Common and Uncommon Mimics of Thoracic Malinancy on PET/CT: Pearls and Pitfalls

Document Type

Conference Proceeding

Publication Date

4-2023

Abstract

Background
In the thorax, there are multiple entities that can increase fluorodeoxyglucose (FDG) concentration, leading to false-positive interpretation. The purpose of this presentation is to review the spectrum of benign entities that may mimic thoracic malignancy on positron emission tomography-computed tomography (PET/CT).

Educational Goals / Teaching Points
Review benign entities that could mimic malignancy on FDG PET/CT and highlight key clinical history, anatomic correlation, and imaging features to clue the interpreting radiologist regarding the potential for increased uptake of a benign etiology on FDG PET/CT.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will include approximately 15 cases from our institution, highlighting key imaging features to avoid pitfalls in thoracic malignancy. We will classify cases into 4 categories: lung parenchymal, pleural, mediastinal, and chest wall. Physiologic sources of pitfalls will be presented such as lipomatous hypertrophy of the interatrial septum. Infectious and inflammatory etiologies will be discussed, including sarcoidosis, fungal infection, and organizing pneumonia. Postoperative entities will include talc pleurodesis and surgical flaps. Cases of breast-related diagnoses such as silicone granulomas and fat necrosis will also be presented.

Conclusion
There are many common and rare mimics of thoracic malignancy on PET/CT that are encountered in daily practice. Awareness of pathology and pitfalls can lead to more accurate diagnosis and improve outcomes for patients.

Comments

American Roentgen Ray Society ARRS Annual Meeting, April 16-20, 2023, Honolulu, HI

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