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Loffeld RJLF, Srbjlin SA. The value of using fludeoxyglucose positron-emission tomography scan with respect to colorectal abnormalities-a cross-sectional study. J Gastrointest Oncol 2019; 10:1-5. [PMID: 30788152 DOI: 10.21037/jgo.2018.09.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Fludeoxyglucose positron-emission tomography (FDG-PET) shows colic uptake regularly. Complementary colonoscopy is done. Aim: study the findings of colonoscopy. Methods All consecutive scans in 5 years were studied. Focal FDG uptake in colon and/or rectum were scored as + or ++. Clinical files and endoscopy reports were studied for final diagnosis. Results Focal FDG uptake was noted in 173 out of 2,075 scans (8.4%). Focal FDG activity was judged ++ in 73 patients (42.2%) and + in 100 (57.8%). The majority of colorectal cancers scored ++. Patients with ++ activity underwent or had undergone significantly more often a colonoscopy compared with patients with + activity, 82% versus 65% (P=0.02). FDG PET/CT was false positive with respect to polyp(s) or cancer in 13 cases (22%) of ++ FGD activity and in 38 cases of + FDG (P<0.001). In 25 patients a total of 69 polyps were not FDG avid. Conclusions FDG-PET scanning is a useful tool in oncology. However, false-positive and false-negative findings with respect to colonic uptake are present in a significant number of patients. If the clinical condition and the potential prognosis allows the performance of colonoscopy this procedure should be done.
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Affiliation(s)
- Ruud J L F Loffeld
- Department of Gastroenterology and Nuclear Medicine, Zaans Medisch Centrum, Zaandam, The Netherlands
| | - Sandra A Srbjlin
- Department of Gastroenterology and Nuclear Medicine, Zaans Medisch Centrum, Zaandam, The Netherlands
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Diagnostic accuracy of F-18 FDG PET/CT for characterization of colorectal focal FDG uptake: a systematic review and meta-analysis. Abdom Radiol (NY) 2019; 44:456-463. [PMID: 30132094 DOI: 10.1007/s00261-018-1747-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION We aimed to explore the role of the diagnostic accuracy of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for characterization of incidental colorectal focal FDG uptake through a systematic review and meta-analysis. METHODS The MEDLINE, EMBASE, and Cochrane Library database, from the earliest available date of indexing through April 30, 2018, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for characterization of incidental colorectal focal FDG uptake. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves. RESULTS Across 8 studies (1451 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.87 (95% CI 0.82-0.90) without heterogeneity (χ2 = 10.84, p = 0.37) and a pooled specificity of 0.83 (95% CI 0.76-0.89) with heterogeneity (χ2 = 130.1, p = 0.00). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 5.2 (95% CI 3.6-7.4) and negative likelihood ratio (LR-) of 0.16 (95% CI 0.12-0.22). The pooled DOR was 32 (95% CI 20-51). CONCLUSION F-18 FDG PET/CT demonstrated good sensitivity and specificity for characterization of incidental colorectal focal FDG uptake. At present, the literature regarding the use of F-18 FDG PET/CT for characterization of incidental colorectal focal FDG uptake remains still limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET/CT for characterization of incidental colorectal focal FDG uptake.
