Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2015

Open Access 01-12-2015 | Research article

Incidental gastrointestinal 18F-Fluorodeoxyglucose uptake associated with lung cancer

Authors: Juliette Vella-Boucaud, Dimitri Papathanassiou, Olivier Bouche, Alain Prevost, Thibault Lestra, Sandra Dury, Hervé Vallerand, Jeanne-Marie Perotin, Claire Launois, Louis Boissiere, Mathilde Brasseur, François Lebargy, Gaëtan Deslee

Published in: BMC Pulmonary Medicine | Issue 1/2015

Login to get access

Abstract

Background

F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is increasingly used for the initial staging and restaging of lung cancer. Incidental gastrointestinal findings are often observed on 18F-FDG PET/CT. The objective of this study was to assess incidental 18F-FDG uptake by the gastrointestinal tract (GIT) in patients with lung cancer.

Methods

Two hundred thirty consecutive 18F-FDG PET/CT examinations performed for lung cancer over a 3-year period were retrospectively reviewed for the presence of incidental FDG uptake in the GIT. The charts of patients with positive FDG uptake were then reviewed and analysed to determine the GIT uptake sites, the standardized uptake value (SUV) max and the final clinical diagnosis.

Results

Fifty-two patients (52/230, 23 %) demonstrated incidental FDG uptake in the GIT. Thirty-three patients (63.5 %) had diffuse uptake (oesophagus, n = 2, colon, n = 31) and 19 patients (36.5 %) had focal uptake (oesophagus, n = 1, small bowel, n = 1, ascending colon, n = 5, descending colon, n = 4, sigmoid, n = 4, rectum, n = 3, and anal margin, n = 1). Twelve of the 52 patients with GIT uptake were further investigated, revealing, a diagnosis of malignancy in 4 patients with focal FDG uptake. No significant differences in mean SUVmax were observed between patients with malignant and benign GIT diseases.

