Table 2.
Limitations of 18F-FDG PET CT in gynaecological malignancies
| Poor spatial resolution and respiratory motion artefact limits identification of sub diaphragmatic peritoneal disease, sub centimetre peritoneal deposits and lung nodules | ||
| Inflammatory and infective pelvic pathology may demonstrate 18F-FDG PET CT uptake thereby causing false positive results | ||
| Physiological cyclical uptake of 18F-FDG uptake seen in normal endometrium during the ovulatory and menstrual phases. Physiological uptake of 18F-FDG uptake in normal ovaries in the follicular and luteal phases | ||
| 18F-FDG uptake by benign leiomyomas | ||
| Physiological excretion of FDG accumulating in the bladder may mask small pelvic masses, parametrial disease or parametrial nodes in endometrial and cervical cancers | ||
| Focal ureteric excretion may be misinterpreted as metabolically active metastatic lymph nodes | ||
| Metallic implants/devices can result in attenuation correction artefacts on PET CT masking small volume peritoneal disease | ||
| Primary mucinous ovarian tumours, nodal and peritoneal metastases from mucinous carcinomas and necrotic lymph nodes may have no or very low FDG uptake and may be missed |