CTICasesMultifocal Ground-Glass Adenocarcinoma with Unexpected High FDG Uptake
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Imaging findings
A patient with multiple lung adenocarcinomas, including a ground-glass nodule observed in 2004. This ground-glass nodule exhibited remarkably high FDG activity on PET imaging, which is unusual for typically low-grade ground-glass lesions. Subsequent imaging showed this and other developing nodules, all presumed to be adenocarcinomas. While blooming artifact was considered, the nuclear medicine team believed the uptake was real.
Key takeaways
This case highlights the variability in FDG avidity of ground-glass nodules and lung adenocarcinomas. While low-grade ground-glass lesions typically show low or no FDG uptake, this case demonstrates that high uptake can occur, posing a diagnostic challenge and potentially leading to misinterpretation or questions of artifact. It reminds practitioners that PET avidity does not perfectly correlate with grade or invasiveness in all pulmonary adenocarcinomas, especially those with a ground-glass component.
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