Conclusion

This study demonstrates a high incidence of FDG uptake in the GIT associated with lung cancer. Focal GIT uptake was frequently associated with malignant disease. These results suggest that further GIT investigations should be performed in patients with focal GIT uptake.
Literature
2.
go back to reference Van Rens MT, De La Rivière AB, Elbers HR, Van den Bosch JM. Prognostic assessment of 2361 patients who underwent pulmonary resection for non-small cell lung cancer, stage I, II and IIIA. Chest. 2000;117(2):374–9.CrossRefPubMed Van Rens MT, De La Rivière AB, Elbers HR, Van den Bosch JM. Prognostic assessment of 2361 patients who underwent pulmonary resection for non-small cell lung cancer, stage I, II and IIIA. Chest. 2000;117(2):374–9.CrossRefPubMed
3.
go back to reference Pasemans M, Sculier JP, Lecombe J, Thiriaux J, Libert P, Sergysels R, et al. Prognostic factors for patients with small cell lung carcinoma. Cancer. 2000;89:523–33. Pasemans M, Sculier JP, Lecombe J, Thiriaux J, Libert P, Sergysels R, et al. Prognostic factors for patients with small cell lung carcinoma. Cancer. 2000;89:523–33.
4.
go back to reference Marom EM, Bruzzi JF, Truong MT. Extrathoracic PET/CT findings in thoracic malignancies. J Thorac Imaging. 2006;21:154–66.CrossRef Marom EM, Bruzzi JF, Truong MT. Extrathoracic PET/CT findings in thoracic malignancies. J Thorac Imaging. 2006;21:154–66.CrossRef
5.
go back to reference Vansteenkiste JF, Stroobants SG. The role of positron emission tomography with 18 F-Fluoro-2-deoxy-D-glucose in respiratory oncology. Eur Respir J. 2001;17:802–20.CrossRefPubMed Vansteenkiste JF, Stroobants SG. The role of positron emission tomography with 18 F-Fluoro-2-deoxy-D-glucose in respiratory oncology. Eur Respir J. 2001;17:802–20.CrossRefPubMed
6.
go back to reference Reed CE, Harpole DH, Posther KE, et al. Results of the American college of surgeons oncology group Z0050 trials: the utility of positron emission tomography in staging potentially operable non-small cell lung cancer. J Thorac Cardiovasc Surg. 2003;126:1943–51.CrossRefPubMed Reed CE, Harpole DH, Posther KE, et al. Results of the American college of surgeons oncology group Z0050 trials: the utility of positron emission tomography in staging potentially operable non-small cell lung cancer. J Thorac Cardiovasc Surg. 2003;126:1943–51.CrossRefPubMed
7.
go back to reference Hicks RJ, Kalff V, MacManus MP, Ware RE, Hogg A, McKenzie AF, et al. (18)F-FDG PET provides high-impact and powerful prognostic stratification in staging newly diagnosed non-small cell lung cancer. J Nucl Med. 2001;42(11):1596–604. Hicks RJ, Kalff V, MacManus MP, Ware RE, Hogg A, McKenzie AF, et al. (18)F-FDG PET provides high-impact and powerful prognostic stratification in staging newly diagnosed non-small cell lung cancer. J Nucl Med. 2001;42(11):1596–604.
8.
go back to reference Hicks RJ, Kalff V, MacManus MP, Ware RE, McKenzie AF, Matthews JP, et al. The utility of (18)F-FDG PET for suspected recurrent non-small cell lung cancer after potentially curative therapy: impact on management and prognostic stratification. J Nucl Med. 2001;42(11):1605–13. Hicks RJ, Kalff V, MacManus MP, Ware RE, McKenzie AF, Matthews JP, et al. The utility of (18)F-FDG PET for suspected recurrent non-small cell lung cancer after potentially curative therapy: impact on management and prognostic stratification. J Nucl Med. 2001;42(11):1605–13.
9.
go back to reference Hoekstra CJ, Stroobants SG, Hoekstra OS, Vansteenkiste J, Biesma B, Schramel FJ, et al. The value of 18 F-Fluoro-2-deoxy-D-glucose positron emission tomography in the selection of patients with stage IIIA-N2 non-small cell lung cancer for combined modality treatment. Lung Cancer. 2003;39(2):151–7. Hoekstra CJ, Stroobants SG, Hoekstra OS, Vansteenkiste J, Biesma B, Schramel FJ, et al. The value of 18 F-Fluoro-2-deoxy-D-glucose positron emission tomography in the selection of patients with stage IIIA-N2 non-small cell lung cancer for combined modality treatment. Lung Cancer. 2003;39(2):151–7.
11.
