FDG-PET/CT in Skeletal Muscle: Pitfalls and Pathologies

• Published in: Seminars in nuclear medicine Vol. 47; no. 4; pp. 362 - 372
• Main Authors: Parida, Girish Kumar, MD, Roy, Shambo Guha, MD, Kumar, Rakesh, MD, PHD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2017
• Subjects: Fluorodeoxyglucose F18; Humans; Muscle, Skeletal - diagnostic imaging; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiology; Radiopharmaceuticals; Tissue Distribution; Tomography, X-Ray Computed
• ISSN: 0001-2998; 1558-4623
• DOI: 10.1053/j.semnuclmed.2017.02.003

FDG-PET/CT is an integral part of modern-day practice of medicine. By detecting increased cellular metabolism, FDG-PET/CT can help us detect infection, inflammatory disorders, or tumors, and also help us in prognostication of patients. However, one of the most important challenges is to correctly differentiate the abnormal uptake that is potentially pathologic from the physiological uptake. So while interpreting a PET/CT, one must be aware of normal biodistribution and different physiological variants of FDG uptake. Skeletal muscles constitute a large part of our body mass and one of the major users of glucose. Naturally, they are often the site of increased FDG uptake in a PET study. We as a nuclear medicine physician must be aware of all the pitfalls of increased skeletal muscle uptake to differentiate between physiological and pathologic causes. In this review, we have discussed the different causes and patterns of physiological FDG uptake in skeletal muscles. This knowledge of normal physiological variants of FDG uptake in the skeletal muscles is essential for differentiating pathologic uptake from the physiological ones. Also, we reviewed the role of FDG-PET/CT in various benign and malignant diseases involving skeletal muscle.