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Journal of Nuclear Medicine Vol. 45 No. 2 290-293
© 2004 by Society of Nuclear Medicine

Brief Communications

Cardiac Pacemakers and Central Venous Lines Can Induce Focal Artifacts on CT-Corrected PET Images

Benjamin S. Halpern, MD, Magnus Dahlbom, PhD, Christian Waldherr, MD, Cecelia S. Yap, MS, Christiaan Schiepers, MD, PhD, Daniel H. Silverman, MD, PhD, Osman Ratib, MD, PhD and Johannes Czernin, MD

Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Clinic/Nuclear Medicine, UCLA School of Medicine, Los Angeles, California

ABSTRACT

PET/CT imaging can be associated with focal artifactual 18F-FDG uptake introduced by metallic implants or contrast agents. It is unknown whether cardiac pacemakers or permanent central venous catheters can also result in such artifacts. Methods: Twenty-seven patients with permanent central venous lines (13 men and 14 women; mean age ± SD, 53.8 ± 16.2 y) and 9 patients with pacemakers (7 men and 2 women; mean age ± SD, 74.8 ± 5.1 y) who were referred for a variety of oncologic indications were studied with lutetium-oxyorthosilicate–based dual-slice PET/CT after injection of 7.77 MBq/kg of 18F-FDG. CT-corrected and -uncorrected PET images were reviewed, and 18F-FDG uptake was graded as absent, mild, moderate, or intense. Results: CT-corrected PET images revealed focally increased uptake of moderate intensity in all patients with cardiac pacemakers and focally increased uptake of mild intensity in 8 of 27 patients (29.6%) with central venous lines. Conclusion: Cardiac pacemakers and reservoirs of central venous lines can induce artifactual 18F-FDG on CT-corrected PET images. Thus, in patients with permanent central lines or pacemakers, both corrected and uncorrected PET images need to be reviewed to avoid false-positive PET findings.

Key Words: PET/CT • artifacts • pacemaker • central venous lines






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Copyright © 2004 by the Society of Nuclear Medicine.