RadioGraphics -- eLetters for Kostakoglu et al., 24 (5) 1411-1431

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RSNA Education Exhibits:
Lale Kostakoglu, Ruth Hardoff, Rosna Mirtcheva, and Stanley J. Goldsmith
PET-CT Fusion Imaging in Differentiating Physiologic from Pathologic FDG Uptake
Radiographics 2004; 24: 1411-1431 [Abstract] [Full text] [PDF]

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Electronic letters published:

About Physiologic FDG Uptake in the Neck: Philippe Henrot (19 October 2004)

About Physiologic FDG Uptake in the Neck 19 October 2004

Philippe Henrot,
Radiologist
Centre Alexis Vautrin, Nancy, France
Send letter to journal:
Re: About Physiologic FDG Uptake in the Neck

p.henrot{at}nancy.fnclcc.fr Philippe Henrot

Editor:
In the article “PET-CT Fusion Imaging in Differentiating Physiologic from Pathologic FDG Uptake” in the September 2004 issue of RadioGraphics (1), the authors describe FDG uptake in the cricoarythenoid muscles that is presumed to be physiologic. However, this uptake appears at the same level as the first tracheal rings on their Figure 7 and seems to be located at the cervico-esophageal junction. Therefore, it could be considered to be the result of the physiologic tonus of the upper esophageal sphincter.
Reference
1. Kostakoglu L, Hardoff R, Mirtcheva R, Goldsmith SJ. PET-CT fusion imaging in differentiating physiologic from pathologic FDG uptake. RadioGraphics 2004; 24:1411-1431.
Dr Kostakoglu responds:
We greatly appreciate Dr Henrot’s interest in our article and critical comment on Figure 7. We are pleased to clarify this particular issue as we agree that the section shown in the article may be misleading to some readers. It would be ideal to show consecutive sections; however, authors must work within the assigned space limitations of published articles, as in this case. The symmetric bilateral FDG uptake characteristics shown in the location referred to by Dr Henrot are typical for posterior cricoarytenoid muscles, which abduct vocal folds in a patient conversing during FDG injection. As can be appreciated in the five additional figures we have provided (particularly Slide 3), these foci of uptake originate from the posterior larynx and extend inferiorly. Although the esophagus is located close to the posterior larynx, the uptake in the esophagus is characteristically unifocal, as shown in Slide 5. These additional figures should be helpful in further clarifying the origin of the FDG uptake.