Nucl Med Mol Imaging.  2006 Aug;40(4):233-236.

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

• Choi SJ
• Kim JH
• Hyun IY

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 cancer. 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.

Keyword

F-18 FDG; PET/CT; respiratory muscles; chronic obstructive pulmonary disease

MeSH Terms

Abdomen
Aged
Diaphragm
Electrons
Glucose
Humans
Intercostal Muscles
Lymph Nodes
Metabolism
Muscles
Neck
Neoplasm Metastasis*
Peritoneum
Positron-Emission Tomography and Computed Tomography
Pulmonary Disease, Chronic Obstructive
Respiratory Muscles*
Ribs
Stomach Neoplasms*
Thoracic Wall
Glucose