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First published online September 27, 2006
British Journal of Radiology (2007) 80, 3-11
© 2007 British Institute of Radiology
doi: 10.1259/bjr/92105597
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Benign variations and incidental abnormalities of myocardial FDG uptake in the fasting state as encountered during routine oncology positron emission tomography studies

K Fukuchi, MD 1,3 H Ohta, MD 2 K Matsumura, MD 2 and Y Ishida, MD 3

1 PET Imaging Center, Shizuoka General Hospital, Shizuoka, 2 Higashitemma Clinic, Osaka, 3 Department of Nuclear Medicine and Radiology, National Cardiovascular Center, Suita, Osaka, Japan


Figure 1
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  		Figure 1. No apparent left ventricular FDG uptake in a patient with non-cardiac disease. Weak FDG activity is seen in the left ventricular cavity as a blood pool. (a) Coronal section and (b) transaxial section.

 

Figure 2
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  		Figure 2. Serial FDG coronal images of the same patient at different examinations.(a,b) No apparent cardiac uptake is seen in the first examination. (c,d) Relatively diffuse cardiac uptake is seen in the second examination, which was performed approximately 4 months after the first examination.

 

Figure 3
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  		Figure 3. Non-homogeneous but physiological FDG uptake in the left ventricle. The base of the heart is often the last to lose FDG uptake, resulting in focal uptake (arrow). (a) Maximal intensity projection image and (b) transaxial section.

 

Figure 4
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  		Figure 4. Atrial muscle FDG uptake. FDG uptake in the left atrium is often detected, can be irregular and may be associated with somewhat focal activity(arrow).

 

Figure 5
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  		Figure 5. A case with lipomatous hypertrophy of the interatrial septum(LHIS). (a) An unenhanced CT scan showing fat density in the interatrial septum. (b) PET image and (c) fused PET/CT image showing increased FDG uptake in LHIS.

 

Figure 6
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  		Figure 6. A patient with old myocardial infarction.(a) Myocardial FDG uptake is observed in the entire left ventricular wall, but a decreasing uptake is seen in the anteroseptal region (black arrow). (b) CT scan from PET/CT demonstrating linear fat deposition (white arrow). (c) Fused PET/CT clearly depicts the decreased FDG uptake corresponding to fat deposited myocardial infarction (white arrow).

 

Figure 7
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  		Figure 7. A patient with atrial fibrillation.(a) Coronal section and (b) transaxial section. Increased FDG uptake is clearly noticed in the enlarged right atrial wall (arrow).

 

Figure 8
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  		Figure 8. A patient with complete left bundle branch block.(a) The myocardial perfusion in the septal wall is decreasing in Technetium-99m sestamibi single photon emission tomography. (b) FDG uptake is also decreasing more greatly and widely than the perfusion abnormality.

 

Figure 9
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  		Figure 9. Cases with cardiomyopathy.(a) A patient with hypertrophic cardiomyopathy. Intense FDG uptake in the hypertrophic septal wall is observed (arrow). (b) A patient with dilated cardiomyopathy. Enlarged left ventricular cavity and relatively homogeneous FDG uptake are seen.

 

Figure 10
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  		Figure 10. A patient with primary pulmonary hypertension. Enlarged right ventricular wall and increased FDG uptake are demonstrated.(a) Transaxial section of FDG PET and (b) contrast enhanced CT image.

 

Figure 11
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  		Figure 11. A patient with cardiac sarcoidosis and complete atrioventricular block. Multifocal FDG uptake in the basal left ventricular wall is seen(arrow). Right ventricular non-homogeneous uptake is also visualized (arrowhead).

 

Figure 12
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  		Figure 12. A patient with right ventricular metastasis from uterine cervical carcinoma.(a) Broad intense FDG accumulation is seen in the right ventricular wall. (b) Contrast enhanced CT scan revealing that the mass is located in the epicardial portion of the right ventricle and invading toward the pericardium.

 

Figure 13
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  		Figure 13. A patient with malignant lymphoma in the right atrium.(a) Transaxial image depicting dense FDG uptake in the right heart system. (b) Contrast enhanced CT revealing that the huge mass is located in the right atrium.

 




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