Positron Emission Tomography Computed Tomography: A Guide for the General Radiologist Clare Beadsmoore, MBBS, MRCP, FRCR, David Newman, MBBS, FRCR, Duncan.

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Date of download: 6/20/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Evaluation of Benign vs Malignant Hepatic Lesions.

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Positron Emission Tomography Computed Tomography: A Guide for the General Radiologist Clare Beadsmoore, MBBS, MRCP, FRCR, David Newman, MBBS, FRCR, Duncan MacIver, MBChB, FRCR, Davina Pawaroo, MBChB, MRCP, FRCR Canadian Association of Radiologists Journal Volume 66, Issue 4, Pages 332-347 (November 2015) DOI: 10.1016/j.carj.2015.02.003 Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 1 Selected axial fused positron emission tomography computed tomography and maximum intensity projection images of a normal scan, showing physiological uptake in the extraocular muscles, mylohyoid muscles, and larynx. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 2 Selected axial computed tomography (CT), positron emission tomography (PET) and fused PETCT and whole body maximum intensity projection images demonstrating physiological muscle uptake in the shoulder girdles and arms, seen in a patient who was on crutches. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 3 Selected fused sagittal, coronal, and axial positron emission tomography computed tomography images demonstrating physiological uterine uptake. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 4 Selected sagittal computed tomography, positron emission tomography, fused and whole-body maximum intensity projection images demonstrating urinary activity in a Urachal remnant. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 5 Selected axial computed tomography, positron emission tomography, fused and whole-body maximum intensity projection images of uptake within brown fat in the neck and thorax. The focal F18-fluorodeoxyglucose accumulation in the left upper quadrant is due to an acute rib fracture (arrowhead). This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 6 Selected axial computed tomography, positron emission tomography, and fused images demonstrating uptake within lipomatous hypertrophy of the interatrial septum. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 7 Selected coronal computed tomography, positron emission tomography, fused and whole-body maximum intensity projection images demonstrating increased pleural uptake in the left hemithorax seen following talc pleurodesis. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 8 Selected axial computed tomography, positron emission tomography, fused and whole-body maximum intensity projection images demonstrating uptake within left axillary lymph and internal mammary nodes in a patient with silicon breast implants, in keeping with silicon adenitis. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 9 (A) Selected coronal computed tomography (CT), positron emission tomography (PET), fused and whole-body maximum intensity projection (MIP) images demonstrating uptake within an aortic graft in keeping with known graft infection in a patient with an F18-fluorodeoxyglucose avid squamous cell carcinoma of the left upper lobe with ipsilateral mediastinal adenopathy and incidental colonic polyps. (B) Selected sagittal CT, PET, fused and whole-body MIP images showing diffuse tracer accumulation within the aorta subclavian, axillary and femoral arteries in keeping with an active large-vessel vasculitis. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 10 Selected axial computed tomography, positron emission tomography, fused and whole-body maximum intensity projection images showing uptake within a presacral collection in a patient with an F18-fluorodeoxyglucose avid right lower lobe tumour. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 11 (A) Selected coronal, axial, and sagittal computed tomography (CT), positron emission tomography (PET), fused and whole-body maximum intensity projection (MIP) images in a patient with an F18-fluorodeoxyglucose avid left upper lobe lung cancer, showing unexpected infection of the patient's implantable cardioverter-defibrillator (ICD) with an L2/3 discitis and para vertebral infection. (B) Selected axial CT, PET, fused and whole-body MIP nonattenuation-corrected images demonstrated uptake around the ICD confirming this is not due to attenuation artefact. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 12 Selected axial computed tomography, positron emission tomography, and fused images demonstrating pericardial uptake in a patient with known rheumatoid arthritis. Note the physiological muscle uptake. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 13 Selected sagittal computed tomography, positron emission tomography, and fused images demonstrating uptake adjacent to the lumbar spine spinous processes in keeping with Baastrup disease. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 14 Selected axial computed tomography, and positron emission tomography and images demonstrating hypometabolism in the left cerebral hemisphere in a patient with a middle cerebral artery territory infarct (top row) and hypometabolism in the right cerebellar hemisphere in the same patient, in keeping with crossed cerebellar diaschisis (bottom row). This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 15 (A) Selected axial computed tomography (CT), positron emission tomography (PET), and fused images demonstrating diffuse uptake in the thyroid in keeping with thyroiditis. (B) Selected axial CT, PET, and fused images demonstrating focal uptake in the left lobe of the thyroid. Biopsy confirmed an incidental thyroid papillary carcinoma. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 16 Axial fused image of the parotid glands demonstrating uptake in the left parotid confirmed on biopsy to be a Warthin tumour. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 17 (A) Selected axial computed tomography (CT), positron emission tomography (PET), fused and whole-body maximum intensity projection (MIP) images demonstrating bilateral an F18-fluorodeoxyglucose (FDG) avid hilar lymphadenopathy in a patient with sarcoid. Note the bilateral nodules in the oblique fissures. (B) Selected axial CT, PET, fused and whole-body MIP images demonstrating a sarcoid-like tumour reaction in a patient with an esophageal carcinoma. Note the uptake in the liver in keeping with a metastasis and within the sternum from a previous sternotomy. (C) Selected axial CT, PET, fused and whole-body MIP images demonstrating an FDG avid left upper lobe lung cancer with involved left hilar, ipsilateral and contralateral mediastinal nodes (N3). This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 18 Selected coronal computed tomography, positron emission tomography, fused and whole-body maximum intensity projection images demonstrating diffuse bowel uptake in a patient taking metformin. Note F18-fluorodeoxyglucose uptake in a right upper lobe lung carcinoma. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions

Figure 19 Selected axial computed tomography, positron emission tomography, fused and whole-body maximum intensity projection images demonstrating focal F18-fluorodeoxyglucose uptake in a patient with a cecal tubular adenoma. The tracer accumulation in the left upper lobe proved to be an area of infective consolidation, the gastric uptake at gastroscopy was confirmed as gastritis. This figure is available in colour online at http://carjonline.org/. Canadian Association of Radiologists Journal 2015 66, 332-347DOI: (10.1016/j.carj.2015.02.003) Copyright © 2015 Canadian Association of Radiologists Terms and Conditions