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[Imaging of secondary pulmonary changes in central bronchial carcinomas by F-18-FDG PET]
B Briele1, P Willkomm, F Grünwald
1Institut für Radiologie des Klinikums Fulda. BerndBriele@t-online.de
Aim:
The presented study was performed in order to evaluate the potential interference of secondary pulmonary changes (dystelectasis, retention pneumonia) with bronchial carcinomas in F-18-FDG-PET.
Method:
A retrospective analysis of F-18-FDG-findings in 33 patients with bronchial carcinoma (staging) was performed. Seven out of fourteen patients with central tumor localisation had secondary pulmonary changes (thorax-x-ray, CT), which were classified as dystelectasis or atelectasis in five cases and as retention pneumonia in two cases.
Results:
Whereas dystelectasis and atelectasis without clinical signs of infection showed only mild to moderate FDG-accumulation (SUV 1.0-2.5; mean: 1.74), an intense FDG-uptake in the two cases with retention pneumonia (SUV 8.4 and 5.5) was observed. Despite of the typical wedge-like shape of pneumonia, differentiation between bronchial carcinoma and pneumonia can be a problem.
Conclusion:
We suggest, that an antibiotic treatment in patients with known retention pneumonia should be performed prior to the PET-scan in order to reduce the interference of inflammatory changes.