go back to reference Liu T, Xu JY, Xu W, Bai YR, Yan WL, Yang HL. Fluorine-18 deoxyglucose positron emission tomography, magnetic resonance imaging and bone scintigraphy for the diagnosis of bone metastases in patients with lung cancer: Which one is the best ? A Meta-analysis. Clin Oncol. 2011;23:350–8.CrossRef Liu T, Xu JY, Xu W, Bai YR, Yan WL, Yang HL. Fluorine-18 deoxyglucose positron emission tomography, magnetic resonance imaging and bone scintigraphy for the diagnosis of bone metastases in patients with lung cancer: Which one is the best ? A Meta-analysis. Clin Oncol. 2011;23:350–8.CrossRef
12.
go back to reference Lin M, Koo JH, Abi-Hanna D. Management of patients following detection of unsuspected colon lesions by PET imaging. Clin Gastroenterol Hepatol. 2011;9:1025–32.CrossRefPubMed Lin M, Koo JH, Abi-Hanna D. Management of patients following detection of unsuspected colon lesions by PET imaging. Clin Gastroenterol Hepatol. 2011;9:1025–32.CrossRefPubMed
13.
go back to reference Kei PL, Vikram R, Yeung HW, Stroehlein JR, Macapinlac HA. Incidental finding of focal FDG uptake in the bowel during PET/ CT: CT features and correlation with histopathologic results. Am J Roentgenol. 2010;194:401–6.CrossRef Kei PL, Vikram R, Yeung HW, Stroehlein JR, Macapinlac HA. Incidental finding of focal FDG uptake in the bowel during PET/ CT: CT features and correlation with histopathologic results. Am J Roentgenol. 2010;194:401–6.CrossRef
14.
go back to reference Weston BR, Iyer RB, Qiao W, Lee JH, Bresalier RS, Ross WA. Ability of integrated positron emission and computed tomography to detect significant colonic pathology: the experience of a tertiary cancer center. Cancer. 2010;116:1454–61.CrossRefPubMed Weston BR, Iyer RB, Qiao W, Lee JH, Bresalier RS, Ross WA. Ability of integrated positron emission and computed tomography to detect significant colonic pathology: the experience of a tertiary cancer center. Cancer. 2010;116:1454–61.CrossRefPubMed
15.
go back to reference Kamel EM, Thumshirn M, Truninger K, Schiesser M, Fried M, Padberg B, et al. Significance of incidental 18 F-FDG accumulations in the gastrointestinal tract in PET/CT: correlation with endoscopic and histopathologic results. J Nucl Med. 2004;45:1804–10. Kamel EM, Thumshirn M, Truninger K, Schiesser M, Fried M, Padberg B, et al. Significance of incidental 18 F-FDG accumulations in the gastrointestinal tract in PET/CT: correlation with endoscopic and histopathologic results. J Nucl Med. 2004;45:1804–10.
16.
go back to reference Prabhakar HB, Sahani DV, Fischman AJ, Mueller PR, Blake MA. Bowel hot spots at PET-CT. Radiographics. 2007;27:145–59.CrossRefPubMed Prabhakar HB, Sahani DV, Fischman AJ, Mueller PR, Blake MA. Bowel hot spots at PET-CT. Radiographics. 2007;27:145–59.CrossRefPubMed
17.
go back to reference Tatlidil R, Jadvar H, Bading JR, Conti PS. Incidental colonic fluorodeoxyglucose uptake: correlation with colonoscopic and histopathologic findings. Radiology. 2002;224:783–7.CrossRefPubMed Tatlidil R, Jadvar H, Bading JR, Conti PS. Incidental colonic fluorodeoxyglucose uptake: correlation with colonoscopic and histopathologic findings. Radiology. 2002;224:783–7.CrossRefPubMed
18.
go back to reference Pandit-Taskar N, Schoder H, Gonen M, Larson SM, Yeung HW. Clinical significance of unexplained abnormal focal FDG uptake in the abdomen during whole-body PET. Am J Roentgenol. 2004;183:1143–7.CrossRef Pandit-Taskar N, Schoder H, Gonen M, Larson SM, Yeung HW. Clinical significance of unexplained abnormal focal FDG uptake in the abdomen during whole-body PET. Am J Roentgenol. 2004;183:1143–7.CrossRef
19.
go back to reference Gutman F, Alberini J-L, Wartski M, Vilain D, Le Stanc E, Sarandi F, et al. Incidental colonic focal lesions detected by FDG PET ⁄ CT. Am J Roentgenol. 2005;185:495–500. Gutman F, Alberini J-L, Wartski M, Vilain D, Le Stanc E, Sarandi F, et al. Incidental colonic focal lesions detected by FDG PET ⁄ CT. Am J Roentgenol. 2005;185:495–500.
20.
go back to reference Israel O, Yefremov N, Bar-Shalom R, Kagana O, Frenkel A, Keidar Z, et al. PET ⁄ CT detection of unexpected gastrointestinal foci of 18 F-FDG uptake: incidence, localization patterns, and clinical significance. J Nucl Med. 2005;46:758–62. Israel O, Yefremov N, Bar-Shalom R, Kagana O, Frenkel A, Keidar Z, et al. PET ⁄ CT detection of unexpected gastrointestinal foci of 18 F-FDG uptake: incidence, localization patterns, and clinical significance. J Nucl Med. 2005;46:758–62.