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Abstract
OBJECTIVE The purpose of this study was to investigate the nature of FDG-avid and non-FDG-avid lesions detected at colonoscopy in patients presenting with incidental focal colonic FDG uptake at PET/CT. MATERIALS AND METHODS Among 9073 patients who underwent PET/CT over a 4-year period, 82 patients without a history of colonic disease had focal colonic FDG uptake and underwent colonoscopy. In consensus, a radiologist and a nuclear physician read images from these PET/CT examinations. They recorded the location of focal FDG uptake in the colon and associated CT abnormalities and measured maximum standardized uptake value (SUVmax) and metabolic volume (MV). Readings were performed twice--first without and second with knowledge of lesion location at colonoscopy. The final diagnosis was based on colonoscopic findings and histopathologic results categorized into benign, premalignant, or malignant. RESULTS One hundred seven foci of colonic FDG uptake at PET/CT and 150 lesions at colonoscopy were detected. Among 107 foci of FDG uptake, 65 (61%) corresponded to a lesion at colonoscopy (true-positive findings), and 42 (39%) did not (false-positive findings). Among 150 lesions found at colonoscopy, 85 (57%) were not FDG avid (false-negative findings). The MV of true-positive findings was lower than that of false-positive findings (4.0 ± 0.4 cm(3) vs 6.2 ± 0.7 cm(3); p = 0.006), but SUVmax did not differ (7.4 ± 0.5 vs 7.7 ± 0.5; p = 0.649). Considering the histopathologic categories of the lesions and the false-positive findings, there was no difference in SUVmax (p = 0.103), but MV was lower in premalignant lesions than in false-positive findings (p = 0.005). CONCLUSION Focal colonic FDG uptake may indicate the presence of a benign, pre-malignant, or malignant lesion. Subsequent colonoscopy should not be restricted to the colonic site of FDG uptake.
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Prevalence and malignancy risk of focal colorectal incidental uptake detected by (18)F-FDG-PET or PET/CT: a meta-analysis. Radiol Oncol 2014; 48:99-104. [PMID: 24991198 PMCID: PMC4078042 DOI: 10.2478/raon-2013-0035] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 05/01/2013] [Indexed: 12/13/2022] Open
Abstract
Background The aim of the study was to meta-analyze published data about prevalence and malignancy risk of focal colorectal incidentalomas (FCIs) detected by Fluorine-18-Fluorodeoxyglucose positron emission tomography or positron emission tomography/computed tomography (18F-FDG-PET or PET/CT). Methods A comprehensive computer literature search of studies published through July 31st 2012 regarding FCIs detected by 18F-FDG-PET or PET/CT was performed. Pooled prevalence of patients with FCIs and risk of malignant or premalignant FCIs after colonoscopy or histopathology verification were calculated. Furthermore, separate calculations for geographic areas were performed. Finally, average standardized uptake values (SUV) in malignant, premalignant and benign FCIs were reported. Results Thirty-two studies comprising 89,061 patients evaluated by 18F-FDG-PET or PET/CT were included. The pooled prevalence of FCIs detected by 18F-FDG-PET or PET/CT was 3.6% (95% confidence interval [95% CI]: 2.6–4.7%). Overall, 1,044 FCIs detected by 18F-FDG-PET or PET/CT underwent colonoscopy or histopathology evaluation. Pooled risk of malignant or premalignant lesions was 68% (95% CI: 60–75%). Risk of malignant and premalignant FCIs in Asia-Oceania was lower compared to that of Europe and America. A significant overlap in average SUV was found between malignant, premalignant and benign FCIs. Conclusions FCIs are observed in a not negligible number of patients who undergo 18F-FDG-PET or PET/CT studies with a high risk of malignant or premalignant lesions. SUV is not reliable as a tool to differentiate between malignant, premalignant and benign FCIs. Further investigation is warranted whenever FCIs are detected by 18F-FDG-PET or PET/CT.
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Cho SH, Kim SW, Kim WC, Park JM, Yoo IR, Kim SH, Oh ST. Incidental focal colorectal 18F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography. World J Gastroenterol 2013; 19:3453-3458. [PMID: 23801838 PMCID: PMC3683684 DOI: 10.3748/wjg.v19.i22.3453] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 01/25/2013] [Accepted: 03/29/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the clinical significance of incidental focal colorectal 18F-fluorodeoxyglucose (18F-FDG) uptake on 18F-FDG-positron emission tomography/computed tomography (PET/CT).
METHODS: The records of all the cases which had undergone colonoscopy after PET/CT within a two weeks interval were reviewed. Adenomas were considered advanced when they were villous, ≥ 10 mm in size, or had high-grade dysplasia. Colorectal cancers and advanced adenomas are collectively referred to as advanced colorectal neoplasms. Receiver-operating characteristic curve analysis was used to determine the significant predictive maximum standardized uptake value (SUVmax) cutoff value for advanced colorectal neoplasms and cancer.
