Abstracts

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E1190. What, That’s Not Cancer? Diagnostic Errors to Avoid in Oncologic PET Imaging
Authors
  1. Kathleen Capaccione; New York Presbyterian- Columbia University Irving Medical Center
  2. Mikhail Doubrovin; New York Presbyterian- Columbia University Irving Medical Center
  3. Shifali Dumeer; New York Presbyterian- Columbia University Irving Medical Center
  4. Volkan Beylergil; New York Presbyterian- Columbia University Irving Medical Center
  5. Andrei Molotkov; New York Presbyterian- Columbia University Irving Medical Center
  6. Akiva Mintz; New York Presbyterian- Columbia University Irving Medical Center
Background
FDG-PET has become an invaluable tool in the diagnosis and monitoring of many types of malignancy. However, the molecular mechanism of FDG-PET imaging is inherently nonspecific resulting in many FDG-avid findings that are not cancer. It is critical for the interpreting radiologist to recognize noncancerous FDG-avid findings on PET in order to accurately diagnose and stage cancer.

Educational Goals / Teaching Points
Here, we will review some of the common and uncommon FDG-avid noncancerous lesions on FDG-PET imaging. In the thorax, commonly seen FDG-avid structures include brown fat, cardiac muscle, misregistration artifact, talc pleurodesis, left atrial appendage, atrial fibrillation, sarcoid, and cervical spine activity. In the abdomen and pelvis, organs that may be physiologically FDG-avid include the bowel, ovaries, endometrium, muscle, bone marrow, and blood vessels. Focal accumulation of FDG can occur throughout the collecting system including in the kidneys, ureters, bladder, and in diverticula or congenital variants. Uterine fibroids can also appear FDG avid. Additional less common causes of FDG avidity in the abdomen/pelvis include transposed ovaries and hernia plugs.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this case-based review, clinicians will become familiar with the imaging appearance of the findings above so as to differentiate them from malignancy. We will review both common locations of these lesions as well as ways to distinguish between them and malignant lesions.

Conclusion
Interpretation of FDG-PET must be done with a firm knowledge of the possible noncancerous lesions that may masquerade as malignancy. Through this presentation clinicians will review the essentials to increase their diagnostic accuracy on FDG-PET imaging.