FDG-PET/CT pitfalls in gynecological and genitourinary oncological imaging

Lakhani A, Nishat Bharwani, Stewart V, Andrea Rockall, Barwick T, Khan S
Cancer imaging : the official publication of the International Cancer Imaging Society · 2015 · doi:10.1186/1470-7330-15-s1-p42 · PMC4601111
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⚙ AI-generated summary by gemini-2.5-flash-lite+body, 2026-08-03 ⓘ

This review explores the role of FDG-PET/CT in gynecological and genitourinary cancers, detailing its mechanism, pitfalls, and imaging features essential for interpreting physiological and non-physiological uptake to minimize false results.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-28 · read from full text ⓘ

This review article examines the utility and technical pitfalls of FDG-PET/CT imaging within the context of gynecological and genitourinary oncology. It details mechanisms of physiological and non-physiological uptake, providing pictorial examples of false positives arising from conditions such as pelvic inflammatory disease, fibroids, and endometriosis, as well as false negatives caused by low-grade tumors or urinary excretion. The authors emphasize that recognizing these artifacts is essential for accurate interpretation and minimizing diagnostic errors in multimodality cancer investigations. Relevance to endometriosis: listed as a cause of false-positive FDG-PET uptake in pelvic imaging, though the paper's main focus is on oncological diagnostics.

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Content

Introduction of FDG-PET/CT ∘ Mechanism of action ∘ Role in gynecological and genitourinary oncological imaging ∘ FDG-PET/CT imaging protocols False positives in gynecological and genitourinary oncological imaging: ∘ Physiological FDG-PET uptake – pictorial examples of uptake in endometrium and ovaries ∘ Non-physiological FDG-PET uptake – pictorial examples of pelvic inflammatory disease, fibroids, endometriosis False negatives in gynecological and genitourinary oncological imaging: ∘ Physiological FDG-PET uptake – pictorial examples of urinary excretion masking malignant lesions ∘ No/low FDG uptake – pictorial examples of necrotic lymphadenopathy and low grade tumours ∘ Artefacts Pearls explaining how to minimise false interpretation

Learning

1. To understand the role of FDG PET/CT imaging in the multimodality investigation of gynecological and genitourinary cancers. 2. To describe the mechanism of action and technical pitfalls of FDG-PET/CT. 3. To highlight key imaging features of physiological and non-physiological FDG uptake and show how this is essential for interpretation of gynecological and genitourinary FDG-PET/CT studies. 4. to review the pathophysiological mechanisms leading to potentially false-positive and false-negative assessments.

Conclusions

FDG-PET/CT has a useful role in gynecological and genitourinary oncological imaging. However, understanding of physiological and non-physiological FDG- PET uptake is vital to understand potential false positive and false negatives in interpretation. FDG PET/CT should be used as one part of the multimodality investigation of gynecological and genitourinary cancers.

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