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According to European Society of Cardiology guidelines (ESC2015) for infective endocarditis (IE) management, modified Duke criteria (mDC) are implemented with a degree of clinical suspicion degree, leading to grades such as “possible” or “rejected” IE despite a persisting high level of clinical suspicion. Herein, we evaluate the 18F-FDG PET/CT diagnostic and therapeutic impact in IE suspicion, with emphasis on possible/rejected IE with a high clinical suspicion. Excluding cases of definite IE diagnosis, 53 patients who underwent 18F-FDG PET/CT for IE suspicion were selected and afterwards classified according to both mDC (possible IE/Duke 1, rejected IE/Duke 0) and clinical suspicion degree (high and low IE suspicion). The final status regarding IE diagnosis (gold standard) was based on the multidisciplinary decision of the Endocarditis Team, including the ‘imaging specialist’. PET/CT images of the cardiac area were qualitatively interpreted and the intensity of each focus of extra-physiologic 18F-FDG uptake was evaluated by a maximum standardized uptake value (SUVmax) measurement. Extra-cardiac 18F-FDG PET/CT pathological findings were considered to be a possible embolic event, a possible source of IE, or even a concomitant infection. Based on the Endocarditis Team consensus, final diagnosis of IE was retained in 19 (36%) patients and excluded in 34 (64%). With a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and global accuracy of 79%, 100%, 100%, 89%, and 92%, respectively, PET/CT performed significantly better than mDC (p = 0.003), clinical suspicion degree (p = 0.001), and a combination of both (p = 0.001) for IE diagnosis. In 41 patients with possible/rejected IE but high clinical suspicion, sensitivity, specificity, PPV, NPV, and global accuracies were 78%, 100%, 100%, 85%, and 90%, respectively. Moreover, PET/CT contributed to patient management in 24 out of 53 (45%) cases. 18F-FDG PET/CT represents a valuable diagnostic tool that could be proposed for challenging IE cases with significant differences between mDC and clinical suspicion degree. 18F-FDG PET/CT allows a binary diagnosis (definite or rejected IE) by removing uncertain diagnostic situations, thus improving patient therapeutic management.

Objective To devise a simple PET-CT score for measurement of muscle disease activity in patients with inflammatory myopathies (IMs) and to assess its validity. Methods A total of 44 PET-CT examinations in 34 IM patients (performed during cancer screening) and 20 PET-CT examinations in matched controls (investigated for pulmonary nodules with a conclusion of benignity) were analysed. Maximal standardized uptake values (SUVmax) were recorded bilaterally in eight proximal muscles. The muscle SUVmax (mSUVmax) was defined as the average of the 16 muscle SUVmax values, normalized on the liver mean SUV. Reliability, validity and responsiveness were evaluated. Results The mSUVmax was increased in IM patients compared with controls. This index allowed the identification of patients with high vs low muscle disease activity using the myositis intention to treat activity index as the gold standard. In patients with subsequent examinations, our method showed good accuracy to detect changes in muscle disease activity [area under the curve 0.96 (95% CI 0.84, 1)]. Responsiveness was strong. Interrater reliability was excellent. Conclusion PET-CT, a non-invasive tool useful for cancer screening, is also valuable to measure muscle disease activity and its evolution in IM patients.

Number: 2 PMID: 30744393

We report a case of a 69-year-old woman with primary hyperoxaluria type I, who developed a severe hypercalcemia despite controlled secondary hyperparathyroidism. Bone scintigraphy showed diffuse increased uptake in axial and peripheral skeleton. F-FDG PET/CT showed countless striking hypermetabolic foci, interesting 2 types of lesions (joint calcifications and periosteal resorptions). Bone biopsy demonstrated inflammatory changes around many calcium oxalate crystals; hypercalcemia was then related to oxalate osteopathy. Immunotherapy with denosumab was thus initiated. Eighteen months later, a second PET/CT showed decreased F-FDG uptake, reflecting treatment efficacy on inflammatory reaction secondary to calcium oxalosis skeletal deposits.

