Pelvic anatomic localization using ureteral activity on FDG positron emission tomography

This case report describes the use of ureteral fluorodeoxyglucose activity as an anatomical landmark to distinguish intraperitoneal structures from extraperitoneal nodes during FDG positron emission tomography interpretation. A 37-year-old woman with non-Hodgkin lymphoma presented with pelvic uptake initially misidentified as iliac lymphadenopathy, but subsequent computed tomography imaging revealed no corresponding nodal disease. By utilizing the excreted radiotracer in the ureters for spatial reference, the authors correctly localized the focal uptake to the ovaries rather than retroperitoneal lymph nodes. The paper demonstrates that while ureteral activity is often a confounding factor, it serves as a reliable marker for differentiating intraperitoneal organs like the ovaries from extraperitoneal structures such as iliac nodes. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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