Discrepant uptake between fluorine-18 fluorodeoxy glucose and Tc-99m sestamibi in bronchioloalveolar cell carcinoma

Several studies have shown the benefit of fluorine-18 fluorodeoxy glucose (FDG) imaging in the differentiation of solitary pulmonary nodules. The majority of malignant tumor have a higher glucose metabolic rate as compared to benign lesions. However, there is a considerable variety in glucose metabolic rate that depends on the aggressiveness and histological subtype of the tumor. Technetium-99m sestamibi (MIBI) is another tumor imaging agent for SPECT. We present a case of bronchioloalveolar cell carcinoma with a false negative finding in FDG imaging and a positive finding in MIBI imaging. This case clearly indicates that the FDG uptake and MIBI uptake might provide different information regarding characteristics of lung cancer.