Potential Role of Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography in Immunoglobulin G4-related Systemic Disease

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BT Kung, CP Wong, TK Au-yong, CM Tong

Hong Kong J Radiol 2013;16:230-4

DOI: 10.12809/hkjr1312138

We report on a 60-year-old man who presented with painless obstructive jaundice, suspicious of hilar cholangiocarcinoma. Positron emission tomography–computed tomography (PET-CT) demonstrated markedly fluorodeoxyglucose-avid bilateral enlarged submandibular masses and extensive hypermetabolic supra- and infra-diaphragmatic lymphadenopathy. Left submandibular excisional biopsy revealed immunoglobulin G4-related systemic disease. Compared with CT or magnetic resonance imaging, fluorine-18 fluorodeoxyglucose PET-CT not only allows whole-body imaging, but also offers metabolic information that helps to reflect disease activity. Fluorine-18 fluorodeoxyglucose PET-CT is a potential useful tool for diagnosis, treatment response assessment, and relapse detection of this systemic disease that is worth further exploration.