Objective: The aim of this study was to compare the dynamic distribution of fluorodeoxyglucose (FDG) in malignant and in infectious lesions.
Methods: The dynamic distribution of FDG was studied in Rowett nude (RNU) rats with a LS174T carcinoma xenograft in the left front leg and an Escherichia coli-induced focal infection in the right front leg. In 5 rats, dynamic FDG-PET was performed (27 frames of 6-15 minutes) up to 4 hours after injection of 11 MBq 18FDG. The mean FDG uptake (SUV) was calculated and plotted by using a region of interest (ROI) centered over both lesions. In groups of 6 rats, the biodistribution of FDG was determined by counting dissected tissues at 1, 2, 3, and 4 hours after an injection of 11 MBq FDG. Means +/- the standard error of the mean (SEM) were calculated.
Results: Dynamic positron emission tomography (PET) visualized both the tumor and the infection. The ROI analysis showed that FDG uptake in the infections was faster and higher, as compared to the tumor lesions. FDG uptake in the tumor reached a standardized uptake value (SUV) of 0.8 +/- 0.3 at 60 minutes and in the infectious lesions a SUV of 1.6 +/- 0.2 at 45 minutes, both remaining constant until 4 hours postinjection (p.i.). In the biodistribution study with ex vivo tissue counting, FDG had accumulated up to 1.1 +/- 0.1 %ID/g and 0.8 +/- 0.1 %ID/g at 1 hour in the tumor and infection, respectively, and remained constant until 4 hours for both lesions without significantly different wash-out from the 2 lesions. The tumor/blood and abscess/ blood ratios increased with time to 57 +/- 17 and 48 +/- 14, respectively.
Conclusion: Although in this model differences in absolute FDG uptake and initial kinetics between tumor and infection were observed, the wash-out rate of FDG from the lesions was similar over time. The retention of FDG in the inflammatory lesion indicated that dual time-point imaging does not necessarily resolve diagnostic pitfalls for FDG-PET in oncology in order to discriminate between malignant tumorous and benign infectious lesions.