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18F-FDG PET and combined diffusion weighted MRI features in pleural infection: A case report
1Department of Nuclear Medicine, Yeungnam University Hospital, Namgu Daemyung 5-dong 317-1, 705-717, Daegu, Korea.
Abstract:
Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) and magnetic resonance imaging (MRI) have been used as problem-solving modalities in cases of infectious or inflammatory diseases or primary or secondary malignancies. The author report a case of incidentally detected pleural infection in a 73-year-old male patient with lung cancer. The patient underwent F-18 FDG PET/CT for initial staging, and primary, right upper lung cancer and a right lower pleural FDG avid lesion were visualized. Additional F-18 FDG positron emission tomography/ magnetic resonance imaging (PET/MR) was performed to achieve a differential diagnosis, and eventually, a diagnosis of primary lung cancer and pleural infection was reached. Follow up PET/CT demonstrated improvement of the lung cancer and pleural infection after radiotherapy and antibiotic administration. Here, the author present the PET and diffusion weighted imaging (DWI) findings of pleural infection. Combined hybrid PET/MR scanner might have aided the differential diagnosis of infection and malignancy.
Insights
This case study highlights how combined PET/MR imaging aided in diagnosing incidental pleural infection in a lung cancer patient. The imaging modalities helped differentiate infection from malignancy, leading to effective treatment.
Area of Science:
- Oncology
- Infectious Diseases
- Radiology
Background:
- Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) and magnetic resonance imaging (MRI) are valuable for diagnosing infections, inflammation, and malignancies.
- Distinguishing between pleural infection and malignancy can be challenging.
Observation:
- A 73-year-old male with lung cancer incidentally presented with a right lower pleural lesion avid for F-18 FDG on PET/CT.
- Additional F-18 FDG positron emission tomography/magnetic resonance imaging (PET/MR) was performed for differential diagnosis.
Findings:
- The combined PET/MR imaging, including diffusion-weighted imaging (DWI), facilitated the diagnosis of both primary lung cancer and pleural infection.
- Follow-up imaging showed improvement after radiotherapy and antibiotic treatment for both conditions.
Implications:
- Hybrid PET/MR scanners can enhance the differential diagnosis of pleural lesions, distinguishing infection from malignancy.
- This case underscores the utility of advanced imaging in managing complex oncologic and infectious conditions.
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