21.
go back to reference Rainis T, Kaidar-Person O, Keren D, Lavy A, Keidar Z. Correlation between incidental FDG PET/CT colorectal observations and endoscopic and histopathological results. Oncology Letters. 2014;7:479–82.PubMed Rainis T, Kaidar-Person O, Keren D, Lavy A, Keidar Z. Correlation between incidental FDG PET/CT colorectal observations and endoscopic and histopathological results. Oncology Letters. 2014;7:479–82.PubMed
22.
go back to reference Treglia G, Calcagni ML, Rufini V, Leccisotti L, Meduri GM, Spitilli MG, et al. Clinical significance of incidental focal colorectal (18)F-fluorodeoxyglucose uptake: Our experience and a review of the literature. Colorectal Dis. 2012;14:174–80. Treglia G, Calcagni ML, Rufini V, Leccisotti L, Meduri GM, Spitilli MG, et al. Clinical significance of incidental focal colorectal (18)F-fluorodeoxyglucose uptake: Our experience and a review of the literature. Colorectal Dis. 2012;14:174–80.
23.
go back to reference Putora PM, Muller J, Borovicka J, Plasswilm L, Schmidt F. Relevance of incidental colorectal FDG-PET/CT-enhanced lesions. Onkologie. 2013;36:200–4.CrossRefPubMed Putora PM, Muller J, Borovicka J, Plasswilm L, Schmidt F. Relevance of incidental colorectal FDG-PET/CT-enhanced lesions. Onkologie. 2013;36:200–4.CrossRefPubMed
24.
go back to reference Gill RS, Perry T, Abele JT, Bédard E, Schiller D. The clinical significance of incidental intra-abdominal findings on positron emission tomography performed to investigate pulmonary nodules. World J Surg Oncol. 2012;10:25.CrossRefPubMedPubMedCentral Gill RS, Perry T, Abele JT, Bédard E, Schiller D. The clinical significance of incidental intra-abdominal findings on positron emission tomography performed to investigate pulmonary nodules. World J Surg Oncol. 2012;10:25.CrossRefPubMedPubMedCentral
25.
go back to reference Zhuang H, Hickeson M, Chacko TK, Duarte PS, Nakhoda KZ, Feng Q, et al. Incidental detection of colon cancer by FDG positron emission tomography in patients examined for pulmonary nodules. Clin Nucl Med. 2002;27:628–32.CrossRefPubMed Zhuang H, Hickeson M, Chacko TK, Duarte PS, Nakhoda KZ, Feng Q, et al. Incidental detection of colon cancer by FDG positron emission tomography in patients examined for pulmonary nodules. Clin Nucl Med. 2002;27:628–32.CrossRefPubMed
26.
go back to reference Cook GJR, Fogelman I, Maisey MN. Normal physiological and benign pathological variants of 18-fluoro-2-deoxyglucose positron emission tomography scanning: potential for error in interpretation. Semin Nucl Med. 1996;26:308–14.CrossRefPubMed Cook GJR, Fogelman I, Maisey MN. Normal physiological and benign pathological variants of 18-fluoro-2-deoxyglucose positron emission tomography scanning: potential for error in interpretation. Semin Nucl Med. 1996;26:308–14.CrossRefPubMed
27.
go back to reference Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: Physiologic and benign variants. Radiographics. 1999;19:61–77.CrossRefPubMed Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: Physiologic and benign variants. Radiographics. 1999;19:61–77.CrossRefPubMed
28.
go back to reference Kim S, Chung JK, Kim BT, Kim SJ, Jeong JM, Lee DS, et al. Relationship between gastrointestinal F-18-fluorodeoxyglucose accumulation and gastrointestinal symptoms in whole-body PET. Clin Posit Imaging. 1999;2:273–80. Kim S, Chung JK, Kim BT, Kim SJ, Jeong JM, Lee DS, et al. Relationship between gastrointestinal F-18-fluorodeoxyglucose accumulation and gastrointestinal symptoms in whole-body PET. Clin Posit Imaging. 1999;2:273–80.
29.
go back to reference Meyer MA. Diffusely increased colonic F-18 FDG uptake in acute enterocolitis. Clin Nucl Med. 1995;20:434–5.CrossRefPubMed Meyer MA. Diffusely increased colonic F-18 FDG uptake in acute enterocolitis. Clin Nucl Med. 1995;20:434–5.CrossRefPubMed
30.
go back to reference Kresnik E, Gallowitsch HJ, Mikosch P, Würtz F, Alberer D, Hebenstreit A, et al. (18)F-FDG positron emission tomography in the early diagnosis of enterocolitis: preliminary results. Eur J Nucl Med Mol Imaging. 2002;29:1389–92. Kresnik E, Gallowitsch HJ, Mikosch P, Würtz F, Alberer D, Hebenstreit A, et al. (18)F-FDG positron emission tomography in the early diagnosis of enterocolitis: preliminary results. Eur J Nucl Med Mol Imaging. 2002;29:1389–92.
