Sectorial Hypermetabolic Pseudolesion in the Liver on FDG PET/CT Caused by SVC Obstruction

Hepatic pseudolesions are relatively frequent in contrast-enhanced CT or MR images, attributable to the unique intrahepatic hemodynamics. It is also well documented that focal liver uptake can result from unusual collateral circulation on radionuclide liver scans. This report presents a case of sectorial hepatic hypermetabolism identified via FDG PET/CT, correlating with areas of increased attenuation in the liver observed on contrast-enhanced chest CT in a patient with lung cancer complicated by superior vena cava obstruction. Notably, the nonphysiological hypermetabolic activity was resolved on subsequent FDG PET/CT imaging conducted 2 days later, following alteration of the tracer injection route.