Premium
Detection of incidental colorectal pathology on positron emission tomography/computed tomography
Author(s) -
Mui Milton,
Akhurst Timothy,
Warrier Satish K.,
Lynch A. Craig,
Heriot Alexander G.
Publication year - 2018
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13739
Subject(s) - medicine , positron emission tomography , positron emission tomography computed tomography , tomography , computed tomography , radiology , positron emission , nuclear medicine , medical physics
Background Positron emission tomography/computed tomography ( PET / CT ) is an important modality in cancer imaging. With its increasing availability and use, it is not uncommon to detect incidental focal colorectal 18 F‐FDG uptake which poses a diagnostic challenge, as they may be associated with malignant or pre‐malignant colorectal lesions. The aim of our study is to determine the proportion of these findings which represents true pathology. Methods Patients with incidental focal colorectal 18 F‐FDG uptake on PET / CT who subsequently underwent colonoscopy between January 2002 to September 2013 were identified from a prospective database in a tertiary referral centre. PET / CT results were correlated with colonoscopy and pathology results in these patients. Positive predictive values ( PPVs ) and 95% confidence intervals ( CIs ) of PET / CT in the detection of incidental colorectal pathology were calculated. Results A total of 148 patients (92 men and 56 women), with a mean age 73 years (range of 36 to 93 years) were included in the study. A total of 170 foci of colorectal 18 F‐FDG uptake were detected on PET / CT . Of these, 101 foci corresponded to a malignant or pre‐malignant lesion ( PPV 59%; 95% CI : 52–67%). On a per‐patient analysis, 93 patients had at least one focus of colorectal 18 F‐FDG uptake which corresponded to a pre‐malignant or malignant lesion ( PPV 63%; 95% CI : 54–71%). Conclusion Focal colorectal 18 F‐FDG uptake on PET / CT is associated with a significant proportion of malignant or pre‐malignant lesions. Further evaluation with colonoscopy is recommended.