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Techniques in Coloproctology
Published in: Techniques in Coloproctology 7/2017

01-07-2017 | Review

Incidental colorectal FDG uptake on PET/CT scan and lesions observed during subsequent colonoscopy: a systematic review

Authors: S. J. Kousgaard, O. Thorlacius-Ussing

Published in: Techniques in Coloproctology | Issue 7/2017

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Abstract

Background

Incidental colorectal fluorodeoxyglucose (FDG) uptake can be observed during a positron emission tomography/computed tomography (PET/CT) scan. For clinical and/or histological assessment of the cause, a colonoscopy is then performed. A systematic review was conducted to investigate the relationship between incidental colorectal FDG uptake and lesions observed during a subsequent colonoscopy.

Methods

A literature search was conducted using PubMed, Embase, and Web of Science with the keywords concerning PET/CT scan and colonoscopy. The studies were selected using inclusion criteria defined a priori and were described individually to examine the correlation between incidental colorectal FDG uptake and the lesions found at colonoscopy.

Results

Twenty-six of 1606 studies found were included. In total, 108,578 patients underwent an FDG-PET/CT scan as part of a diagnostic work-up or cancer staging. In total, 2546 incidental colorectal FDG uptakes were described in 2121 patients (mean age 62.7 years SD ± 5.1), of which 2045 uptakes in 1635 patients were examined by colonoscopy, within a mean of 37 days (SD ± 28). The colonoscopic lesions included neoplasms (n = 1097; 322 cancers), benign lesions (n = 273), and inflammatory lesions (n = 71). Colonoscopies were normal in 604 patients. In total, 82% of lesions were located in the same location as the FDG uptakes. The positive predictive value was 70% (95% CI [68–72]).

Conclusions

Incidental colorectal FDG uptake, as evaluated by subsequent colonoscopy, often reveals neoplastic lesions. Predominantly, lesions were located at the same location as FDG uptake. Further investigation is warranted before recommending that incidental colorectal FDG uptake should always result in referral to diagnostic colonoscopy.
Appendix
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Metadata
Title
Incidental colorectal FDG uptake on PET/CT scan and lesions observed during subsequent colonoscopy: a systematic review
Authors
S. J. Kousgaard
O. Thorlacius-Ussing
Publication date
01-07-2017
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 7/2017
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-017-1652-6

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