Background and Purpose. Several studies have evaluated the role of fluorine-18-fluorodeoxyglucose positron emission tomography and positron emission tomography/computed tomography (FDG-PET and PET/CT) in diagnosing and assessing disease activity in patients with retroperitoneal fibrosis (RF). The aim of our paper is to perform a literature review on this topic. Methods. Scientific articles that evaluated the usefulness of FDG-PET and PET/CT in patients with RF were searched and discussed. Results. Eleven studies were found, and the main findings of these articles were described. Conclusion. FDG-PET and PET/CT are useful functional imaging methods for assessing patients with RF both in the diagnosis and in the treatment response evaluation. Moreover, further studies are needed to substantiate the role of FDG-PET and PET/CT in patients with RF. 1. Introduction Retroperitoneal fibrosis (RF) is a chronic inflammatory disease, characterized by the presence of retroperitoneal inflammatory tissue, typically surrounding abdominal aorta and/or iliac arteries, and often leading to the involvement of adjacent structures, more frequently the ureters and inferior vena cava [1–7]. RF is a complex clinical entity still incompletely defined and with unclear etiology. Idiopathic RF (even reported as Ormond’s disease) represents two thirds of all cases of RF. A true idiopathic form is present in any cases of RF in which no potential etiologic condition may be identified. The pathogenesis of the idiopathic RF appears today to be related to IgG4 autoimmune mechanisms “hyper-IgG4 disease”. Otherwise, RF in the presence of aortic atheromatous inflammation (atheromatous aortitis) has been included, more than twenty years ago, among the secondary forms, since this condition appears to be elicited by antigen-acting oxidized-LDL and/or ceroid, that are present within the atheromatous plaque. Etiology of other secondary RF refers to medications (drug-induced RF), infections, traumas, surgery, radiation therapy, and malignancies [1–7]. Clinical presentation of RF is usually characterized by constitutional symptoms and back or abdominal pain. Because of the presence of increased serum inflammatory markers levels and positive autoantibodies, and the frequent association with autoimmune diseases (such as Riedel’s thyroiditis, sarcoidosis, inflammatory aneurysm, and autoimmune pancreatitis), some authors suspected that RF may result from autoimmune mechanisms [7] or, even, be considered as distinct autoimmune diseases [3, 8–11]. A frequent complication of RF is unilateral or bilateral
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