- 期刊
False-Positive Bony FDG Accumulations Due to Fractures in a Patient with Lung Cancer: the Value of Integrated Information of PET/CT
一位肺癌病患因骨折導致在骨骼部份有僞陽性氟－18-去氧葡萄糖攝取增加：正子斷層造影中整合電腦斷層影像之價值
摘要
氟－18-去氧葡萄糖正子斷層造影檢查對於癌症息者（包含肺癌）之癌症分期、追蹤及治療效果評估而言相當重要，是臨床不可或缺之診斷利器。然而，氣－18-去氧葡萄糖除了癌症細胞攝取外，有時亦會因其他原因而造成僞陽性攝取增加。在此，我們報告一位78歲男性肺癌息者，以正子斷層造影追蹤檢查時發現骨骼部份有多處氟－18-去氧葡萄糖攝取增加現象，包含肋骨、右側肩膀，右側胸鎖骨及腰椎第二節等處，初步懷疑有骨頭轉移的現象。然而在仔細比對了正子斷層造影中電腦斷層影像後發現病灶爲典型骨折之表現；再次追蹤病患相關病史後也證實最近曾因車禍造成胸部有直接的撞擊。在後續追蹤檢查的影像，包含正子斷層造影檢查和骨骼掃描，肋骨部份之病灶也已完全消失。因此這些骨骼的病灶最後被認爲是撞擊後骨折所造成。這個病例報告顯示在正子斷層造影檢查影像中整合電腦斷層影像之價值，除可幫助解剖定位外，亦可呈現正子影像上異常的病灶在形態上的特徵，可避免因骨折造成僞陽性氟－18-去氧葡萄糖之誤判。
並列摘要
Fluorine-18-fluorodeoxyglocose (18F-FDG) positron emission tomography (PET) or PET/computed tomography (CT) is a powerful modality in the staging, follow-up and therapeutic evaluation of oncologic patients, including lung cancer. However, FDG is not a specific tracer for cancer and false-positive uptake occasionally occurred. Here, we present a 78-year-old male with history of lung cancer underwent 18F-FDG PET/CT for follow-up. The PET images showed multiple FDG-avid foci in the bony structures, including ribs, distal and proximal portions of right clavicle and L2 vertebra, and were initially considered as bony metastases. But the co-registered CT images showed typical evidences of fractures and history of recent traffic accident with direct impaction to the chest was traced. Follow-up images, including PET/CT and bone scan, revealed complete resolution of the rib lesions. The bony lesions were finally considered as traumatic fractures. The presented case demonstrates the value of the co-registered CT images in PET/CT study not only in attenuation correction and anatomical localization but also morphological characterization of the FDG-avid lesions to avoid false positive interpretation due to traumatic fractures.
延伸閱讀
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