ARRS 2022 Abstracts


E1250. PET/CT Characterization of FDG Avid Tracheal Lesions and Their Impact on Patient Management
  1. Yonatan Rotman; University of Rochester Medical Center
  2. Ethan Bauer; Tel Aviv University
  3. David Bass; University of Rochester Medical Center
  4. Savita Puri; University of Rochester Medical Center
FDG avid lesions of the tracheobronchial tree are rare and often malignant. Tumors of the trachea can either arise from the trachea itself, known as primary tracheal tumors, or occur as a result of direct invasion from nearby structures, such as the lung, larynx, esophagus, or thyroid gland. Management of a tracheal tumor depends on its pathological type, its extent of disease, and comorbidities of the patient. Although imaging findings can be nonspecific, knowledge of some imaging features along with clinical and epidemiologic considerations can aid the radiologist in narrowing the differential diagnosis or provide a specific diagnosis in some cases. The purpose of this exhibit is to review the anatomy and a broad spectrum of pathologic processes affecting of the tracheobronchial tree combined with discussion on multimodality imaging findings highlighting the significance of metabolic activity on FDG PET/CT.

Educational Goals / Teaching Points
The goals of this exhibit are to review the relevant anatomy of the tracheobronchial tree and principles of FDG PET/CT imaging; present a case series of common and uncommon benign and malignant tracheal lesions identified by PET/CT, their FDG avidity, and correlation with other imaging modalities, histopathology, and/or clinical follow up including response to targeted therapeutic interventions; and use a case-based approach to discuss the impact of PET/CT findings on patient management and outcomes.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this exhibit we will discuss PET/CT findings of FDG and Dotatate avid benign and malignant lesions of the upper tracheobronchial tree with histopathologic confirmation and/or response to targeted therapies. Specific examples include primary and secondary malignant tumors, benign papilloma, adherent secretions, and inflammation. This exhibit will highlight the significance and relationship of intensity of FDG and Dotatate uptake with various etiologies of tracheal lesions. After viewing this exhibit, residents, fellows, and general radiologists will gain understanding of the imaging characteristics of PET/CT avid upper tracheobronchial tree lesions. This familiarity will enable them to develop an effective differential diagnosis and guide the clinician to an appropriate treatment/intervention.

After viewing this exhibit the reader will gain insight into various FDG avid benign and malignant conditions effecting the trachea, their clinical significance, and impact on patient management, an understanding of which is critical to help direct the next step in patient management.