31.
go back to reference Neurath MF, Vehling D, Schung K, Holtmann M, Brockmann H, Helisch A, et al. Noninvasive assessment of Crohn’s disease activity: a comparison of 18 F-fluorodeoxyglucose positron emission tomography, hydromagnetic resonance imaging, and granulocyte scintigraphy with labeled antibodies. Am J Gastroenterol. 2002;97:1978–85. Neurath MF, Vehling D, Schung K, Holtmann M, Brockmann H, Helisch A, et al. Noninvasive assessment of Crohn’s disease activity: a comparison of 18 F-fluorodeoxyglucose positron emission tomography, hydromagnetic resonance imaging, and granulocyte scintigraphy with labeled antibodies. Am J Gastroenterol. 2002;97:1978–85.
32.
go back to reference Giovannucci E. An updated review of the epidemiological evidence that cigarette smoking increases risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev. 2001;10:725–31.PubMed Giovannucci E. An updated review of the epidemiological evidence that cigarette smoking increases risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev. 2001;10:725–31.PubMed
33.
go back to reference Chen YK, Kao CH, Liao AC, Shen YY, Su CT. Colorectal cancer screening in asymptomatic adults: the role of FDG PET scan. Anticancer Res. 2003;23:4357–61.PubMed Chen YK, Kao CH, Liao AC, Shen YY, Su CT. Colorectal cancer screening in asymptomatic adults: the role of FDG PET scan. Anticancer Res. 2003;23:4357–61.PubMed
34.
go back to reference Terauchi T, Murano T, Daisaki H, Kanou D, Shodha H, Kakinuma R, et al. Evaluation of whole body cancer screening using 18 F-2-deoxy-2-fluoro-D-glucose positron emission tomography: A preliminary report. Ann Nucl Med. 2008;22:379–85.CrossRefPubMed Terauchi T, Murano T, Daisaki H, Kanou D, Shodha H, Kakinuma R, et al. Evaluation of whole body cancer screening using 18 F-2-deoxy-2-fluoro-D-glucose positron emission tomography: A preliminary report. Ann Nucl Med. 2008;22:379–85.CrossRefPubMed
35.
go back to reference Purandare NC, Gawade SK, Puranik AD, Agrawal A, Shah S, Rangarajan V. Etiology and significance of incidentally detected focal colonic uptake on FDG PET/CT. Indian J Radiol Imaging. 2012;22:260–6.CrossRefPubMedPubMedCentral Purandare NC, Gawade SK, Puranik AD, Agrawal A, Shah S, Rangarajan V. Etiology and significance of incidentally detected focal colonic uptake on FDG PET/CT. Indian J Radiol Imaging. 2012;22:260–6.CrossRefPubMedPubMedCentral
36.
go back to reference Lee C, Koh SJ, Kim JW, Lee KL, Im JP, kim SG, et al. Incidental colonic 18F-Fluorodeoxyglucose uptake: do we need colonoscopy for patients with focal uptake confined to the left-sided colon? Dig Dis Sci. 2013;58:229–35. Lee C, Koh SJ, Kim JW, Lee KL, Im JP, kim SG, et al. Incidental colonic 18F-Fluorodeoxyglucose uptake: do we need colonoscopy for patients with focal uptake confined to the left-sided colon? Dig Dis Sci. 2013;58:229–35.
37.
go back to reference Roh SH, Jung SA, Kim SE, Kim HI, Lee MJ, Tae CH, et al. The clinical meaning of benign colon uptake in 18F-FDG PET: Comparison with colonoscopic findings. Clin Endosc. 2012;45:145–50. Roh SH, Jung SA, Kim SE, Kim HI, Lee MJ, Tae CH, et al. The clinical meaning of benign colon uptake in 18F-FDG PET: Comparison with colonoscopic findings. Clin Endosc. 2012;45:145–50.
38.
go back to reference Chopra A, Ford A, De Noronha R, Matthews S. Incidental findings on positron emission tomography/CT scans performed in the investigation of lung cancer. Br J Radiol. 2012;85:229–37.CrossRef Chopra A, Ford A, De Noronha R, Matthews S. Incidental findings on positron emission tomography/CT scans performed in the investigation of lung cancer. Br J Radiol. 2012;85:229–37.CrossRef
Metadata
Title
Incidental gastrointestinal 18F-Fluorodeoxyglucose uptake associated with lung cancer
Authors
Juliette Vella-Boucaud
Dimitri Papathanassiou
Olivier Bouche
Alain Prevost
Thibault Lestra
Sandra Dury
Hervé Vallerand
Jeanne-Marie Perotin
Claire Launois
Louis Boissiere
Mathilde Brasseur
François Lebargy
Gaëtan Deslee
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2015
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-015-0152-6

Other articles of this Issue 1/2015

BMC Pulmonary Medicine 1/2015 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.