Details

Autor(en) / Beteiligte

• Kirchner, Julian
• Schaarschmidt, Benedikt M.
• Kour, Firas
• Sawicki, Lino M.
• Martin, Ole
• Bode, Johannes
• Dahl, Stephan vom
• Keitel, Verena
• Häussinger, Dieter
• Antke, Christina
• Buchbender, Christian
• Antoch, Gerald
• Heusch, Philipp

Titel

Incidental 18F-FDG uptake in the colon: value of contrast-enhanced CT correlation with colonoscopic findings

Ist Teil von

• European journal of nuclear medicine and molecular imaging, 2020-04, Vol.47 (4), p.778-786

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2020

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Objectives To evaluate the impact of morphological information derived from contrast-enhanced CT in the characterization of incidental focal colonic uptake in 18 F-FDG PET/CT examinations. Methods A total of 125 patients (female: n = 53, male: n = 72) that underwent colonoscopy secondary to contrast-enhanced, full-dose PET/CT without special bowel preparation were included in this retrospective study. PET/CT examinations were assessed for focal colonic tracer uptake in comparison with the background. Focal tracer uptake was correlated with morphological changes of the colonic wall in the contrast-enhanced CT images. Colonoscopy reports were evaluated for benign, inflammatory, polypoid, precancerous, and cancerous lesions verified by histopathology, serving as a reference standard. Sensitivity, specificity, PPV, NPV, and accuracy for detection of therapeutic relevant findings were calculated for (a) sole focal tracer uptake and (b) focal tracer uptake with correlating CT findings in contrast-enhanced CT. Results In 38.4% (48/125) of the patients, a focal 18 F-FDG uptake was observed within 67 lesions. Malignant lesions were endoscopically and histopathologically diagnosed in eleven patients, and nine of these were detected by focal 18 F-FDG uptake. A total of 34 lesions with impact on short- or long-term patient management (either being pre- or malignant) were detected. Sensitivity, Specificity, PPV, NPV, and accuracy for sole 18 F-FDG uptake for this combined group were 54%, 69%, 29%, 85%, and 65%. Corresponding results for focal 18 F-FDG uptake with correlating CT findings were 38%, 90%, 50%, 86%, and 80%. This resulted in a statistically significant difference for diagnostic accuracy ( p = 0.0001) Conclusion By analyzing additional morphological changes in contrast-enhanced CT imaging, the specificity of focal colonic 18 F-FDG uptake for precancerous and cancerous lesions can be increased but leads to a considerate loss of sensitivity. Therefore, every focal colonic uptake should be followed up by colonoscopy.