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False positive fluorine-18 fluorodeoxy-D-glucose positron emission tomography finding caused by osteoradionecrosis in a nasopharyngeal carcinoma patient

Departments of ¹ Nuclear Medicine, ² Radiation Oncology and ³ Diagnostic Radiology, Chang Gung Memorial Hospital and University, 5 Fu-Hsing Street, Kweishan Taoyuan 333, Taiwan

View larger version (90K): [in a new window]   Figure 1. The contrast-enhanced MRI images, (a) coronal view, (b) transverse view, revealed a soft tissue lesion in the nasopharynx with bony destruction in the skull base (arrowhead). The lesion was more prominent than before. Therefore, recurrent tumour was highly suspected.

View larger version (82K): [in a new window]   Figure 2. The whole body FDG PET scan was performed at 40 min after intravenous injection of 370 MBq (10 mCi) of 18F-FDG. One focal area of significant FDG-6-phosphate accumulation in the right skull base region was noted (arrow). The delayed imaging was performed 3 h after injection. (a) Coronal view, (b) transverse view; SUVmax in early and delayed images were 5.1 and 5.3, respectively. The lesion was later debrided and proved to be osteoradionecrosis without malignant cells histologically.

View larger version (78K): [in a new window]   Figure 3. In order to rule out the possibility of inaccurate siting of the surgery, FDG PET scan was performed again 2 months after debridement, (a) coronal view, (b) transverse view. No treatment for cancer was prescribed between the two scans. The scan revealed that the previous FDG avid lesion had disappeared.