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131I scan plays a crucial role in the management of patients with differentiated thyroid cancer for the evaluation of remnant thyroid tissue, residual/recurrent metastatic disease, posttherapy tracer distribution, and response assessment to high-dose 131I therapy. Different causes secondary to physiological, pathological, and anatomical variations have been described for false-positive findings in the whole-body planar images. This case report of a patient of differentiated thyroid cancer with undocumented trauma to the left knee region a day before receiving the high-dose radioiodine therapy showed an interesting image finding of tracer uptake at unusual site in the posttherapy whole-body 131I scan.

Author(s): Muhonen, Ethan G; Mahboubi, Hossein; Moshtaghi, Omid; Sahyouni, Ronald; Ghavami, Yaser; Maducdoc, Marlon; Lin, Harrison W; Djalilian, Hamid R | Abstract: ObjectivesTo investigate false-positive findings on non-echoplanar (non-EPI) diffusion-weighted magnetic resonance imaging (DWI) in patients under surveillance post-cholesteatoma surgery.Study design, setting, subjects, and methodsA retrospective review was performed on patients diagnosed with cholesteatoma who underwent surgical resection and were then followed by serial non-EPI DWI using half-Fourier acquisition single-shot turbo spin echo (HASTE) sequence. All patients had at least two annual follow-up imaging studies.ResultsFalse-positive findings were identified in four patients. The size of the suspected lesions was 4 to 12 mm. Otoendoscopy was used during all primary cases and Argon laser was used in one case. In all cases, the entire cholesteatoma was removed, and no residual disease was detected at the end of the procedures. One patient underwent revision surgery but only cartilage graft was found in the area of concern. All patients had stable or resolved hyperintense areas in the subsequent HASTE sequences.ConclusionFalse positive findings can occur with non-EPI DWI MRI and patients need to be counseled accordingly before revision surgery. Decreasing intensity and dimension of a suspected lesion and a positive finding in an area other than the location of the initial cholesteatoma may favor a false positive. If a false positive finding is suspected when the surgeon is confident of complete resection of the cholesteatoma, an MRI can be repeated in 6 to 12 months to assess changes in the dimension and intensity of the area of concern. Cartilage grafts may cause restricted diffusion on DWI sequences.

Background The F-18 fluorodeoxyglucose positron emission/computed tomography (FDG PET/CT) has become an established diagnostic imaging for malignancy. However, there are other diseases that can also be identified with FDG, some of them are infections such as tuberculosis. Case presentation In this case report, two patients showed multiple hypermetabolic tuberculosis lesions on FDG PET/CT, with one of the patients having history of malignancy. The objective of the present case report is to emphasize the need to use other differential diagnosis techniques for tuberculosis especially in tuberculosis-endemic countries when interpreting FDG PET/CT. Conclusion By analyzing diagnostic imaging alone, there is a high chance of misinterpreting asymptomatic tuberculosis patient as having malignancy. Therefore, there is need for correlation with clinical data as well as other imaging modalities and PET/CT with more specific tracer in order to differentiate malignancy from benign disease such as tuberculosis.

A 73-year-old man with history of prostatic adenocarcinoma radical prostatectomy underwent 99mTc-MDP whole-body bone scan and subsequent 68Ga-labeled prostate-specific membrane antigen (PSMA) ligand PET/CT for restaging due to a gradual rise of prostate-specific antigen levels. Whole-body bone scan showed two focal zones of slightly increased uptake in the right fronto-parietal and temporal bones. 68Ga-PSMA PET/CT scan showed local recurrence in the prostatic bed and two foci of slightly increased uptake in the right temporal and fronto-parietal lobes. A brain CT scan, with IV contrast confirmed that foci of increased uptake in the temporal and parietal lobes were consistent with typical meningioma.

Primary Epstein–Barr virus (EBV) infection is common in childhood, and dual positivity of serum EBV IgM and cytomegalovirus (CMV) IgM antibodies occur in some cases. This study aimed to evaluate the cause of EBV and CMV IgM dual positivity to determine whether it represents a false-positive finding or a true coinfection. A total of 494 children diagnosed with primary EBV infection, manifesting as infectious mononucleosis, were recruited. The diagnosis was based on positive EBV viral capsid antigen (VCA) IgM antibodies, and serum CMV IgM antibodies and liver enzymes were also evaluated in 149 subjects. Of 149 children with primary EBV infection, 40 (26.8%) had serum EBV VCA IgM and CMV IgM dual positivity. However, true CMV infection was confirmed only in 1 child of 40 (2.5%) who was positive for both serum CMV Ag and urine CMV polymerase chain reaction (PCR) and negative for serum CMV IgG antibody. Among the children with primary EBV infection, the rate of dual positivity was higher in infants and lower in adolescents (P = .013). Liver enzymes were more significantly elevated in children with dual positivity than in those with negative results for CMV IgM antibodies (P = .026), which correlated with the serum EBV and CMV IgM titers. Serum EBV and CMV IgM dual positivity are more prevalent in children with primary EBV infection than what was previously reported. Our results indicate that serum EBV and CMV IgM dual positivity represents a false-positive finding, as opposed to an actual CMV coinfection, possibly due to antigenic cross-reactivity.

