Incidental Finding of Osteopoikilosis on 18F-FDG and 18F-NaF PET/CT

109Introduction:A 42-year-old woman was referred to us after suffering intermittent abdominal pain for 10 months. Ultrasonography showed a mass on the left ovary. Her Ca125 was elevated to 1154 U / ml (normal reference < 35 U / ml). An 18F-FDG PET/CT was employed to assess the disease activity and stage the extent of the disease. The maximum intensity projection image (Fig 1, MIP, A) revealed two foci of increased tracer uptake in the left chest (dotted head), the right lower abdomen (yellow arrow). On axial PET images, these foci corresponded to left hilar lymph node (B, the right upper row, dotted head), the right ovary (C, the right midrow, yellow arrow) on the CT and fusion images. In addition, a large solid mass approximately 6.2 x 4.2 cm in size with non-uniform density and peripherally abnormally uptake of FDG was seen in the region of left pelvis (C, red arrowheads). Unexpectedly, there were numerous small sclerotic lesions in the vertebras without obvious FDG uptake (D, the right lower row, blue thin arrows). The findings were suggestive of a pelvic malignancy, likely ovarian cancer, with multiple metastases. Further 18F-NaF PET/CT scan was performed to evaluate the extent of the sclerotic lesions. The MIP image (Fig 2, A) showed abnormally increased activity in the head (B, small arrow), and left femur (C, curved arrow). On the axial images, the elevated NaF activity in the frontal bone (B, small arrow), distal femur and patella (C, curved arrow) with increased N...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Musculoskeletal Source Type: research