Palliative radiotherapy has been shown to have effects on Quality of Life during painful bone metastasis. This review aimed to determine equivalence in pain relief (PR) and retreatment rate (RR) using both single and multi-fraction irradiations, based on evaluation of the trial's quality. We performed a systematic review since ICRU 50 Report (1993) to June 2017, then evaluated trials for reproducibility and good methodology criteria. We found five studies that were reproducible in both dose and volume prescription. One study used three-dimensional (3D) treatment planning. Equivalence between single and multi-fraction schedules was demonstrated for PR after 3 months, but a 2-3 time RR appeared after single-fraction schedules, notably in the first year after treatment (primarily during the first four months). Reserving long course therapy for well-preserved patients would allow for better long-term efficacy with lower RR, while altered patients would suffer less from single-fraction treatments. It appears that life expectancy might not be used as a criterion for this choice.

Infection and malignancy represent two common complications after solid organ transplantation, which are often characterized by poorly specific clinical symptomatology. Herein, we have evaluated the role of 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) in this clinical setting. Fifty-eight consecutive patients who underwent FDG PET/CT after kidney, lung or heart transplantation were included in this retrospective analysis. Twelve patients underwent FDG PET/CT to strengthen or confirm a diagnostic suspicion of malignancies. The remaining 46 patients presented with unexplained inflammatory syndrome, fever of unknown origin (FUO), CMV or EBV seroconversion during post-transplant follow-up without conclusive conventional imaging. FDG PET/CT results were compared to histology or to the finding obtained during a clinical/imaging follow-up period of at least 6 months after PET/CT study. Positive FDG PET/CT results were obtained in 18 (31 %) patients. In the remaining 40 (69 %) cases, FDG PET/CT was negative, showing exclusively a physiological radiotracer distribution. On the basis of a patient-based analysis, FDG PET/CT’s sensitivity, specificity, PPV and NPV were respectively 78 %, 90 %, 78 % and 90 %, with a global accuracy of 86 %. FDG PET/CT was true positive in 14 patients with bacterial pneumonias (n = 4), pulmonary fungal infection (n = 1), histoplasmosis (n = 1), cutaneous abscess (n = 1), inflammatory disorder (sacroiliitis) (n = 1), lymphoma (n = 3) and NSCLC (n = 3). On the other hand, FDG PET/CT failed to detect lung bronchoalveolar adenocarcinoma, septicemia, endocarditis and graft-versus-host disease (GVHD), respectively, in four patients. FDG PET/CT contributed to adjusting the patient therapeutic strategy in 40 % of cases. FDG PET/CT emerges as a valuable technique to manage complications in the post-transplantation period. FDG PET/CT should be considered in patients with severe unexplained inflammatory syndrome or FUO and inconclusive conventional imaging or to discriminate active from silent lesions previously detected by conventional imaging particularly when malignancy is suspected.

Background Although the relationship between malignancies and catecholamine-induced myocardial stunning remains largely speculative, it has been suggested that the presence of cancer may lower the threshold for stress stimuli and/or may aggravate cardiac adrenoreceptor sensitivity. We sought to investigate whether associations exist between a previous or current diagnosis of malignancy, diagnostic parameters during hospitalization and death in takotsubo. Methods and results The 154 takotsubo patients were retrospectively identified between May 2008 and December 2014. Previous history of malignancy was identified in 44 patients (28.5%). Cardiac arrest was present at admission in 13 patients (8.4%). Intra-aortic balloon pump was inserted in 16 patients (10.4%). In patients with malignancy, higher B-type natriuretic peptide (BNP), leukocyte and C-reactive protein (CRP) peaks could be observed during the hospital phase. Initial impairment of left ventricular ejection fraction was negatively related to BNP, leukocyte, and CRP peaks. At a median follow-up of 364 days, all-cause death occurred in 41 patients (26.6%) and cardiac death in 12 patients (7.7%). Multivariate Cox regression analysis identified malignancy (hazard ratio 4.77 (1.02-22.17), leukocyte peak and age as independent predictors of cardiac death. Malignancy (2.62 (1.26-5.44), leukocyte peak (1.05 (1.01-1.08) and initial cardiac arrest (6.68 (2.47-18.01) were identified as independent predictors of overall mortality. Conclusions In the present takotsubo patients, the prevalence of malignancy was high and may have affected cardiovascular outcomes through the activation of inflammatory and neurohormonal mechanisms. (Circ J 2016; 80: 2192-2198).

