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Recurrent Laryngeal Nerve Palsy in Patients with Lung Cancer: Detection with PET-CT Image Fusion—Report of Six Cases¹

¹ From the Division of Nuclear Medicine, Department of Medical Radiology, University Hospital of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland. Received July 23, 2001; revision requested September 6; revision received November 13; accepted December 12. E.M.K. supported by the Swiss Federal Commission for Scholarships for Foreign Students. Address correspondence to H.C.S. (e-mail: hans.steinert@dmr.usz.ch).

Positron emission tomography (PET) with fluorodeoxyglucose (FDG) was performed for preoperative staging of lung cancer. In six of 184 patients, there was an intense FDG accumulation in the lower anterior neck. Fusion of PET and computed tomographic images revealed that the focal FDG uptake was localized in the internal laryngeal muscles. This finding was a result of compensatory laryngeal muscle activation caused by contralateral recurrent laryngeal nerve palsy due to direct nerve invasion by lung cancer of the left mediastinum or lung apices. The knowledge of this pitfall is important to avoid false-positive PET results.

© RSNA, 2002

Index terms: Computed tomography (CT), 27.12112, 27.12115 • Data fusion • Image fusion • Larynx, abnormalities, 271.829 • Lung neoplasms, 60.321 • Positron emission tomography (PET), 27.12163, 27.12166

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