Elimination of Artifactual Accumulation of FDG in PET Imaging of Colorectal Cancer

Abstract

Elimination of artifactual accumulation of FDG in the colon and urinary system is essential if primary cancer, associated adenopathy, or subtle recurrences are to be evaluated in FDG PET imaging of the abdomen and pelvis.

Application of positron emission tomography imaging to cancer screening

“…These can be categorized into 4 groups: urologic cancers, cancers of low cell density (signet ring cell cancer of the stomach and scirrhous-type breast cancer), small cancers and hypometabolic or FDG-negative cancers (lung cancer and hepatoma). Renal excretion of FDG may hamper the detection of urologic cancers (Miraldi et al, 1998). Low tumour cellularity may result in low FDG accumulation (Higashi et al, 1998).…”

Influence of Bowel Preparation Before 18F-FDG PET/CT on Physiologic 18F-FDG Activity in the Intestine

“…Many patients will be referred for colonoscopy, which generates additional costs and causes discomfort to the patients (3,4). In the literature, recommendations have been made in order to reduce physiologic uptake of 18 F-FDG in the intestine or to improve the ability to evaluate intestinal structures (5)(6)(7)(8). However, no published study has proven that bowel preparation before PET/CT is beneficial.…”

The incremental value of dual modality PET/CT imaging over PET imaging alone in advanced colorectal cancer

“…There is growing consensus that 18 F-fl uorodeoxyglucose positron emission tomography (FDG PET) is a successful modality in evaluating many types of cancer, including colorectal cancer. It is based on the principal that malignant cells have a high glucose-6-phosphatase activity and rapidly turnover 18 F-fl urodeoxyglucose, thereby increasing the signal to background ratio and creating 'hot spots'.…”

“…It is based on the principal that malignant cells have a high glucose-6-phosphatase activity and rapidly turnover 18 F-fl urodeoxyglucose, thereby increasing the signal to background ratio and creating 'hot spots'. The reported increased sensitivity of FDG PET over CT has been attributed to the ability of FDG PET to detect metabolic abnormalities that precede the morphological changes seen by CT [1].…”

“…This is disadvantageous to the surgeon, especially when the planning of a precise resection is required. There is also the problem with normal physiological uptake of the tracer seen in the digestive tract and genitourinary system, which can lead to false positives and lower specifi city [17][18][19].…”