Resume Etat de la question Le developpement d’une maladie atherothrombotique acceleree constitue la principale cause de morbi-mortalite des patients diabetiques. Le depistage precoce de l’ischemie myocardique silencieuse (IMS) revet chez ces patients, une importance particuliere. Objectifs Evaluer l’interet : (i) du dosage de marqueurs d’activite de la maladie atherothrombotique refletant les processus inflammatoires (fibrinogene, CRP, MCP-1), l’apoptose (microparticules [MP]), l’activation plaquettaire (CD40-L, P-selectine, GP V, MPs plaquettaires) et endotheliale (VCAM-1, vWF, PAI-1, MPs endotheliales), la stimulation neurohormonale et les pressions de remplissage (BNP) ; (ii) de parametres issus de l’echographie cardiaque ou carotidienne dans le depistage de l’ischemie myocardique identifiee par la realisation d’une scintigraphie myocardique de perfusion. Resultats Cinquante-cinq patients diabetiques (62 ± dix ans) et 15 patients non diabetiques (46 ± 14 ans) ont ete inclus. Le diagnostic d’IMS est etabli chez 23 patients diabetiques (42 %). Une elevation du statut inflammatoire et de l’activation/apoptose leucocytaire est retrouvee dans la population diabetique. Dans l’ensemble de la population etudiee, une elevation des MPs porteuses de CD31 et de CD11a est retrouvee chez les patients presentant une ischemie myocardique. Dans la population diabetique aucun des marqueurs d’activite de la maladie atherothrombotique etudies n’est associe a l’IMS. Au contraire, la masse ventriculaire gauche et la surface de l’oreillette gauche sont associees en analyse univariee a l’IMS. En analyse multivariee, seule la surface de l’oreillette gauche (superieure a 18,5 cm 2 ) est un facteur independamment associe a l’existence d’une ischemie myocardique silencieuse (OR 4,14 ; IC [1,7–16,13] ; p = 0,039). Conclusion Aucun des parametres d’activite de la maladie atherothrombotique etudies ne permet d’identifier les patients diabetiques presentant une IMS. En analyse multivariee, seule la dilatation de l’oreillette gauche est associee au developpement d’une ischemie myocardique silencieuse. Ce parametre pourrait s’integrer dans la stratification du risque myocardique des patients diabetiques.

We present the case of a 40-year-old man consulting for uncontrollable episodes of laughing related to emotional lability and not systematically linked to feelings of happiness. Seven months earlier he had presented a pontine ischemic stroke related to an occlusion of the basilar and left vertebral arteries. No epileptic activity or new MRI brain lesions were found. Brain perfusion SPECT performed showed marked hypoperfusion in the right frontal inferior and temporoinsular regions, suggesting a diaschisis phenomenon caused by pontine lesions and highlighted laughing regulation pathways. The patient was successfully treated with a serotonergic reuptake inhibitor, fluoxetine.

We describe the efficient algebraic reconstruction (EAR) method, which applies to cone-beam tomographic reconstruction problems with a circular symmetry. Three independant steps/stages are presented, which use two symmetries and a factorization of the point spread functions (PSFs), each reducing computing times and eventually storage in memory or hard drive. In the case of pinhole single photon emission computed tomography (SPECT), we show how the EAR method can incorporate most of the physical and geometrical effects which change the PSF compared to the Dirac function assumed in analytical methods, thus showing improvements on reconstructed images. We also compare results obtained by the EAR method with a cubic grid implementation of an algebraic method and modeling of the PSF and we show that there is no significant loss of quality, despite the use of a noncubic grid for voxels in the EAR method. Data from a phantom, reconstructed with the EAR method, demonstrate 1.08-mm spatial tomographic resolution despite the use of a 1.5-mm pinhole SPECT device and several applications in rat and mouse imaging are shown. Finally, we discuss the conditions of application of the method when symmetries are broken, by considering the different parameters of the calibration and nonsymmetric physical effects such as attenuation.

Aim To assess the extent to which bone marrow scintigraphy (BMS) makes the interpretation of leucocyte scintigraphy (LS) easier and improves its diagnostic value. Methods Seventy-three 111In LSs, 99mTc hydroxymethylene diphosphonate bone scintigraphies (BSs) and 99mTc sulfur colloid BMSs were performed in 60 patients with suspected infection related to a hip prosthesis or knee prosthesis, either in situ (+group, n = 43) or after removal for septic loosening (-group, n = 30). Bacteriological samples were obtained from all patients. LS was interpreted together with BS (LS-BS) or with BMS (LS-BMS) by three independent readers. Results The concordance among readers, estimated by the kappa test, was average with LS-BS (kappa/kappam coefficients = 0.58, 0.58 and 0.46, respectively, for the three pairs of readers) and excellent with LS-BMS (kappa/kappam coefficients = 1.00 for the three pairs of readers). With LS-BS, 64/219 interpretations were equivocal whereas only one was equivocal with LS-BMS. Sensitivity, specificity and accuracy of LS-BMS were, respectively, 80%, 94% and 91% in the +group, and 33%, 100% and 93% in the -group. Conclusion We conclude that (1) the interpretation of the results for LS-BMS is very easy, in contrast to LS-BS; (2) the diagnostic value of LS-BMS for detecting infected joint prostheses is good; and (3) additional data are needed to assess the accuracy of LS-BMS when the prosthesis has been removed.

