Focal Fat Spared Area in the Liver Masquerading as Hepatic Metastasis on F-18 FDG PET Imaging

Purandare, Nilendu; Rangarajan, Venkatesh; Rajnish, Anshu; Shah, Sneha; Arora, Abhishek; Pathak, Sulabha

doi:10.1097/rlu.0b013e318187ef32

Cited by 16 publications

(9 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A case report by Purandare et al ( 14 ) describes a case of focal increased FDG uptake in a region of focal fatty sparing in the liver. The measured SUV in this focus was 4.0.…”

Section: Nuclear Medicine: Effect Of Hepatic Steatosis On Liver Fdg Umentioning

confidence: 99%

Effect of Hepatic Steatosis on Liver FDG Uptake Measured in Mean Standard Uptake Values

Abele¹,

Fung²

2010

Radiology

View full text Add to dashboard Cite

show abstract

“…A case report by Purandare et al ( 14 ) describes a case of focal increased FDG uptake in a region of focal fatty sparing in the liver. The measured SUV in this focus was 4.0.…”

Section: Nuclear Medicine: Effect Of Hepatic Steatosis On Liver Fdg Umentioning

confidence: 99%

Effect of Hepatic Steatosis on Liver FDG Uptake Measured in Mean Standard Uptake Values

Abele¹,

Fung²

2010

Radiology

View full text Add to dashboard Cite

show abstract

“…This accumulation of FDG uptake at focal hepatic steatosis can cause a diagnostic dilemma in imaging by mimicking metastasis (24,25). Conversely, focal fat spared area in a liver with diffuse fatty infiltration can demonstrate focal FDG uptake masquerading as liver metastases, probably when steatosis is not accompanied with inflammation (26,27) In our study, we found a statistically significant difference between the body weight (p<0.001), serum ALT levels (0.025), DM status (0.002), and glucose levels (p<0.001) of the patients with fatty liver and the control group. There may be a positive correlation between serum liver enzyme levels and SUVs of liver on FDG PET that can affect diagnostic sensitivity of hepatic malignant or infectious lesions on FDG PET (28).…”

Section: Discussionmentioning

confidence: 99%

“…Although the application of SUV eliminates some degree of uncertainty in patient size and the amount of injected FDG, it is still liable to many weaknesses that can cause misleading results. SUV, rather than being an absolute value in characterization of lesions, is a proportional value without units, so to measure the amount of tumoral FDG uptake, there is always a need for a region in Eur Arch Med Res 2019; 35 (1): [27][28][29][30][31][32] the body supposed to have normal FDG uptake. The liver has long been used as a reference organ for this purpose (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Effect of Fatty Infiltration on Hepatic FDG Uptake

Özülker¹,

Özülker²

2019

eamr

View full text Add to dashboard Cite

In fluorodeoxyglucose (FDG) positron emission tomography (PET)/computerized tomography (CT) studies, physiological liver FDG uptake has been used as a reference in the evaluation of FDG uptake in pathological processes, even in malignancies. There is an ongoing debate on the effect of liver attenuation and FDG uptake in the liver. We aimed to evaluate the possible effect of fatty infiltration on the standardized uptake value (SUV) of the liver. Methods: A total of 88 patients were included in this study. Subjects were divided into 2 groups by calculating the Hounsfield unit (HU) of the liver from the unenhanced CT part of the PET/CT study and comparing it with that of the spleen. Fatty liver group included 42 patients (26 female, 16 male) with a mean age of 59.6±11.6 years, while control group consisted of 46 patients (22 female, 24 male) with a mean age of 60.2±11 years. The patients with a mean liver attenuation value (in HU) equal and greater than that of spleen were enrolled in the control group, while the patients with a mean liver attenuation value lower than the spleen were included in the fatty liver group. A subset of patients in the fatty liver group with difference in attenuation between the liver and spleen of more than 10 HU (HUS-HUL >10) were evaluated separately. Age, weight, history of diabetes mellitus (DM) and chemotherapy, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, simultaneous blood glucose levels during PET scan and the elapsed time between FDG injection and the beginning of PET scan were recorded. Results: The average SUVmean and SUVmax values were 2.7±0.7 and 3.6±0.9 in the fatty liver group, 2.8±0.7 and 3.8±1 in the HUS-HUL >10 group and 3.3±0.6 and 4.4±0.9 in the control group, respectively. The average SUVmean and SUVmax values of the fatty liver group and HUS-HUL >10 group were significantly different from the control group (p<0.05). The patients in the fatty liver group had higher ALT (p=0.025) and glucose levels (p=0.001), weight (p=0.001), and DM rate (p=0.002) compared to the control group. Conclusion: Hepatic steatosis causes a statistically significant decrease in SUVmean and SUVmax values in liver. Therefore, we must be careful when using the liver as an internal reference organ

show abstract

“…[2] These patterns have been reported to mimic metastases on cross-sectional imaging. [34] Contrarily, a true hepatic lesions simulate fat sparing, is documented in a single case, where US and magnetic resonance imaging (MRI) was used for confirmation. [5] Fatty liver is seen as diffuse hypodensity on CT images, with attenuation values less than 40 Hounsfield units (HU) on unenhanced images.…”

Section: Discussionmentioning

confidence: 99%

Hepatic metastasis disguised as fat spared area in the background of fatty liver: Detection on FDG PET/CT

et al. 2013

Self Cite

View full text Add to dashboard Cite

Area of fat sparing in fatty liver is known to pose a diagnostic challenge in an oncological setting, especially in cancers with higher propensity for liver metastases. We report an unusual appearance of hepatic metastases in a fat spared area, on both computed tomography (CT) and positron emission tomography (PET), in a combined 18 fluorine-fluorodeoxyglucose (18 F-FDG) PET/CT study done in metastatic adenocarcinoma of colon.

show abstract

Focal Fat Spared Area in the Liver Masquerading as Hepatic Metastasis on F-18 FDG PET Imaging

Cited by 16 publications

References 6 publications

Effect of Hepatic Steatosis on Liver FDG Uptake Measured in Mean Standard Uptake Values

Effect of Hepatic Steatosis on Liver FDG Uptake Measured in Mean Standard Uptake Values

Assessment of the Effect of Fatty Infiltration on Hepatic FDG Uptake

Hepatic metastasis disguised as fat spared area in the background of fatty liver: Detection on FDG PET/CT

Contact Info

Product

Resources

About