RESULTS: Ninety-five colorectal lesions matched the site of incidental focal colorectal 18F-FDG uptake on PET/CT and 146 did not. Colonoscopy showed advanced colorectal neoplasms corresponding to the site of 18F-FDG uptake in 49 of the 95 (51.5%) lesions with incidental uptake. Of the lesions without incidental uptake, only 6 of 146 (4.1%) had advanced colorectal neoplasms on colonoscopy, indicating a statistically significant difference between the two groups (P < 0.001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of incidental focal 18F-FDG uptake in identifying advanced colorectal neoplasms were 89.1%, 75.3%, 51.6%, 95.9%, and 78.4%, respectively. In detecting only CRC, these values were 89.2%, 69.6%, 34.7%, 97.3%, and 72.6%, respectively. The significant SUVmax cutoff value for advanced colorectal neoplasms (area under the curve 0.755, P < 0.001) was 4.35, with a sensitivity, specificity, PPV, NPV, and accuracy of 75.5%, 65.2%, 69.8%, 71.4% and 70.5%, respectively. For CRC, 5.05 was the significant SUVmax cutoff value (area under the curve 0.817, P < 0.001), with a sensitivity, specificity, PPV, NPV, and accuracy of 84.8%, 71.0%, 80.9%, 89.8%, and 75.8%, respectively.
CONCLUSION: The presence of incidental focal colorectal 18F-FDG uptake on PET/CT with a SUVmax ≥ 4.35 increases the likelihood of an advanced colorectal neoplasm.
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HAMEEDUDDIN A, SINGH NK, COOK GJR, CHUA SC. Assessment of incidental and clinically unsuspected fluorodeoxyglucose-avid foci detected on oncological positron emission tomography/CT. IMAGING 2013. [DOI: 10.1259/imaging.20110088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Lee C, Koh SJ, Kim JW, Lee KL, Im JP, Kim SG, Kim JS, Jung HC, Kim BG. Incidental colonic 18F-fluorodeoxyglucose uptake: do we need colonoscopy for patients with focal uptake confined to the left-sided colon? Dig Dis Sci 2013; 58:229-35. [PMID: 22886593 DOI: 10.1007/s10620-012-2333-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 07/18/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIMS Although access to [18F]2-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography and computed axial tomography (PET/CT) for patients with malignancy has increased, little information is available on the suitability of PET/CT for diagnosis of advanced colonic neoplasms in oncology patients and on the clinical significance of incidental 18F-FDG focal uptake confined to the left-sided colon. METHODS Patients who underwent 18F-FDG PET/CT followed, within 90 days, by colonoscopy were identified. Case-control analysis was undertaken to determine whether focal 18F-FDG uptake confined to the left-sided colon was associated with advanced neoplasms in the right-sided colon. RESULTS One hundred ninety-five patients with colonic 18F-FDG uptake and 561 without colonic (18)F-FDG uptake were identified. Of the 195 patients with focal colonic 18F-FDG activity, 103 patients (52.8%) had 145 advanced colonic neoplasms, including 58 colon cancers and 11 metastatic cancers. In the detection of advanced colonic neoplasms, the sensitivity, specificity, positive predictive value, and negative predictive value of PET/CT were 54.4, 82.4, 46.9, and 86.3%, respectively. Overall accuracy was 76.2%. Ten (8.0%) of the 125 patients with focal 18F-FDG uptake confined to the left-sided colon had three colon cancers and seven advanced adenomas in the right-sided colon. Case-control analysis revealed that focal 18F-FDG uptake confined to the left-sided colon was associated with an advanced neoplasms in the right-sided colon (OR, 3.02; 95% CI, 1.12-8.13; P = 0.023). CONCLUSIONS Colonic focal (18)F-FDG uptake by oncology patients warrants endoscopic verification. Complete colon evaluation by colonoscopy is required, even for patients with focal 18F-FDG uptake confined to the left-sided colon.
