Following invasive thoracic procedures, it's possible to mistake increased radiotracer uptake on positron emission tomography (PET) for malignancy, cautions a group of clinicians.

Following invasive thoracic procedures, it's possible to mistake increased radiotracer uptake on positron emission tomography (PET) for malignancy, cautions a group of clinicians in the September issue of Mayo Clinic Proceedings.

In the paper, they describe five patients in whom PET scans using fluorine 18-labeled fluorodeoxyglucose showed increased metabolic activity without corresponding abnormalities on computed tomography after bronchoscopic biopsy or thoracoscopic wedge resection.

"To our knowledge, we are the first to report such a finding," write Dr. Margaret M. Johnson from Mayo Clinic, Jacksonville, Florida, and colleagues.

In three patients, increased radiotracer uptake was evident on PET scans obtained between six and 12 days after bronchoscopic biopsy, while in two patients increased uptake of lower intensity was evident three weeks after thoracoscopic lung resection.

The researchers hypothesize that the increased glucose metabolism seen in these patients "likely results from procedure-induced tissue damage, which leads to an inflammatory response that attracts neutrophils and macrophages."

"These five cases illustrate a previously unreported potential cause of false-positive PET scan interpretations," Dr. Johnson and colleagues comment. "Performing diagnostic and staging PET before invasive thoracic procedures can eliminate the potential for clinical misjudgment," they suggest.

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