18F-FDG PET/CT of Generalized Arteritis

Area of Science:

• Vascular inflammation
• Nuclear medicine imaging
• Oncology

Background:

• Paraneoplastic syndromes can manifest with diverse systemic symptoms.
• Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (F-FDG PET/CT) is crucial for staging cancer and detecting inflammation.
• Arterial involvement in paraneoplastic syndromes is rare but significant.

Observation:

• A 75-year-old male presented with weight loss, cough, headache, and leg weakness.
• Initial suspicion of a paraneoplastic syndrome prompted F-FDG PET/CT imaging.
• Unexpected symmetrical F-FDG uptake was observed in numerous large and medium-sized arteries.

Findings:

• The F-FDG PET/CT revealed diffuse, moderate-to-intense tracer uptake across multiple large and medium arteries.
• A distinctive feature was the extensive involvement of head, neck, and extremity vessels.
• Notably, the aorta demonstrated relatively spared F-FDG uptake compared to other visualized arteries.

Implications:

• This case highlights the potential for F-FDG PET/CT to detect atypical vascular inflammation associated with paraneoplastic syndromes.
• The unique pattern of arterial involvement may offer insights into the pathophysiology of paraneoplastic vasculopathy.
• Further research is warranted to understand the clinical significance and diagnostic utility of this imaging finding.