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F-18 FDG Uptake in Respiratory Muscle Mimicking Metastasis in Patients with Gastric Cancer  

Choi, Seung-Jin (Department of Nuclear Medicine, Inha Univiersity College of Medicine)
Kim, Jeong-Ho (Department of Radiology, Gachon Medical School Gil Medical Center)
Hyun, In-Young (Department of Nuclear Medicine, Inha Univiersity College of Medicine)
Publication Information
Nuclear Medicine and Molecular Imaging / v.40, no.4, 2006 , pp. 233-236 More about this Journal
Abstract
A 67-year-old man with a history of chronic obstructive pulmonary disease (COPD) underwent F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for staging of gastric cancer. The projection images of F-18 FDG PET/CT showed intensely increased F-18 FDG uptake in the anterior neck, chest wall, and upper abdomen. We suspected distant metastases of cervical lymph nodes, ribs, and peritoneum in gastric canter. However, the transaxial images of F-18 FDG PET/CT showed abnormal F-18 FDG uptake in scalene muscles of anterior neck, intercostal muscles of chest wall, and diaphragm of upper abdomen. Patients with COPD use respiratory muscles extensively on the resting condition. These excessive physiologic use of respiratory muscles causes increased F-18 FDG uptake as a result of increased glucose metabolism. The F-18 FDG uptake in respiratory muscles of gastric cancer patient with COPD mimicked distant metastases in cervical lymph nodes, ribs, and peritoneum.
Keywords
F-18 FDG; PET/CT; respiratory muscles; chronic obstructive pulmonary disease;
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