Introduction Le syndrome de Takotsubo se caracterise habituellement par une presentation mimant cliniquement et electriquement un syndrome coronaire aigu, avec ballonisation de l’apex du ventricule gauche a l’echocardiographie ; la coronarographie exclut alors une coronaropathie stenosante significative. Nous rapportons le cas d’un diagnostic atypique puisque fortuit. Materiel/resultats Une patiente de 60 ans se presente en consultation cardiologique dans le cadre du suivi d’une hypercholesterolemie severe, sans autre facteur de risque cardiovasculaire organique. L’ECG montre une abrasion des ondes R en anterieur et des ondes T biphasiques en lateral. L’echocardiographie met en evidence une akinesie apicale isolee, avec conservation de la fraction d’ejection ventriculaire gauche (FEVG) globale. La scintigraphie myocardique de perfusion (99 mTc-tetrofosmine) n’allegue pas d’ischemie myocardique sous stress (effort sous maximal significatif et Dipyridamole a 0,70 mg/kg), huit jours apres la consultation initiale, il existe toutefois une alteration de l’epaississement en antero-apical. La scintigraphie a la 123I-mIBG et la TEP/TDM au 18F-FDG sont typiques d’une cardiopathie adrenergique apicale en montrant, respectivement, un deficit adrenergique et une lacune metabolique glucosee. La coronarographie elimine une stenose coronaire significative et le recouvrement de la cinetique apicale ventriculaire gauche est constate echographiquement lors de la consultation a trois mois. Discussion Le polymorphisme du syndrome de Takotsubo est connu (formes apicale, medio-ventriculaire, inversee, focale). Concernant le facteur declenchant, l’hyperadrenergie semble le denominateur commun de l’alteration transitoire de la FEVG et, a ce titre, on retrouve souvent un stress emotionnel ou une circonstance organique (hemorragie sous arachnoidienne, pheochromocytome) expliquant cette hyperadrenergie. Toutefois, pour cette patiente, c’est l’interrogatoire attentif qui a decele un stress professionnel semblant a l’origine de ce Takotsubo cliniquement muet. La resolution du conflit professionnel a d’ailleurs coincide avec le recouvrement de la cinetique apicale ventriculaire gauche. Conclusion Devant des troubles de la cinetique segmentaire ventriculaire gauche de decouverte fortuite, apres avoir elimine une origine ischemique, il semble legitime d’evoquer une cause adrenergique. Dans ce cadre, la medecine nucleaire apporte une imagerie caracteristique, utile au diagnostic.

We report the case of a 73-year-old woman presenting sudden blindness caused by bilateral simultaneous central retinal artery occlusion revealed by ophthalmoscopy. Temporal artery biopsy confirmed the giant cell arteritis. The patient was treated with a systemic steroid without visual recovery. FDG PET/CT was performed 6 months later in the context of persistent inflammatory syndrome. This case shows the close relationship between functional activity and glucose energy metabolism. We observed both bilateral occipital hypometabolism corresponding to loss of functional activity and bilateral temporal (auditory areas) and orbitofrontal hypermetabolism related to compensatory neuronal plasticity.

Because of its high diagnostic sensitivity in detection of unknown primary tumors, F-18 FDG PET/CT was used in the exploration of a 51-year-old woman presenting with multiple lymphadenopathy of the hepatic hilum and several hepatic and splenic hypodensities on radiologic examinations for which malignancy was suspected. Despite the morphofunctional malignant appearance, both histologic examination and PCR analysis revealed Bartonella henselae infection. Moreover, repeat F-18 FDG PET showed disease regression during focused antibiotic therapy.

