Stroke Occurring in 18 F-FDG PET/CT Session

Area of Science:

• Nuclear Medicine
• Neurology
• Oncology

Background:

• 18F-FDG PET/CT is a standard imaging modality for cancer staging and restaging.
• Intracerebral hemorrhage can present with diverse neurological symptoms.

Purpose of the Study:

• To report a case of incidental finding of intracerebral hematoma during PET/CT for lung cancer restaging.
• To highlight the utility of PET/CT in detecting acute intracranial events.

Main Methods:

• Whole-body 18F-FDG PET/CT was performed for lung adenocarcinoma restaging.
• A dedicated cranial PET/CT scan was conducted due to patient symptoms.
• Contrast-enhanced cranial CT was performed for further evaluation.

Main Results:

• Initial PET/CT showed a hypermetabolic lesion in the right lung, suspicious for metastasis.
• Cranial PET/CT revealed an intracerebral hematoma and glucose hypometabolism in the left occipital lobe.
• Follow-up CT demonstrated progressive hematoma, midline shift, and tentorial herniation.

Conclusions:

• 18F-FDG PET/CT can incidentally detect acute intracranial pathology.
• Prompt recognition of intracerebral hematoma is crucial for timely intervention.
• This case underscores the importance of considering neurological emergencies during oncologic imaging.