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Affiliation(s)
- Changhyun Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
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Putora PM, Müller J, Borovicka J, Plasswilm L, Schmidt F. Relevance of Incidental Colorectal FDG-PET/CT-Enhanced Lesions. ACTA ACUST UNITED AC 2013; 36:200-4. [DOI: 10.1159/000350302] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Farquharson AL, Chopra A, Ford A, Matthews S, Amin SN, De Noronha R. Incidental focal colonic lesions found on (18)Fluorodeoxyglucose positron emission tomography/computed tomography scan: further support for a national guideline on definitive management. Colorectal Dis 2012; 14:e56-63. [PMID: 21831171 DOI: 10.1111/j.1463-1318.2011.02760.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIM (18)Fluorodeoxyglucose ((18)FDG) positron emission tomography/computed tomography (PET/CT) is an established part of staging in a wide variety of malignancies. Incidental abnormal uptake of (18)FDG of unknown significance is frequently encountered. Therefore, we investigated patients with abnormal colonic uptake of (18)FDG, determined by PET/CT images, using colonoscopy. METHOD The radiology reports of all patients referred to a tertiary referral centre for a PET/CT scan were reviewed retrospectively. Patients with abnormal colonic uptake of (18)FDG were identified and the PET/CT findings were correlated with colonoscopic findings. RESULTS Of 555 consecutive patients identified over a 26-month period, 53 had abnormal colonic uptake of (18)FDG, as determined by PET/CT images. Twenty-nine were not investigated following discussion in a specialist multidisciplinary (MDT) meeting, according to local protocol. Twenty out of 24 patients investigated by endoscopy had a colonic lesion correlating to the site identified on the PET/CT image: 16 patients had tubulovillous adenomas (nine of which were > 10 mm), two had invasive adenocarcinomas, two had diverticular disease and one had collagenous colitis; no colonic lesion was detected in three. These findings were incidental and not related to the primary diagnosis for which the scan was being performed. Accordingly, a positive predictive value of 83% is associated with the finding of abnormal uptake of (18)FDG on PET/CT images. CONCLUSION Incidental abnormal colonic uptake of (18)FDG, determined by a PET/CT scan requires definitive colonic investigation in patients suitable for further treatment because significant colonic pathology is frequently identified. The benefit of this approach should be discussed in specialist MDT meetings and tailored to each patient; however, national guidelines for management are required.
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Affiliation(s)
- A L Farquharson
- Colorectal Surgical Unit, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, UK.
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Treglia G, Calcagni ML, Rufini V, Leccisotti L, Meduri GM, Spitilli MG, Dambra DP, De Gaetano AM, Giordano A. Clinical significance of incidental focal colorectal (18)F-fluorodeoxyglucose uptake: our experience and a review of the literature. Colorectal Dis 2012; 14:174-80. [PMID: 21689289 DOI: 10.1111/j.1463-1318.2011.02588.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM The aims of the present study were: (i) to evaluate the focal incidental colorectal uptake of (18)F-fluorodeoxyglucose ([(18)F]FDG) and to correlate it with colonoscopy and histological findings; (ii) to evaluate the relationship between the presence/absence of neoplastic disease and clinical data and the anatomical site of [(18)F]FDG uptake; and (iii) to compare our results with those reported for incidental colorectal uptake of [(18)F]FDG in the literature and those obtained from various screening programmes for colorectal cancer. METHOD The database of 6000 patients referred for [(18)F]FDG positron emission tomography/computed tomography (PET-CT) to our centre was retrospectively reviewed for incidental colorectal uptake of [(18)F]FDG. Patients with focal uptake were selected and the aetiology of PET findings was verified with a subsequent colonoscopy and histopathological analysis when available. RESULTS Incidental colorectal uptake of [(18)F]FDG was seen in 144 (2.4%) patients, of whom 64 (1.1%) had focal uptake; 48 out of these 64 patients underwent colonoscopy, which showed malignant tumours in 12 (25%), premalignant lesions in 19 (40%), non-neoplastic lesions in six (12%) and lesions not confirmed by colonoscopy in 11 (23%). Our data agreed with previously published data. Statistical analysis did not show any significant relationship between the presence/absence of neoplastic disease and patient sex or age, type of primary disease and anatomical site of [(18)F]FDG uptake. Comparing our data with various screening programmes, a significant difference was found only with series in which colonoscopy was performed in patients at high risk for colorectal cancer. CONCLUSION Focal incidental colorectal uptake of [(18)F]FDG is observed in about 1% of PET/CT studies and carries a high risk of neoplastic disease. A PET-CT report should suggest colonoscopy when abnormal findings are reported.
