Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
Introduction to PET/CT Imaging
12 topics, 49 min.
Introduction to PET/CT Imaging
1 m.How to Use the Case Viewer to Evaluate PET/CT Images in this Course
2 m.What is PET/CT Imaging?
7 m.Commonly Used Positron-emitting Radionuclides
2 m.PET/CT Imaging Acquisition
4 m.PET/CT Quality Control
5 m.Quantification of Tracer Uptake
6 m.Factors Impacting Quantification of Tracer Uptake
3 m.Where to Start: Reading a PET/CT Study
9 m.Case: Systematic Approach to Reading a PET/CT Study
9 m.Case: Setting Up Your Imaging Display for a PET/CT Study
5 m.PET/CT Report Example
2 m.Lesson
FDG Use in PET/CT
8 topics, 28 min.
Introduction to FDG
4 m.FDG: Patient Preparation
2 m.FDG: Patterns of Muscle Uptake
6 m.FDG: Patterns of Bone Marrow Uptake and the Effects of G-CSF
5 m.FDG: Patterns of Bone Marrow Uptake and the Effects of Bone Marrow Disease
3 m.Case: Normal Distribution of FDG Tracer
4 m.Case: Abnormal Distribution of FDG (Hyperinsulinemia)
6 m.Cases: Abnormal Distribution of FDG (Hyperinsulinemia, Rhabdomyolysis, Myositis)
2 m.Lesson
FDG: Common Pitfalls and Benign Lesions
9 topics, 21 min.
Lesson
FDG Use in Hematologic Malignancies
8 topics, 40 min.
Role of FDG PET/CT Imaging in Lymphoma: Classification and Staging
7 m.Role of FDG PET/CT Imaging in Lymphoma: Response to Therapy
3 m.Role of FDG PET/CT Imaging in Lymphoma: Follow-up Reports
3 m.FDG Case: Hodgkin's Lymphoma, Initial Presentation
9 m.FDG Case: Hodgkin's Lymphoma, Follow-up
6 m.FDG Case: DLBCL, Initial Presentation
5 m.FDG Case: DLBCL, Follow-up
5 m.FDG Case: Multiple Myeloma
7 m.Lesson
FDG Use in Lung Cancer
5 topics, 17 min.
Lesson
FDG Use in Head & Neck Cancer
3 topics, 14 min.
Lesson
FDG Use in Breast Cancer
2 topics, 8 min.
Lesson
FDG Use in Immunotherapy
3 topics, 18 min.
Lesson
DOTATATE Use in PET/CT
7 topics, 15 min.
Lesson
DOTATATE and FDG Use in Neuroendocrine Tumors
6 topics, 22 min.
Lesson
PSMA Use in PET/CT
4 topics, 9 min.
Lesson
PSMA Use in Prostate Cancer
5 topics, 23 min.
0:01
This is a 70-year-old male that came
0:05
for a evaluation of the response to therapy
0:09
for diffuse large b-cell lymphoma.
0:12
And here what I want to show you is this
0:15
intense uptake in the colon that, uh, we can see
0:21
it's kind of patchy, but we ultimately see it throughout.
0:24
And this is a common situation that we encounter
0:29
in the breathing room every day.
0:31
This is the classic pattern of bowel uptake related
0:36
to metformin use.
0:39
Metformin is an anti-diabetic drug that
0:45
promotes glucose uptake in the bowel.
0:48
And we see it
0:49
because we normally don't have the patients
0:52
to stop this, uh, medication.
0:55
Some people may recommend
0:57
that they can be discontinued 48 hours prior
1:00
to the FDG pit,
1:02
but the reality is that we normally don't ask the patients
1:06
to do so unless we know that there is a bowel lesion.
1:11
You can imagine that having this intense, uh,
1:15
uptake may limit your ability to detect
1:19
bowel lesions.
1:21
So this is something that we recognize as a pitfall,
1:25
but we also recognize the limitation that it can provide.
1:30
Ultimately, we always have the CT
1:32
and that may help us, uh, identify other indirect signs
1:36
that may indicate
1:38
that there might be something else aside from just the
1:42
expected bowel optic for metformin.
1:44
The differential diagnosis for these would be colitis,
1:48
but uh, normally colitis is more segmental.
1:51
It's not so diffuse.
1:54
It is also common to see not only large bowel,
1:58
but also intense small bowel uptake.
2:02
So both can be seen with the same medication.
FDG Case: Metformin
HIDEInteractive Transcript
0:01
This is a 70-year-old male that came
0:05
for a evaluation of the response to therapy
0:09
for diffuse large b-cell lymphoma.
0:12
And here what I want to show you is this
0:15
intense uptake in the colon that, uh, we can see
0:21
it's kind of patchy, but we ultimately see it throughout.
0:24
And this is a common situation that we encounter
0:29
in the breathing room every day.
0:31
This is the classic pattern of bowel uptake related
0:36
to metformin use.
0:39
Metformin is an anti-diabetic drug that
0:45
promotes glucose uptake in the bowel.
0:48
And we see it
0:49
because we normally don't have the patients
0:52
to stop this, uh, medication.
0:55
Some people may recommend
0:57
that they can be discontinued 48 hours prior
1:00
to the FDG pit,
1:02
but the reality is that we normally don't ask the patients
1:06
to do so unless we know that there is a bowel lesion.
1:11
You can imagine that having this intense, uh,
1:15
uptake may limit your ability to detect
1:19
bowel lesions.
1:21
So this is something that we recognize as a pitfall,
1:25
but we also recognize the limitation that it can provide.
1:30
Ultimately, we always have the CT
1:32
and that may help us, uh, identify other indirect signs
1:36
that may indicate
1:38
that there might be something else aside from just the
1:42
expected bowel optic for metformin.
1:44
The differential diagnosis for these would be colitis,
1:48
but uh, normally colitis is more segmental.
1:51
It's not so diffuse.
1:54
It is also common to see not only large bowel,
1:58
but also intense small bowel uptake.
2:02
So both can be seen with the same medication.
Report
Faculty
Elisa Franquet Elia, MD
Assistant Professor of Radiology
UMass Chan Medical School
Tags
Response and assessment
PET/CT FDG
PET
Oncologic Imaging
Nuclear Medicine
General Oncologic Imaging Concepts
Drug related
© 2026 Medality. All Rights Reserved.
