Pitfalls in integrated CT-PET of the thorax: Implications in oncologic imaging

Integrated computed tomography-positron emission tomography (CT-PET) scanners improve localization of regions of increased [18F]-fluoro-2-deoxy-D-glucose (FDG) uptake and staging accuracy by allowing the near-simultaneous acquisition of coregistered, spatially matched functional and morphologic data in the same examination. However, many benign lesions can accumulate FDG and be potential pitfalls in interpretation. With the increased use of CT-PET in oncologic imaging, misinterpretation of these potential pitfalls can have significant clinical ramifications and alter staging and management. In this article, we review the physiologic uptake of FDG, normal variants, and potential pitfalls in the integrated CT-PET imaging of the thorax and their implications in oncologic imaging.