Radiology - Research Publications

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Author: Hicks, Rodney × Author: Hofman, Michael × Author: Lade, Stephen × Start date: 2010 × Type: Journal Article ×

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    High FDG activity in focal fat necrosis: a pitfall in interpretation of posttreatment PET/CT in patients with non-Hodgkin lymphoma
    Kashyap, R ; Lau, E ; George, A ; Seymour, JF ; Lade, S ; Hicks, RJ ; Hofman, MS (SPRINGER, 2013-09)
    PURPOSE: PET/CT has a major role in lymphoma imaging, but glycolytic activity in inflammatory processes can reduce specificity. In this study we evaluated restaging PET/CT findings in patients with non-Hodgkin lymphoma (NHL) and fat necrosis. METHODS: We identified 16 patients from 8,819 restaging FDG PET/CT scans with suspicion of or biopsy-proven fat necrosis on PET/CT. RESULTS: All patients had NHL and demonstrated focal FDG-avid nodular change on CT with density higher than that of fat but lower than that of soft tissue. Histological confirmation was obtained in eight patients, with high GLUT-1 staining between necrotic tissue and organizing fat necrosis evident. Uptake resolved in four patients, and surveillance was continuing in four without relapse. CONCLUSION: Although rare, identification of fat necrosis in patients with a solitary FDG-avid nodule after therapy is important and may lead to the avoidance of unnecessary interventions or treatment. Specific features on CT aid identification, whilst follow-up imaging can be helpful as the metabolic abnormality regresses with time.