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FDG Case: Metallic Artifact

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This is a 68-year-old female with history

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of the future large B-cell lymphoma

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that was undergoing therapy.

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And this study was done for, uh, follow up.

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In this case, I want to focus our attention into the area

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of uptake that we see in the mein,

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particularly in the heart.

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We can see that there's intense linear FDG uptake

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that corresponds to this metallic density that

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corresponded to an left appendage clip.

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And one of the things that we have discussed

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is if the uptake related to metallic devices

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is, uh, related to, uh, attenuation correction artifact

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or is indeed abnormal tracer uptake from

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for instance, infection.

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I wanna show you how we can troubleshoot

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and distinguish these two.

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And what I'm going

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to do is compare the attenuation corrected PET

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with a non attenuation corrected pet.

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I have pulled the non attenuation corrected image here and,

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and you can see that there is rarely any uptake in the area

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of the metallic device and is increased

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after attenuation correction.

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And therefore, these intensity is related

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to the overcorrection from the attenuation map

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rather than pathologic activity within the tissue

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that is closely approximated to the very high density

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material in the body may appear falsely elevated

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as a high intensity on the AC data

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as we have seen in this case.

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And always keep in mind that you have available the raw data

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to troubleshoot these situations

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and also pay close attention to the ct,

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which might help you interpret these artifacts.

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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

Iatrogenic

General Oncologic Imaging Concepts