Proliferating trichilemmal cyst is considered as a rare tumor that originates in the outer root sheath of hair follicle. Metastatic potential has not been yet fully established. Moreover, histological analysis does not allow precise malignancy prediction. Proliferating trichilemmal cyst glucose metabolism behavior was never previously described. Herein, we report the case of a 62-year-old patient with a left shoulder proliferating trichilemmal cyst showing an intense uptake of ¹⁸F-FDG on PET/CT examination. ¹⁸F-FDG PET/CT could be proposed to optimize diagnostic strategy of patients with proliferating trichilemmal cysts.

Diffuse, increased gastric wall F-18 FDG uptake is widely observed during PET/CT examinations, frequently unrelated to malignant findings, but simply caused by inflammatory disease, physiological emptying, or visceral thickening. Hence, elevated F-18 FDG gastric uptake can lead to equivocal misinterpretation, especially in patients with known gastric malignant disease, at posttherapy reevaluation. Gastric wall contraction can increase F-18 FDG uptake, especially for a remnant stomach, increasing the percentage of false-positive results with a direct impact on therapeutic management. One field PET/CT acquisition centered on the hypochondrial regions a few minutes after water ingestion should be performed routinely if standard images are doubtful (increased tracer uptake and visceral thickening) to differentiate benign from malignant uptake.

In-111 DTPA-D-Phe1-octreotide (In-111 pentetreotide) is a widely used radiotracer for somatostatin receptor (SSTR) in- vestigations in neuroendocrine (NE) pathology. Cellular SSTR den- sity is directly related to the degree of NE cellular differentiation. Poorly differentiated cell lines show a surface reduction of SSTRs, which may lead to misinterpreting the In-111 pentetreotide scintig- raphy results as negative. A case of anorectal small-cell undifferen- tiated neuroendocrine carcinoma is reported. This pathologic finding is rare, highly aggressive, and associated with a dramatic prognosis. The patient was investigated with In-111 pentetreotide SPECT and low-dose computed tomography (CT) for anatomic reference. De- spite its low degree of differentiation, the tumor showed high tracer uptake characterized by a positive incremental trend as shown by comparison of the 4-hour and 24-hour SPECT images, suggesting specific receptorial binding of In-111 pentetreotide.

To gain more insight into the involvement of inflammatory response and neurohumoral activation in Takotsubo cardiomyopathy (TTC), we investigated C-reactive protein (CRP), leukocytes, plasma catecholamines levels, iodine 123 meta-iodobenzylguanidine (123I-mIBG) myocardial uptake, myocardial perfusion (thallium 201 [201Tl] or technetium [Tc] 99m-tetrofosmin myocardial single photon emission computed tomography [SPECT]), and metabolism (fluorine 18-fluorodeoxyglucose positron emission tomography).Inflammatory status and brain natriuretic peptide (BNP) levels in 17 patients with TTC were compared with 14 age-matched patients. In TTC, elevated levels of CRP were evidenced on admission, reaching a peak in the following days (P.01). CRP levels were correlated to baseline left ventricular ejection fraction (LVEF) and BNP levels (P.05). Leukocytes were correlated to BNP and noradrenaline levels. Myocardial 123I-mIBG SPECT showed a reduced activity in the midventricle and apex corresponding to 35% +/- 23% of the total myocardial mass, partially reversible at follow-up. An identical pattern was retrieved when assessing myocardial glucose metabolism. At rest, no relevant abnormalities of myocardial perfusion could be evidenced at the subacute phase.Inflammatory status in TTC was related to LVEF impairment and to the extent of neurohormonal activation. The hypothesis of a catecholamine-induced myocardial "stunning" is emphasized by the evidence of a reduced 123I-mIBG myocardial activity, impairment of myocardial glucose metabolism, and wall motion kinetic after the same temporospatial distribution.

