Significance of FDG-PET in Identification of Diseases of the Appendix – Based on Experience of Two Cases Falsely Positive for FDG Accumulation

A discussion of the significance of F-fluorodeoxyglucose positron emission tomography (FDG-PET) in the identification of diseases of the appendix is presented based on two cases falsely positive for FDG accumulation. Both cases were palpable for a tumor in the lower right abdominal region and a prominently enlarged appendix was depicted by CT. Although the patients underwent ileocecal resection based on a strong suspicion of appendiceal cancer rather than appendicitis since abnormal accumulation exhibiting maximum standard uptake values (SUVs) of 7.27 and 17.11, respectively, was observed at the same site in FDG-PET examination and since there no malignant findings observed histologically, the patients were diagnosed with appendicitis. Although FDG specifically accumulates not only in malignant tumors, but also in diseases such as acute or chronic inflammation, abscesses and lymphadenitis, and identification based on SUVs has been reported to be used as a method of identification, the two cases reported here were both false-positive cases exhibiting high maximum SUVs. At the present time, although the significance of FDG-PET in the identification of diseases of the appendix is somewhat low and there are limitations on its application, various research is currently being conducted with the aim of improving diagnostic accuracy, and it is hoped that additional studies will be conducted in the future.