RT Journal Article
SR Electronic
T1 Physiologic 18F-fluorodeoxyglucose uptake in muscle: Unusual findings and the role of PET/CT
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1068
OP 1068
VO 50
IS supplement 2
A1 Broski, Stephen
A1 Wong, Ka Kit
A1 Geatti, Onelio
A1 Bou-Assaly, Wessam
A1 Djekidel, Mehdi
A1 Fig, Lorraine
YR 2009
UL http://jnm.snmjournals.org/content/50/supplement_2/1068.abstract
AB 1068 Learning Objectives 1. Recognize the spectrum of normal skeletal muscle 18F-FDG uptake. 2. Describe the mechanisms of 18F-FDG uptake in skeletal muscle. 3. Discuss the additional value of CT in differentiating physiologic from pathologic skeletal muscle uptake. 4. Improve the ability /level of confidence of nuclear physicians in interpreting PET-CT. Summary: This educational exhibit presents illustrative cases of unusual physiologic skeletal muscle uptake with 18F-FDG PET/CT imaging. Skeletal muscle relies extensively on glycolysis for energy production and unusual patterns of physiologic 18F-FDG muscle activity may be an interpretative pitfall. It is thus important for nuclear physicians to be familiar with the spectrum of normal muscle uptake, including anatomic variants. Resting skeletal muscle demonstrates low level 18F-FDG uptake, whereas contraction or activation of muscle groups before, during, or after radiotracer injection can result in intense physiologic uptake. Focal physiologic muscle uptake may follow surgical/non-surgical trauma. Several mechanisms cause diffuse skeletal muscle uptake, including endogenous or exogenous insulin and muscle contraction in anxious patients. Careful patient preparation will reduce the number of cases with unwanted muscle uptake. Combined 18F-FDG PET/CT imaging allows for more precise anatomic and morphologic delineation of those muscular structures with increased 18F-FDG activity, compared to stand-alone PET. The additional value of CT in differentiating physiologic from pathological 18F-FDG uptake will be highlighted.