The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2004 March;48(1):33-8

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Atypical thoracic and supraclavicular FDG-uptake in patients with Hodgkin’s and non-Hodgkin’s lymphoma

Döbert N., Menzel C., Hamscho N., Wördehoff W., Kranert W. T., Grünwald F.

Department of Nuclear Medicine University of Frankfurt, Frankfurt, Germany

Aim. In FDG-PET imag­ing abnor­mal suprac­la­vic­u­lar and par­a­ver­te­bral FDG ­uptake is a fre­quent find­ing ­which recent­ly ­could be dem­on­strat­ed to part­ly rep­re­sent ­brown fat tis­sue. This ­study was car­ried out to fur­ther inves­ti­gate caus­es for ­this phe­nom­e­non. Patients var­i­ables ­such as age, gen­der, ­body ­mass ­index (BMI) and the val­ue of seda­tion and ­delayed imag­ing ­were com­pared ­with the pres­ence of atyp­i­cal ­uptake in 2 dis­tinct ­groups of dis­eas­es, Hodgkin’s dis­ease (HD) and non-Hodgkin’s lym­pho­ma (NHL).
Methods. PET imag­es of 81 ­patients (53 HD and 28 NHL) ­were eval­u­at­ed for atyp­i­cal ­uptake. In 5 ­patients addi­tion­al ­delayed imag­es ­were ­acquired. Sedatives ­were ­used in anx­ious ­patients (n=45).
Results. Twelve out of 53 ­patients ­with HD and 2 out of 28 ­patients ­with NHL ­showed an atyp­i­cal ­uptake. The BMI of ­patients ­with atyp­i­cal ­uptake (­median, 21 kg/m2 ver­sus 24 kg/m2; p<0.05) and the age (­median, 25 ­y ver­sus 44 ­y; p<0.05) ­were sig­nif­i­cant­ly low­er com­pared ­with ­patients with­out atyp­i­cal ­uptake. In near­ly 50% of all wom­en ­with HD≤30 y and 20% of all ­male ­patients ­with HD≤30 y an atyp­i­cal ­uptake was ­observed. Delayed imag­es ­showed a SUVmax ­decrease in 4 ­patients and an ­increase in 1 ­patient. All ­patients ­with atyp­i­cal ­uptake ­received sed­a­tives ­which had an anx­i­o­lyt­ic ­effect in all ­patients, but did not pre­vent atyp­i­cal ­uptake.
Conclusion. Abnormal suprac­la­vic­u­lar and par­a­ver­te­bral FDG accu­mu­la­tion ­occurs par­tic­u­lar­ly in young­er ­patients and ­those ­with low­er BMI val­ues. The use of sed­a­tives or ­delayed acqui­si­tion does not ­increase the diag­nos­tic infor­ma­tion in ­these cas­es.