Premium
Can positron emission tomography detect colorectal adenomas and cancers?
Author(s) -
Igarashi Kimihiro,
Hotta Kinichi,
Imai Kenichiro,
Yamaguchi Yuichiro,
Ito Sayo,
Kawata Noboru,
Tanaka Masaki,
Kakushima Naomi,
Takizawa Kohei,
Matsubayashi Hiroyuki,
Endo Masahiro,
Asakura Kouiku,
Oishi Takuma,
Shimoda Tadakazu,
Ono Hiroyuki
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13543
Subject(s) - medicine , positron emission tomography , colorectal cancer , positron emission tomography computed tomography , radiology , nuclear medicine , oncology , cancer
Background and Aim Fluorine‐18 2‐fluoro‐2‐deoxy‐ d ‐glucose positron emission tomography (PET) is effective and less invasive than other modalities used to diagnose tumors, including colorectal cancer (CRC). However, the detectability of adenomas and CRCs, especially in the early stages, is unclear. Methods We evaluated the records of 2323 consecutive eligible patients who underwent both a total colonoscopy (TCS) and PET between October 2002 and September 2012 at a tertiary cancer center. The PET findings were verified by TCS performed independently within 1 year. Target lesions were defined as CRCs and adenomas that were 6 mm or larger in size. Results Total colonoscopy detected 532 target lesions ≥ 6 mm in size: 56 T2–T4 CRCs, 39 T1 CRCs, 223 advanced adenomas, and 214 low‐grade adenomas. Of the 532 lesions, 216 (40.6%) were PET positive. Of the 369 cases with positive uptakes, PET detected target lesions in the matched segments for 58.5% (216/369). Sensitivity of PET to T2–T4 CRCs, T1 CRCs, advanced adenomas, and low‐grade adenomas was 92.9%, 79.5%, 50.7%, and 9.3%, respectively. PET could detect 76.5% (13/17) of T1 CRCs whose size is 10 to 19 mm and 85.0% (17/20) of T1 CRCs equal or larger than 20 mm. The multivariate analysis excluding T2–T4 CRCs showed malignant histology, larger size, protruded lesions, villous histology, and lesions in distal colon were significant factors. Conclusions Sensitivity of PET for detecting T2–T4 and even T1 cancers are promising. However, sensitivity of PET to adenomas, even advanced adenomas, is limited.