Comparison of standardized uptake values measured on F-NaF PET/CT scans using three different tube current intensities

Pitfalls and artifacts in the interpretation of oncologic PET/CT of the chest

PET/CT is widely used for the evaluation of patients with thoracic malignancies. Although the levels of ¹⁸F-fluorodeoxyglucose (FDG) uptake are usually high in neoplastic diseases, they can also be physiological, due to artifacts. In addition, FDG uptake can occur in benign conditions such as infectious, inflammatory, and iatrogenic lesions. Furthermore, some malignant tumors, such as adenocarcinoma in situ (formerly known as bronchoalveolar carcinoma) and carcinoid tumors, may not show FDG uptake. Here, we illustrate the main pitfalls and artifacts in the interpretation of the results of oncologic PET/CT of the chest, outlining strategies for avoiding misinterpretation.