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European Journal of Nuclear Medicine and Molecular Imaging

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01-04-2020 | Computed Tomography | Original Article

Incidental ¹⁸F-FDG uptake in the colon: value of contrast-enhanced CT correlation with colonoscopic findings

Authors: Julian Kirchner, Benedikt M. Schaarschmidt, Firas Kour, Lino M. Sawicki, Ole Martin, Johannes Bode, Stephan vom Dahl, Verena Keitel, Dieter Häussinger, Christina Antke, Christian Buchbender, Gerald Antoch, Philipp Heusch

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2020

Abstract

Objectives

To evaluate the impact of morphological information derived from contrast-enhanced CT in the characterization of incidental focal colonic uptake in ¹⁸F-FDG PET/CT examinations.

Methods

A total of 125 patients (female: n = 53, male: n = 72) that underwent colonoscopy secondary to contrast-enhanced, full-dose PET/CT without special bowel preparation were included in this retrospective study. PET/CT examinations were assessed for focal colonic tracer uptake in comparison with the background. Focal tracer uptake was correlated with morphological changes of the colonic wall in the contrast-enhanced CT images. Colonoscopy reports were evaluated for benign, inflammatory, polypoid, precancerous, and cancerous lesions verified by histopathology, serving as a reference standard. Sensitivity, specificity, PPV, NPV, and accuracy for detection of therapeutic relevant findings were calculated for (a) sole focal tracer uptake and (b) focal tracer uptake with correlating CT findings in contrast-enhanced CT.

Results

In 38.4% (48/125) of the patients, a focal ¹⁸F-FDG uptake was observed within 67 lesions. Malignant lesions were endoscopically and histopathologically diagnosed in eleven patients, and nine of these were detected by focal ¹⁸F-FDG uptake. A total of 34 lesions with impact on short- or long-term patient management (either being pre- or malignant) were detected. Sensitivity, Specificity, PPV, NPV, and accuracy for sole ¹⁸F-FDG uptake for this combined group were 54%, 69%, 29%, 85%, and 65%. Corresponding results for focal ¹⁸F-FDG uptake with correlating CT findings were 38%, 90%, 50%, 86%, and 80%. This resulted in a statistically significant difference for diagnostic accuracy (p = 0.0001)

Conclusion

By analyzing additional morphological changes in contrast-enhanced CT imaging, the specificity of focal colonic ¹⁸F-FDG uptake for precancerous and cancerous lesions can be increased but leads to a considerate loss of sensitivity. Therefore, every focal colonic uptake should be followed up by colonoscopy.

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Title: Incidental 18F-FDG uptake in the colon: value of contrast-enhanced CT correlation with colonoscopic findings
Authors: Julian Kirchner
Benedikt M. Schaarschmidt
Firas Kour
Lino M. Sawicki
Ole Martin
Johannes Bode
Stephan vom Dahl
Verena Keitel
Dieter Häussinger
Christina Antke
Christian Buchbender
Gerald Antoch
Philipp Heusch
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Colonoscopy
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04579-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Incidental ¹⁸F-FDG uptake in the colon: value of contrast-enhanced CT correlation with colonoscopic findings

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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