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J Nucl Med. 2008; 49 (Supplement 1):251P
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General Clinical Specialties: General Practice-Oncology

General Practice-Oncology Posters

The significance of a fatty hilum within an FDG avid lymph node

Julio Sepulveda1, Wanzhen Zeng1, John Carew2 and David Schuster1

1 Radiology, Emory University Hospital, Atlanta, Georgia; 2 School of Public Health, Emory University, Atlanta, Georgia

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Objectives: A fatty hilum within a lymph node on CT is considered a benign characteristic. Yet, at times there is associated FDG activity. This study examines the nature of FDG uptake within nodes with a fatty hilum on PET/CT.

Methods: 11 PET/CT scans for cancer staging that had increased FDG uptake in lymph nodes with fatty hila were retrospectively reviewed. Benign or malignant etiology were determined by clinical and imaging follow-up. 95% bootstrap confidence intervals were computed to assess the mean differences in SUVmax and short-axis nodal diameter between benign and malignant nodes.

Results: Twelve lymph nodes from eleven patients with FDG uptake and fatty hila had a mean SUV of 4.7 ± 2.7 (range: 2.2 to 11.4), and a mean diameter of 1.2 cm ± 0.4 (range: 0.7 to 1.6 cm). Six lymph nodes were of malignant etiology. The mean SUV of the malignant nodes was 5.3 ± 3.7 with a mean diameter of 1.4 cm ± 0.4. Six lymph nodes were of benign etiology. Mean SUV of the benign nodes was 4 ± 1.4 with a mean diameter of 1 cm ± 0.2. Confidence intervals for the mean SUV and diameter differences are (-4.43, 1.27) and (-0.733, -0.0667), respectively.

Conclusions: Hypermetabolic activity in a lymph node with a fatty hilum may be of benign or malignant etiology. The 95% confidence interval for SUV overlaps zero, indicating no evidence of a difference in SUV between benign and malignant nodes. There is weak evidence to support that malignant nodes are larger. The presence of a fatty hilum should not dissuade further investigation in the proper clinical scenario.





This Article
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Sepulveda, J.
Right arrow Articles by Schuster, D.
PubMed
Right arrow Articles by Sepulveda, J.
Right arrow Articles by Schuster, D.