Inadvertent intraarterial injection of 18F-FDG: A case report and literature review of hot forearm and hot hand signs

Abstract

Unintentional intraarterial injection of radiotracers may cause artifacts leading to difficulties in accurately interpreting PET/CT images. We report a case of a 73-y-old man with a history of metastatic colon cancer who underwent a PET/CT scan for restaging. In the PET scan, there was intense and diffuse distribution of 18F-FDG in his left forearm and hand. This is a classic sign of an accidental intraarterial injection of 18F-FDG in the antecubital region. Similar phenomena after inadvertent intraarterial injection of other radiotracers are reviewed. The associated risk factors, preventive measures, and radiation dose to the arm are discussed. © 2011 by the Society of Nuclear Medicine, Inc.