Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Dig Dis Sci. 2018 Jun;63(6):1541-1550. doi: 10.1007/s10620-018-5026-3. Epub 2018 Mar 21.
Disease activity in ulcerative colitis (UC) is best assessed clinically by Mayo score. 18-Fluorodeoxyglucose positron emission tomography-computerized tomography (FDG PET-CT) is a noninvasive imaging technique to assess extent, disease activity and response to treatment of UC, especially in high risk population or patients unwilling for endoscopy.
We conducted a prospective observational study with the aim of assessing and correlating UC disease activity by clinical criteria, endoscopy, histology, serum and fecal biomarkers, and FDG PET-CT.
Sixty eligible patients of UC were enrolled into three groups (26 remission, 24 moderate and 10 severe activity) as per Mayo score and FDG PET-CT was performed within 72 h of colonoscopy. ESR, CRP, and fecal calprotectin (FC) levels were determined for all patients.
Of 60 enrolled patients, 10% patients had proctitis, 43.3% left-sided colitis, and 46.7% extensive colitis. ESR, CRP, FC levels, and rectal PET activity were significantly higher in groups with moderate and severe disease activity. Rectal PET activity showed a significant correlation with the Mayo score (k = 0.465, p < 0.001), endoscopic subscore (k = 0.526, p < 0.001), histological score (k = 0.496, p < 0.001), and FC (k = 0.279, p = 0.031). Extent evaluation by FDG PET-CT and colonoscopy showed a significant correlation (k = 0.582, p < 0.001). Besides, FDG PET-CT identified sacroiliitis in one patient and adenocarcinoma in one patient.
FDG PET-CT is a reliable noninvasive tool for detection of disease activity, extent in UC with good correlation with Mayo score, histology and fecal biomarkers and accurate predictor of disease remission.
溃疡性结肠炎（UC）的疾病活动度最好通过 Mayo 评分进行临床评估。18-氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（FDG PET-CT）是一种非侵入性成像技术，用于评估 UC 的范围、疾病活动度和对治疗的反应，尤其是在高危人群或不愿接受内镜检查的患者中。
我们进行了一项前瞻性观察性研究，旨在评估并比较 UC 疾病活动度的临床标准、内镜、组织学、血清和粪便生物标志物以及 FDG PET-CT。
根据 Mayo 评分，将 60 例符合条件的 UC 患者分为三组（26 例缓解组、24 例中度活动组和 10 例重度活动组），并在结肠镜检查后 72 小时内进行 FDG PET-CT。所有患者均测定红细胞沉降率（ESR）、C 反应蛋白（CRP）和粪便钙卫蛋白（FC）水平。
在纳入的 60 例患者中，10%的患者为直肠炎，43.3%为左半结肠炎，46.7%为广泛性结肠炎。ESR、CRP、FC 水平和直肠 PET 活性在中度和重度疾病活动组中显著升高。直肠 PET 活性与 Mayo 评分（k=0.465，p<0.001）、内镜亚评分（k=0.526，p<0.001）、组织学评分（k=0.496，p<0.001）和 FC（k=0.279，p=0.031）均有显著相关性。FDG PET-CT 和结肠镜检查的范围评估显示出显著的相关性（k=0.582，p<0.001）。此外，FDG PET-CT 在一名患者中发现了骶髂关节炎，在一名患者中发现了腺癌。
FDG PET-CT 是一种可靠的非侵入性工具，可用于检测 UC 的疾病活动度和范围，与 Mayo 评分、组织学和粪便生物标志物具有良好的相关性，是疾病缓解的准确预测指标。
