Department of Gastroenterology, Hepatology and Nutrition, Unit 1466, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-1402, USA.
Cancer. 2010 Mar 15;116(6):1454-61. doi: 10.1002/cncr.24885.
The ability of integrated positron emission tomography and computed axial tomography (PET-CT) to detect colonic pathology is not fully defined. The purpose of this study was to assess the ability of PET-CT to detect colonic pathology and to determine the significance of ((18)F)2-fluoro-2-deoxyglucose ((18)F-FDG) activity noted incidentally in the colon on PET-CT.
Records for all patients who underwent PET-CT and colonoscopy at our institution were reviewed. Patients with history of colonic malignancy or colon surgery were excluded.
Fifty-eight patients had incidental colonic (18)F-FDG activity on PET (Group A) and 272 had none (Group B). In Group A, 65% of patients had pathologic findings detected on colonoscopy that corresponded to the site of PET activity. Standardized uptake value (SUV) readings were not helpful in distinguishing true-positives from false-positives. In Group B, 11.8% of patients were found to have significant colonic findings. Lesions not detected by PET-CT included 4 colon cancers, 7 advanced adenomas, and 10 patients with colonic lymphoma. Overall, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET-CT for detecting significant pathology were 53%, 93%, 65%, 89%, and 85%, respectively. For detecting colon cancer and adenomas 10 mm or more, the sensitivity, specificity, PPV, NPV, and accuracy of PET-CT were 72%, 90%, 45%, 96%, and 88%, respectively.
Incidental colonic activity detected by PET-CT warrants further evaluation with colonoscopy. However, negative PET-CT does not rule out significant colonic pathology including colon cancer, advanced adenomas, or lymphoma.
正电子发射断层扫描和计算机轴向断层扫描（PET-CT）检测结肠病变的能力尚未完全明确。本研究旨在评估 PET-CT 检测结肠病变的能力，并确定在 PET-CT 上偶然发现的结肠内（18）F-氟-2-脱氧葡萄糖（（18）F-FDG）活性的意义。
回顾了我院所有行 PET-CT 和结肠镜检查的患者记录。排除有结直肠恶性肿瘤或结肠手术史的患者。
58 例患者 PET 上有偶然的结肠（18）F-FDG 活性（A 组），272 例患者无（B 组）。在 A 组中，65%的患者在结肠镜检查中发现与 PET 活性部位相对应的病理发现。标准化摄取值（SUV）读数无助于区分真正的阳性和假阳性。在 B 组中，11.8%的患者发现有明显的结肠病变。PET-CT 未检测到的病变包括 4 例结肠癌、7 例高级别腺瘤和 10 例结直肠淋巴瘤。总的来说，PET-CT 检测有意义的病变的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性分别为 53%、93%、65%、89%和 85%。对于检测直径 10mm 或以上的结肠癌和腺瘤，PET-CT 的敏感性、特异性、PPV、NPV 和准确性分别为 72%、90%、45%、96%和 88%。
PET-CT 偶然发现的结肠活性需要进一步行结肠镜检查评估。然而，阴性的 PET-CT 并不能排除包括结肠癌、高级别腺瘤或淋巴瘤在内的有意义的结肠病变。
