Relevance of Incidental Colorectal FDG-PET/CT-Enhanced Lesions

Abstract

Introduction: Positron emission tomography/computed tomographies (PET/CTs) may result in incidental findings of fluorodeoxyglucose (FDG)-avid lesions in the colon. The aim of this study was to assess the relevance of a colonoscopic workup of such lesions. Patients and Methods: We retrospectively analysed all PET/CT reports (n = 4,973) generated in our nuclear medicine department between May 2006 and May 2011; in 69 cases a colonoscopic evaluation was recommended for incidental FDG-avid lesions. Results: Of these 69 cases, 51 underwent colonoscopy because of the potential need for further treatment. The maximum standardized uptake values (SUVmax) ranged from 5.0 to 42.0 with an average of 10.9. In 44 of the 51 patients, a histopathological abnormality was found on colonoscopy, 44 in the location described by PET/CT. A further 38 lesions were identified that were not visible on PET/CT. The histopathological evaluation in the 51 patients revealed 14 hyperplastic polyps, 27 adenomas with low-grade and 4 with high-grade dysplasia, 3 adenocarcinomas and 1 neuro-endocrine tumour. Conclusion: Incidental findings of focal colorectal FDG uptake should lead to further workup with colonoscopy. The SUVmax was not predictive for higher grade histologies. With an SUV of 5 the yield was high for colonic premalignant and malignant lesions. However, malignancy cannot be ruled out in focal lesions with an SUV of less than 5, and for individual patients a colonoscopy should not be ruled out.

Retrospective chart analysis of incidental findings detected by 18F‐fluorodeoxyglucose‐PET/CT in patients with cutaneous malignant melanoma

“…The colorectal cancers diagnosed in our cohort were mostly at an early stage of development, showing the clear benefit of FDG‐PET/CT because surgery was still possible at a premetastatic stage. In summary, incidental foci in the gastrointestinal tract should be worked up using colonoscopy .…”

Pièges et faux-semblant de la TEP/TDM au 18F-FDG dans le bilan de carcinose péritonéale d’origine colorectale : une analyse de 37 patients

“…Les zones focales d'hypermétabolisme sur les images de TEP/TDM au 18 F-FDG étaient considérées comme des résul-tats positifs quand elles étaient visibles sur au moins deux coupes contiguës, avec une activité supérieure à celle des tissus environnants et une valeur maximale d'absorption normalisée (SUV max) supérieure à 5 [18,19].…”

“…Selon les critères de l'étude, des faux positifs de la TEP/TDM au 18 Parmi les 37 patients de notre étude, 33 avaient des résultats vrais positifs à la TEP/TDM au 18 F-FDG. La valeur prédictive positive de la TEP/TDM au 18 F-FDG pour le diagnostic de carcinose péritonéale d'origine colorectale sur une base par patient était de 92 % (33/37 ; IC 95 % : 78-98 %).…”

“…Cette recherche initiale a identifié un total de 62 patients (36 hommes, 26 femmes) avec un âge moyen de 55 ± 9,2 ans (SD) [extrêmes : 23-74 ans]. Parmi eux, 25 patients ont été exclus après examen des dossiers parce qu'ils n'avaient pas eu une exploration chirurgicale complète de l'abdomen et du pelvis du fait d'une carcinose péritonéale importante (n = 21) ou ont eu la TEP/TDM au18 F-FDG après chirurgie de cytoréduction (n = 4). Notre conseil éthique a approuvé l'analyse rétrospective des données et un consentement éclairé était obtenu pour tous les patients.…”

PWE-023 Is It Worth Chasing Incidental Colonic Hot Spots On Routine Pet Ct Scans?

“…2 Cancer detection rates of 7.8-18.9% have been quoted in various studies. 1,3 Our aim was to evaluate colonic FDG avid lesions on PET by endoscopy. Methods An analysis of prospectively collected database of all patients (n = 1564) who had PET for various malignancy between January 2011 to September 2013 was performed.…”