Resume La cardiomyopathie de Takotsubo (CTT), decrite initialement au debut des annees 1990, represente 1 a 2 % des evenements cardiaques aigus et fait partie des diagnostics differentiels du syndrome coronarien aigu (SCA). Les examens isotopiques suivants : tomoscintigraphie myocardique au 201Tl (ou 99mTc-tetrofosmine), a la 123I-meta-IodoBenzyl-Guanidine (123I-mIBG) et tomographie par emission de positons (TEP)-tomodensitometrie (TDM) au 18F-flurodesoxyglucose (FDG) ont permis respectivement l’etude de la perfusion, de l’innervation et du metabolisme ventriculaire gauche (VG) afin d’evaluer l’apport de ces techniques chez des patients atteints de CTT. Dans les 15 jours suivant le declenchement de la maladie, quatre patients ont beneficie d’une tomoscintigraphie myocardique de perfusion et d’une tomoscintigraphie myocardique a la 123I-mIBG. Un TEP-FDG cardiaque a aussi ete realise chez deux d’entre eux. Nous avons reevalue l’innervation et le metabolisme myocardique trois mois et plus de six mois apres la phase aigue et compare le niveau de fixation des radionucleides. La perfusion du VG etait normale chez tous les patients, alors que l’examen a la 123I-mIBG et le TEP-FDG cardiaque montraient en phase subaigue une hypofixation apicale. L’association d’une perfusion normale et d’un metabolisme glucidique altere etait en faveur d’un aspect de « discordance inverse » entre la perfusion et le metabolisme dans la region apicale du VG. Les anomalies de fixation initiales de la 123I-mIBG et du FDG tendaient a se normaliser sur les examens ulterieurs. Les resultats ont montre la part neurogene preponderante dans l’etat de sideration myocardique apicale definissant la CTT. La tomoscintigraphie myocardique a la 123I-mIBG est l’examen a retenir pour eliminer plus facilement ce diagnostic parmi les diagnostics differentiels de SCA.

Prognosis of patients with Bartholin’s gland carcinoma(BGC) is strictly related to the nodal stage at diagnosis. Thus, it iscrucial to perform reliable staging for optimal treatment planning. Inspite of wide clinical utilization of F-18 FDG PET in oncologicalroutine, its role in vulvar malignancies is not completely defined. Tokeep organs and preserve anal and ureteral function, a patient withadvanced undifferentiated BGC (FIGO IV-A) received 50 Gy to thewhole pelvis, whole vagina and bilateral inguinal lymph nodes withconcomitant chemotherapy, followed by interstitial brachytherapy.F-18 FDG PET-CT was performed at staging and after treatmentcompletion. Complete regression of the initial metabolic abnormal-ities was shown on posttreatment images, confirming the efficacy ofthe adopted conservative approach. F-18 FDG PET-CT imagingcould have a role in staging and assessing treatment efficacy inaggressive BGC. Key Words: Bartholin’s gland carcinoma, undifferentiatedcarcinoma, F-18 FDG PET, chemoradiation, brachytherapy(

This prospective and bi-centric study was conducted in order to determine the impact of antidiabetic treatments (AD) on (18)F-FDG bowel uptake in type 2 diabetic patients.Fifty-five patients with previously diagnosed and treated type 2 diabetes mellitus (group 1) were divided in two subgroups: AD treatment including metformin (n=32; group 1a) and AD treatment excluding metformin (n=23; group 1b). The 95 patients without diabetes mellitus made up controls (group 2). (18)F-FDG uptake in small intestine and colon was visually graded and semi-quantitatively measured using the maximum standardized uptake value.(18)F-FDG bowel uptake was significantly increased in AD patients (group 1) as compared to controls (group 2) (p0.001). Bowel uptake was significantly higher in AD patients including metformin (group 1a) as compared to AD patients excluding metformin (group 1b) (p0.01), whose bowel uptake was not significantly different from controls (group 2). A metformin treatment was predictive of an increased bowel uptake in the small intestine (odds ratio OR=16.9, p0.0001) and in the colon (OR=95.3, p0.0001), independently of the other factors considered in the multivariate analysis. Bowel uptake pattern in the patients treated with metformin was typically intense, diffuse and continuous along the bowel, strongly predominant in the colon, in both the digestive wall and lumen.This study emphasizes that metformin significantly increases (18)F-FDG uptake in colon and, to a lesser extent, in small intestine. It raises the question of stopping metformin treatment before an (18)F-FDG PET/CT scan is performed for intra-abdominal neoplasic lesion assessment.

[ 18 F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography is a widely developed method that allows not only accurate staging of cancers but also prognostic information in order to lead antimitotic modalities. Among primitive uterine malignant tumors, non-Hodgkin lymphoma (NHL) is rare. Herein, we report the case of a 61-year-old woman with uterine NHL whose diagnostic and therapeutic approaches were essentially managed by [ 18 F]FDG imaging. Because of a high sensitivity from major glucidic uptake in aggressive NHL lesions, [ 18 F]FDG positron emission tomography/computed tomography easily showed the exact extension of disease and its metabolic status early after beginning chemotherapy.