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Affiliation(s)
- G Treglia
- Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
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11
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The clinical significance of incidental intra-abdominal findings on positron emission tomography performed to investigate pulmonary nodules. World J Surg Oncol 2012; 10:25. [PMID: 22284669 PMCID: PMC3283458 DOI: 10.1186/1477-7819-10-25] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 01/27/2012] [Indexed: 11/18/2022] Open
Abstract
Background Lung cancer is a common cause of cancer-related death. Staging typically includes positron emission tomography (PET) scanning, in which18F-fluoro-2-dexoy-D-glucose (FDG) is taken up by cells proportional to metabolic activity, thus aiding in differentiating benign and malignant pulmonary nodules. Uptake of FDG can also occur in the abdomen. The clinical significance of incidental intraabdominal FDG uptake in the setting of pulmonary nodules is not well established. Our objective was to report on the clinical significance of incidental intra-abdominal FDG activity in the setting of lung cancer. Methods Fifteen hundred FDG-PET reports for studies performed for lung cancer were retrospectively reviewed for the presence of incidental FDG-positive intraabdominal findings. Patient charts with positive findings were then reviewed and information extracted. Results Twenty-five patients (25/1500) demonstrated incidental intraabdominal FDG uptake thought to be significant (1.7%) with a mean patient age of 71 years. Colonic uptake was most common (n = 17) with 9 (52%) being investigated further. Of these 9 cases, a diagnosis of malignancy was made in 3 patients, pre-malignant adenomas in 2 patients, a benign lipoma in 1 patient and no abnormal findings in the remaining patients. 8 patients were not investigated further (3 diagnosed with metastatic lung cancer and 2 were of advanced age) secondary to poor prognosis. Conclusion Incidental abdominal findings in the colon on FDG-PET scan for work-up of pulmonary nodules need to be further investigated by colonoscopy.
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Lin M, Koo JH, Abi-Hanna D. Management of patients following detection of unsuspected colon lesions by PET imaging. Clin Gastroenterol Hepatol 2011; 9:1025-32. [PMID: 21723237 DOI: 10.1016/j.cgh.2011.06.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 04/29/2011] [Accepted: 06/14/2011] [Indexed: 12/11/2022]
Abstract
Positron emission tomography (PET) is a well-established and integral component of multimodality imaging in oncology. However, the expanded use of PET in oncological and also non-oncological imaging (such as in assessing inflammatory conditions) has identified more lesions or tumors at unsuspected locations, such as in the large bowel during examination of patients not known to have colorectal disease. We review the clinical significance of colon lesions that were discovered incidentally by PET imaging and management strategies for gastroenterologists.
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Affiliation(s)
- Michael Lin
- Department of Nuclear Medicine and PET, Liverpool Hospital, University of New South Wales, Liverpool, New SouthWales, Austrailia.
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Treglia G. Comment on "Incidental focal hypermetabolic colorectal lesions identified by positron emission tomography: prevalence of malignancy". ABDOMINAL IMAGING 2011; 36:489-490. [PMID: 21562885 DOI: 10.1007/s00261-011-9747-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Lin M, Wong K, Ng WL, Shon IH, Morgan M. Positron emission tomography and colorectal cancer. Crit Rev Oncol Hematol 2011; 77:30-47. [PMID: 20619671 DOI: 10.1016/j.critrevonc.2010.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 04/30/2010] [Accepted: 04/30/2010] [Indexed: 12/16/2022] Open
Abstract
Colorectal cancer (CRC) is a major cause of cancer-related morbidity and mortality. Molecular imaging using positron emission tomography (PET) is now an integral part of multidisciplinary cancer care. In this review, we discuss the role of PET in CRC including well established indications in the assessment of recurrent disease and emerging applications such as initial staging, monitoring therapy efficacy and using PET for radiotherapy planning. With rapid advancement in imaging technology, we also discuss the future potential of combining PET and magnetic resonance imaging and the use of novel radiotracers.
