Journal
JOURNAL OF NUCLEAR MEDICINE
Volume 62, Issue 9, Pages 1301-1306Publisher
SOC NUCLEAR MEDICINE INC
DOI: 10.2967/jnumed.120.256081
Keywords
F-18-FDG PET; brain; hypermetabolism; epilepsy
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When interpreting clinical F-18-FDG PET scans of the brain in children, hypometabolism is typically seen, with occasional focal areas of hypermetabolism that may not necessarily indicate seizure activity. Various conditions can cause focal hypermetabolism on F-18-FDG PET studies, and it is important for radiologists and nuclear medicine physicians to be aware of these to accurately assess the findings.
When one is interpreting clinical F-18-FDG PET scans of the brain (excluding tumors) in children, the typical abnormality seen is hypometabolism of various brain regions. Focal areas of hypermetabolism are noted occasionally, and the usual interpretation is that the hypermetabolic region represents a seizure focus. In this review, I discuss and illustrate the multiple causes of hypermetabolism on F-18-FDG PET studies that should not be interpreted as seizure activity, as such an interpretation could potentially be incorrect. Various conditions in which focal hypermetabolism can be encountered on F-18-FDG PET studies include interictal hypermetabolism, Sturge-Weber syndrome, changes associated with brain plasticity after injury, Rett syndrome, hypoxic-ischemic brain injury, various inborn errors of metabolism, and autoimmune encephalitis. The radiologist or nuclear medicine physician interpreting clinical F-18-FDG PET studies should be aware of these circumstances to accurately assess the findings.
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