Question:

The simplest way to prove that an area of FDG accumulation is a CT attenuation correction artifact is to:
1. look at the attenuation corrected PET images
2. look at the fused PET/CT images using the attenuation corrected PET images
3. look at the non-attenuation-corrected PET images
4. look at the sinograms
5. look at the CT





Answer:

The correct answer for the question "The simplest way to prove that an area of FDG accumulation is a CT attenuation correction artifact is to:" is:

3. look at the non-attenuation-corrected PET images



Explanation

When inspecting the non-AC images, any suspected lesion will still remain, whereas an artifact will not. Examining the attenuation corrected PET images (answer A) would show the artifact, as AC artifacts are generated during the attenuation correction process. The fused PET/CT images using AC PET images (answer B) would give a similar appearance as answer A, but with the CT images as well. Sinograms (answer D) would not show image information. Answer E may be helpful, but would not prove that an area of activity was indeed artifact from attenuation correction.



From the manuscript:
Calcified Lymph Nodes Causing Clinically Relevant Attenuation Correction Artifacts on PET/CT Imaging
Radiology Case. 2010 Feb; 4(2):31-37


This article belongs to the Nucs section.




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From the manuscript

Calcified Lymph Nodes Causing Clinically Relevant Attenuation Correction Artifacts on PET/CT Imaging

Free full text article: Calcified Lymph Nodes Causing Clinically Relevant Attenuation Correction Artifacts on PET/CT Imaging

Abstract
There are several artifacts unique to PET/CT imaging, with CT-based attenuation correction (AC) artifacts being among the most commonly reported. AC artifacts from calcified lymph nodes represent clinically significant and easily misinterpreted PET/CT artifacts that have received little attention in the literature. In this case series, we report three cases of calcified lymph nodes causing an AC artifact and one case of a highly calcified lymph node without an AC artifact. All three cases of calcified lymph nodes causing an AC artifact would have resulted in a change in patient staging, and likely management, if the nodes had been misinterpreted as malignant nodes. In PET/CT imaging, this artifact needs to be considered as a potential cause of apparent FDG activity when calcified lymph nodes are present on the CT portion of a PET/CT study in order to avoid misinterpretation and potential patient mismanagement.






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