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Anterior Layering of Excreted 18F-FDG in the Bladder on PET/CT: Frequency and Cause

¹ All authors: Department of Radiology, University of California, San Francisco, Box 0628, M-392, 505 Parnassus Ave., San Francisco, CA 94143-0628.

View larger version (54K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —52-year-old woman with breast cancer. Coned-down transverse PET image of urinary bladder shows fluid-fluid level with anterior layering of 18F-FDG-impregnated urine.

View larger version (145K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —75-year-old man with melanoma imaged without IV iodinated contrast material. CT (A) and PET (B) images of urinary bladder show homogeneous appearance of bladder contents without anterior layering of 18F-FDG.

View larger version (71K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —75-year-old man with melanoma imaged without IV iodinated contrast material. CT (A) and PET (B) images of urinary bladder show homogeneous appearance of bladder contents without anterior layering of 18F-FDG.

View larger version (179K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —72-year-old man with colon cancer and new bladder metastasis. IV and oral contrast-enhanced CT image obtained through pelvis shows enhancing mass (arrow) arising from left posterior bladder wall.

View larger version (60K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —72-year-old man with colon cancer and new bladder metastasis. PET image obtained at same level as A shows anterior layering of excreted 18F-FDG (arrow), thereby revealing FDG-avid mass in posterior bladder.

View larger version (120K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —72-year-old man with colon cancer and new bladder metastasis. Fused PET/CT image. Note that some misregistration (arrow) occurred due to gradual filling of bladder with urine between time of CT and time of PET image acquisitions.

View larger version (31K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —Agitated PET/CT phantom. Volume-rendered CT reconstruction of bottle containing 18F-FDG solution and dilute iodinated contrast material that was shaken 5 minutes before imaging. Note gradual CT attenuation gradient with increased CT attenuation fluid in dependent portion of bottle.

View larger version (54K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —Agitated PET/CT phantom. Volume-rendered reconstruction of fused PET/CT scan corresponding to A shows higher FDG activity displaced in nondependent portion of bottle.

View larger version (50K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5 —Nonagitated PET/CT phantom. Volume-rendered reconstruction of fused PET/CT images shows well-defined fluid-fluid level (arrow) after slow, dependent injection of iodinated contrast material, which anteriorly displaced 18F-FDG solution.

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