Hematopoietic Cytokine-Mediated FDG Uptake Simulates the Appearance of Diffuse Metastatic Disease on Whole-Body PET Imaging

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Abstract
FDG-PET is increasingly being used to assess malignant tumors. However, leukocyte colony-stimulating factors(CSFs), which promote the expansion of hematopoietic bone marrow, have also been demonstrated to cause increased bone-marrow FDG uptake. Three hundred FDG-PET studies conducted over a 1-year period were reviewed for diffuse bone-marrow uptake. Elevated bone-marrow uptake on PET was correlated with pathological findings and courses of granulocyte-CSF (G-CSF) therapy. These results demonstrate that G-CSF mediated FDG uptake in bone marrow is often indistinguishable from that caused by disseminated metastatic disease. However, the bone-marrow response to G-CSF decreases rapidly following the last CSF administration. Therefore, FDG-PeT in patients receiving G-CSF should be delayed, when possible, until 5 days after the end of G-CSF therapy.