F-fluoro-2-deoxy-D-glucose (FDG)

FDG is a radioactive sugar (a glucose molecule tagged with a small amount of radioactive fluorine-18) that is injected before a PET scan. Cells that use a lot of sugar, including most cancer cells and areas of active inflammation, take up FDG, which then lights up on the scan. This allows doctors to see where in the body tissue is metabolically active, not just where there is a mass on a CT image.

Origin

FDG was first synthesized in 1968 by Tatsuo Ido, Al Wolf, and colleagues at Brookhaven National Laboratory, and used in the first human brain PET imaging by Abass Alavi at the University of Pennsylvania in 1976. It has since become the most widely used radiotracer in clinical PET imaging worldwide.

Significance in Asbestos Context

For patients with suspected or confirmed asbestos-related disease, FDG-PET (often combined with CT as PET/CT) is used to help distinguish benign pleural changes, such as plaques or scarring, from malignant ones like mesothelioma or lung cancer, to stage disease before treatment, and to monitor response to chemotherapy or immunotherapy. FDG uptake is reported as an SUV (standardized uptake value); higher values raise concern for cancer but can also occur with infection, prior talc pleurodesis, or post-radiation inflammation, so the scan is interpreted alongside biopsy and other imaging. PET findings frequently appear in medical records used to support a mesothelioma or lung cancer diagnosis and can be important documentation in a legal claim.

Example Sentence

Her oncologist ordered an FDG-PET/CT to determine whether the thickened pleura seen on CT was scar tissue from old asbestos exposure or an early mesothelioma.

Related Terms

Positron Emission Tomography (PET), SUV (Standardized Uptake Value), Mesothelioma, Pleural Plaques, Staging, Pleurodesis

Notes

• Ask whether your PET scan report includes SUV values and whether uptake is described as focal (suspicious) or diffuse (often inflammatory); request copies of the full report and images for your records and your legal team.
• Tell the technologist if you have had talc pleurodesis, recent surgery, radiation, or an infection. All can cause false-positive FDG uptake that mimics cancer.
• Diabetic patients should ask about blood sugar control before the scan, since high glucose levels can reduce the accuracy of FDG imaging.
• PET findings alone do not confirm mesothelioma or lung cancer; tissue biopsy remains the diagnostic standard, and the PET should be read in conjunction with CT, MRI, and pathology results.