Loffeld Ruud J L F, Srbjlin Sandra A
Department of Gastroenterology and Nuclear Medicine, Zaans Medisch Centrum, Zaandam, The Netherlands.
J Gastrointest Oncol. 2019 Feb;10(1):1-5. doi: 10.21037/jgo.2018.09.03.
Fludeoxyglucose positron-emission tomography (FDG-PET) shows colic uptake regularly. Complementary colonoscopy is done. Aim: study the findings of colonoscopy.
All consecutive scans in 5 years were studied. Focal FDG uptake in colon and/or rectum were scored as + or ++. Clinical files and endoscopy reports were studied for final diagnosis.
Focal FDG uptake was noted in 173 out of 2,075 scans (8.4%). Focal FDG activity was judged ++ in 73 patients (42.2%) and + in 100 (57.8%). The majority of colorectal cancers scored ++. Patients with ++ activity underwent or had undergone significantly more often a colonoscopy compared with patients with + activity, 82% versus 65% (P=0.02). FDG PET/CT was false positive with respect to polyp(s) or cancer in 13 cases (22%) of ++ FGD activity and in 38 cases of + FDG (P<0.001). In 25 patients a total of 69 polyps were not FDG avid.
FDG-PET scanning is a useful tool in oncology. However, false-positive and false-negative findings with respect to colonic uptake are present in a significant number of patients. If the clinical condition and the potential prognosis allows the performance of colonoscopy this procedure should be done.
氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)常显示结肠摄取。需进行结肠镜检查作为补充。目的:研究结肠镜检查的结果。
对5年内所有连续扫描进行研究。结肠和/或直肠的局灶性FDG摄取分为+或++。研究临床档案和内镜报告以得出最终诊断。
在2075次扫描中有173次(8.4%)发现局灶性FDG摄取。73例患者(42.2%)的局灶性FDG活性被判定为++,100例(57.8%)为+。大多数结直肠癌评分为++。与FDG活性为+的患者相比,FDG活性为++的患者接受或已接受结肠镜检查的比例显著更高,分别为82%和65%(P=0.02)。在13例(22%)FDG活性为++的病例和38例FDG活性为+的病例中,FDG PET/CT在息肉或癌症方面出现假阳性(P<0.001)。在25例患者中,共有69个息肉不摄取FDG。
FDG-PET扫描是肿瘤学中的一种有用工具。然而,相当数量的患者在结肠摄取方面存在假阳性和假阴性结果。如果临床情况和潜在预后允许进行结肠镜检查,则应进行该检查。