Purpose: To communicate a clinically important artifact in positron emission tomography (PET) images using a PET/computerized tomography (CT) scanner with CT-based attenuation correction.
Procedure: A 65-year-old man with a maxillary sinus squamous cell carcinoma was injected with 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) and underwent a PET scan using a dual modality PET/CT scanner with CT-based attenuation correction. Immediately afterward, the patient had a second scan using a different PET scanner that used a high-energy transmission source for attenuation correction.
Results: The PET/CT scanner images demonstrated a focus of activity in the attenuation corrected PET images corresponding to a pacemaker in the left chest wall. No abnormal focus was noted in the nonattenuation corrected PET images. The patient had no signs or symptoms of inflammation at the site. A second scan using a PET scanner with a high-energy transmission source demonstrated no abnormal focus in the AC PET images.
Conclusions: PET/CT scanners using CT-based attenuation methodology can overcorrect dense objects resulting in hot spot artifacts in AC PET images.