Hepatic Vascular Shunts Mimicking Malignant Lesions on 18F-FDG PET/CT Imaging: Interpretation Pitfall in the Background of Cirrhotic Liver

Sanchay Jain; Assim Saad Eddin; Parren McNeely; Michael Graham; Ahmad Shariftabrizi

doi:10.4274/mirt.galenos.2025.45712

Abstract

A 44-year-old female presented with recent history of ischemic strokes and hypercoagulability and chronic alcoholic cirrhosis. ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography was performed during the workup for vasculitis. PET features of vasculitis were not identified, but liver showed multiple hepatic FDG avid foci, concerning for malignant or metastatic disease in the background of cirrhosis of liver. To characterize these lesions, liver magnetic resonance imaging was subsequently performed which revealed hepatic vascular shunts corresponding to the sites of the FDG avid foci. This case highlights potential interpretation n pitfall arising due to FDG avidity in the vascular shunts resembling malignant or metastatic lesions.

Keywords:

18F-FDG PET/CT, hepatic vascular shunt, liver cirrhosis

Figure 1

Ethics

Informed Consent: Requirement for informed consent was waived by University of Iowa’s Human Subject Office.

Authorship Contributions

Concept: P.M., M.G., A.S., Design: A.S., Data Collection or Processing: S.J., A.S.E., Analysis or Interpretation: P.M., M.G., A.S., Literature Search: S.J., A.S.E., Writing: S.J., A.S.E.

Conflict of Interest: No conflicts of interest were declared by the authors.

Financial Disclosure: The authors declare that this study has received no financial support.

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