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Prevalence of non 18 F‐fluorodeoxyglucose‐avid incidental findings of clinical significance on whole body positron emission tomography/computed tomography: A review of 500 consecutive cases
Author(s) -
Sheldon James A,
Yap Kelvin K,
Taubman Kim L,
Schlicht Stephen M
Publication year - 2018
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12690
Subject(s) - medicine , clinical significance , positron emission tomography , radiology , fluorodeoxyglucose , computed tomography , statistical significance , nuclear medicine , pathology
The prevalence of incidental 18 F‐fluorodeoxyglucose ( FDG )‐avid findings on positron emission tomography–computed tomography ( PET / CT ) has been extensively described. Few studies, however, have assessed the prevalence and significance of non‐ FDG ‐avid findings; pathology that is identified on review of the low‐dose, non‐contrast CT . The aim of this study was to determine the overall prevalence of non FDG ‐avid incidental findings on PET / CT and the prevalence of ‘clinically significant’ non FDG ‐avid pathology. Methods Five hundred consecutive whole body PET / CT studies performed in 2016 at a university affiliated tertiary hospital were retrospectively reviewed by two radiologists experienced in reporting PET / CT . Findings were categorized according to potential clinical relevance, and a targeted follow‐up of clinically significant incidental findings was performed. Results Incidental findings were encountered in 463 of 500 (92.6%) patients. In 226 patients, these findings had been detected on previous imaging studies, with unknown incidental findings present in 237 of 500 (47.4%) patients. 113 of 500 (22.6%) patients had non‐avid incidental findings of potentially major clinical significance, and in 35 patients (7.0%) these findings were considered previously unknown. The most common non‐avid findings of potentially major significance were pulmonary nodules (6 mm or larger), moderate or large size pleural effusions, and vascular aneurysms. Unknown incidental findings of potentially major clinical significance were significantly higher in patients imaged for melanoma staging ( P = 0.004). Conclusion The prevalence of incidental findings of clinical significance that do not accumulate FDG in PET / CT is not insignificant. Routine systematic review of the low‐dose CT is required to avoid missing potentially clinically important findings, in particular pleural effusions, vascular aneurysms and metastatic pulmonary nodules.