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Prevalence, Challenges, and Solutions for ¹⁸F-FDG PET Studies of Obese Patients: A Technologist's Perspective

¹ Nuclear Medicine Technology Program, Department of Medical Imaging and Radiation Therapeutics, Doisy College of Health Sciences, Saint Louis University, St. Louis, Missouri; and ² Division of Nuclear Medicine, Department of Radiology, Saint Louis University, St. Louis, Missouri

View larger version (23K): [in this window] [in a new window]   FIGURE 1.  Excess body weight by sex.

View larger version (67K): [in this window] [in a new window]   FIGURE 2.  Coronal PET maximum-intensity projection of 132-kg (290-lb) 49-y-old woman (BMI, 42; blood glucose level, 104 mg/dL) with history of melanoma in whom only emission images were obtained. She refused transmission portion of scan because of being uncomfortable.

View larger version (76K): [in this window] [in a new window]   FIGURE 3.  Coronal PET maximum-intensity projection of 159-kg (350-lb) 50-y-old man (BMI, 48; blood glucose level, 93 mg/dL) with history of melanoma who was imaged with arms up. Images are normally acquired with arms down, but because of body habitus, this patient would fit in scanner only with arms up.

View larger version (78K): [in this window] [in a new window]   FIGURE 4.  Coronal PET maximum-intensity projection of 158-kg (348-lb) 61-y-old man (BMI, 47; blood glucose level, 165 mg/dL) with history of pancreatic cancer who was imaged with only right arm up because of shoulder pain in left arm.

View larger version (141K): [in this window] [in a new window]   FIGURE 5.  Coronal PET maximum-intensity projection of 168-kg (370-lb) 51-y-old man (BMI, 52; blood glucose level, 138 mg/dL) with suggestive lung nodule who was imaged in left decubitus position. Images were limited by vast size of this patient's abdomen.

View larger version (87K): [in this window] [in a new window]   FIGURE 6.  Coronal PET maximum-intensity projection of 170-kg (375-lb) 72-y-old man (BMI, 55; blood glucose level, 98 mg/dL) with lung nodule who was imaged prone with both arms extended over his head. Note heart position.