Ability of integrated positron emission and computed tomography to detect significant colonic pathology

Abstract

BACKGROUND:The ability of integrated positron emission tomography and computed axial tomography (PET‐CT) to detect colonic pathology is not fully defined. The purpose of this study was to assess the ability of PET‐CT to detect colonic pathology and to determine the significance of (18F)2‐fluoro‐2‐deoxyglucose (18F‐FDG) activity noted incidentally in the colon on PET‐CT.METHODS:Records for all patients who underwent PET‐CT and colonoscopy at our institution were reviewed. Patients with history of colonic malignancy or colon surgery were excluded.RESULTS:Fifty‐eight patients had incidental colonic 18F‐FDG activity on PET (Group A) and 272 had none (Group B). In Group A, 65% of patients had pathologic findings detected on colonoscopy that corresponded to the site of PET activity. Standardized uptake value (SUV) readings were not helpful in distinguishing true‐positives from false‐positives. In Group B, 11.8% of patients were found to have significant colonic findings. Lesions not detected by PET‐CT included 4 colon cancers, 7 advanced adenomas, and 10 patients with colonic lymphoma. Overall, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET‐CT for detecting significant pathology were 53%, 93%, 65%, 89%, and 85%, respectively. For detecting colon cancer and adenomas 10 mm or more, the sensitivity, specificity, PPV, NPV, and accuracy of PET‐CT were 72%, 90%, 45%, 96%, and 88%, respectively.CONCLUSIONS:Incidental colonic activity detected by PET‐CT warrants further evaluation with colonoscopy. However, negative PET‐CT does not rule out significant colonic pathology including colon cancer, advanced adenomas, or lymphoma. Cancer 2010. © 2010 American Cancer Society.

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

“…21 In one study, negative PET scan results did not rule out colonic involvement in lymphoma patients. 22 …”

Incidence and risk factors for colorectal neoplasia in patients with oral squamous cell carcinoma

“…Positron emission tomography-computed tomography has recently been used as a tool to detect SPT in oral cancer [23], but, its specificity is not acceptable for the detection of advanced colorectal neoplasias [24] and it is not a substitute for colonoscopy. Although few studies have referred to the prevalence of head and neck cancers in patients with colorectal cancer, several studies have suggested possible associations between these diseases [25,26].…”

Facial Cosmetic Filler Injections as Possible Target for Systemic Sarcoidosis in Patients Treated with Interferon for Chronic Hepatitis C: Two Cases

“…The association of sarcoidosis and other granulomatous dermatoses with α-interferon is now well known [2,3,4,5]. It is not limited to patients treated for chronic hepatitis C. For instance, interferon-induced sarcoidosis has been reported in patients treated for chronic myelogenous leukaemia and melanoma [6, 7].…”

“…It is not limited to patients treated for chronic hepatitis C. For instance, interferon-induced sarcoidosis has been reported in patients treated for chronic myelogenous leukaemia and melanoma [6, 7]. These interferon-induced sarcoidoses often have a good prognosis [2,3,4]. A complete healing of sarcoidosis may be expected after stopping the interferon treatment.…”

“…α-Interferon may favour the development of sarcoidosis [2,3,4]. Interferon is known to stimulate natural killer cell activity.…”