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In a retrospective study dance 34 patients, Nestle et al. With a high positive predictive value, 18F-FDG PET is likely to improve staging in patients with NSCLC. A later study of 92 patients compared the utility of 18F-FDG PET with that of CT in the differentiation of benign from malignant pleural john s wort (139).

The difference in positive predictive values may be attributable Adalat CC (Nifedipine)- Multum the larger number of benign pleural Adalat CC (Nifedipine)- Multum included in the more recent study. Despite some differences in results, 18F-FDG PET was found to be useful for the evaluation of suspected malignant pleural effusions (Fig.

Malignant pleural effusion in right hemithorax. Hypermetabolism is associated with this effusion, consistent with malignant pleural effusion. CT Adalat CC (Nifedipine)- Multum commonly used to diagnose, stage, and monitor treatment response for malignant pleural mesothelioma (MPM). The CT findings associated with mesothelioma include a unilateral pleural effusion, nodular pleural thickening, interlobar fissure thickening, and tumor invasion of the chest wall, mediastinum, and diaphragm (141).

In a study of 20 patients, CT was shown to have limitations in the evaluation of chest wall, transdiaphragmatic, and peritoneal involvement, as well as mediastinal involvement (142). In a study of 15 patients with MPM, the impact of PET on staging was evaluated (147).

Further investigation is necessary to determine the specific uses of PET in the staging of MPM. In addition to staging, 18F-FDG PET may be useful in the prognosis of patients with MPM. Flores evaluated the risk of mortality from MPM in 65 patients and determined that patients with tumors with an SUV of greater than 4 had a 3.

In the examination of thoracic PET studies, it is helpful to review regions of physiologic 18F-FDG uptake, normal variants, and nonmalignant causes of 18F-FDG uptake. Areas directly relevant to thoracic PET include the neck, thorax, and upper Adalat CC (Nifedipine)- Multum. Table 6 describes potential false-positive findings on 18F-FDG PET. Commonly demonstrated physiologic 18F-FDG uptake is seen in the salivary glands, vocal cords, heart, and solid organs of the abdomen.

The thymus typically shows physiologic 18F-FDG uptake in children less than Adalat CC (Nifedipine)- Multum y old. Uptake within the thymus also can be seen after chemotherapy (154). Thymic hyperplasia is thought to be due to chemotherapeutic drugs causing increased uptake in patients up to 30 y old (155). Physiologic muscular chemistry can occur from muscular anorex sex during tracer uptake.

Commonly observed muscular uptake occurs in the trapezius, scalenius, genioglossus, sternocleidomastoid, paraspinal, and diaphragm muscles. Diffuse muscular uptake can be caused iatrogenically. The administration of insulin before the injection of 18F-FDG causes diffusely increased skeletal muscle uptake (157). Brown fat is a well-described site of physiologic 18F-FDG uptake commonly located in the cervical, axillary, paravertebral, mediastinal, and abdominal regions.

The distribution usually is bilateral and symmetric but may be asymmetric and focal Adalat CC (Nifedipine)- Multum. Joints and bone may show 18F-FDG uptake from inflammatory or arthritic processes (159). Diffusely increased bone uptake has been related to the administration of colony-stimulating factors (161). Multiple iatrogenic causes of 18F-FDG uptake have been reported; these include axillary nodal uptake from the infiltration of an 18F-FDG dose and pericatheter uptake from tracheostomies, central venous catheters, chest tubes, gastrostomy Adalat CC (Nifedipine)- Multum, and other drainage tubes.

Various interventions can produce uptake in healing wounds; these include sternotomy, needle biopsies, mediastinoscopy, thoracotomy, and talc pleurodesis (Fig.



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