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  • Title: Focal F-18 FDG uptake mimicking malignant gastric localizations disappearing after water ingestion on PET/CT images.
    Author: Imperiale A, Cimarelli S, Sellem DB, Blondet C, Contantinesco A.
    Journal: Clin Nucl Med; 2006 Dec; 31(12):835-7. PubMed ID: 17117089.
    Abstract:
    Diffuse, increased gastric wall F-18 FDG uptake is widely observed during PET/CT examinations, frequently unrelated to malignant findings, but simply caused by inflammatory disease, physiological emptying, or visceral thickening. Hence, elevated F-18 FDG gastric uptake can lead to equivocal misinterpretation, especially in patients with known gastric malignant disease, at posttherapy reevaluation. Gastric wall contraction can increase F-18 FDG uptake, especially for a remnant stomach, increasing the percentage of false-positive results with a direct impact on therapeutic management. One field PET/CT acquisition centered on the hypochondrial regions a few minutes after water ingestion should be performed routinely if standard images are doubtful (increased tracer uptake and visceral thickening) to differentiate benign from malignant uptake.
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