FDG PET/CT imaging in granulomatous changes secondary to breast silicone injection

Ho, Linh; Wassef, Heidi; Seto, John

doi:10.1016/j.crad.2010.02.011

Cited by 11 publications

(11 citation statements)

References 13 publications

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“…In addition, we correlate our patient’s gallium scan with a F-18-fluorodeoxyglucose (FDG) PET/CT to emphasize that increased FDG uptake may also be seen in the setting of prior silicone injections in the buttocks or elsewhere in the body. Because previous case reports demonstrating Ga-67 uptake due to silicone injections in the buttocks were published before the clinical use of PET/CT, correlation with PET/CT was not available at that time (8, 9, 10). …”

Section: Discussionmentioning

confidence: 99%

“…In addition to causing increased tracer uptake on gallium scan, it is well known that the inflammatory granulomatous response following silicone injections can cause increased FDG uptake on PET/CT (10, 11, 12). Previous studies have shown that SUVs may vary greatly in the setting of inflammation and can be very high (5, 11, 12).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that SUVs may vary greatly in the setting of inflammation and can be very high (5, 11, 12). The most important concept for physicians to recognize is that focally increased FDG uptake at the site of prior silicone injections may cause false-positive results by mimicking tumor (10). This is particularly important in the breast (10).…”

Section: Discussionmentioning

confidence: 99%

“…The most important concept for physicians to recognize is that focally increased FDG uptake at the site of prior silicone injections may cause false-positive results by mimicking tumor (10). This is particularly important in the breast (10). FDG uptake in the breast after silicone implant or injection may mimic a new primary breast tumor, recurrent breast tumor in a patient with previous disease, or positive lymph nodes (10, 13).…”

Section: Discussionmentioning

confidence: 99%

“…This is particularly important in the breast (10). FDG uptake in the breast after silicone implant or injection may mimic a new primary breast tumor, recurrent breast tumor in a patient with previous disease, or positive lymph nodes (10, 13). Migration of silicone into the lymphatics after injection can also cause false-positive interpretation at sites that are remote from the initial silicone injection site (10, 13, 14).…”

Section: Discussionmentioning

confidence: 99%

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Silicone granulomas following free silicone gluteal augmentation

Wosnitzer¹,

Mirtcheva²

2011

Radiology Case Reports

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Gallium-67 citrate has long been used for imaging of infection and inflammation. Although gallium-67 uptake due to silicone implants and silicone injections has been previously reported in the literature, very few cases are documented. We report a case of increased gallium-67 uptake in the buttocks in a patient who previously received silicone injections in the buttocks, to reemphasize silicone augmentation as a potential source of gallium-67 uptake. In addition, we present a F-18-fluorodeoxyglucose (FDG) PET/CT scan from the same patient to demonstrate mild diffuse FDG uptake in the buttocks in the region of previous silicone injection. Although FDG is well known to accumulate in areas of inflammation such as prior sites of silicone injection or silicone implantation in the breast, FDG uptake in the buttocks due to silicone injections has not been previously reported or correlated with a gallium scan.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Silicone granulomas following free silicone gluteal augmentation

Wosnitzer¹,

Mirtcheva²

2011

Radiology Case Reports

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When should we recommend use of dual time-point and delayed time-point imaging techniques in FDG PET?

Cheng

Torigian

Zhuang

et al. 2013

Eur J Nucl Med Mol Imaging

141

145

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FDG PET and PET/CT are now widely used in oncological imaging for tumor characterization, staging, restaging, and response evaluation. However, numerous benign etiologies may cause increased FDG uptake indistinguishable from that of malignancy. Multiple studies have shown that dual time-point imaging (DTPI) of FDG PET may be helpful in differentiating malignancy from benign processes. However, exceptions exist, and some studies have demonstrated significant overlap of FDG uptake patterns between benign and malignant lesions on delayed time-point images. In this review, we summarize our experience and opinions on the value of DTPI and delayed time-point imaging in oncology, with a review of the relevant literature. We believe that the major value of DTPI and delayed time-point imaging is the increased sensitivity due to continued clearance of background activity and continued FDG accumulation in malignant lesions, if the same diagnostic criteria (as in the initial standard single time-point imaging) are used. The specificity of DTPI and delayed time-point imaging depends on multiple factors, including the prevalence of malignancies, the patient population, and the cut-off values (either SUV or retention index) used to define a malignancy. Thus, DTPI and delayed time-point imaging would be more useful if performed for evaluation of lesions in regions with significant background activity clearance over time (such as the liver, the spleen, the mediastinum), and if used in the evaluation of the extent of tumor involvement rather than in the characterization of the nature of any specific lesion. Acute infectious and non-infectious inflammatory lesions remain as the major culprit for diminished diagnostic performance of these approaches (especially in tuberculosis-endemic regions). Tumor heterogeneity may also contribute to inconsistent performance of DTPI. The authors believe that selective use of DTPI and delayed time-point imaging will improve diagnostic accuracy and interpretation confidence in FDG PET imaging.

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