Predictors of Neoplasia in Colonic Wall Thickening Detected via Computerized Tomography

Karaçin, Cengiz; Türker, Sema; Eren, Tulay; Imamoğlu, Gökşen İnanç; Yılmaz, Kemalettin; Coşkun, Yusuf; Güneş, Serra Özbal; Yazılıtaş, Doğan; Simsek, Zahide; Altınbaş, Mustafa

doi:10.7759/cureus.10553

Cited by 3 publications

(4 citation statements)

References 16 publications

(27 reference statements)

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“…In particular, splenic enlargement can be observed in 50%-87.9% colon cancer patients treated with oxaliplatin-based ChT with 31% median change of spleen size [ 87 ]. This finding seems to be a surrogate of oxaliplatin-induced SOS, above mentioned among ChT-induced liver injuries, that can be complicated by thrombocytopenia, which has been confirmed to be higher in colon cancer patients treated by oxaliplatinum and developing splenomegaly after ChT [ 87 ]. Thus, this imaging feature encountered in follow-up imaging examinations of oncology patients may be a warning sign in terms of developing SOS.…”

Section: Imaging Findingsmentioning

confidence: 99%

Imaging side effects and complications of chemotherapy and radiation therapy: a pictorial review from head to toe

et al. 2021

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Newer biologic drugs and immunomodulatory agents, as well as more tolerated and effective radiation therapy schemes, have reduced treatment toxicity in oncology patients. However, although imaging assessment of tumor response is adapting to atypical responses like tumor flare, expected changes and complications of chemo/radiotherapy are still routinely encountered in post-treatment imaging examinations. Radiologists must be aware of old and newer therapeutic options and related side effects or complications to avoid a misinterpretation of imaging findings. Further, advancements in oncology research have increased life expectancy of patients as well as the frequency of long-term therapy-related side effects that once could not be observed. This pictorial will help radiologists tasked to detect therapy-related complications and to differentiate expected changes of normal tissues from tumor relapse.

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Section: Imaging Findingsmentioning

confidence: 99%

Imaging side effects and complications of chemotherapy and radiation therapy: a pictorial review from head to toe

et al. 2021

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“… 16 found four subjects with neoplasia that was localized in all cases, while Karacin et al . 7 showed that 63% cases of localized CWT had neoplasia and that focal and asymmetric CWT are independent risk factors for neoplasia. In our study, even though localized CWT did not have a strong predictive value based on the ROC curve, it was found to be independently associated with CRC based on our multivariable logistic regression.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Previous studies have shown an incidence of 7-21% malignancy rate in patients with CWT. [5][6][7][8][9] No clear consensus exists to date to address the role of colonoscopy in patients with CWT. Some previous studies have suggested performing colonoscopy in these subjects 10,11 but the results remain conflicting.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of colorectal carcinoma and inflammatory bowel disease in patients with colonic wall thickening

et al. 2022

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Background and Aim: Colonic wall thickening (CWT) is commonly associated with clinically significant pathologies, but predictive factors of such pathologies are not well known. This study aims to identify the predictors of clinically significant pathologies, such as colorectal carcinoma (CRC) and inflammatory bowel disease (IBD), in patients with CWT. Methods: Subjects with an abnormal abdominal computed tomography (CT) and a follow-up colonoscopy between 2010 and 2020 were retrospectively reviewed. Patients with CWT in the CT were included and examined in this study. A multivariable logistic regression analysis was performed to assess for factors independently associated with CRC or IBD in these subjects. Receiver operating characteristic (ROC) curve analysis was used to further examine significant parameters in multivariable logistic regression analysis. Results: Among 403 patients with CWT on CT scans who underwent a colonoscopy, 269 subjects who met the inclusion criteria were identified and studied. On multivariable logistic regression models, elevated platelet count, low hematocrit, and localized CWT were found to be independently associated with CRC, while elevated platelet count and younger age were independently associated with IBD. On ROC curve analysis for CRC, area under the curve (AUC) for hematocrit, platelets, and localized CWT was 0.76, 0.75, and 0.61, respectively. On ROC curve analysis for IBD, AUC for age and platelets was 0.90 and 0.69, respectively. Conclusion: Elevated platelet count, low hematocrit, and localized CWT can be potentially used as predictors of CRC in patients with CWT. Elevated platelet count and young age can be used to predict IBD in these patients.

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Combined SUVmax and localized colonic wall thickening parameters to identify high-risk lesions from incidental focal colorectal 18F-FDG uptake foci

Li²,

Guo³

et al. 2022

Front. Oncol.

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ObjectiveTo evaluate the detection ability of 18F-FDG PET/CT for identifying high-risk lesions (high-risk adenomas and adenocarcinoma) from incidental focal colorectal 18F-FDG uptake foci combining maximum standard uptake value (SUVmax) and localized colonic wall thickening (CWT). The secondary objective was to investigate the factors of missed detection of high-risk adenomas by 18F-FDG PET/CT.Patients and methodsA total of 6394 patients who underwent 18F-FDG PET/CT in our hospital from August 2019 to December 2021 were retrospectively analysed, and 145 patients with incidental focal colorectal 18F-FDG uptake foci were identified. The optimal cut-off value of SUVmax for 18F-FDG PET/CT diagnosis of high-risk lesions was determined by receiver operating characteristic (ROC) curves. SUVmax and localized CWT were combined to identify high-risk lesions from incidental focal colorectal 18F-FDG uptake foci. The characteristics of incidental adenomas detected and high-risk adenomas missed by 18F-FDG PET/CT were compared.ResultsOf the 6394 patients, 145 patients were found to have incidental focal colorectal FDG uptake foci (2.3%), and 44 patients underwent colonoscopy and pathological examination at the same time. In fact, 45 lesions, including 12 low-risk lesions and 33 high-risk lesions (22 high-risk adenomas, 11 adenocarcinoma), were found by colonoscopy. The area under the ROC curve of SUVmax for low-risk lesions and high-risk lesions was 0.737, and the optimal cut-off value was 6.45 (with a sensitivity of 87.9% and specificity of 58.3%). When SUVmax ≥6.45, the combination of localized CWT parameters has little influence on the sensitivity and specificity of detection; when SUVmax <6.45, the combination of localized CWT parameters can improve the specificity of detection of high-risk lesions, but the sensitivity has little change. In addition, the size of high-risk adenomas discovered incidentally by 18F-FDG PET/CT was larger than that of high-risk adenomas missed, but there was no significant difference in lesion location, pathological type or intraepithelial neoplasia between the two groups.ConclusionsThe combination of SUVmax and localized CWT parameters of 18F-FDG PET/CT helped identify high-risk lesions from incidental focal colorectal 18F-FDG uptake foci, especially for lesions with SUVmax <6.45. Lesion size may be the only factor in 18F-FDG PET/CT missing high-risk adenomas.

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Predictors of Neoplasia in Colonic Wall Thickening Detected via Computerized Tomography

Cited by 3 publications

References 16 publications

Imaging side effects and complications of chemotherapy and radiation therapy: a pictorial review from head to toe

Imaging side effects and complications of chemotherapy and radiation therapy: a pictorial review from head to toe

Predictors of colorectal carcinoma and inflammatory bowel disease in patients with colonic wall thickening

Combined SUVmax and localized colonic wall thickening parameters to identify high-risk lesions from incidental focal colorectal 18F-FDG uptake foci

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