F-18 FDG PET/CT characterization of talc pleurodesis-induced pleural changes over time: a retrospective study

Clin Nucl Med. 2009 Dec;34(12):886-90. doi: 10.1097/RLU.0b013e3181bece11.


Purpose: The current study characterized pleural changes induced by talc pleurodesis (TP), based on serial positron emission tomography/computer-tomography (PET/CT) with F-18 fluorodeoxyglucose (FDG).

Materials and methods: A total of 8 cancer patients who had both TP and PET/CT and no evidence of active pleural involvement after TP were retrospectively evaluated. Maximum standard uptake values, maximum Hounsfield units (HU), and thickness were followed over time.

Results: The 8 patients had 25 PET/CT scans performed in an average of 22 months after TP. An increased FDG uptake was associated with an increase in pleural thickness within 5 months after TP, and both parameters showed statistical significance as compared with findings before TP. After 5 months of TP, the standard uptake value appeared to persist or increase further, and the pleural thickening stabilized. The formation of calcification was a slow process and might lag behind the changes in FDG metabolism and pleural thickness. The HU did not change significantly once pleural calcification had been formed.

Conclusions: Knowledge of aforementioned pleural changes may help differentiate TP induced pleural inflammation from pleural malignancy and to avoid false-positive interpretation of FDG PET/CT exams.

MeSH terms

  • Diagnosis, Differential
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Male
  • Middle Aged
  • Pleural Effusion / diagnosis*
  • Pleural Effusion / therapy*
  • Pleural Neoplasms / diagnosis
  • Pleurisy / diagnosis
  • Pleurisy / etiology
  • Pleurodesis / methods*
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Radiopharmaceuticals
  • Retrospective Studies
  • Talc / administration & dosage*
  • Talc / adverse effects
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Talc