Positron‐emission tomography pitfalls related to oral prosthesis12. (9th July 2012)

• Record Type: Journal Article
• Authors: More, Yogesh; Dusing, Reginald; Counts, Shaheen; Bond, Justin; Tsue, Terrance; Girod, Douglas
• Is Part Of: Laryngoscope. Volume 123:Number 2(2013:Feb.)
• Page Start: 404
• Page End: 406
• Publication Date: 2012-07-09
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.23423
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <p>This case report describes false‐positive positron‐emission tomography/computed tomography (PET/CT) findings related to oral prostheses and its implications in cancer surveillance. In head and neck cancer management, F18‐flurodeoxyglucose (FDG) PET/CT is widely accepted for evaluating treatment response and detecting recurrence. Interpretation of FDG PET/CT images in this setting is often challenging due to various prostheses and reconstruction methods. Following surgery for squamous cell carcinoma of the maxillary alveolus, a 61‐year‐old female had a FDG PET/CT scan on a 7‐month follow‐up that showed high FDG uptake along the resection site. Clinical examination showed no signs of inflammation or recurrence. Repeat FDG PET/CT without the prosthesis was normal. The PET/CT attenuation‐corrected images demonstrated high FDG uptake (standardized uptake value: 11.6) along the resection site corresponding to contrast‐enhanced CT images of the lesion. PET/CT nonattenuation‐corrected images also confirmed increased activity. Repeat PET/CT without the prosthesis was normal. FDG is not tumor specific; it can accumulate in inflammation, infection, and post‐therapy settings. Metallic and high‐density prostheses show radial artifacts on CT and falsely elevated FDG uptake on PET/ CT in adjacent areas. Salivary pooling may concentrate FDG. The presence of oral prostheses has not been described as a cause of this high level of activity. PET/CT images that demonstrate intense activity corresponding to dense structures should be viewed with caution. A detailed history and physical exam as well as knowledge of artifacts are pertinent for the managing physician. Laryngoscope, 2012</p> </abstract>