Fat necrosis after abdominal surgery: A pitfall in interpretation of FDG-PET/CT.
Eur Radiol
; 28(6): 2264-2272, 2018 Jun.
Article
en En
| MEDLINE
| ID: mdl-29264635
ABSTRACT
OBJECTIVE:
We describe FDG-PET/CT findings of postoperative fat necrosis in patients following abdominal surgery, and evaluate their changes in size and FDG uptake over time.METHODS:
FDG-PET/CT scans from January 2007-January 2016 containing the term 'fat necrosis' were reviewed. Lesions meeting radiological criteria of fat necrosis in patients with prior abdominal surgery were included.RESULTS:
Forty-four patients, 30 males, mean age 68.4 ± 11.0 years. Surgeries laparotomy (n=37; 84.1 %), laparoscopy (n=3; 6.8 %), unknown (n=4; 9.1 %). CTs of all lesions included hyperdense well-defined rims surrounding a heterogeneous fatty core. Sites peritoneum (n=34; 77 %), omental fat (n=19; 43 %), subcutaneous fat (n=8; 18 %), retroperitoneum (n=2; 5 %). Mean lesion long axis 33.6±24.9 mm (range 13.0-140.0). Mean SUVmax 2.6±1.1 (range 0.6-5.1). On serial CTs (n=34), lesions decreased in size (p=0.022). Serial FDG-PET/CT (n=24) showed no significant change in FDG-avidity (p=0.110). Mean SUVmax did not correlate with time from surgery (p=0.558) or lesion size (p=0.259).CONCLUSION:
Postsurgical fat necrosis demonstrated characteristic CT features and may demonstrate increased FDG uptake. However, follow-up of subsequent imaging scans showed no increases in size or FDG-avidity. Awareness of this entity is important to avoid misinterpretation of findings as recurrent cancer. KEY POINTS ⢠Postsurgical fat necrosis may mimic cancer in FDG-PET/CT. ⢠Follow-up of fat necrosis showed no increase in FDG intensity. ⢠CT follow-up showed a decrease in lesion size. ⢠FDG uptake did not correlate with time lapsed from surgery.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Abdomen
/
Necrosis Grasa
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Israel