We present two cases of cholesteatoma and one false positive finding in non-EP DW MRI in order to highlight the differential diagnosis in imaging and emphasize the need to discuss the findings with the otologic surgeon. The first case demonstrates different MRI signal patterns encountered in a patient with cholesteatoma. The second report is a rare case of supralabyrinthine cholesteatoma with atypical clinical presentation. The third case presents a rare but important false positive finding in non-EP DW MRI. Clinical and imaging findings are discussed taking into account the current literature.

Xanthogranulomatous inflammation in the spinal epidural space is extremely rare. We report a case of a 62-year-old man with a xanthogranulomatous inflammation in the spinal epidural space mistaken for lymphoma because of its avid F FDG uptake on PET/CT. This case emphasizes the need for caution when evaluating a spinal epidural mass using F FDG PET/CT as xanthogranulomatous inflammation can induce a false-positive reading on F-FDG PET/CT.

An outbreak of dengue fever occurred in Japan in August 2014. We herein report the case of a 63-year-old man who presented with a persistent fever in September 2014. Acute parvovirus B19 infection led to a false positive finding of dengue fever on a rapid diagnostic test (Panbio Dengue Duo Cassette(TM)). To the best of our knowledge, there are no previous reports of a false positive result for dengue IgM with the dengue rapid diagnostic test. We believe that epidemiological information on the prevalence of parvovirus B19 is useful for guiding the interpretation of a positive result with the dengue rapid diagnostic test.

Sclerosing Angiomatoid Nodular Transformation (SANT) is a rare benign vascular tumor of spleen. It consists of multiple angiomatoid nodules surrounded by dense fibrous tissue that often coalesces centrally to form a scar, which is considered to be a characteristic feature. These are usually asymptomatic and incidentally detected on imaging for other underlying pathology. SANTs can be 18F-Fluorodeoxyglucose (18F-FDG) avid on positron emission tomography-computed tomography (PET-CT) and thus can lead to false positive finding in oncological patients.

症例は58歳，男性．胃上部2型進行癌に対し胃全摘術，D2リンパ節郭清，脾・膵尾部合併切除術を行った．病理組織学的に低分化型腺癌で，深達度SS，2群リンパ節に転移を認め，T2，N2，H0，P0，CY0，M0，Stage IIIB，根治度Bであった．5年前より狭心症と糖尿病のため内服治療中であったがいずれもコントロール良好であった．術前の腫瘍マーカーCEA値は3.3ng/mLと正常範囲内であった．術後2カ月目よりCEA値の増加および空腹時血糖値の上昇を認めた．術後4カ月目にはCEA 12.0ng/mL，空腹時血糖232mg/dL，HbA1c 8.6となった．画像評価を行うも明らかな再発病変を同定できなかったため，無治療のまま厳重に経過観察をすることとした．同時に食事・内服療法による糖尿病の治療も開始した．以後血糖コントロールの安定とともに腫瘍マーカー値は漸減していった．術後4年3カ月の現在まで無再発生存中である．

Bronchial anthracofibrosis characterized by bronchostenosis associated with anthracotic pigmentation in bronchoscopic finding without a relevant history of pneumoconiosis or smoking has been recently described as a clinical entity. Radiologic finding of bronchial obstructive lesion and mediastinal lymph nodes in bronchial anthracofibrosis can be mimicking cancer. However, the metabolic characteristics of bronchial anthracofibrosis have hardly been reported. Here, we report a case of bronchial anthracofibrosis which showing hypermetabolism on F-18 FDG PET.

