Hot-Clot Artifacts in the Lung Parenchyma on F-18 Fluorodeoxyglucose Positron Emission Tomography/CT due to Faulty Injection Techniques: Two Case Reports

Özdemir, Elif; Poyraz, Nilüfer Yildirim; Keskin, Mutlay; Kandemir, Zuhal; Türkölmez, Şeyda

doi:10.3348/kjr.2014.15.4.530

Cited by 19 publications

(16 citation statements)

References 8 publications

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“…More than half of DVTs occur in calf veins or pelvic veins, where ultrasonography has limited sensitivity and none of the above mentioned techniques address vessels outside the pulmonary and proximal femoral vasculature. FDG-PET/CT provides whole-body assessment, and a mounting number of case reports demonstrate sightings of venous activity consistent with VTE in venous vasculature throughout the body and in various clinical settings: lower extremity veins [24][25][26][27][28], iliac vein [26], upper extremity veins [29][30][31], superior vena cava [32,33], inferior vena cava [34][35][36], portal vein [37,36], renal vein [34], jugular vein [38], brachiocephalic vein [33,39], indwelling catheters [40][41][42], superior sagittal sinus [43,33], pulmonary embolism (including supposed microembolism from injection artefacts) [44][45][46][47][48][49][50][51][52][53][54][55][56][57][58], lung infarction [59][60][61], right-heart...…”

Section: Discussionmentioning

confidence: 99%

FDG-PET/CT in venous thromboembolism

Hess

Frary

Gerke

et al. 2018

Clin Transl Imaging

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Purpose: Venous thromboembolism (VTE) is common; deep venous thrombosis (DVT) and pulmonary embolism (PE) are the most common presentations. VTE may arise in the entire venous bed and the diagnosis may be difficult. VTE is a dynamic disease, inflammation is key, and FDG-PET/CT has been proposed, e.g. to detect thrombi in any anatomic location, to differentiate acute from chronic VTE, and to differentiate bland VTE from tumor thrombosis. The aim of this systematic review was to assess if the potential uses of 18 F-Fluorodeoxyglucose positron emission tomography/computer tomography (FDG-PET/CT) in VTE are described and documented in the literature. Methods: PubMed and Embase databases were searched. Duplicates and papers in other languages than English and Scandinavian were removed. Remaining papers were screened by title and abstract. Eligible papers were assessed in full-text. Results: The master search yielded 3,897 hits, 316 papers were eligible for full-text assessment. Ten papers were included; six on diagnostic performance of PET/CT in VTE, and four on the ability of PET/CT to differentiate bland VTE from tumor thrombosis. Three papers were prospective, seven were retrospective. Conclusion: If applied early, FDG-PET/CT may have a role in diagnosing DVT, but not PE, to discriminate acute from chronic VTE, and to demonstrate recurrent VTE. FDG-PET/CT is by some considered adept in differentiating bland VTE from tumor thrombosis, but we find this controversial due to FDG avidity in bland VTE. FDG-PET/CT may be feasible when screening for occult malignancy. However, in all mentioned areas, available literature is too sparse and too heterogeneous to allow firm conclusions.

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Section: Discussionmentioning

confidence: 99%

FDG-PET/CT in venous thromboembolism

Hess

Frary

Gerke

et al. 2018

Clin Transl Imaging

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“…During the intravenous access or injection, radiotracer can be inadvertently deposited into the tissue surrounding the vein . This is known as an infiltration and can affect the net activity available for circulation or alter the kinetics of availability …”

Section: Introductionmentioning

confidence: 99%

“…The accuracy of quantitative imaging is assured by processes including clock synchronization, residual syringe activity subtraction, patient weight measurement, and patient blood glucose measurement. [4][5][6][7][8][9] Inaccuracies can introduce image errors that negatively affect disease staging, 1,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] interpretation of longitudinal disease progression, 10,[12][13][14][15][30][31][32][33][34][35][36][37][38][39][40][41][42][43] tumor volume measurements, 44 myocardial perfusion measurements, 1,31,...…”

Section: Introductionmentioning

confidence: 99%

“…49 This is known as an infiltration and can affect the net activity available for circulation or alter the kinetics of availability. 10,26,29,42,43 A potential method of injection QC would be to position a topical scintillation sensor proximal to the injection site ( Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

“…The accuracy of quantitative imaging is assured by processes including clock synchronization, residual syringe activity subtraction, patient weight measurement, and patient blood glucose measurement . Inaccuracies can introduce image errors that negatively affect disease staging, interpretation of longitudinal disease progression, tumor volume measurements, myocardial perfusion measurements, and neurological assessments …”

Section: Introductionmentioning

confidence: 99%

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Technical Note: Characterization of technology to detect residual injection site radioactivity

et al. 2019

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PurposeEach year in the United States, approximately 18.5 million nuclear medicine procedures are performed. Various quality control measures are implemented to reduce image errors and improve quantification of radiotracer distribution. However, there is currently no routine or timely feedback about the quality of the radiotracer injection. One potential solution to evaluate the injection quality is to place a topical scintillation sensor near the injection site to record the presence of residual activity. This work investigates a sensor design for identification of injections where the prescribed radioactive activity is not fully delivered into the patient's circulation (an infiltration).MethodsThe sensor consists of a single unshielded bismuth germanate (BGO) crystal (3 mm × 3 mm × 3 mm). Using radioactive sources with gamma energies that span the range commonly used in nuclear medicine, we quantified energy resolution and linearity. Additionally, we computed sensitivity by comparing the calculated incident activity to the activity measured by the sensor. Sensor output linearity was calculated by comparing measured data against the radioactive decay of a source over multiple half‐lives. The sensor incorporates internal temperature feedback used to compensate for ambient temperature fluctuations. We investigated the performance of this compensation over the range of 15°C–35°C.ResultsEnergy spectra from four sensors were used to calculate the energy resolution: 67% for 99mTc (141 keV), 67% for 133Ba (344 keV), 42% for 18F (511 keV), and 32% for 137Cs (662 keV). Note that the energy used for 133Ba is a weighted average of the three photon emissions nearest to the most abundant (356 keV). Sensor energy response was linear with a difference of 1%–2% between measured and predicted values. Energy‐dependent detector sensitivity, defined as the ratio of measured photons to incident photons for a given isotope, decreased with increasing photon energy from 55.4% for 99mTc (141 keV) to 3.3% for 137Cs (662 keV). Without compensation, error due to temperature change was as high as 53%. Temperature compensation reduced the error to less than 1.4%. Sensor output linearity was tested to as high as 210 kcps and the maximum magnitude error was 4%.ConclusionsThe performance of the sensor was adequate for identification of excessive residual activity at an injection site. Its ability to provide feedback may be useful as a quality control measure for nuclear medicine injections.

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18F-FDG PET/CT: Normal Variants, Artifacts, and Pitfalls in Lung Cancer

Agrawal

Rangarajan

2018

PET/CT in Lung Cancer

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Hot-Clot Artifacts in the Lung Parenchyma on F-18 Fluorodeoxyglucose Positron Emission Tomography/CT due to Faulty Injection Techniques: Two Case Reports

Cited by 19 publications

References 8 publications

FDG-PET/CT in venous thromboembolism

FDG-PET/CT in venous thromboembolism

Technical Note: Characterization of technology to detect residual injection site radioactivity

18F-FDG PET/CT: Normal Variants, Artifacts, and Pitfalls in Lung Cancer

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