Anemia and PET imaging

Aim Anemia is a blood disorder characterized by reduced Hemoglobin concentration and/or red blood cells numbers. Most common causes of anemia are iron deficiency anemia and anemia of chronic disease (anemia of chronic inflammation), but there is a long list of conditions which cause anemia. Bone marrow (BM), spleen, and liver are the main organs but various other tissues are also involved depending on the type of anemia. In this article, we aimed to review the role of PET imaging in anemia. Methods Normal BM, typical and atypical forms of hematopoiesis, pathogenesis of various forms of anemia, and PET findings in anemia with various radiotracers such as F-18-fluorodeoxyglucose, F-18-fluorothymidine, Fe-52 compounds and F-18-sodium fluoride were reviewed. Results In cases with anemia PET can help in determining the extent of BM expansion, distribution of BM, detecting proliferative activity of BM and BM islands in acellular BM on iliac biopsy, guiding BM biopsies, detecting typical or atypical extramedullary hematopoiesis, acute BM infarctions and various other complications such as osteomyelitis, cerebral infarction and infarction in various other tissues. Anemia-related PET findings can mimic tumor/metastases. Conclusion PET imaging is useful for assessing various types of anemia. It is also important to be aware of anemia-related PET findings to avoid mistaking them for malignancy or metastases.