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Hypermetabolic activity in patients with active retroperitoneal fibrosis on F-18 FDG PET: report of three cases

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Abstract

Idiopathic retroperitoneal fibrosis is an uncommon disease characterized by periaortic inflammation with gradual fibrosis and distortion of retroperitoneal structures such as the ureter. Several earlier case reports have documented hypermetabolic retroperitoneal activity on fluorodeoxyglucose positron emission tomography (FDG PET) in patients with active disease, and a decrease in the activity following immunosuppressive therapy. We report FDG PET positive findings in three patients presenting with active retroperitoneal fibrosis. In two cases, enhancing periaortic soft tissue seen on computed tomography (CT) markedly diminished following immunosuppressive therapy. In one patient, repeat FDG PET was performed following immunosuppressive therapy, with complete resolution of the retroperitoneal FDG avidity. We suggest that FDG PET may play a useful adjunct to anatomic imaging and serum inflammatory markers in assessing the severity of inflammation in retroperitoneal fibrosis, and in assessing the likelihood of response to immunosuppressive therapy. FDG PET may also be used in follow-up to assess therapeutic response if CT findings are unclear.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32256, USA

    Phillip M. Young & Jeffrey J. Peterson

  2. Department of Internal Medicine, Division of Rheumatology, Mayo Clinic, Jacksonville, FL, USA

    Kenneth T. Calamia

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  1. Phillip M. Young
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  2. Jeffrey J. Peterson
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  3. Kenneth T. Calamia
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Correspondence to Phillip M. Young.

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Young, P.M., Peterson, J.J. & Calamia, K.T. Hypermetabolic activity in patients with active retroperitoneal fibrosis on F-18 FDG PET: report of three cases. Ann Nucl Med 22, 87–92 (2008). https://doi.org/10.1007/s12149-007-0077-0

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  • DOI: https://doi.org/10.1007/s12149-007-0077-0

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