Relatively high F-18 fluorodeoxyglucose uptake in paranasal sinus aspergillosis: A PET study

Abstract

We report a case of maxillary sinus (MS) aspergillosis studied by positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) and by 67Ga-citrate (Ga) single photon emission computed tomography (SPECT). The FDG uptake existed in the lesion and along the inflammatory edematous mucous membrane of the MS. Ga uptake occurred not only in the lesion and in the mucous membrane but also in the MS. Relative quantification, the standardized uptake value (SUV) of the lesion showed relatively high FDG uptake (3.7). But in other reports, many malignant head and neck tumors had a SUV below 3.7. It was thought to be difficult to differentiate between aspergillosis and malignant head and neck tumors by FDG-PET.

Mediastinal hibernoma simulates a malignant lesion on dual time point FDG imaging

“…FDG uptake does not always distinguish benign from malignant lesions. Infection, inflammation, and granulomatous lesions including sarcoidosis [2], tuberculosis [3], and aspergillosis [4] exhibits high FDG uptake. Conversely, bronchoalveolar carcinoma and carcinoid tumors may not show significantly increased FDG activity [5].…”

Imaging of Invasive Fungal Infections- The Role of PET/CT

“…20 The evidence for the use of FDG PET/CT in IFD has been building up over the last few decades through case reports and some retrospective single-centred studies. 18,[21][22][23][24][25][26] Initial studies performed when malignancies were the main indications FDG PET/CT revealed that IFIs could be a cause of false-positive for malignancy. 27,28 FDG PET/CT was subsequently realized to potentially play a role in infectious and inflammatory diseases, including IFD.…”

Imaging fungal infections in children

“…These 68 Ga-siderophores were found to be superior to 68 Ga–citrate which had a slow excretion and high blood pool uptake [ 105 , 106 ]. 67 Ga-citrate was previously used in fungal infections and in one study it was compared with FDG [ 99 ]. It was noted to be able to accumulate in IFI lesions without blood vessel in an area where FDG showed minimal uptake; however, in areas of IFI with relatively preserved vasculature, uptake of FDG was more intense [ 99 ].…”

“…67 Ga-citrate was previously used in fungal infections and in one study it was compared with FDG [ 99 ]. It was noted to be able to accumulate in IFI lesions without blood vessel in an area where FDG showed minimal uptake; however, in areas of IFI with relatively preserved vasculature, uptake of FDG was more intense [ 99 ]. Further studies are necessary to determine whether 68 Ga-citrate has advantages over FDG in humans.…”