Pelvic Anatomic Localization Using Ureteral Activity on FDG Positron Emission Tomography

A 37-year-old woman with non-Hodgkin lymphoma had a F-18 fluorodeoxyglucose positron emission tomography (FDG PET) scan which showed 2 foci of pelvic uptake initially thought to represent iliac nodes. However, a computed tomography scan demonstrated no pelvic nodes in the regions of uptake. Using excreted ureteral FDG activity as a landmark, the foci of uptake were identified as intraperitoneal and localized to the ovaries. Although ureteral activity is often a confounding factor during PET image interpretation, it can be used to demarcate intraperitoneal (eg, ovary) from extraperitoneal (eg, iliac node) pelvic structures to arrive at the correct interpretation.