Wu Guo-zheng, Sun Da, Chen Jian-yong, Qiu Ji-miao, Kong Yan
PET-CT Center, 113 Hospital of PLA, Zhejiang Ningbo 315040, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Jun;16(6):555-60.
To investigate the value of incidental focal (18)F-FDG uptake in the colon and rectum and characteristics of functional anatomic form for differential diagnosis of colorectal benign or malignant diseases.
Clinical data and images of incidental focal hypermetabolism focus in colon and rectum of 37 individuals undergoing (18)F-FDG PET-CT were analyzed retrospectively. According to the eventual outcomes of pathological examination and clinical follow-up, these cases were divided into four subgroups: malignant disease, benign tumor (including precancerous change), inflammation and physiological uptake. Radioactive uptake level (SUVmax) and change of delayed imaging (RI) of focal hypermetabolism focus were compared between groups. The data analysis was performed using variance analysis.
The average SUVmax was 6.3±3.7, 8.8±6.5, 5.2±1.4, and 3.8±0.9 in malignant disease (n=11), benign (precancerous) tumor (n=9), inflammation (n=9) and physiological uptaking (n=8) respectively. The average SUVmax was 7.6±5.6 in benign and malignant tumor, and 4.7±1.5 in inflammation and physiological uptake. The distinction of average SUVmax was not statistically significant between benign and malignant tumor or inflammation and physiological uptake. But it was higher in tumors as compared to inflammation or physiological uptake with a statistically difference (P<0.05). The RI was 0.3±0.2, 0.4±0.1, 0.3±0.2, 0.4±0.2 in above 4 groups respectively, and the differences were not statistically significant.
The incidental focal hypermetabolism focus in the colon the rectum during (18)F-FDG PET-CT may indicate potential colorectal malignant diseases and precancerous lesions. SUVmax value in focal hypermetabolism focus in the colon and rectum can help to distinguish tumor from inflammation or physiological uptake. But there is no diagnostic value for distinguishing malignant disease from benign tumor.
探讨结肠和直肠偶然局灶性（18）F-FDG摄取的价值以及功能性解剖形态特征，以用于结直肠良恶性疾病的鉴别诊断。
回顾性分析37例行（18）F-FDG PET-CT检查的个体结肠和直肠偶然局灶性代谢增高灶的临床资料及图像。根据病理检查及临床随访的最终结果，将这些病例分为四个亚组：恶性疾病、良性肿瘤（包括癌前病变）、炎症和生理性摄取。比较各组局灶性代谢增高灶的放射性摄取水平（SUVmax）及延迟显像变化（RI）。采用方差分析进行数据分析。
恶性疾病组（n=11）、良性（癌前）肿瘤组（n=9）、炎症组（n=9）和生理性摄取组（n=8）的平均SUVmax分别为6.3±3.7、8.8±6.5、5.2±1.4和3.8±0.9。良性和恶性肿瘤组的平均SUVmax为7.6±5.6，炎症和生理性摄取组为4.7±1.5。良性与恶性肿瘤组或炎症与生理性摄取组之间平均SUVmax的差异无统计学意义。但肿瘤组的SUVmax高于炎症或生理性摄取组，差异有统计学意义（P<0.05）。上述4组的RI分别为0.3±0.2、0.4±0.1、0.3±0.2、0.4±0.2，差异无统计学意义。
（18）F-FDG PET-CT检查时结肠和直肠偶然局灶性代谢增高灶可能提示潜在的结直肠恶性疾病和癌前病变。结肠和直肠局灶性代谢增高灶的SUVmax值有助于鉴别肿瘤与炎症或生理性摄取。但对于鉴别恶性疾病与良性肿瘤无诊断价值。
