F-18 FDG PET/CT Imaging in Normal Variants, Pitfalls and Artifacts in the Abdomen and Pelvis

Since its introduction into clinical practice, multimodality imaging has revolutionized diagnostic imaging for both oncologic and non-oncologic pathologies. 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging which takes advantage of increased anaerobic glycolysis that occurs in tumor cells (Warburg effect) has gained significant clinical relevance in the management of most, if not all oncologic conditions. Because FDG is taken by both normal and abnormal tissues, PET/CT imaging may demonstrate several normal variants and imaging pitfalls. These may ultimately impact disease detection and diagnostic accuracy. Imaging specialists (nuclear medicine physicians and radiologists) must demonstrate a thorough understanding of normal and physiologic variants in the distribution of 18F-FDG; including potential imaging pitfalls and technical artifacts to minimize misinterpretation of images. The normal physiologic course of 18F-FDG results in a variable degree of uptake in the stomach, liver, spleen, small and large bowel. Urinary excretion results in renal, ureteric, and urinary bladder uptake. Technical artifacts can occur due to motion, truncation as well as the effects of contrast agents and metallic hardware. Using pictorial illustrations, this paper aims to describe the variants of physiologic 18F-FDG uptake that may mimic pathology as well as potential benign conditions that may result in misinterpretation of PET/CT images in common oncologic conditions of the abdomen and pelvis.

Normal Variant Distribution among Elderly Patients Who Visited Airlangga University Dental Hospital

Background and Objective. A normal variant of the oral cavity in humans, especially when aging, indicates how the body adapts to the environment, a lifestyle, and irritation. This study aimed to examine the distribution of normal variants among elderly patients who visited Airlangga University Dental Hospital. Method. This was a descriptive observational design study. Examination of oral soft tissue was performed on elderly dental patients who came to the hospital from January to December 2019. Results. Sixty-eight (68) elderly patients, 60 years of age and over, 35 males and 33 females. The study identified 138 normal oral variations of soft tissues and oral structures. The three highest distributions obtained were coated tongue, lingual varicosities, and fissured tongue. Conclusion. The normal variants of oral mucosa and oral structure in the elderly resulted from how the body adapted to the environment and the awareness of the systemic disease that might occur.

Prevalence of Sesamoids and Accessory ossicles of the Foot: A Radiographic study of the Indian population and a literature review

The prevalence of accessory ossicles and sesamoids is widely variable.[1,4,5] These bones are normal variants and remain asymptomatic, usually overlooked or misdiagnosed.[1,6] These ossicles and sesamoids are involved in various diseases, including fractures, dislocations, degenerative changes. Others include osteonecrosis, osteoarthritis, osteochondral lesion, avascular necrosis, and impingement syndromes.

Evaluatation Of Rib Variations In Chest Radiograph

Rib variations are usually incidental findings on imaging studies and are rarely symptomatic. If in adequately evaluated they are easily overlooked as most of the X-ray is aimed at evaluating the lung parenchyma. Trauma related lesions might usually be misinterpreted as rib variations and sometimes rib lesions may mimic a variant of rib and radiologists should be familiar with a number of normal variants of the ribs to avoid mistaking them for an abnormality. In this article we will discuss and illustrate variety of anatomical rib variants and their incidence in this given population. Anatomical rib variants include developmental deformities, cervical rib, Bifid (forked), fused rib and hypertrophied transverse process of C7 be used. The aim of our study is to have a comprehensive evidence-based morphological assessment of normal anatomical variations of ribs and their prevalence in this population. A Retrospective study of Chest radiographs of 1000 adults who visited our hospital for a routine check-up or for various medical examinations from September 1st 2018 to September 30th 2018, were consecutively reviewed for normal variations of rib. In our study of 1000 radiographs (Male 652 and female 348), there are 10 cervical ribs, 5 bifid ribs, 16 cases of hypertrophied transverse process and 3 fused rib. Thus in conclusion, the knowledge of incidence of normal anatomical variations of ribs and their appearance in a given population is important for radiologist as it avoids any misinterpretation of these relatively normal variants and signals a possibility of neurovascular compression if clinically relevant.

Cranial Ultrasound in Preterm Neonates of Gestational Age 28 to 34 Weeks: A Single Centre Experience From Western India

Context: Intraventricular hemorrhage and periventricular leukomalacia, the common brain injuries in premature infants, are major causes for early death in the neonatal period and later motor and cognitive disabilities. This study was undertaken to find out the incidence of normal cranial ultrasound (CUS), normal variants, and abnormal CUS findings. Evidence Acquisition: This prospective, observational study was conducted at Neonatal ICU, Department of Paediatrics, Civil Hospital, Ahmedabad, over a period of 2 years from September 1, 2014, to August 31, 2016. Detailed history, examination, and risk factor assessment was done for all 180 subjects. The neonates were subjected to cranial ultrasound during admission and on follow-up. Results: Upon sonographic evaluation, 125 (69.44%) neonates had normal ultrasound, 34 (18.90%) had normal variants, and 21 (11.66%) had abnormal cranial ultrasound findings. The predominant normal variants observed were cavum septum pellucidum (18; 10%) and choroid plexus cyst (11; 6.1%). The most common abnormality detected was intraventricular hemorrhage (15; 8.3%) and was found to have a clinically significant correlation with surfactant use and with mechanical ventilation ( P value < .05). Follow-up scans could be performed on 70 subjects out of which 2 had normal variants and 3 had abnormal CUS findings. Conclusion: Establishing institutional CUS scanning protocols will go a long way in decreasing morbidity and mortality in preterm neonates.

A clinical study of cutaneous manifestations in neonates at a tertiary health care center

<p class="abstract"><strong>Background:</strong> Cutaneous alterations are commonly seen in neonates as a normal process of adaptation to the external air environment after birth. It is good to know about transient skin lesions in infants to distinguish them from other conditions that prevent unwanted neonate therapy. Parents should be confident of the excellent prognosis of these manifestations of the skin. The aim of the study was to determine the patterns of cutaneous manifestations occurring among the newborn.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in the newborn with at-least one cutaneous manifestation. A detailed history of the neonates and mother was collected using pre-designed proforma.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of 100 neonates, 52 were males, 48 were females, of these, 85 were born at term, 10 were preterm, and 5 were post-term. Mongolian spot was seen in lumbosacral, buttocks and extremities in 80 (80%) neonates, vernix caseosa in 20 (20%) neonates. Milia in 14 (14%) neonates, eczematous eruption in 30 (12.5%).</p><p class="abstract"><strong>Conclusions:</strong> This neonatal skin research has provided details on normal variants occurs during the neonatal phase. It is necessary to know that most newborn skin lesions are temporary and do not require any treatment.</p>