Abstract
As the number of clinical applications of 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET-CT) grows, familiarity with the conditions that can be diagnosed by this modality and when relevant pieces of additional information can be obtained becomes increasingly important for both requesting physicians and nuclear medicine physicians or radiologists who interpret the findings. Apart from its heavy use in clinical oncology, FDG PET-CT is widely used in a variety of non-oncologic conditions interconnecting to such disciplines as general internal medicine, infectious diseases, cardiology, neurology, surgery, traumatology, orthopedics, pediatrics, endocrinology, rheumatology, psychiatry, neuropsychology, and cognitive neuroscience. The aim of this review was to summarize the current evidence of FDG PET-CT applications in evaluating non-oncologic pathologies and the relevant information it can add to achieve a final diagnosis.
Highlights
The clinical applications of positron emission tomography/computed tomography (PET-CT) with the glucose analogue 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) are spreading beyond the area of oncology
FDG PET-CT proved valuable in detecting both infections and malignancies in HIV-positive patients, showing an overall sensitivity and specificity of over 90% for localization of focal pathology in subjects presenting with unexplained fever, weight loss, or confusion[53]
The modality proved especially useful in detecting the source of fever of unknown origin, including in immunocompromised and HIV-positive subjects, by showing an overall sensitivity and specificity of over 90% for localization of focal pathology in subjects presenting with unexplained fever, weight loss, or confusion
Summary
The clinical applications of positron emission tomography/computed tomography (PET-CT) with the glucose analogue 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) are spreading beyond the area of oncology. [3,4,5] For example, it has been shown that stimulation with cytokines results in GLUT 1 overexpression and increased glucose uptake in both inflammatory and granulation tissues[6] This avidity of inflammatory cells for 18F-FDG has led to the concept of using FDG PET-CT for imaging a variety of inflammatory and infectious conditions, including granulomatous diseases and fungal infections. An increasing number of reports indicate that FDG PET-CT has become a useful tool in the diagnosis, treatment evaluation and follow-up of patients with such conditions as sarcoidosis, spondylodiscitis, and vasculitis, and is already the gold standard for some indications[1,13,14]. Comparative studies performed in patients with non-healing diabetic foot ulcers indicate that MRI appears superior to FDG PET in detecting foot ulcer-associated osteomyelitis and might be the preferred imaging modality in such cases[17]. It can be used to follow the development of vasculitis activity during therapy
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