WEB This is a Web exclusive article. ET with 18F-FDG has been successfully used for the diagnosis, management, and follow-up of many malignant tumors. PET is particularly useful for staging of head and neck tumors and for detecting recurrence [1]. Its utility in other settings, however, such as detection of non–squamous cell cancer of the head and neck and differentiating benign salivary gland tumors from malignant ones, is limited [2, 3]. This lack of usefulness may partly be explained by the poor anatomic localization of PET combined with variable physiologic uptake of FDG in the head and neck. These factors decrease the specificity of PET for head and neck cancer and thus increase the rate of false-positive findings. Combined PET/CT scanners, which fuse the functional data of PET with the anatomic data of CT, have shown promise in the evaluation of cancer of the head and neck [4]. Non–squamous cell cancer of the head and neck, particularly salivary gland tumors, however, have not been studied extensively with either PET or combined PET/CT. In cases that have been studied, the variable uptake from salivary gland tumors often causes false-negative results [4–6]. In addition, some benign tumors of the salivary glands, particularly Warthin’s tumor, show focal FDG uptake leading to false-positive results [2]. These false-positive findings reduce the utility of PET in differentiating benign salivary gland tumors from malignant tumors. We report a case of a benign parotid oncocytoma that had marked FDG avidity on PET/CT.

Purpose: To compare the performance of virtual and conventional colonoscopy for the detection of colorectal polyps using a multislice spiral CT scanner (MSCT). Materials and Methods: 48 patients (20 women, 28 men, mean age 61.5 5 years) with clinical indication for conventional colonoscopy were prospectively studied using a MSCT (Somatom Volume Zoom, Siemens, Forchheim). Examination was performed after standard oral preparation for colonoscopy and colonic distension with room air and i.v. butylscopolamin. Images were obtained in prone and supine position using a detector configuration of 4 × 1 mm, a table feed of 5 mm/rotation at 140 mAs and 120 kV. Slice thickness and reconstruction increment were 3 and 1.5 mm, respectively. CT data were assessed by two blinded radiologists on a Vitrea workstation (Vital Images, USA) using a software with multiplanar and volume-rendering capabilities. Results: 33 patients had normal findings on conventional colonoscopy. In 15 patients a total of 30 polyps and one carcinoma with stenosis were identified. MSCT-colonography identified the carcinoma and 23 polyps (77%). 3 of 3 polyps were 10 mm or more (100%), 6 of 7 were 5.1 to 9.9 mm (86%) and 14 of 20 were 5 mm or smaller (70%). There were 13 false positive findings for polyps (10 lesions < 6 mm in 5 patients) and no false positive finding of carcinoma. Conclusions: MSCT colonography allows accurate detection of polyps larger than 10 mm. Compared to published results of single-slice CT, multislice CT colonography increases the rate of detection of small colorectal polyps in particular. However, false positive results still remain a problem.

We report herein two cases of suture granuloma showing focal intense 2-deoxy-2-[18F]fluoro- d -glucose (FDG)-uptake in positron emission tomography (PET). Follow-up FDG-PET after surgical intervention for head and neck cancer revealed lesions with high FDG-uptake, which were highly suspected of being a recurrent tumor. The lesions were subjected to excisional biopsy for definitive diagnosis. Histopathological examination proved them to be suture granulomas caused by non-absorbable silk sutures. It should be emphasized that suture granulomas can show false-positive findings on FDG-PET, thus requiring differential diagnosis from recurrent tumors.

Absence seizures are characterized by sudden loss of consciousness and interruption of ongoing motor activities for a brief period of time lasting few to several seconds and up to half a minute. Due to their brevity and subtle clinical manifestations absence seizures are easily missed by inexperienced observers. Accurate evaluation of their high frequency of recurrence can be a challenge even for experienced observers. We present a novel method for detecting and analyzing absence seizures acquired from electroencephalogram (EEG) recordings in patients with absence seizures. Six patients were included in this study, two seizure free, of a total recording time of 26 hours, and four experiencing over 100 seizures within 14.5 hours of total recordings. Our algorithm detected only one false positive finding in the first seizure free patients and 148 of 186 continuous uninterrupted 3Hz spike and wave discharge (SWD) epochs in the rest of the patients. Out of the total 38 missed SWD epochs 28 were

The value of colour Doppler sonography in the diagnosis of renal artery stenosis has been studied retrospectively. 17 patients were examined (34 main renal arteries and 7 accessory renal arteries; ages 37 to 84 years; 7 males and 10 females). We studied 1) ability to study the main renal arteries, 2) visibility of accessory renal arteries and 3) the sensitivity and specificity of colour Doppler sonography for the diagnosis of renal artery stenosis. The results were compared with intraarterial angiography. Demonstration of the main renal arteries with colour Doppler sonography was possible in 23 of the 34 vessels. Not a single of the 7 accessory renal arteries was demonstrated by colour Doppler sonography. Of 8 angiographically demonstrated stenoses (more than 50% narrowing) 2 were missed by colour Doppler sonography. One stenosis was correctly diagnosed and 5 were incorrectly evaluated by sonography. 16 out of 18 angiographically normal main renal arteries were correctly evaluated by colour Doppler sonography but 2 showed a false positive finding. This results in a sensitivity of 17% and a specificity of 89% per kidney. Colour Doppler sonography cannot be recommended as a screening method for renal artery stenosis in view of its limited accuracy.

