Hostname: page-component-77c89778f8-m8s7h Total loading time: 0 Render date: 2024-07-24T22:40:47.910Z Has data issue: false hasContentIssue false
  • English
  • Français

Radiographic properties of injected calcium hydroxylapatite: potential false positive findings on positron emission tomography

Published online by Cambridge University Press:  18 March 2008

E J Damrose
E J Damrose*
Affiliation:
Division of Laryngology, Department of Otolaryngology/Head and Neck Surgery, Stanford University Medical Center, Stanford, California, USA
*
Address for correspondence: Dr Edward J Damrose, Division of Laryngology, Department of Otolaryngology/Head and Neck Surgery, Stanford University Medical Center, 801 Welch Road, Stanford, CA 94305, USA. Fax: +1 650 725 8502 E-mail: edamrose@stanford.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To describe the positron emission tomography and computed tomography features of injected calcium hydroxylapatite, and to discuss how these may be mistaken for malignancy.

Case report:

Positron emission tomography is now readily employed in the staging and monitoring of patients with head and neck carcinoma. Concomitant with the growing use of this modality has been the increasing popularity of injected calcium hydroxylapatite to treat glottic incompetence secondary to vocal fold paralysis or following partial laryngectomy. A patient developed aspiration following near-total laryngectomy and subsequently underwent injection of calcium hydroxylapatite, with effective resolution of the aspiration. The patient underwent positron emission tomography scanning as part of routine tumour surveillance; this showed intense tracer uptake at the site of injection, and this pattern persisted for one year following injection.

Conclusions:

As injectable calcium hydroxylapatite becomes more widely used, especially in the treatment of patients with a history of head and neck cancer, physicians should be aware it may cause a potentially misleading, false positive positron emission tomography finding.

Keywords

HydroxylapatitePositron Emission TomographyComputed TomographyLaryngectomyAspiration
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 12 , December 2008 , pp. 1394 - 1396
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Chhetri, DK, Jahan-Parwar, B, Hart, SD, Bhuta, SM, Berke, GS. Injection laryngoplasty with calcium hydroxylapatite gel implant in an in vivo canine model. Ann Otol Rhinol Laryngol 2004;113:259–64Google Scholar
2Rosen, CA, Thedki, AA. Vocal fold augmentation with injectable calcium hydroxylapatite: short-term results. J Voice 2004;18:387–91Google Scholar
3Belafsky, PC, Postma, GN. Vocal fold augmentation with calcium hydroxylapatite. Otolaryngol Head Neck Surg 2004;131:351–4CrossRefGoogle ScholarPubMed
4Rosen, CA, Garner-Schmidt, J, Casiano, R, Anderson, TD, Johnson, F, Reussner, L et al. Vocal fold augmentation with calcium hydroxylapatite (CaHA). Otolaryngol Head Neck Surg 2007;136:198–204Google Scholar
5Lee, B, Woo, P. Use of injectable hydroxyapatite in the secondary setting to restore glottic competence after partial laryngectomy with arytenoidectomy. Ann Otol Rhinol Laryngol 2004;113:618–22CrossRefGoogle ScholarPubMed
6Suits, GW, Cohen, JI, Everts, EC. Near-total laryngectomy: patient selection and technical considerations. Arch Otolaryngol Head Neck Surg 1996;122:473–5CrossRefGoogle ScholarPubMed
7Coniglio, JU, Winkle, MR, Bennett, GH, Martin, B, Pacella, SJ. Myomucosal shunt plugging to prevent aspiration after near-total laryngectomy. Laryngoscope 1999;109:1167–9Google Scholar
8Brasnu, D, Strome, M, Laccourreye, O, Weinstein, G, Menard, M. Gax collagen as an adjunctive measure for the incontinent myomucosal shunt. Arch Otolaryngol Head Neck Surg 1991;117:767–8Google Scholar
9Heller, MT, Meltzer, CC, Fukui, MB, Rosen, CA, Chander, S, Martinelli, MA et al. Superphysiologic FDG uptake in the non-paralyzed vocal cord. Resolution of a false-positive PET result with combined PET-CT imaging. Clin Positron Imaging 2000;3:207–11Google Scholar
10Yeretsian, RA, Blodgett, TM, Branstetter, BF 4th, Roberts, MM, Meltzer, CC. Teflon-induced granulomas: a false-positive finding with PET resolved with combined PET and CT. AJNR Am J Neuroradiol 2003;24:1164–6Google ScholarPubMed
11Hewitt, RJ, Singh, A, Wareing, MJ. Teflon-induced granuloma: a source of false positive positron emission tomography and computerized tomography interpretation. J Laryngol Otol 2004;118:822–4Google Scholar
12Harrigal, C, Branstetter, BF 4th, Snyderman, CH, Maroon, J. Teflon granuloma in the nasopharynx: a potentially false-positive PET/CT finding. AJNR Am J Neuroradiol 2005;26:417–20Google Scholar
13Chadwick, JL, Khalid, A, Wagner, H, Stack, BC Jr.Teflon granulomas results in a false-positive “second primary” on 18F-2-deoxyglucose positron emission tomography in a patient with a history of nasopharyngeal cancer. Am J Otolaryngol 2007;28:251–3Google Scholar