Incidental colonic focal lesions detected by FDG PET/CT
Incidental colonic focal lesions detected by FDG PET/CT
复制标题
DOI：
10.2214/ajr.185.2.01850495
复制
发表时间：
2005-08-01
影响因子：
5
通讯作者：
Pecking, AP
中科院分区：
文献类型：
--
作者：
Gutman, F;Alberini, JL;Pecking, AP
目标。本研究的目的是评估FDGPET/CT在检测结肠病变，特别是晚期肿瘤(绒毛状腺瘤或10 mm腺瘤、癌)中的作用。由于F-18FDG在腺瘤性息肉中的积聚，使用FDG的PET可以发现早期的癌前病变。对1,716例除结直肠癌外的各种恶性疾病患者进行了为期一年的FDG PET/CT研究。将注射FDG后1h获得的PET图像与用于衰减校正的平扫CT图像进行融合分析。在45例表现为结肠局灶性FDG摄取的患者中，20名患者(21个病灶)接受了结肠镜检查，必要时还进行了息肉切除。结果：15例患者的18个结肠镜异常均与FDG病灶相关，5例患者未发现结肠异常(假阳性结果)。组织病理学结果显示13例患者为晚期肿瘤(13例绒毛状腺瘤和3例癌)和2例增生性息肉。FP和真阳性结肠FDG病灶的平均SUVmax有差异，但无统计学意义(p=0.14)。结论：PET/CT上偶发的结肠局灶性FDG摄取是结肠镜检查发现(前)恶性病变的依据。PET和CT图像的融合可以准确地定位病变。PET/CT是区分病理性FDG摄取与生理性摄取的有用工具。
OBJECTIVE. The aim of this study was to assess the performance of FDG PET/CT for the detection of colonic lesions, especially advanced neoplasms (villous or > 10-mm adenomas, carcinomas). Because of F-18 FDG accumulation in adenomatous polyps, PET using FDG can detect early premalignant colorectal lesions.MATERIALS AND METHODS. FDG PET/CT studies performed for a 1-year period in 1,716 consecutive patients with various malignant diseases, except colorectal cancer, were retrospectively reviewed. PET images obtained 1 hr after FDG injection and noncontrast CT images used for attenuation correction were fused for analysis. Of 45 patients showing intense focal colonic FDG uptake, 20 patients (with 21 foci) underwent a colonoscopic investigation, and, when necessary, polyp resection. The intensity of FDG uptake was quantified using the standardized uptake value (SUVmax).RESULTS. The FDG colonic foci were associated with 18 colonoscopic abnormalities in 15 patients, with no colonic abnormality detected in five patients (false-positive [FP] results). Histopathologic findings revealed advanced neoplasms in 13 patients (13 villous adenomas and three carcinomas) and two cases of hyperplastic polyps. A difference in the mean SUVmax was found between FP and true-positive colonic FDG foci but was not statistically significant (p = 0.14).CONCLUSION. Presence of a focal colonic FDG uptake incidental finding on a PET/CT scan justifies a colonoscopy to detect (pre-)malignant lesions. The fusion of PET and CT images allows an accurate localization of the lesions. PET/CT is a useful tool to differentiate pathologic from physiologic FDG uptake.