Abstract
A 44-year-old woman presented with high [18F]FDG uptake liver lesion after six courses of R-CHOP and radiotherapy for abdominal DLBCL, which was misdiagnosed as a hepatic invasion. EOB–MRI showed slight T2 hyperintensity, low-intensity DWI, and decreased EOB uptake in the hepatocellular phase. Compared with the pretreatment planning CT, the liver lesion coincided with the area of >40.5 Gy, resulting in the diagnosis of RILD. At the follow-up [18F]FDG PET/CT 7 months after irradiation, the abnormal liver uptake disappeared. Comparing [18F]FDG PET/CT, EOB–MRI, and planning CT can lead to the correct diagnosis of RILD and avoid unnecessary biopsies and treatment changes.
Highlights
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Compared with the pretreatment planning CT images, it can be recognized that the liver lesion coincides with the area of 90% of the prescribed dose, i.e., the area of >40.5 Gy (G yellow line), and that the highest dose area has the highest [18F]FDG avidity (I–K arrows) and lowest EOB uptake (M arrow)
radiation-induced liver disease (RILD) is usually asymptomatic and not associated with liver enzyme elevations but is known to have a high [18F]FDG uptake [1], occurring in 3–8% of patients with esophageal cancer treated with chemoradiation who are reevaluated by PET/CT [2]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Lymphoma Showing High [18F]FDG Avidity and Low EOB Uptake Compared with the pretreatment planning CT images, it can be recognized that the liver lesion coincides with the area of 90% of the prescribed dose, i.e., the area of >40.5 Gy (G yellow line), and that the highest dose area has the highest [18F]FDG avidity (I–K arrows) and lowest EOB uptake (M arrow).
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