¹⁸F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描偶然发现的结直肠摄取。
Incidental focal colorectal ¹⁸F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.
机构信息
Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 137-701, South Korea.
出版信息
World J Gastroenterol. 2013 Jun 14;19(22):3453-8. doi: 10.3748/wjg.v19.i22.3453.
AIM
To assess the clinical significance of incidental focal colorectal ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) uptake on ¹⁸F-FDG-positron emission tomography/computed tomography (PET/CT).
METHODS
The records of all the cases which had undergone colonoscopy after PET/CT within a two weeks interval were reviewed. Adenomas were considered advanced when they were villous, ≥ 10 mm in size, or had high-grade dysplasia. Colorectal cancers and advanced adenomas are collectively referred to as advanced colorectal neoplasms. Receiver-operating characteristic curve analysis was used to determine the significant predictive maximum standardized uptake value (SUVmax) cutoff value for advanced colorectal neoplasms and cancer.
RESULTS
Ninety-five colorectal lesions matched the site of incidental focal colorectal ¹⁸F-FDG uptake on PET/CT and 146 did not. Colonoscopy showed advanced colorectal neoplasms corresponding to the site of ¹⁸F-FDG uptake in 49 of the 95 (51.5%) lesions with incidental uptake. Of the lesions without incidental uptake, only 6 of 146 (4.1%) had advanced colorectal neoplasms on colonoscopy, indicating a statistically significant difference between the two groups (P < 0.001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of incidental focal ¹⁸F-FDG uptake in identifying advanced colorectal neoplasms were 89.1%, 75.3%, 51.6%, 95.9%, and 78.4%, respectively. In detecting only CRC, these values were 89.2%, 69.6%, 34.7%, 97.3%, and 72.6%, respectively. The significant SUVmax cutoff value for advanced colorectal neoplasms (area under the curve 0.755, P < 0.001) was 4.35, with a sensitivity, specificity, PPV, NPV, and accuracy of 75.5%, 65.2%, 69.8%, 71.4% and 70.5%, respectively. For CRC, 5.05 was the significant SUVmax cutoff value (area under the curve 0.817, P < 0.001), with a sensitivity, specificity, PPV, NPV, and accuracy of 84.8%, 71.0%, 80.9%, 89.8%, and 75.8%, respectively.
CONCLUSION
The presence of incidental focal colorectal ¹⁸F-FDG uptake on PET/CT with a SUVmax ≥ 4.35 increases the likelihood of an advanced colorectal neoplasm.
目的
评估¹⁸F-氟脱氧葡萄糖（¹⁸F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）上偶然发现的局灶性结直肠¹⁸F-FDG 摄取的临床意义。
方法
回顾了在两周内进行结肠镜检查后 PET/CT 检查的所有病例记录。当腺瘤呈绒毛状、≥10mm 或具有高级别异型增生时，被认为是高级别。结直肠癌和高级别腺瘤统称为高级别结直肠肿瘤。使用受试者工作特征曲线分析确定高级别结直肠肿瘤和癌症的有意义的最大标准化摄取值（SUVmax）预测截断值。
结果
95 个结直肠病变与 PET/CT 上偶然发现的局灶性结直肠¹⁸F-FDG 摄取部位相匹配，146 个病变不匹配。结肠镜检查显示，在 95 个偶然摄取部位中，有 49 个（51.5%）存在高级别结直肠肿瘤。在没有偶然摄取的病变中，仅 146 个中的 6 个（4.1%）在结肠镜检查中存在高级别结直肠肿瘤，两组之间存在统计学显著差异（P<0.001）。偶然发现的局灶性¹⁸F-FDG 摄取在识别高级别结直肠肿瘤方面的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性分别为 89.1%、75.3%、51.6%、95.9%和 78.4%。仅检测 CRC 时，这些值分别为 89.2%、69.6%、34.7%、97.3%和 72.6%。高级别结直肠肿瘤的显著 SUVmax 截断值（曲线下面积 0.755，P<0.001）为 4.35，其敏感性、特异性、PPV、NPV 和准确性分别为 75.5%、65.2%、69.8%、71.4%和 70.5%。对于 CRC，5.05 是显著的 SUVmax 截断值（曲线下面积 0.817，P<0.001），其敏感性、特异性、PPV、NPV 和准确性分别为 84.8%、71.0%、80.9%、89.8%和 75.8%。
结论
PET/CT 上偶然发现的局灶性结直肠¹⁸F-FDG 摄取，SUVmax≥4.35 时，高级别结直肠肿瘤的可能性增加。
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