PET-BT’de Uterusda Tesadüfi Olarak Saptanan Benign/Fizyolojik 18F-FDG Tutulumları ve Etkileyen Faktörler

Amaç: Flor-18 işaretli florodeoksiglukoz (18F-FDG ) ile pozitron emisyon tomografisi/bilgisayarlı tomografi (PET-BT) tetkiki sırasında fizyolojik ve/veya benign nedenlerle oluşabilecek uterin 18F-FDG tutulumları ve bunu etkileyebilecek faktörleri araştırmaktır. Gereç ve Yöntem: Jinekolojik onkolojik patolojiler dışındaki nedenlerle PET-BT çekilen ve yüksek uterin 18F-FDG tutulumu saptanan, geçirilmiş uterin cerrahisi olmayan 10’u premenopozal toplam 16 hasta çalışmaya dahil edildi. Tüm hastalar pelvik manyetik rezonans (MR) tetkiki ile değer-lendirildi. Bulgular: Yüksek uterin 18F-FDG tutulumu mevcut olan 16 hastamızın 13’ünde uterin leiomyom saptanırken 3’ünde herhangi bir pelvik patoloji saptanmadı. Pelvik patoloji saptanmayan hastaların hepsine menstrüasyon döneminde PET-BT çekildiği saptandı. Leiomyom’lu 13 hastanın ortalama SUVmax değeri 5.41 idi. Yapılan istatistiksel analizde SUVmax değeri ile yaş, menopoz durumu, kan LDH düzeyi, miyom çapı, miyomun tekli/çoklu olması ve tamoksifen kullanımı parametreleri arasında korelasyon olmadığı saptandı. Menstrüasyon‘a bağlı uterin 18F-FDG tutulumu saptadığımız 3 hastanın ortalama SUVmax değeri 7.3’dü. Sonuç: Özellikle premenopozal dönemde PET-BT’de rastlantısal saptanan uterin 18F-FDG tutulumlarının, malign süreçler ekarte edildikten sonra menstrüasyona ya da benign patolojilere bağlı olabileceği akılda tutulmalıdır.

Incidentally Detected Benign/Physiologic Uterine 18F-FDG Uptake in PET-CT and Affecting Factors

Objective: The aim is to investigate the uterine uptake that may be caused by physiologic and/or benign reasons during fluorine-18 fluorodeoxyglu-cose (18F-FDG ) positron emission tomography/computed tomography (PET-CT) examination and the factors affecting it. Material and Method: A total number of 16 patients with high uterine 18F-FDG uptake, who had not undergone surgery and who had a PET-CT scan due to reasons other than gynecologic oncology were included in the study. Ten of them were in the premenopausal period. All patients were examined with pelvic magnetic resonance imaging (MRI). Results: Of the total 16 patients with high uterine 18F -FDG uptake, uterine leiomyoma was detected in 13 of the patients, whereas there was not any sign of pelvic pathology in 3 of the patients. It was understood that the patients who were not diagnosed with pelvic pathology, had received PET-CT scan during their menstruation period. Mean SUVmax value of the 13 patients with leiomyoma was 5.41. It was determined by the statistical analysis that there is no correlation between SUVmax value and the parameters such as age, menopausal status, serum LDH level, diameter of myoma, single or multiple status of the myomas and administration of tamoxifen. Mean SUVmax values of 3 patients with detected menstruation-related uterine 18F-FDG uptake was 7.3. Conclusion: It should be kept in mind that especially in premenopausal period, uterin 18F-FDG uptake which is incidentally detected during PET-CT may be related to menstruation or benign pathologies after excluding malignant processes.

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