall bladder, linear uptake along the canine mandible, and focal uptake in the gastrointestinal tract. Benign activity was often seen and related to healing, inflammation, and indwelling implants. Artifacts were most often related to injection or misregistration. Further experience in recognizing the common veterinary FDG physiologic variation, incidental radiopharmaceutical uptake, and artifacts is important to avoid misinterpretation and false‐positive diagnoses. 18F-Fluoro-deoxyglucose positron emission computed tomography (FDG-PET/CT) is an emerging diagnostic imaging modality in veterinary medicine; however, little published information is available on physiologic variants, benign processes, and artifacts. The purpose of this retrospective study was to describe the number of occurrences of non-neoplastic disease-related FDG-PET/CT lesions in a group of dogs and cats. Archived FDG-PET/CT scans were retrieved and interpreted based on a consensus opinion of two board-certified veterinary radiologists. Non-neoplastic disease-related lesions were categorized as physiologic variant, benign activity, or equipment/technology related artifact. If the exact cause of hypermetabolic areas could not be determined, lesions were put into an indeterminate category. A total of 106 canine and feline FDG-PET/CT scans were included in the study. In 104 of the 106 scans, a total of 718 occurrences of physiologic variant, areas of incidental benign activity, and artifacts were identified. Twenty-two of 23 feline scans and 82 of 83 canine scans had at least one artifact. Previously unreported areas of increased radiopharmaceutical uptake included foci associated with the canine gall bladder, linear uptake along the canine mandible, and focal uptake in the gastrointestinal tract. Benign activity was often seen and related to healing, inflammation, and indwelling implants. Artifacts were most often related to injection or misregistration. Further experience in recognizing the common veterinary FDG physiologic variation, incidental radiopharmaceutical uptake, and artifacts is important to avoid misinterpretation and false-positive diagnoses.18F-Fluoro-deoxyglucose positron emission computed tomography (FDG-PET/CT) is an emerging diagnostic imaging modality in veterinary medicine; however, little published information is available on physiologic variants, benign processes, and artifacts. The purpose of this retrospective study was to describe the number of occurrences of non-neoplastic disease-related FDG-PET/CT lesions in a group of dogs and cats. Archived FDG-PET/CT scans were retrieved and interpreted based on a consensus opinion of two board-certified veterinary radiologists. Non-neoplastic disease-related lesions were categorized as physiologic variant, benign activity, or equipment/technology related artifact. If the exact cause of hypermetabolic areas could not be determined, lesions were put into an indeterminate category. A total of 106 canine and feline FDG-PET/CT scans were included in the study. In 104 of the 106 scans, a total of 718 occurrences of physiologic variant, areas of incidental benign activity, and artifacts were identified. Twenty-two of 23 feline scans and 82 of 83 canine scans had at least one artifact. Previously unreported areas of increased radiopharmaceutical uptake included foci associated with the canine gall bladder, linear uptake along the canine mandible, and focal uptake in the gastrointestinal tract. Benign activity was often seen and related to healing, inflammation, and indwelling implants. Artifacts were most often related to injection or misregistration. Further experience in recognizing the common veterinary FDG physiologic variation, incidental radiopharmaceutical uptake, and artifacts is important to avoid misinterpretation and false-positive diagnoses. |
Author | Loeber, Samantha Randall, Elissa Kraft, Susan |