Avid functional (18)F-FDG uptake of skeletal muscle is a known false positive finding of PET-CT study especially after involuntary muscle exercise just prior to the study. We describe the case of a 50-year-old man in whom the finding of avid (18)F-FDG uptake of pectoralis major muscle was encountered during investigation of metastatic melanoma.

Methods 24 primary and pre-treated patients diagnosed with multiple myeloma according to the International Myeloma Working Group criteria were examined by F-FDG PET/CT and whole-body MRI including DWI (b= 0, and b= 800 s/mm). F-FDG PET/MRI was used to achieve correct matching of findings in the corresponding PET/ CT study. Suspicious lesions were defined by the imaging gold-standard of nonenhanced T1-w/T2-wMRI and low-dose CT.

False-positive findings are commonly seen in positron emission tomography computed tomography imaging. One of the most common false positive finding is uptake of fluorodeoxyglucose in brown adipose tissue. Herein, we report two cases with incidentally detected hibernomas-a brown fat containing tumor with metabolic activity.

PET/CT is a widely accepted imaging modality in the diagnosis and staging of lymphoma because of the increased FDG uptake commonly detected in malignant lesions. However, various causes of false-positive FDG localization have been described, including in nonmalignant lymph nodes. We report a patient with a history of Hodgkin lymphoma who presented with bilateral axillary lymphadenopathy, which was intensely FDG-avid on PET/CT imaging. Biopsy of lymph nodes from both axillae revealed benign follicular hyperplasia. Follicular hyperplasia is a potential false-positive finding on PET/CT imaging, and obtaining pathologic confirmation of malignancy should be considered before treatment.

Nearly 13 years ago inflammation imaging using labeled white blood cells (WBCs) has been introduced in clinical nuclear medicine.

Varicocele is the most frequent operable cause of male infertility. It is often difficult to diagnose small lesions merely by clinical examination. The fact that a measurable rise of scrotal temperature occurs in a certain number of infertile patients has helped to extend thermography also to the detection of such cases (Comhaire et al., 1976; Zorgniotti and MacLeod, 1973).

Identification of genetic variants affecting complex traits such as obesity is confounded by many types of bias, especially when effect sizes are small. Given our findings of a positive association between rs7566605 and body mass index in four out of five separate samples, a false positive finding cannot be ruled out with certainty but seems unlikely. Meta-analyses of multiple large studies will help refine the estimate of the effects of rs7566605 on body mass index.

Somatostatin receptor scintigraphy with In-111 octreotide has shown excellent accuracy in many neuroendocrine tumors, including carcinoid. Substantial gallbladder activity may be present on early images; however, the administration of a fatty meal and/or the effect of time generally results in littl

CT was carried out in 50 patients with clinical suspicion of hyperparathyroidism, in order to localise the adenoma. In 45 patients, the diagnosis was confirmed at operation and adenomas or hyperplastic glands were removed. In the remaining five patients the diagnosis was not confirmed at operation, nor by the subsequent clinical course. On four occasions, CT correctly turned out to be negative and in one patient a false positive finding was obtained. Amongst the 45 patients, a total of 59 enlarged glands (adenomas or hyperplastic glands) were found at operation and removed. Pre-operative CT was positive and correct in 78% and negative and incorrect in 22%. Of eight adenomas in the mediastinum, seven could be recognised pre-operatively. Previous operations on the neck did not reduce diagnostic accuracy. The techniques and results are described and discussed.

Selective venous sampling for parathormone estimations has become an important method in the diagnosis of primary hyperparathyroidism and, together with thyroid phlebography, is an accurate means for localising hormone active parathyroid tissue. Thirty-three patients were examined by this technique and in 25 of these an exploration was carried out subsequently. Twenty-one had primary hyperparathyroidism. In one case hormone analysis lead to a false positive finding. In 18 of these 21 patients, the hormone-active parathyroid tissue was correctly localised. Phlebography showed evidence of an adenoma in five patients, but is of most use for localising the source of the hormone.

A consecutive series of 301 ultrasonically guided fine needle aspiration biopsies of renal masses was reviewed. The retrieval rate was 95 per cent and a correct cytological diagnosis was established in 82 per cent of the cases. There were 14 false positive aspirates, for a predictive value of a malignant aspirate of only 93 per cent. All false positive results were misinterpreted as relatively well differentiated adenocarcinoma. We conclude that renal fine needle aspiration biopsy may add information but the risk of a false positive finding must always be considered.