18F-fluorideoxyglucose positron emission tomography/computed tomography imaging: artifacts and pitfalls.

"F-fluorodeoxyglucose, being a radiolabeled glucose analogue, is a marker of glucose metabolism indicator. Since glucose uptake is increased in malignant tumors, its major application is in oncology. However, an increased 18F-fluorodeoxyglucose uptake is found in various benign tumors, granulomatous diseases, tuberculosis, inflammation, infection. A healing process may be interpreted as a false positive finding. In contrast, some types of renal cell cancers and lymphomas, neuroendocrine tumors, colonic mucinous adenocarcinomata, hepatocellular carcinomas, prostate cancer, and carcinoid tumors have low "F-fluorodeoxyglucose avidity which may give a misleading false negative result. In addition, an increased "F-fluorodeoxyglucose uptake in the bone marrow may be seen in oncologycal patients following various types of therapy. Besides the advantages of hybrid positron emission tomography-computed tomography imaging, this dual-modality scanning may produce their own specific artifacts due to different causes, such as metallic implants, respiratory motion, contrast medium and truncation. Proper patient preparation is required to minimize the potential artifactual uptake patterns that make reporting difficult. It is important to learn about proper quality control, imaging and reconstruction and to be familiar with potential artifacts and, pitfalls for the accurate interpretation of "F-fluorodeoxyglucose positron emission tomography-computed tomography.