Fleming M, Knox M, Kennedy M J
St lames's Hospital, James's St, Dublin 8.
Ir Med J. 2013 May;106(5):151-3.
The aim of this study was to evaluate the detection rate of incidental colorectal malignancies using whole-body 18FDG-PET/CT at an Irish teaching hospital. We performed a retrospective review of the records of 800 consecutive patients undergoing PET-CT scans at our institution from January 2009 - August 2009. The radiologic reports were analysed and all scans with focal colonic FDG uptake were audited. The colonoscopic and histologic records of the patients who underwent further investigation were reviewed for cancerous and pre-cancerous histology. A total of 643 patients were included in the study. Forty-eight patients (7.5%) had scans which demonstrated focal colonic FDG uptake. Of the 21 patients who underwent further investigation with endoscopy, 14 (66.7%) had biopsies which were positive for dysplasia, this represented 2.2% of the total patients undergoing PET-CT. Eight of these fourteen patients (1.2% of the total) had biopsies demonstrating adenocarcinoma. Four of these patients (50%) had TNM stage 1 or 2 colorectal carcinoma and underwent subsequent curative surgical resection. We found a 2.2% rate of incidentally-diagnosed colorectal malignant and premalignant lesions in patients undergoing PET-CT at our institution. A 1.2% rate of adenocarcinoma was identified. This rate is higher than previously described in the literature.
本研究的目的是评估在一家爱尔兰教学医院使用全身18FDG-PET/CT检测偶发性结直肠恶性肿瘤的检出率。我们对2009年1月至2009年8月在我院连续接受PET-CT扫描的800例患者的记录进行了回顾性分析。分析了放射学报告，并对所有有局灶性结肠FDG摄取的扫描进行了审核。对接受进一步检查的患者的结肠镜检查和组织学记录进行了审查，以确定是否存在癌性和癌前组织学。共有643例患者纳入本研究。48例患者（7.5%）的扫描显示局灶性结肠FDG摄取。在21例接受内镜进一步检查的患者中，14例（66.7%）活检显示发育异常阳性，这占接受PET-CT检查的患者总数的2.2%。这14例患者中有8例（占总数的1.2%）活检显示腺癌。其中4例患者（50%）患有TNM 1期或2期结直肠癌，并随后接受了根治性手术切除。我们发现在我院接受PET-CT检查的患者中，偶发性诊断的结直肠恶性和癌前病变的发生率为2.2%。腺癌的发生率为1.2%。这一发生率高于先前文献中所描述的。
