Şimşek Fikri S, İspiroğlu Murat, Taşdemir Bekir, Köroğlu Reyhan, Ünal Kemal, Özercan Ibrahim H, Entok Emre, Kuşlu Duygu, Karabulut Koray
aDepartment of Nuclear Medicine, Elazig Education and Research Hospital bDepartment of Pathology cDepartment of General Surgery, Faculty of Medicine, Firat University, Elazig dDepartment of Gastroenterology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaras eDepartment of Nuclear Medicine, Faculty of Medicine, Dicle University, Diyarbakir fDepartment of Nuclear Medicine, Faculty of Medicine, Karabuk University, Karabuk gDepartment of Nuclear Medicine, Faculty of Medicine, Izmir University, Izmir hDepartment of Nuclear Medicine, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
Nucl Med Commun. 2015 Dec;36(12):1195-201. doi: 10.1097/MNM.0000000000000388.
F-Fluorodeoxyglucose (F-FDG) PET/CT represents an imaging modality that is gaining increasingly more prominence in screening, staging, and therapeutic monitoring of malignant diseases. An incidental focus of uptake in different regions of the body is not an uncommon finding during PET/CT imaging. Patients with incidental gastrointestinal tract findings comprise ∼3% of the overall patient group. The aim of the current study was to provide contributory information in relation to the answer on the most appropriate approach in cases with incidental colonic F-FDG uptake.
A retrospective examination was performed on PET/CT results of 5258 patients. Of these, 152 were recommended to undergo colonoscopy because of the presence of suspicious foci and 31 underwent colonoscopy within 60 days with biopsy from all visible lesions. These dates were also examined.
Of the 24 patients undergoing colonoscopy with a suspicion of malignancy, five (20.83%) had no pathological findings. Of the 19 (79.17%) cases with a pathological finding in endoscopy, histopathology showed a benign lesion in five (20.83%), premalignant lesion in seven (29.17%), and a malignant lesion in seven (29.17%). Among seven patients undergoing colonoscopy because of a suspicion of inflammatory bowel disease, five were free of pathological signs and two patients with pathological endoscopy findings had nonspecific inflammation as documented by histopathological examination.
Colonoscopic and histopathological examination of the increased foci of colonic F-FDG uptake incidentally detected at PET/CT seems to be a plausible approach.
氟代脱氧葡萄糖（F-FDG）PET/CT是一种在恶性疾病的筛查、分期及治疗监测中日益重要的成像方式。在PET/CT成像过程中，身体不同部位出现意外的摄取灶并非罕见发现。胃肠道意外发现的患者约占总体患者群体的3%。本研究的目的是为解决PET/CT偶然发现结肠F-FDG摄取病例的最合适处理方法提供相关信息。
对5258例患者的PET/CT结果进行回顾性检查。其中，152例因存在可疑病灶被建议行结肠镜检查，31例在60天内接受了结肠镜检查，并对所有可见病变进行了活检。同时也对这些数据进行了检查。
在24例因怀疑恶性肿瘤而接受结肠镜检查的患者中，5例（20.83%）未发现病理结果。在19例（79.17%）内镜检查有病理发现的病例中，组织病理学显示5例（20.83%）为良性病变，7例（29.17%）为癌前病变，7例（29.17%）为恶性病变。在7例因怀疑炎症性肠病而接受结肠镜检查的患者中，5例无病理体征，2例内镜检查有病理发现的患者经组织病理学检查证实为非特异性炎症。
对PET/CT偶然发现的结肠F-FDG摄取增加灶进行结肠镜及组织病理学检查似乎是一种可行的方法。