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Affiliation(s)
- Michael Lin
- Department of Nuclear Medicine and PET, Liverpool Hospital, Sydney, Australia; University of New South Wales, Sydney, Australia.
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Luboldt W, Volker T, Wiedemann B, Zöphel K, Wehrmann U, Koch A, Toussaint T, Abolmaali N, Middendorp M, Aust D, Kotzerke J, Grünwald F, Vogl TJ, Luboldt HJ. Detection of relevant colonic neoplasms with PET/CT: promising accuracy with minimal CT dose and a standardised PET cut-off. Eur Radiol 2010; 20:2274-85. [PMID: 20503051 PMCID: PMC2914265 DOI: 10.1007/s00330-010-1772-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Revised: 02/16/2010] [Accepted: 02/19/2010] [Indexed: 12/21/2022]
Abstract
Objective: To determine the performance of FDG-PET/CT in the detection of relevant colorectal neoplasms (adenomas ≥10 mm, with high-grade dysplasia, cancer) in relation to CT dose and contrast administration and to find a PET cut-off. Methods: 84 patients, who underwent PET/CT and colonoscopy (n = 79)/sigmoidoscopy (n = 5) for \documentclass[12pt]{minimal}
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\begin{document}$${\left( {{\hbox{79}} \times {\hbox{6}} + {\hbox{5}} \times {\hbox{2}}} \right)} = {\hbox{484}}$$\end{document} colonic segments, were included in a retrospective study. The accuracy of low-dose PET/CT in detecting mass-positive segments was evaluated by ROC analysis by two blinded independent reviewers relative to contrast-enhanced PET/CT. On a per-lesion basis characteristic PET values were tested as cut-offs. Results: Low-dose PET/CT and contrast-enhanced PET/CT provide similar accuracies (area under the curve for the average ROC ratings 0.925 vs. 0.929, respectively). PET demonstrated all carcinomas (n = 23) and 83% (30/36) of relevant adenomas. In all carcinomas and adenomas with high-grade dysplasia (n = 10) the SUVmax was ≥5. This cut-off resulted in a better per-segment sensitivity and negative predictive value (NPV) than the average PET/CT reviews (sensitivity: 89% vs. 82%; NPV: 99% vs. 98%). All other tested cut-offs were inferior to the SUVmax. Conclusion: FDG-PET/CT provides promising accuracy for colorectal mass detection. Low dose and lack of iodine contrast in the CT component do not impact the accuracy. The PET cut-off SUVmax ≥ 5 improves the accuracy.
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Beatty JS, Williams HT, Gucwa AL, Hughes MP, Vasudeva VS, Aldridge BA, Fields DM, David GS, Lind DS, Kruse EJ, McLoughlin JM. The predictive value of incidental PET/CT findings suspicious for breast cancer in women with non-breast malignancies. Am J Surg 2009; 198:495-9. [DOI: 10.1016/j.amjsurg.2009.06.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 06/14/2009] [Accepted: 06/14/2009] [Indexed: 11/27/2022]
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Descamps V, Landry J, Francès C, Marinho E, Ratziu V, Chosidow O. Facial Cosmetic Filler Injections as Possible Target for Systemic Sarcoidosis in Patients Treated with Interferon for Chronic Hepatitis C: Two Cases. Dermatology 2008; 217:81-4. [PMID: 18446029 DOI: 10.1159/000128281] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Accepted: 11/22/2007] [Indexed: 11/19/2022] Open
Affiliation(s)
- Vincent Descamps
- Department of Dermatology, Bichat Claude Bernard Hospital, Paris, France.
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