Department of Gastrointestinal Surgery and Clinical Cancer Research Unit, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Tech Coloproctol. 2017 Jul;21(7):521-529. doi: 10.1007/s10151-017-1652-6. Epub 2017 Jun 15.
Incidental colorectal fluorodeoxyglucose (FDG) uptake can be observed during a positron emission tomography/computed tomography (PET/CT) scan. For clinical and/or histological assessment of the cause, a colonoscopy is then performed. A systematic review was conducted to investigate the relationship between incidental colorectal FDG uptake and lesions observed during a subsequent colonoscopy.
A literature search was conducted using PubMed, Embase, and Web of Science with the keywords concerning PET/CT scan and colonoscopy. The studies were selected using inclusion criteria defined a priori and were described individually to examine the correlation between incidental colorectal FDG uptake and the lesions found at colonoscopy.
Twenty-six of 1606 studies found were included. In total, 108,578 patients underwent an FDG-PET/CT scan as part of a diagnostic work-up or cancer staging. In total, 2546 incidental colorectal FDG uptakes were described in 2121 patients (mean age 62.7 years SD ± 5.1), of which 2045 uptakes in 1635 patients were examined by colonoscopy, within a mean of 37 days (SD ± 28). The colonoscopic lesions included neoplasms (n = 1097; 322 cancers), benign lesions (n = 273), and inflammatory lesions (n = 71). Colonoscopies were normal in 604 patients. In total, 82% of lesions were located in the same location as the FDG uptakes. The positive predictive value was 70% (95% CI [68-72]).
Incidental colorectal FDG uptake, as evaluated by subsequent colonoscopy, often reveals neoplastic lesions. Predominantly, lesions were located at the same location as FDG uptake. Further investigation is warranted before recommending that incidental colorectal FDG uptake should always result in referral to diagnostic colonoscopy.
正电子发射断层扫描/计算机断层扫描（PET/CT）检查期间可观察到偶然的结直肠氟脱氧葡萄糖（FDG）摄取。为了对原因进行临床和/或组织学评估，随后进行结肠镜检查。进行了系统评价，以研究偶然的结直肠 FDG 摄取与随后结肠镜检查中观察到的病变之间的关系。
使用 PubMed、Embase 和 Web of Science 检索了与 PET/CT 扫描和结肠镜检查相关的关键词，并进行了文献检索。使用事先定义的纳入标准选择研究，并单独描述以检查偶然的结直肠 FDG 摄取与结肠镜检查中发现的病变之间的相关性。
在 1606 项研究中，有 26 项符合纳入标准。共有 108578 名患者接受了 FDG-PET/CT 扫描，作为诊断性检查或癌症分期的一部分。共有 2121 名患者（平均年龄 62.7 ± 5.1 岁）在 2045 名患者中描述了偶然的结直肠 FDG 摄取，平均在 37 天（SD ± 28）内进行了结肠镜检查。结肠镜下病变包括肿瘤（n = 1097；322 例癌症）、良性病变（n = 273）和炎症性病变（n = 71）。604 名患者的结肠镜检查正常。共有 82%的病变位于与 FDG 摄取相同的位置。阳性预测值为 70%（95%CI[68-72]）。
通过随后的结肠镜检查评估偶然的结直肠 FDG 摄取，常显示出肿瘤性病变。病变主要位于与 FDG 摄取相同的位置。在建议偶然的结直肠 FDG 摄取总是需要进行诊断性结肠镜检查之前，需要进一步研究。
