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Case Reports
. 2007 Aug 3:7:147.
doi: 10.1186/1471-2407-7-147.

Case report: PET/CT, a cautionary tale

Jayson Wang  1 , Gary Cook, John Frank, Roberto Dina, Naomi Livni, John Lynn, William Fleming, Michael J Seckl
Affiliations
Case Reports

Case report: PET/CT, a cautionary tale

Jayson Wang et al. BMC Cancer. .

Abstract

Background: The use of combined positron emission tomography/computerised tomography (PET/CT) scanners in oncology has been shown to improve the staging of tumours and the detection of relapses. However, mis-registration errors are increasingly recognised to be a common pitfall of PET/CT studies.

Case presentation: We report a patient with a germ cell tumour of the testis, who underwent a PET/CT scan to detect the site of relapse with a view to surgical removal. However, the PET/CT scan mislocalised the tumour site to be within the T2 vertebral body. A subsequent endoscopic ultrasound scan however showed the tumour to be anterior to the vertebral body, which was confirmed at surgery.

Conclusion: In this report, we highlight the artefactual mislocalisation errors which may occur with PET/CT imaging, and the need to review and verify these scans.

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Figures

Figure 1
Figure 1
A & B: Axial and sagital view of 18FDG-PET scan of the patient showing region of 18FDG uptake anterior to the vertebral body. C: CT scan of the positive region identified on the 18FDG-PET scan. D: MRI of the thoracic spine in the region identified on the PET scan. E & F: Axial and sagital view of PET/CT scan of the patient showing that the lesion with 18FDG uptake was within the vertebral body. G: Endoscopic ultrasound image showing the tumour anterior to the vertebral body. H: Non-attenuated PET scan image from the PET/CT scan.
Figure 2
Figure 2
A: Haematoxylin and eosin stained section of the tumour resected from the mediastinal of the patient (100× magnification). The tumour nodule showed evidence of organoid arrangement. B: Section of the resected tumour showing tumour cells expressing AFP, as detected by immunohistochemistry (600× magnification). C: Graph of the AFP marker profile from 1993 to 2005 showing the history for relapses and treatments received by the patient.
See this image and copyright information in PMC

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