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Physiologic Uterine Uptake of FDG During Menstruation Demonstrated with Serial Combined Positron Emission Tomography and Computed Tomography

CHANDER, SUBHASH, M.D.,*; MELTZER, CAROLYN CIDIS, M.D.*† AND; McCOOK, BARRY M., M.D.*

Original Articles
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F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has been used extensively to stage, restage, and follow neoplastic disease. However, focal accumulation of FDG may cause false-positive results in certain physiologic conditions. In this report, a unique PET and computed tomography (CT) combination scan helped define physiologic accumulation of FDG in the uterus during menstruation in a 40-year-old woman with a history of rectal melanoma and possible recurrent disease. An initial PET study, performed during menstruation, was followed immediately by a PET-CT scan, which showed marked accumulation of FDG in the posterior pelvis, localized to a retroverted uterus. An FDG PET-CT scan repeated 2 weeks later confirmed resolution of this “lesion.” Thus, combined PET-CT correctly differentiated physiologic FDG uptake in a retroverted uterus from recurrent rectal melanoma. This case shows that physiologic FDG accumulation in the uterus should be considered when focal FDG accumulation is observed in the pelvis in women of reproductive age.

From the Departments of Radiology* and Psychiatry,† University of Pittsburgh, Pittsburgh, Pennsylvania

Received for publication August 6, 2001.

Accepted August 29, 2001.

Reprint requests: Carolyn Cidis Meltzer, University of Pittsburgh Medical Center, PET Facility B-938, 200 Lothrop Street, Pittsburgh, Pennsylvania 15213–2582. E-mail: meltzercc@radserv.arad.upmc.edu

© 2002 Lippincott Williams & Wilkins, Inc.