Budak Emine, Yanarateş Ahmet
Nuclear Medicine, Ministry of Health, İzmir, Turkey.
Ministry of Health, İzmir, Turkey.
Nuklearmedizin. 2020 Jun;59(3):235-240. doi: 10.1055/a-1084-4723. Epub 2020 Feb 24.
The present study evaluates the role of PET parameters pertaining to incidentally detected foci of colorectal uptake (IFCU) on FDG PET/CT in the differentiation of benign, premalignant and malignant lesions.
This retrospective study included 74 patients. The colonoscopic and histopathological findings were regarded as the reference standards. The results were evaluated on a lesion basis by dividing the lesions into three groups as benign, premalignant and malignant. The maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume(MTV) and total lesion glycolysis(TLG) values of the three groups were compared.
There were 88 IFCU in a total of 74 patients (27 female, 47 male, mean age 65 years). Of the 88 IFCU, 26 were qualified as benign, 42 as premalignant and 20 as malignant. Malignant + premalignant lesions were found in 62/88 (70.4 %) of the IFCU. The SUVmax of the benign lesions was significantly lower than those of the premalignant and malignant lesions; and SUVmean was lower than that of the malignant lesions. The MTV of the malignant lesions was significantly higher than that of the premalignant and benign lesions; and TLG was higher than that of the premalignant lesions. The optimum cut-off value in differentiating between the malignant and non-malignant lesions was 9.15 for SUVmax, 5.05 for SUVmean, 4.7 for MTV and 30.25 for TLG.
PET parameters can guide the differentiation of benign, premalignant and malignant lesions with IFCU. Besides, patients with IFCU should undergo further evaluation due to high probability of premalignant and malignant lesions.
本研究评估18F-氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（FDG PET/CT）中与偶然发现的结肠摄取灶（IFCU）相关的PET参数在鉴别良性、癌前和恶性病变中的作用。
这项回顾性研究纳入了74例患者。结肠镜检查和组织病理学检查结果被视为参考标准。通过将病变分为良性、癌前和恶性三组，以病变为基础评估结果。比较三组的最大标准化摄取值（SUVmax）、平均SUV（SUVmean）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）值。
74例患者（27例女性，47例男性，平均年龄65岁）共有88个IFCU。在88个IFCU中，26个为良性，42个为癌前病变，20个为恶性。88个IFCU中的62个（70.4%）发现有恶性+癌前病变。良性病变的SUVmax显著低于癌前和恶性病变；SUVmean低于恶性病变。恶性病变的MTV显著高于癌前和良性病变；TLG高于癌前病变。区分恶性和非恶性病变的最佳截断值为：SUVmax为9.15，SUVmean为5.05，MTV为4.7，TLG为30.25。
PET参数可指导IFCU的良性、癌前和恶性病变的鉴别。此外，由于IFCU发生癌前和恶性病变的可能性较高，应进行进一步评估。
