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DOI: 10.1148/rg.246045701
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Spectrum of Thymic Uptake at 18F-FDG PET1

Brett Ferdinand, MD, Pramod Gupta, MD and Elissa L. Kramer, MD

1 From the Department of Radiology, NYU School of Medicine, Rm HW231, Nuclear Medicine/Radiology, Tisch Hospital, 550 First Ave, New York, NY 10016. Received February 6, 2004; revision requested April 7 and received May 19; accepted May 20. All authors have no financial relationships to disclose. Address correspondence to E.L.K. (e-mail: elissa.kramer@med.nyu.edu).



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  		Figure 1.  Transaxial (left), coronal (middle), and sagittal (right) 18F-FDG PET scans obtained in an 11-year-old boy with lymphoma demonstrate an inverted V-shaped area of anterior mediastinal uptake on the transaxial view with a maximum standardized uptake value (SUV) of 3.0. Given the morphologic features, this finding is typical of normal thymic uptake.

 


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  		Figure 2.  Transaxial (left), coronal (middle), and sagittal (right) 18F-FDG PET scans obtained in a 64-year-old man with fatty infiltration of the thymus demonstrate a region of near-absent 18F-FDG uptake corresponding to the expected location of the thymus.

 


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  		Figure 3.  Transaxial (left), coronal (middle), and sagittal (right) 18F-FDG PET scans obtained in a 17-year-old girl who was being treated for lymphoma demonstrate linear uptake in the anterior mediastinum with a maximum SUV of 3.8. Differentiation of lymphoma from thymic hyperplasia is difficult in such cases. A repeat study performed 5 months later showed continued absence of lymphoma with persistent anterior mediastinal uptake in the same triangular configuration. This finding was believed to represent thymic hyperplasia.

 


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  		Figure 4a.  (a) Transaxial (left), coronal (middle), and sagittal (right) 18F-FDG PET scans obtained in a 14-year-old boy with lymphoma involving the right arm demonstrate a triangular area of anterior mediastinal uptake. This area was believed to represent normal thymic uptake on the basis of morphologic features and a maximum SUV of 2.8. The maximum SUV of the mass in the right upper extremity was 15.6. (b) CT scan demonstrates a normal-appearing thymus corresponding to the area of anterior mediastinal uptake seen at 18F-FDG PET.

 


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  		Figure 4b.  (a) Transaxial (left), coronal (middle), and sagittal (right) 18F-FDG PET scans obtained in a 14-year-old boy with lymphoma involving the right arm demonstrate a triangular area of anterior mediastinal uptake. This area was believed to represent normal thymic uptake on the basis of morphologic features and a maximum SUV of 2.8. The maximum SUV of the mass in the right upper extremity was 15.6. (b) CT scan demonstrates a normal-appearing thymus corresponding to the area of anterior mediastinal uptake seen at 18F-FDG PET.

 


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  		Figure 5.  Transaxial (left), coronal (middle), and sagittal (right) 18F-FDG PET scans obtained in a 55-year-old man demonstrate an anterior mediastinal mass with a maximum SUV of 4.5. The lesion was resected and proved to be an invasive thymoma.

 


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  		Figure 6.  Transaxial (left), coronal (middle), and sagittal (right) 18F-FDG PET scans obtained in a 55-year-old man with a thymic carcinoma demonstrate anterior mediastinal uptake with a maximum SUV of 7.5.

 




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