Cristina Nanni Stefano Fanti Lucia Zanoni Radiology for PET/CT Reporting 123 Cristina Nanni – Stefano Fanti – Lucia Zanoni Radiology for PET/CT Reporting Cristina Nanni – Stefano Fanti – Lucia Zanoni Radiology for PET/CT Reporting Cristina Nanni Lucia Zanoni Department of Nuclear Medicine Department of Nuclear Medicine Universitary Hospital Universitary Hospital Sant’Orsola-Malpighi Sant’Orsola-Malpighi Bologna Bologna Italy Italy Stefano Fanti Department of Nuclear Medicine Universitary Hospital Sant’Orsola-Malpighi Bologna Italy ISBN 978-3-642-40293-7 ISBN 978-3-642-40294-4 (eBook) DOI 10.1007/978-3-642-40294-4 Springer Heidelberg New York Dordrecht London Library of Congress Control Number: 2013954849 © Springer-Verlag Berlin Heidelberg 2014 Th is work is subject to copyright. 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Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. Th e use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. Th e publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Pref ace PET/CT reading may sometimes be challenging. It is not infrequent, in fact, to meet abnormal fi ndings on CT images (even not related to the neoplastic disease under evaluation) that are functionally silent and therefore diffi cult to interpret for nuclear medicine practitioners. Frequently, these fi ndings are clinically relevant and deserve to be reported, interpreted, and compared to previous scans. Th is may have an impact on patient management since the highest diagnostic information must be provided by an expensive test such as PET/CT. Generally CT images associated to a PET scan are acquired in a low-dose modality and therefore turn out to be suboptimal for CT image interpretation. Sometimes a comparison with a full-resolution and contrast- enhanced CT atlas may be diffi cult. Low-dose CT slices are thicker than diagnostic CT and poorer in anatomical details, and this aff ects the accuracy in recognizing both anatomical structures and pathologi- cal fi ndings. Th is atlas provides a “normal anatomy” chapter that is built on low-dose CT images from PET/CT standard acquisition, identifying all the relevant anatomical structures detectable without contrast media administration that can help in accurately describ- ing all FDG-positive fi ndings extension. Other chapters (thorax, abdomen, pelvis, musculoskeletal system) present cases with common and uncommon FDG-negative anatomical abnormalities. All the images can be directly compared to the CT images acquired on standard PET/CT. In the end, this atlas is aimed to help nuclear medicine practitioners routinely reading PET/CT scan in easily recognizing and interpreting the most common CT abnormalities. Bologna Cristina Nanni July 2013 Stefano Fanti Lucia Zanoni v Contents Chapter 1 Normal Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Chapter 2 Head and Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Chapter 3 Thorax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Chapter 4 Abdomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Chapter 5 Pelvis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Chapter 6 Musculoskeletal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 vii Chapter 1 Normal Anatomy C. Nanni et al., Radiology for PET/CT Reporting, 1 DOI 10.1007/978-3-642-40294-4_1, © Springer-Verlag Berlin Heidelberg 2014 1 Normal Anatomy 2