Technical Improvements in Fluorine-18-FDG PET Imaging of the Abdomen and Pelvis

Abstract

PET tumor imaging of the abdomen and pelvis is prone to artifacts due to urinary tract activity. A new technique has been developed to reduce such artifacts and enhance study interpretation.

Methods: Thirty minutes after the injection of ¹⁸F-FDG, 500 cc 0.45% NaCI were administered intravenously over 30 min and a Foley catheter was placed in the bladder. At the start of imaging (60 min post-injection), furosemide was given (0.3 mg/kg). Prior to imaging the pelvis, the urinary catheter was clamped and saline was introduced retrograde into the bladder until full.

Results: This technique has been used successfully in more than 130 patients, resulting in a marked improvement in study quality and tumor detection.

Conclusion: Hydration and administration of furosemide, along with placement of a Foley catheter in the bladder, have proven effective in eliminating image artifacts originating from the kidneys, ureters and bladder. Backfilling the bladder also provides a well-defined anatomic landmark for study interpretation.