Situs inversus totalis shown in the 18F-FDG PET/CT scan.

Hellenic Journal of Nuclear Medicine ñ May August 2007 To the Editor: A 38 years old woman with a history of Hodgkin’s disease after a course of chemotherapy was referred to our PET/CT department to search for possible recurrent disease. After 6 h of fasting, her serum glucose level was 103 mg/dl and the patient was injected intravenously (i.v.) with 510,6 MBq of 18F-FDG. The patient was imaged after one hour using a dedicated Siemens Biograph LSO HI-REZ integrated PET/CT camera. The CT scan without i.v. contrast medium, was used for anatomical landmarking and attenuation correction. The scan depicted no recurrent disease but showed situs inversus (Figs 1A, 1B and 1C). Situs inversus is a rare congenital anomaly characterized by transposition of organs to the opposite side of the body. The overall incidence of this anomaly is in the region of 1:5000 to 1:20,000, and being slightly more common in males [1]. Situs inversus may be complete (situs inversus totalis) or partial (situs inversus partialis) confined to either the thoracic or the abdominal viscera [2]. This anomaly apparently does not influence normal life expectancy [3]. Although this anomaly is not considered to be a premalignant entity, several malignant neoplasms have been reported in association with situs inversus totalis[1,4,5], as well as hepatic cirrhosis [6] and calculus cholocystitis [7].