Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, 137-701, South Korea.
J Gastrointest Surg. 2012 Oct;16(10):1847-53. doi: 10.1007/s11605-012-1941-3. Epub 2012 Jun 30.
We assessed the ability of positron emission tomography-computed tomography (PET/CT) to detect synchronous colonic pathology and determined the significance of 18F-fluorodeoxyglucose (18F-FDG) activity in the colon of gastric cancer patients.
A total of 239 gastric cancer patients who underwent PET/CT and colonoscopy preoperatively were included. FDG uptake patterns on PET/CT were classified as (1) group A, focal; (2) group B, diffuse; and (3) group C, no uptake. The PET/CT findings were compared with the results of concurrent colonoscopy.
In group A, a total of 123 polyps of >0 mm were observed. Of these, nine polyps were colonic adenocarcinomas and six were high-grade dysplasia. The incidence of colonic adenocarcinomas was significantly higher in group A than in the other two groups (p = 0.037). There was a significant correlation between SUVmax values and incidence of colonic polyps of >10 mm (r = 0.471, p = 0.04). The distribution pattern of SUVmax in polyps with adenoma (>10 mm) was less homogenous than in polyps (>10 mm) with adenocarcinoma.
The focal colonic FDG uptake in PET/CT requires colonoscopic confirmation. The suspicion of colonic malignancy increased in the presence of polyps >10 mm that showed a positive correlation with the SUVmax.
我们评估了正电子发射断层扫描计算机断层扫描（PET/CT）检测同步结肠病变的能力，并确定了胃癌患者结肠中 18F-氟脱氧葡萄糖（18F-FDG）活性的意义。
共纳入 239 例术前接受 PET/CT 和结肠镜检查的胃癌患者。将 PET/CT 上的 FDG 摄取模式分为（1）组 A，局灶性；（2）组 B，弥漫性；和（3）组 C，无摄取。将 PET/CT 结果与同期结肠镜检查结果进行比较。
在组 A 中，共观察到 123 个>0mm 的息肉。其中，9 个息肉为结肠腺癌，6 个为高级别异型增生。组 A 中结肠腺癌的发生率明显高于其他两组（p=0.037）。SUVmax 值与>10mm 结肠息肉的发生率之间存在显著相关性（r=0.471，p=0.04）。在>10mm 腺瘤性息肉中，SUVmax 的分布模式不如在>10mm 腺癌性息肉中均匀。
PET/CT 中局灶性结肠 FDG 摄取需要结肠镜确认。存在与 SUVmax 呈正相关的>10mm 息肉时，怀疑存在结肠恶性肿瘤的可能性增加。