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References | Bhargava P, Zhuang H, Kumar R, et al. Iatrogenic artifacts on whole-body F-18 FDG PET imaging. Clin Nucl Med 2004;29:429-439. Yoshikawa H, Randall EK, Kraft SL, et al. Comparison between 2-F-18-fluoro-2-deoxy-d-glucose positron emission tomography and contrast-enhanced computed tomography for measuring gross tumor volume in cats with oral squamous cell carcinoma. Vet Radiol Ultrasound 2013;54:307-313. Cook GJ, Wegner EA, Fogelman I. Pitfalls and artifacts in 18FDG PET and PET/CT oncologic imaging. Semin Nucl Med 2004;34:122-133. Gorospe L, Raman S, Echeveste J, et al. Whole-body PET/CT: spectrum of physiological variants, artifacts and interpretative pitfalls in cancer patients. Nucl Med Commun 2005;26:671-687. Bockisch A, Beyer T, Antoch G, et al. Positron emission tomography/computed tomography-imaging protocols, artifacts, and pitfalls. Mol Imaging Biol 2004;6:188-199. Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. Radiographics 1999;19:61-77; quiz 150-151. LeBlanc AK, Jakoby B, Townsend DW, et al. Thoracic and abdominal organ uptake of 2-deoxy-2-[18F]fluoro-d-glucose (18FDG) with positron emission tomography in the normal dog. Vet Radiol Ultrasound 2008;49:182-188. LeBlanc AK, Wall JS, Morandi F, et al. Normal thoracic and abdominal distribution of 2-deoxy-2-[18F]fluoro-d-glucose (18FDG) in adult cats. Vet Radiol Ultrasound 2009;50:436-441. Martinez NE, Kraft SL, Gibbons DS, et al. Occupational per-patient radiation dose from a conservative protocol for veterinary (18) F-fluorodeoxyglucose positron emission tomography. Vet Radiol Ultrasound 2012;53:591-597. Fukui MB, Blodgett TM, Snyderman CH, et al. Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. Radiographics 2005;25:913-930. Chambers MA, Moylan JS, Smith JD, et al. Stretch-stimulated glucose uptake in skeletal muscle is mediated by reactive oxygen species and p38 MAP-kinase. J Physiol 2009;587:3363-3373. Randall EK, Kraft SL, Yoshikawa H, et al. Evaluation of 18F-FDG PET/CT as a diagnostic imaging and staging tool for feline oral squamous cell carcinoma. Vet Comp Oncol 2013;[Epub ahead of print]. Lee MS, Lee AR, Jung MA, et al. Characterization of physiologic 18F-FDG uptake with PET-CT in dogs. Vet Radiol Ultrasound 2010;51:670-673. Li TR, Tian JH, Wang H, et al. Pitfalls in positron emission tomography/computed tomography imaging: causes and their classifications. Chin Med Sci J 2009;24:12-19. Blake MA, Singh A, Setty BN, et al. Pearls and pitfalls in interpretation of abdominal and pelvic PET-CT. Radiographics 2006;26:1335-1353. Hansen AE, McEvoy F, Engelholm SA, et al. FDG PET/CT imaging in canine cancer patients. Vet Radiol Ultrasound 2011;52:201-206. Wang X, Koch S. Positron emission tomography/computed tomography potential pitfalls and artifacts. Curr Probl Diagn Radiol 2009;38:156-169. Murata Y, Watanabe H, Kubota K, et al. PET/CT evaluation of the physiologic accumulation of 18F-FDG within the gallbladder vesicle. Nucl Med Biol 2007;34:961-966. Ballegeer EA, Forrest LJ, Jeraj R, et al. PET/CT following intensity-modulated radiation therapy for primary lung tumor in a dog. Vet Radiol Ultrasound 2006;47:228-233. Nakamoto Y, Tatsumi M, Hammoud D, et al. Normal FDG distribution patterns in the head and neck: PET/CT evaluation. Radiology 2005;234:879-885. Metser U, Even-Sapir E. Increased (18)F-fluorodeoxyglucose uptake in benign, nonphysiologic lesions found on whole-body positron emission tomography/computed tomography (PET/CT): accumulated data from four years of experience with PET/CT. Semin Nucl Med 2007;37:206-222. 2009; 24 2004; 29 2013; 54 2009; 50 1999; 19 2005; 234 2008; 49 2004; 34 2006; 47 2006; 26 2011; 52 2004; 6 2013 2005; 26 2007; 34 2009; 38 2009; 587 2010; 51 2012; 53 2007; 37 2005; 25 e_1_2_6_21_1 e_1_2_6_10_1 e_1_2_6_20_1 e_1_2_6_9_1 e_1_2_6_8_1 e_1_2_6_19_1 e_1_2_6_5_1 e_1_2_6_4_1 e_1_2_6_7_1 e_1_2_6_6_1 e_1_2_6_13_1 e_1_2_6_14_1 e_1_2_6_3_1 e_1_2_6_11_1 e_1_2_6_2_1 e_1_2_6_12_1 e_1_2_6_22_1 e_1_2_6_17_1 e_1_2_6_18_1 e_1_2_6_15_1 e_1_2_6_16_1 |
