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Artifactual spinal metastases imaged by PET/CT: a case report
1Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut 06520-8042, USA. phillip.kuo@yale.edu
Journal of Nuclear Medicine Technology
|December 3, 2005
Summary
Vertebroplasty can cause false positives on 18F-FDG PET scans due to an attenuation correction artifact. Radiologists should be aware of this imaging artifact when interpreting scans in patients who have undergone spinal procedures.
Area of Science:
- Nuclear Medicine
- Radiology
- Oncology
Background:
- Multiple myeloma patients often experience spinal fractures requiring interventions like vertebroplasty.
- 18F-FDG PET imaging is crucial for staging and restaging multiple myeloma.
- Vertebroplasty involves injecting bone cement into fractured vertebrae.
Observation:
- A 55-year-old patient with multiple myeloma showed increased 18F-FDG uptake in previously treated thoracic vertebrae.
- Comparison between attenuation-corrected and non-attenuation-corrected PET images revealed the increased activity was an artifact.
- CT correlation confirmed the increased uptake corresponded to the sites of vertebroplasty.
Findings:
- The increased 18F-FDG uptake was identified as an attenuation correction artifact, not true tumor progression.
- This artifact is associated with the presence of bone cement used in vertebroplasty.
- Four distinct foci of artifactual uptake were noted in the thoracic spine.
Implications:
- Awareness of this vertebroplasty-related artifact is essential for accurate interpretation of 18F-FDG PET scans in myeloma patients.
- Misinterpretation could lead to incorrect treatment decisions and unnecessary interventions.
- Vigilance is recommended as vertebroplasty use for malignant spinal fractures increases.
