Dr Fabrice Gutman and colleagues from France assessed the performance of 2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography/computed tomography for the detection of colonic lesions.
18FDG is radiotracer for imaging human brain function.
The researchers especially assessed the ability of FDG positron emission tomography/computed tomography to detect advanced neoplasms.
Because of FDG accumulation in adenomatous polyps, positron emission tomography using FDG can detect early premalignant colorectal lesions.
The research team retrospectively reviewed FDG positron emission tomography/computed tomography studies performed for a 1-year period.
The studies assessed included 1716 consecutive patients with various malignant diseases, except colorectal cancer.
Positron emission tomography images obtained 1 hr after FDG injection and noncontrast computed tomography images used for attenuation correction were fused for analysis.
The team reported that of 45 patients with intense focal colonic FDG uptake, 20 underwent colonoscopic investigation, and, if necessary, polyp resection.
The intensity of FDG uptake was quantified using the standardized uptake value.
| FDG colonic foci were associated with 18 colonoscopic abnormalities in 15 patients|
|American Journal of Roentgenology|
The team found that FDG colonic foci were associated with 18 colonoscopic abnormalities in 15 patients.
The researchers noted that FDG foci were associated with a false-positive results, where no colonic abnormality was detected in 5 patients.
Histopathologic findings revealed advanced neoplasms in 13 patients and 2 cases of hyperplastic polyps.
The researchers noted a non-significant difference in the mean standardized uptake value between false-positive and true-positive colonic FDG foci.
Dr Gutman's team concludes, “The presence of a focal colonic FDG uptake incidental finding on a positron emission tomography/computed tomography scan justifies a colonoscopy to detect pre-malignant lesions.”
“The fusion of positron emission tomography and computed tomography images allows an accurate localization of the lesions.”
“Positron emission tomography/computed tomography is a useful tool to differentiate pathologic from physiologic FDG uptake.”