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18F-FDG uptake in the normal appendix in adults: PET/CT evaluation.
Christopher Silman1, Shunro Matsumoto2, Asami Ono2
1Department of Radiology, Oita University Faculty of Medicine, Yufu City, Oita, 879-5593, Japan. silmanchristopher@gmail.com.
Annals of Nuclear Medicine
|January 18, 2019
Summary
The normal adult appendix shows low 18F-fluorodeoxyglucose (18F-FDG) uptake on PET/CT scans, typically lower than the liver. Rarely, high FDG accumulation can occur, making differentiation from appendiceal pathology challenging.
Area of Science:
- Nuclear Medicine
- Radiology
- Oncology
Background:
- Positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDG) is crucial for diagnosing various pathologies.
- Understanding normal organ uptake is essential for accurate interpretation of PET/CT scans.
- The 18F-FDG activity in the normal adult appendix has not been well-characterized.
Purpose of the Study:
- To determine the level of 18F-FDG activity in the normal adult appendix using PET/CT.
- To establish a reference range for normal appendiceal 18F-FDG uptake.
- To compare appendiceal 18F-FDG uptake with that of the normal liver.
Main Methods:
- Retrospective review of 303 asymptomatic adult patients' PET/CT scans.
- Qualitative and quantitative assessment of 18F-FDG uptake in the appendix.
- Calculation of maximum standardized uptake value (SUVmax) for appendix and liver, and their ratio.
Main Results:
- The mean appendiceal SUVmax was 1.14 (range 0.52-5.12), with a mean appendix-to-liver SUVmax ratio of 0.34.
- Three patients (1%) showed high FDG accumulation (SUVmax > 3.00).
- No significant correlations were found between appendiceal SUVmax and age, BMI, or blood glucose levels.
Conclusions:
- Normal adult appendix exhibits low 18F-FDG uptake on PET/CT, generally lower than the liver.
- Rare instances of high appendiceal 18F-FDG uptake can mimic pathology.
- Distinguishing normal high uptake from appendiceal pathology solely on PET/CT can be challenging.
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