Abstract:
Positron emission tomography (PET) with [F-18]-fluoro-deoxy-glucose (FDG) has a well
established and growing role in the management of most lymphomas. The interpretation
of FDG PET scans in HIV positive patients is however challenging. This is largely due to scan
changes giving a higher likelihood of false positive studies from both the direct effects of
HIV and its treatment, and related to secondary HIV-related pathology. There is currently
a need for further clinical research to evaluate to contribution of FDG PET in the management
of HIV positive patients with lymphoma. In this paper existing studies related to FDG
PET scanning in HIV positive patients will be reviewed, and potential pitfalls will be
identified. These pitfalls can be avoided to some extent by the interpreter having a good
clinical knowledge of the individual patients’ condition, and an awareness of known
scintigraphic patterns that can occur in these patients. PET remains a sensitive tool for
the localisation of pathology, however when the exact nature of lesions has a direct bearing
on patient management lesions need to be biopsied where possible. FDG PET can be particularly
useful for the characterisation of brain lesions suspected to be related to primary
central nervous system lymphoma.
