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European Radiology
Published in: European Radiology 9/2010

Open Access 01-09-2010 | Gastrointestinal

Detection of relevant colonic neoplasms with PET/CT: promising accuracy with minimal CT dose and a standardised PET cut-off

Authors: Wolfgang Luboldt, Teresa Volker, Bärbel Wiedemann, Klaus Zöphel, Ursula Wehrmann, Arne Koch, Todd Toussaint, Nasreddin Abolmaali, Markus Middendorp, Daniela Aust, Jörg Kotzerke, Frank Grünwald, Thomas J. Vogl, Hans-Joachim Luboldt

Published in: European Radiology | Issue 9/2010

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Abstract

Objective:

To determine the performance of FDG-PET/CT in the detection of relevant colorectal neoplasms (adenomas ≥10 mm, with high-grade dysplasia, cancer) in relation to CT dose and contrast administration and to find a PET cut-off.

Methods:

84 patients, who underwent PET/CT and colonoscopy (n = 79)/sigmoidoscopy (n = 5) for \({\left( {{\hbox{79}} \times {\hbox{6}} + {\hbox{5}} \times {\hbox{2}}} \right)} = {\hbox{484}}\) colonic segments, were included in a retrospective study. The accuracy of low-dose PET/CT in detecting mass-positive segments was evaluated by ROC analysis by two blinded independent reviewers relative to contrast-enhanced PET/CT. On a per-lesion basis characteristic PET values were tested as cut-offs.

Results:

Low-dose PET/CT and contrast-enhanced PET/CT provide similar accuracies (area under the curve for the average ROC ratings 0.925 vs. 0.929, respectively). PET demonstrated all carcinomas (n = 23) and 83% (30/36) of relevant adenomas. In all carcinomas and adenomas with high-grade dysplasia (n = 10) the SUVmax was ≥5. This cut-off resulted in a better per-segment sensitivity and negative predictive value (NPV) than the average PET/CT reviews (sensitivity: 89% vs. 82%; NPV: 99% vs. 98%). All other tested cut-offs were inferior to the SUVmax.

Conclusion:

FDG-PET/CT provides promising accuracy for colorectal mass detection. Low dose and lack of iodine contrast in the CT component do not impact the accuracy. The PET cut-off SUVmax ≥ 5 improves the accuracy.
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Metadata
Title
Detection of relevant colonic neoplasms with PET/CT: promising accuracy with minimal CT dose and a standardised PET cut-off
Authors
Wolfgang Luboldt
Teresa Volker
Bärbel Wiedemann
Klaus Zöphel
Ursula Wehrmann
Arne Koch
Todd Toussaint
Nasreddin Abolmaali
Markus Middendorp
Daniela Aust
Jörg Kotzerke
Frank Grünwald
Thomas J. Vogl
Hans-Joachim Luboldt
Publication date
01-09-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 9/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1772-0

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