How can we differentiate reactive changes from residual neoplasia in post-operative PET/CT?

“Sometimes, reactive (immflamatory) changes may exhibit high FDG uptake and therefore it might be difficult to differenciate it from residual neoplasia. However, there are many different approaches you may do in order to help you distinguish reactive vs. malignancy such as dual time phase/acquisition, diffuse vs. focal uptake…and obviously clinical history (time from surgery… it’s recommended to wait at least a month after the surgical procedure to perform the examination). If with these, you’re not able to discriminate it, then a clinical context and a re-scaning after a few weeks or a month could be suggested.”

Dr. José Vercher-Conejero
Barcelona, Spain

Question submitted during the the Conference on Hybrid Imaging Live 2019 regarding Dr. Vercher-Conejero’s lecture on “Pitfalls in 18F-FDG PET/CT”