Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
Eur J Nucl Med Mol Imaging. 2010 Apr;37(4):714-21. doi: 10.1007/s00259-009-1335-2. Epub 2009 Dec 22.
Extent of involvement and activity of ulcerative colitis (UC) is best evaluated by colonoscopy. Colonoscopy however carries risk during acute exacerbation. We investigated the utility of PET/CT colonography for assessment of extent and activity of UC.
Within a 1-week window, 15 patients with mild to moderately active UC underwent colonoscopy and PET/CT colonography 60 min after injection of 10 mCi of (18)F-fluorodeoxyglucose (FDG). PET activity score based on the amount of FDG uptake and endoscopic mucosal activity in seven colonic segments of each patient was recorded. The mean maximum standardized uptake value (SUV(max)) of seven segments was compared with activity in liver. A PET activity grade of 0, 1, 2 or 3 was assigned to each region depending upon their SUV(max) ratio (colon segment to liver).
The extent of disease was left-sided colitis in five and pancolitis in ten. The mean Ulcerative Colitis Disease Activity Index (UCDAI) was 7.6. The number of segments involved as per colonoscopic evaluation and PET/CT colonography was 67 and 66, respectively. There was a good correlation for extent evaluation between the two modalities (kappa 55.3%, p = 0.02). One patient had grade 0 PET activity, nine had grade 2 and five had grade 3 PET activity. In six patients, there was one to one correlation between PET activity grades with that of endoscopic grade. One patient showed activity in the sacroiliac joint suggesting active sacroiliitis.
PET/CT colonography is a novel non-invasive technique for the assessment of extent and activity of the disease in patients with UC.
通过结肠镜检查可最佳评估溃疡性结肠炎（UC）的累及范围和活动程度。然而，在急性加重期间，结肠镜检查存在风险。我们研究了 PET/CT 结肠成像在评估 UC 累及范围和活动程度中的应用。
在 1 周的时间窗内，15 例轻至中度活动的 UC 患者在结肠镜检查后 60 分钟接受了 10 mCi（18）F-氟脱氧葡萄糖（FDG）注射的 PET/CT 结肠成像。根据每位患者的七个结肠节段的 FDG 摄取量和内镜黏膜活性记录基于 PET 活性评分。将七个节段的平均最大标准化摄取值（SUV(max)）与肝脏的活性进行比较。根据每个区域的 SUV(max)比值（结肠节段与肝脏），将每个区域的 PET 活性分为 0、1、2 或 3 级。
疾病范围为左结肠炎 5 例，全结肠炎 10 例。平均溃疡性结肠炎疾病活动指数（UCDAI）为 7.6。根据结肠镜检查和 PET/CT 结肠成像评估，受累节段的数量分别为 67 和 66。两种方法在评估范围方面具有良好的相关性（kappa 值为 55.3%，p = 0.02）。一名患者的 PET 活性为 0 级，9 名患者为 2 级，5 名患者为 3 级。在 6 例患者中，PET 活性分级与内镜分级之间存在一对一的相关性。一名患者的骶髂关节出现活性，提示活动性骶髂关节炎。
PET/CT 结肠成像术是一种评估 UC 患者疾病范围和活动程度的新型非侵入性技术。
