Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
Colorectal Dis. 2012 Feb;14(2):174-80. doi: 10.1111/j.1463-1318.2011.02588.x.
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.
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.
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.
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.
本研究的目的是：(i)评估氟-18-脱氧葡萄糖([(18)F]FDG)在偶然发现的结直肠摄取情况，并将其与结肠镜检查和组织学发现进行相关分析；(ii)评估是否存在肿瘤性疾病与临床数据以及[(18)F]FDG摄取的解剖部位之间的关系；(iii)将我们的结果与文献中报告的偶然发现的结直肠摄取[(18)F]FDG的结果以及来自各种结直肠癌筛查计划的结果进行比较。
回顾性分析了 6000 例因[(18)F]FDG 正电子发射断层扫描/计算机断层扫描(PET-CT)而到我们中心就诊的患者的数据库，以评估[(18)F]FDG 在偶然发现的结直肠摄取情况。选择有局灶性摄取的患者，并在有条件时通过随后的结肠镜检查和组织病理学分析来验证 PET 结果的病因。
144 例(2.4%)患者出现偶然发现的结直肠[(18)F]FDG 摄取，其中 64 例(1.1%)有局灶性摄取；这 64 例患者中有 48 例行结肠镜检查，其中 12 例(25%)发现恶性肿瘤，19 例(40%)发现癌前病变，6 例(12%)发现非肿瘤性病变，11 例(23%)结肠镜检查未确诊。我们的数据与以前发表的数据一致。统计学分析显示，是否存在肿瘤性疾病与患者的性别或年龄、原发疾病的类型和[(18)F]FDG 摄取的解剖部位之间无显著关系。将我们的数据与各种筛查计划进行比较，仅与在结直肠癌高危患者中进行结肠镜检查的系列数据有显著差异。
在大约 1%的 PET/CT 研究中观察到偶然发现的结直肠[(18)F]FDG 局灶性摄取，并且存在高度的肿瘤性疾病风险。当报告异常发现时，PET-CT 报告应建议进行结肠镜检查。
