Clinical nuclear medicine
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Clinical nuclear medicine · Sep 2009
Unexpected accumulation of F-18 FDG in the urinary bladder after bladder irrigation and retrograde filling with sterile saline: a possible pitfall in PET examination.
: Bladder irrigation and retrograde filling technique has been used to reduce urinary F-18 FDG (FDG) activity for better image interpretation in patients with pelvic tumors. Despite the zealous use of this technique, FDG accumulation in the urinary bladder has been reported and might cause false-positive or false-negative results. In this study, we analyzed the pattern and estimated the incidence of the unexpected accumulation of urinary FDG activity after bladder irrigation and retrograde filling with sterile saline. ⋯ : Unexpected FDG activity in the urinary bladder, either focal or diffuse, may occur after bladder irrigation and retrograde filling and interfere with pelvic image interpretation. Great caution is required to avoid misdiagnosis: focal FDG accumulation may mimic tumor uptake of FDG whereas diffuse FDG activity may obliterate a FDG-avid pelvic lesion. Repeated bladder irrigation and retrograde filling, and prone-position imaging are useful techniques to ascertain the nature of the FDG accumulation.