References_xml | – reference: Hansen AE, McEvoy F, Engelholm SA, et al. FDG PET/CT imaging in canine cancer patients. Vet Radiol Ultrasound 2011;52:201-206. – reference: Ballegeer EA, Forrest LJ, Jeraj R, et al. PET/CT following intensity-modulated radiation therapy for primary lung tumor in a dog. Vet Radiol Ultrasound 2006;47:228-233. – reference: Randall EK, Kraft SL, Yoshikawa H, et al. Evaluation of 18F-FDG PET/CT as a diagnostic imaging and staging tool for feline oral squamous cell carcinoma. Vet Comp Oncol 2013;[Epub ahead of print]. – reference: LeBlanc AK, Wall JS, Morandi F, et al. Normal thoracic and abdominal distribution of 2-deoxy-2-[18F]fluoro-d-glucose (18FDG) in adult cats. Vet Radiol Ultrasound 2009;50:436-441. – reference: Chambers MA, Moylan JS, Smith JD, et al. Stretch-stimulated glucose uptake in skeletal muscle is mediated by reactive oxygen species and p38 MAP-kinase. J Physiol 2009;587:3363-3373. – reference: LeBlanc AK, Jakoby B, Townsend DW, et al. Thoracic and abdominal organ uptake of 2-deoxy-2-[18F]fluoro-d-glucose (18FDG) with positron emission tomography in the normal dog. Vet Radiol Ultrasound 2008;49:182-188. – reference: Bockisch A, Beyer T, Antoch G, et al. Positron emission tomography/computed tomography-imaging protocols, artifacts, and pitfalls. Mol Imaging Biol 2004;6:188-199. – reference: Cook GJ, Wegner EA, Fogelman I. Pitfalls and artifacts in 18FDG PET and PET/CT oncologic imaging. Semin Nucl Med 2004;34:122-133. – reference: Nakamoto Y, Tatsumi M, Hammoud D, et al. Normal FDG distribution patterns in the head and neck: PET/CT evaluation. Radiology 2005;234:879-885. – reference: Fukui MB, Blodgett TM, Snyderman CH, et al. Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. Radiographics 2005;25:913-930. – reference: Blake MA, Singh A, Setty BN, et al. Pearls and pitfalls in interpretation of abdominal and pelvic PET-CT. Radiographics 2006;26:1335-1353. – reference: Yoshikawa H, Randall EK, Kraft SL, et al. Comparison between 2-F-18-fluoro-2-deoxy-d-glucose positron emission tomography and contrast-enhanced computed tomography for measuring gross tumor volume in cats with oral squamous cell carcinoma. Vet Radiol Ultrasound 2013;54:307-313. – reference: Metser U, Even-Sapir E. Increased (18)F-fluorodeoxyglucose uptake in benign, nonphysiologic lesions found on whole-body positron emission tomography/computed tomography (PET/CT): accumulated data from four years of experience with PET/CT. Semin Nucl Med 2007;37:206-222. – reference: Lee MS, Lee AR, Jung MA, et al. Characterization of physiologic 18F-FDG uptake with PET-CT in dogs. Vet Radiol Ultrasound 2010;51:670-673. – reference: Bhargava P, Zhuang H, Kumar R, et al. Iatrogenic artifacts on whole-body F-18 FDG PET imaging. Clin Nucl Med 2004;29:429-439. – reference: Martinez NE, Kraft SL, Gibbons DS, et al. Occupational per-patient radiation dose from a conservative protocol for veterinary (18) F-fluorodeoxyglucose positron emission tomography. Vet Radiol Ultrasound 2012;53:591-597. – reference: Murata Y, Watanabe H, Kubota K, et al. PET/CT evaluation of the physiologic accumulation of 18F-FDG within the gallbladder vesicle. Nucl Med Biol 2007;34:961-966. – reference: Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. Radiographics 1999;19:61-77; quiz 150-151. – reference: Gorospe L, Raman S, Echeveste J, et al. Whole-body PET/CT: spectrum of physiological variants, artifacts and interpretative pitfalls in cancer patients. Nucl Med Commun 2005;26:671-687. – reference: Li TR, Tian JH, Wang H, et al. Pitfalls in positron emission tomography/computed tomography imaging: causes and their classifications. Chin Med Sci J 2009;24:12-19. – reference: Wang X, Koch S. 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Snippet | 18F‐Fluoro‐deoxyglucose positron emission computed tomography (FDG‐PET/CT) is an emerging diagnostic imaging modality in veterinary medicine; however, little... 18F-Fluoro-deoxyglucose positron emission computed tomography (FDG-PET/CT) is an emerging diagnostic imaging modality in veterinary medicine; however, little... |
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SubjectTerms | Animals Cats Colorado computed tomography diagnostic use Dogs FDG Fluorodeoxyglucose F18 gall bladder gastrointestinal system Incidence PET/CT Positron-Emission Tomography Positron-Emission Tomography - standards Positron-Emission Tomography - veterinary Radiopharmaceuticals Retrospective Studies veterinary veterinary medicine |
Title | Physiologic variants, benign processes, and artifacts from 106 canine and feline fdg‐pet/computed tomography scans |
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