A 22 year old female with a complex medical history presented to our department with a complaint of pain around the site of her Portocath (POC). Multiple imaging techniques failed to identify any sign of infection around the POC.
A 99mTc-Phytate Colloid labelled white cell (LWC) scan was arranged to identify any infective processes in or around the POC. Severe difficulty was encountered attempting to gain IV access aside from the POC and the LWC scan had to be aborted. In order to identify infection of the POC a Positron Emission Tomography (PET) scan using oral administration of 18F-fluorodeoxyglucose (18F-FDG) was arranged.
The oral 18F-FDG PET scan showed active glucose metabolism around the site of the POC port and along the catheter tubing near the medial right clavicle.
As a result of this the POC was removed and replaced and the patient is now receiving continued antibiotics and medication through her new POC.
In conclusion we found oral administration of 18F-FDG to be a suitable alternative to IV administered 18F-FDG in order to obtain functional imaging in a case where there was severe difficulty in obtaining venous access.