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Physiological FDG uptake in the ovaries after hysterectomy
Sadahiko Nishizawa1, Masayuki Inubushi, Fukujiro Ozawa
1Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, 5000 Hirakuchi, Hamamatsu 434-0041, Japan. sadahiko@hmp.or.jp
Annals of Nuclear Medicine
|August 21, 2007
Summary
Physiological ovarian 18F-fluorodeoxyglucose (FDG) uptake is common in women of reproductive age after hysterectomy, even with preserved ovaries. Correlating FDG-PET findings with pelvic MR imaging is crucial to prevent misdiagnosis.
Area of Science:
- Nuclear Medicine
- Gynecologic Oncology
- Radiology
Background:
- Physiological 18F-fluorodeoxyglucose (FDG) uptake in the ovaries and uterus of premenopausal women can lead to false-positive findings on FDG positron emission tomography (PET) scans.
- This uptake is often linked to the menstrual cycle.
Purpose of the Study:
- To determine if women of reproductive age with preserved ovaries after hysterectomy exhibit physiological ovarian FDG uptake.
- To assess the implications for diagnostic accuracy in FDG-PET imaging.
Main Methods:
- Retrospective review of 26 women post-hysterectomy who underwent three annual cancer screenings.
- FDG-PET and pelvic magnetic resonance (MR) imaging were utilized for assessment.
- Ovarian function was evaluated based on MR imaging findings.
Main Results:
- Seven women (ages 34-52) with functioning ovaries (indicated by MR imaging changes) showed focal FDG uptake (SUV 4.2 +/- 1.1) on PET scans.
- Nineteen women (ages 47-59) with non-functioning ovaries (stable MR imaging appearance) did not exhibit ovarian FDG uptake.
- Four of the seven women with functioning ovaries demonstrated FDG uptake in their ovaries.
Conclusions:
- Physiological ovarian FDG uptake is common in women of reproductive age even after hysterectomy, provided ovaries are preserved and functioning.
- Accurate interpretation requires correlating focal pelvic FDG uptake with MR imaging findings to avoid false-positive diagnoses, especially when hormonal cycles are not easily determined.
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