ABSTRACT
Context: The importance of physiologic distribution of 18F-FDG in the spinal cord.Objective: The recognition of the physiologic distribution of 18F-FDG in the spinal cord is pivotal for accurate PET/CT imaging interpretation, especially in oncologic patients. Therefore, we performed a systematic review to investigate the normal distribution of 18F-FDG throughout the spinal cord.Methods: Data sources: We carried out a comprehensive search of the literature on the physiologic patterns of 18F-FDG distribution in the spinal cord. PubMed and Scopus databases were searched using the following keywords: "spinal cord" AND "FDG". Data extraction: Findings of the selected articles were described.Results: Thirteen studies comprising 24,125 patients entered the systematic review. These investigations showed discrepancies in location, size, number, and intensity of 18F-FDG uptake throughout the spinal cord. However, cumulative results showed that 18F-FDG uptake was higher in the lower thoracic portion of spinal cord (T11-T12). Moreover, a decreasing trend in 18F-FDG uptake was observed from cervical to lumbar levels. Low maximal standardized uptake values, female sex, and higher body weight seem to be related to the physiological spinal cord 18F-FDG uptake.Conclusions: On 18F-FDG PET/CT imaging, focal hypermetabolism of the spinal cord at the level of lower thoracic and lower cervical vertebrae should be considered physiological until proven otherwise.
Subject(s)
Fluorodeoxyglucose F18 , Spinal Cord Injuries , Female , Humans , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Spinal Cord/diagnostic imagingABSTRACT
Von Hippel-Lindau disease is an inherited syndrome associated with several benign and malignant tumors such as central nervous system (CNS) hemangioblastoma. Herein, we report a known case of A Von Hippel-Lindau patient with a cerebral hemangioblastoma who was referred for further evaluation because of recent paraparesis. F-FDG PET/CT showed no focal uptake in the thoracic spine, which demonstrated increased Ga DOTATATE activity, owing to overexpression of somatostatin receptors, suggesting spinal cord hemangioblastoma. This case report indicates the significant role of Ga-labeled somatostatin receptor analogs in the diagnosis of hemangioblastoma.
Subject(s)
Cerebellar Neoplasms/diagnostic imaging , Fluorodeoxyglucose F18 , Hemangioblastoma/diagnostic imaging , Organometallic Compounds , Positron Emission Tomography Computed Tomography , von Hippel-Lindau Disease/complications , Adult , Cerebellar Neoplasms/complications , Cerebellar Neoplasms/metabolism , Hemangioblastoma/complications , Hemangioblastoma/metabolism , Humans , Male , Receptors, Somatostatin/metabolismABSTRACT
Extraosseous accumulation of technetium-99m-methyl diphosphonate (99mTc-MDP) on bone scan is not common. This phenomenon is often attributed to abnormality of calcium metabolism and has been reported in a variety of conditions including metabolic diseases and malignancies. A five years old boy is presented here, who was admitted to the pediatric emergency suffering from fatigue, respiratory symptoms, weight loss, intermittent fevers, anorexia, nausea and vomiting, edema of legs and abdominal distension for one month. The initial laboratory analysis revealed hypercalcemia. The patient was referred for whole body bone scan with suspicion of malignancy and bone metastasis. The bone scan revealed highly increased radiotracer uptake in both lungs in the perfusion and blood pool phases. Delayed images also showed increased activity in lungs and gastric wall. The skeleton was not seen clearly. Bone marrow aspiration was done and established the diagnosis of ALL. The patient deceased due to respiratory failure 20 days later. Diffuse lung uptake in this patient was consistent with respiratory failure and poor prognosis. It is reported that bone scan may be useful for assessment of the extent of metastatic calcification and may establish suitable management to prevent organ failure.
