Cover Image: 18F-FDG uptake in the aorta at an early stage of metabolic syndrome. Early atherosclerosis?
Roy Moncayo, Dirk Heute, and Eveline Donnemiller
Department of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria
E-mail address: Roy.Moncayo@uibk.ac.at
A 42-year-old man with thyroid cancer was investigated by positron emission tomography (PET) with 18-F-fluorodeoxyglucose (18F-FDG) and computed tomography (CT) during a routine oncological follow-up because of a thoracic metastasis. Both imaging modalities were analysed by 3D-image fusion (volume fusion, HERMES from Nuclear Diagnostics, Sweden). Two examinations with 18F-FDG PET were performed within a time interval of 4 months (December 2002–April 2003). The first functional imaging with PET disclosed a normal distribution in the middle of the thoracic cavity. Prior to the second PET study, the patient received an i.v. vitamin-C supplementation (15 g), which was prescribed for an on-going dental therapy. Vitamin C levels remained unchanged after the infusion (7 µg/L). A slight hyperglycaemia, blood sugar 130 mg/dL, was recorded at the time of the second PET study. The figure shows the follow-up PET depicting a diffuse uptake in the aortic arch. The corresponding CT image was uneventful. One year after these initial investigations, the patient has developed a full-blown metabolic syndrome including a diabetic condition. We interpret the image as an indirect sign of early metabolic derangements with vitamin C depletion and hyperglycaemia.
Figure legend
Three-dimensional volume fusion of CT (in grey scale) and 18-F-fluorodeoxyglucose positron emission tomography images (colour scale) showing uptake in the aortic arch. The aortic uptake is clearly more intense (yellow colour) than the one observed within the thoracic cavity (blue colour).
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