Skeletal Muscle Uptake of Fluorine-18-FDG: Effect of Oral Diazepam

We have observed a pattern of symmetrically increased uptake of [18F]fluorodeoxyglucose (FDG) in the neck and thoracic paravertebral regions of several patients referred for whole-body PET. The distribution is suggestive of uptake in contracting skeletal muscle in tense patients. To test this hypothesis, six successive patients who exhibited this pattern of uptake underwent rescanning using an identical imaging protocol but with oral diazepam before injection of FDG. The increased neck and paravertebral uptake was significantly reduced or abolished with diazepam, confirming the supposition that this increased neck and paravertebral uptake represents a normal variant of muscle uptake. Oral diazepam, given before the uptake period can be helpful in such patients to exclude the masking of potential abnormalities by this characteristic pattern of FDG uptake.