HEMATOPOIETIC CYTOKINE-MEDIATED FDG UPTAKE SIMULATES THE APPEARANCE OF DIFFUSE METASTATIC DISEASE ON WHOLE-BODY PET IMAGING

FDG-PET is increasingly being used to assess malignant tumors. However , leukocyte colony-stimulating factors (CSFs), which promote the expan sion of hematopoietic bone marrow, have also been demonstrated to caus e increased bone-marrow FDG uptake. Three hundred FDG-PET studies cond ucted over a 1-year period were reviewed for diffuse bone-marrow uptak e. Elevated bone-marrow uptake on PET was correlated with pathological findings and courses of granulocyte-CSF (G-CSF) therapy. These result s demonstrate that G-CSF mediated FDG uptake in bone marrow is often i ndistinguishable 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.