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LETTER TO EDITOR
Year : 2014  |  Volume : 29  |  Issue : 3  |  Page : 201-202  

F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of recurrence carcinoma cervix


Hainan Medical University, China; Faculty of Medicine, University of Nis, Serbia; Joseph Ayobabalola University, Nigeria

Date of Web Publication11-Jul-2014

Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok, Thailand

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.136609

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How to cite this article:
Wiwanitkit V. F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of recurrence carcinoma cervix. Indian J Nucl Med 2014;29:201-2

How to cite this URL:
Wiwanitkit V. F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of recurrence carcinoma cervix. Indian J Nucl Med [serial online] 2014 [cited 2019 Dec 16];29:201-2. Available from: http://www.ijnm.in/text.asp?2014/29/3/201/136609

Sir,

The recent report on F-18 fluorodeoxyglucose (F-18-FDG) positron emission tomography (PET)/computed tomography (CT) in the detection of recurrence carcinoma cervix is very interesting. [1] Bhoil et al. concluded that "PET/CT appears to have an important role in detecting recurrence following primary treatment of cervical cancer." [1] It is no doubt that the tool can be useful in investigative medicine for searching malignancy. However, there are some concerns on the F-18-FDG PET/CT. Errors can be seen in some cases. The good examples are the errors that can be seen in the case with existed atherosclerotic plaques [2] and lymphadenopathy due to infectious etiologies. [3] To diagnose, the careful interpretation on investigation result accompanied with available history and clinical features of the patients is required.

Reply by the author

Dear Prof. Viroj,

Thank you very much for showing your interest in our paper on F-18 fluorodeoxyglucose (F-18-FDG) positron emission tomography (PET)/computed tomography (CT) in the detection of recurrence carcinoma cervix. [1] I fully agree with your views that interpretation of PET/CT data with relation to the history, clinical features and investigative findings can never underestimate while reporting. However, with regard to false positive results due to atherosclerotic plaque, Hanif et al. [2] did not made use of hybrid imaging (PET/CT). Data were interpreted using only the PET images, hence probably the false positive. A hybrid imaging enables correct fusion of data from two modalities performed sequentially in a single session. CT attenuation correction or respiratory motion may create reconstruction artifacts leading to false positive F-18-FDG uptake. A correctly fused PET/CT helps not only in attenuation correction, but also in proper localization thus reducing the chances of false positive.

False positive FDG avid lymphadenopathy due to infectious etiologies [3] is a well-known fact. It applies to all malignancies irrespective of the site of primary. However, A follow-up PET/CT imaging or if needed histopathological correlation can be done. Even in our study, we had four false positive cases of which two patient with suspected local recurrence and lung metastasis had normal study on follow-up scan. In another two cases showed inflammatory pathology on histopathological examination. PET/CT helps the treating doctor to be more vigilant on such lymph nodes.

Amit Bhoil

Department of Nuchlear Medicine, PGIMER, Chandigarh, India

 
   References Top

1.Bhoil A, Mittal BR, Bhattacharya A, Santhosh S, Patel F. Role of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of recurrence in patients with cervical cancer. Indian J Nucl Med 2013;28:216-20.  Back to cited text no. 1
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2.Hanif MZ, Ghesani M, Shah AA, Kasai T. F-18 fluorodeoxyglucose uptake in atherosclerotic plaque in the mediastinum mimicking malignancy: Another potential for error. Clin Nucl Med 2004;29:93-5.  Back to cited text no. 2
    
3.Jacene HA, Stearns V, Wahl RL. Lymphadenopathy resulting from acute hepatitis C infection mimicking metastatic breast carcinoma on FDG PET/CT. Clin Nucl Med 2006;31:379-81.  Back to cited text no. 3
    




 

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