FDG-PET/CT: Spektrum physiologischer Normvarianten der Traceraufnahme

Zusammenfassung

Die Positronenemissionstomografie (PET) mit ¹⁸F-Fluorodesoxyglukose (FDG) in Kombination mit einer Computertomografie (CT) ist eine etablierte und nützliche Untersuchungsmethode bei der Diagnostik inflammatorischer/infektiöser Erkrankungen, bei der Beurteilung neurologischer und kardiologischer Pathologien und v. a. im Rahmen von Staging und Nachsorge zahlreicher maligner Neoplasien.

Nach intravenöser Applikation der FDG stellen sich durch Tracerakkumulation oder –exkretion Gehirn, Myokard, Gastrointestinaltrakt, Leber, Nieren und Harntrakt in der PET intensiv dar. In diesem Artikel wird die physiologische Aufnahme der ¹⁸F-Fluorodesoxyglukose in der positronenemissionstomografischen Ganzkörperuntersuchung beschrieben. Darüber hinaus werden in einer topografischen Gliederung zahlreiche physiologische Normvarianten aufgelistet und diskutiert. Eine akkurate Interpretation der PET-Bilder setzt eine umfassende Kenntnis dieser normalen physiologischen Distribution des radioaktiven Tracers und der häufig zu beobachtenden Normvarianten oder aktivierungs- bzw. medikamenteninduzierten FDG-Speicherungen voraus, die mit malignen Läsionen verwechselt werden können. Auf diese Weise können Fehlinterpretationen vermieden und die exzellenten diagnostischen Möglichkeiten der FDG-PET/CT voll ausgeschöpft werden.

Abstract

Positron emission tomography with the glucose analogue ¹⁸F-fluordeoxyglucose in combination with computed tomography is an established and useful method in the diagnosis of inflammatory/infectious diseases, in the assessment of neurological and cardiac pathologies and especially in the context of staging and follow-up of many malignant neoplasias.

After intravenous administration, high FDG activity can be detected in brain, myocardium, gut, liver, kidneys and urinary tract due to tracer accumulation or excretion. An accurate interpretation of PET images requires a comprehensive knowledge of the normal physiological distribution of FDG and its frequently encountered normal variations, which may be confused with malignant lesions. Thus, misinterpretations of PET/CT findings can be avoided.

The objective of this article is to describe the physiological uptake of FDG in a whole-body FDG/PET-scan. Moreover, numerous normal variants are listed and discussed in a topographical arrangement.

Schlüsselwörter

PET/CT - FDG - Normvarianten - physiologische Traceraufnahme

Key words

PET/CT - FDG - normal variants - physiologic tracer uptake

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