Radiological impact of the use of calcium hydroxylapatite dermal fillers

Abstract

Aim: To report a case series in which the radiological features of the subcutaneous use of calcium hydroxylapatite (CaHa) dermal fillers are described for the first time.

Materials and methods: Five patients with facial hyperattenuating hypermetabolic subcutaneous lesions were identified on 2- [(18)F]-fluoro-2-deoxy-D-glucose (FDG) positron-emission tomography/computed tomography (PET/CT), who gave a history of facial injections to augment physical appearance. Correlation with additional imaging studies was performed.

Results: All cases had subcutaneous high attenuation material on CT (range 280-700HU), which was FDG avid on PET, with a standardized uptake value (SUV) range of 2.9-13.4. Magnetic resonance imaging (MRI) demonstrated a heterogeneous intermediate signal intensity subcutaneous lesion with enhancement post-gadolinium in one case.

Conclusions: CaHa dermal filler is hyperattenuating on CT, hypermetabolic on FDG-PET imaging, of intermediate signal intensity on MRI, and is a potential cause of a false-positive imaging study.