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Increased Genioglossus Muscle FDG Activity Due to Using Pacifier
1From the Department of Radiology, University of Pennsylvania Health System.
Clinical Nuclear Medicine
|February 23, 2022
Summary
Persistent submental focal activity on FDG PET/CT in a pediatric liver transplant patient was linked to pacifier use and genioglossus muscle activity. This finding highlights a potential imaging artifact to consider in similar cases.
Area of Science:
- Nuclear Medicine
- Pediatric Imaging
- Transplant Medicine
Background:
- Posttransplant lymphoproliferative disorder (PTLD) is a significant complication following organ transplantation.
- FDG PET/CT is a key imaging modality for evaluating PTLD.
- Unusual patterns of FDG uptake can mimic or obscure true pathology.
Purpose of the Study:
- To investigate the cause of persistent focal submental FDG uptake in an infant liver transplant recipient.
- To differentiate artifactual uptake from true PTLD in the submental region.
- To assess the impact of pacifier use on FDG PET/CT findings.
Main Methods:
- Case report of an 18-month-old girl with a history of liver transplant.
- Serial FDG PET/CT imaging performed to evaluate PTLD.
- Correlation of imaging findings with clinical history, including pacifier use.
- Analysis of uptake in relation to specific muscle activity.
Main Results:
- FDG PET/CT revealed widespread hypermetabolic lymphadenopathy and visceral activity consistent with PTLD.
- Persistent focal submental FDG uptake was observed across three separate studies.
- This submental activity resolved after chemotherapy, but the specific cause remained unclear initially.
- Submental uptake correlated with pacifier use prior to imaging and genioglossus muscle activity.
Conclusions:
- Pacifier use can lead to artifactual FDG uptake in the submental region due to genioglossus muscle activity.
- This benign finding can mimic true pathology on FDG PET/CT in pediatric transplant patients.
- Awareness of this potential pitfall is crucial for accurate interpretation of FDG PET/CT scans in this population.
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